Category / Health, Wellbeing & Society

Understanding how people with depression think about how the past could have turned out differently

Fusion, Fusion Investment Fund

The period of funding from the BU Fusion Investment Fund (Co-Creation and Co-Production Strand) has just finished for my joint psychology and psychiatry research project into the role of counterfactual thinking in depression. Counterfactual thinking is thinking about how the past could have been different. It is closely tied-up with the emotion of regret but can help people prepare to deal more effectively with similar situations in the future. For example, a person who thinks that an intimate relationship that failed would have survived if they had taken more account of how their partner was feeling (counterfactual thinking) can adapt their behaviour accordingly in their next intimate relationship in order to try to prevent the breakdown of the relationship and ensure its longevity.

My collaborator on the Fusion-funded project is Dr Paul Walters who’s a Consultant Psychiatrist for Dorset HealthCare University NHS Foundation Trust (DHUFT) based at Weymouth. A student from the Psychology Department’s Foundations in Clinical Psychology Master’s degree course (Stephen Richer) worked on the project by interviewing DHUFT patients who are diagnosed with depression. The project ran from December 2013 to July 2015, in which time a total of 29 patients were assessed. Although the project funding has ended, participant recruitment will continue until the required number of 65 participants is reached, which should be by October 2015.

Preliminary analysis of the data from the project suggests that the patients assessed tend to focus on aspects of the self (e.g., personality characteristics) when thinking counterfactually about a negative social event from their past. This finding contrasts with the counterfactual thoughts of people that have not received a formal clinical diagnosis of depression who, our previous research has found, tend to focus more on factors that are external to the self (e.g., other people’s behaviour) when mentally ‘undoing’ a previous negative social event. Once the data are collected from all 65 participants with depression, more meaningful comparisons between the counterfactual thoughts of depressed and non-depressed people will be drawn. Ultimately, Paul Walters and I hope that the findings of the project will aid in the refinement of the cognitive behavioural therapies that psychiatrists and clinical psychologists administer for the treatment of depression. Once the results of the data from all 65 participants have been analysed and written-up for publication, Paul and I plan to submit a funding bid to the National Institute of Health Research for a follow-on intervention project into tailoring cognitive behavioural therapies for depression based on the factors that influence the counterfactual thoughts of the patients with depression.

Overall, the BU Fusion funding has been immensely beneficial for engaging students and a key external stakeholder in the local community (DHUFT) in a valuable piece of applied research that has important psychotherapeutic implications for mental health patients and professional best practice implications for mental healthcare professionals.

Thank you, Fusion Investment Fund, I couldn’t have done the research without you.

Dr Kevin Thomas, Department of Psychology, Faculty of Science and Technology.

Global Food Security – new programme of research to be announced

Funding opportunities

 Chicken and globe

The Global Food Security (GFS) Programme will soon be announcing a new five-year interdisciplinary programme of research.

The programme has been co-designed by BBSRC, ESRC, NERC, Defra and FSA, in partnership with wider stakeholders, and will address a major food security challenge: Resilience of the UK Food System in a Global Context

For more information click here

The Midwifery quilt online- URA scheme funded project

Fusion, Women's Academic Network

As part of my EdD thesis on ‘The essence of the art of a midwife..’ http://eprints.uwe.ac.uk/16560/    I created a reflexive textile quilt, with each of the squares representing an entry in my research diary. Whenever I have been to conferences with my quilt the question has always been asked ‘what do the squares mean’? Though I anticipate that anyone looking at it will gather their own interpretation of the squares my stories behind them are now accessible online. In the spring of this year I applied, and was pleased to receive, funding from the BU Undergraduate research assistantship scheme in order to create a web site for the quilt. For the past six weeks George Upson undergraduate student from the BA (Hons) Media Production course has been active in designing and creating the web site with me and learning about the world of academia in a small way. I am indebted to him for his creative abilities and to Garratt Lynch and Richard Wallis for their early support in the process, and also for the URA scheme!

The Midwifery quilt maybe accessed here http://www.midwiferyquilt.co.uk/

Dr Jenny Hall

Ethical fundraising : Protecting vulnerable adults from aggressive fundraising techniques

Festival of Learning, Research Ethics

Dr Lee-Ann Fenge

Dr Lee-Ann Fenge

There is growing awareness in the government and media of the importance of recognising and responding to the risks posed by financial abuse of vulnerable older people. My last two blogs have focused on financial scams and mass marketing fraud, but it is now becoming recognised that the charity sector are also employing dubious marketing techniques to elicit money from vulnerable individuals.

The marketing techniques and fundraising methods of charities have come under the spotlight since the death of Olive Cooke, 92, in May. Although her family insist that the numerous approaches she received from charities were not to blame for her death, the fact that she received 267 charity letters in one month alone started alarm bells ringing. Some charities working with emotionally upsetting issues (such as animal cruelty) sometimes employ shocking imagery which has been described as psychoactive advertising (Bennett, 2015). These types of marketing approaches seek to evoke a positive emotional response to fundraising, but can be upsetting for those who receive such material through the post.
As a result of governmental concern about the fundraising methods employed by some charities, changes will be
introduced as amendments to the Charities Bill. This new legislation will tighten rules on how fundraisers approach people who are vulnerable, and how vulnerable adults should be protected from high-pressure marketing tactics.

Some charities have already responded to these concerns by suspending operations with call centres which use
high pressure fundraising techniques.It is interesting to note that although the government is seeking to put a brake on aggressive fundraising techniques, this comes at a time when the remit of the Charity Commission to effectively regulate the sector has been reduced due to budget reductions following the UK Treasury’s Comprehensive Spending Review 2014–15. This has resulted in a reduction in the Commission’s regulatory engagement with charities. As part of the government response to concerns about unethical fundraising tactics, Sir Stuart Etherington, Chief Executive of the National Council for Voluntary Organisations (NCVO), will chair an urgent review of fundraising self-regulation.

It is important that the charity sector develop good practice guidance which embraces the responsibility to safeguard vulnerable groups, and put an end to working with companies which use aggressive fundraising techniques.

The National Centre for Post-Qualifying Social Work at BU is currently working collaboratively with the Chartered Trading Standards Institute (CTSI) to develop good practice guides and advice for professionals working with vulnerable citizens and their families/carers about responding to the risks posed by financial scams. We will be hosting an event as part of the ESRC Festival of Social Science on 10th November to explore with the sector how we develop better responses to safeguarding those most at risk of financial exploitation. Details of how to book onto this event will be posted in the near future.

Reference:

Bennett, R. (2015) Individual characteristics and the arousal of mixed emotions: consequences for the effectiveness of charity fundraising advertisements, International Journal of Nonprofit and Voluntary Sector Marketing 20: 188–209

‘Meet the Editors’ at BU Midwifery Education Conference

Publishing

Slide1Dr. Jenny Hall and Prof. Edwin van Teijlingen are holding a lunchtime at today’s (Friday 3rd July 2015) BU Midwifery Education Conference (#MidEd15) in Business School.  The one-hour session is advertised under the title ‘Believe you can write!’  Both BU academics are editors and on editorial boards of several prestigious health journals across the globe.       Slide2

Over the past few years CMMPH staff have written and published several articles on academic writing and publishing.  Some of these papers have been co-authored by BU Visiting Faculty, Dr. Bri jesh Sathian (Nepal), Dr. Emma Pitchforth (RAND, Cambridge), Ms. Jillian Ireland (NHS Poole) and/or Prof. Padam Simkhada (Liverpool John Moores University).

 

Prof. Edwin van Teijlingen & Dr. Jenny Hall

CMMPH

Twitter accounts:  @HallMum5   /   @EvanTeijlingen

Realist methodologies – it’s a case of C+M=O don’t you know

PG research, student research, Training

1401Having led some seminars at BU, and dipped my toe in to teaching, as a useful mechanism and resource, I have often wondered what contexts make for a good workshop. It would be my suggestion that some or all of; insightful means of relating content; inspiring delivery; a variety of taught and practical exercises; and an opportunity to network and socialise are needed for an enjoyable workshop experience. These are the contexts which I hypothesize to be conducive toward a good workshop outcome. My experiences of workshops in my early career researcher and PhD journey to date have been mostly positive, but I have never experienced all of the above in equal high measure – UNTIL NOW!

This week I have attended a 3 day workshop on Realist Methodologies. The workshop was hosted by the University of Liverpool, but delivered on their London campus in the heart of the city’s financial district.

The content and resources was communicated and contextualised by facilitators Justin Jagosh (University of Liverpool), Geoff Wong (University of Oxford) and Sonia Dalkin (Northumbria University) in a manner that was informative, insightful and engaging. There was a good mix of taught material and hands on exercises. However, there were also chances to present and constructively discuss your work to the wider and interdisciplinary group, and opportunities for one on ones with the facilitators to discuss and (de)construct your own realist projects. In addition, there was also an opportunity to chat in an informal setting over some pizza, pasta, beer and gin & tonics! All of this led to enhanced reasoning, a mechanism, with an outcome of increased understanding.

So in a way that is succinct and accessible, what is realist methodology and what how can it be applied in research? I’ve actually dropped in some hints in the two larger paragraphs above… Before the methodology is outlined, firstly it is useful to discuss the philosophical position on which realist methodologies are based.

Critical Realism

Realist methodology and evaluation is underpinned by the critical realist philosophical works of the likes of Roy Bhaskar and Andrew Sayer (to name a few). This furthers a philosophical position that “…there exists both an external world independent of human consciousness, and at the same time a dimension which includes our socially determined knowledge about reality.” (Danermark et al., 2002: 5-6). On this basis, it is possible to be a positivist and objective ontologist (what is) whilst, at the same time, being an epistemological interpretivist (what it is to know).

Going deeper (stay with me!), Roy Bhaskar proposed three realms of reality. The actual, (objective entities that manifest in the real world), real (Subjective structures, phenomena and agency that act as causal mechanisms in the real world) and the empirical (Observable human consciousness and perspectives on the actual and real). As Easton states, “The most fundamental aim of critical realism is explanation; answers to the question “what caused those events to happen?”” (2010: 121).

Realist Evaluation

Based on this, and in the context of evaluating social programmes, realist evaluation is a research approach that seeks to ‘scratch beneath the surface’ and offer a ‘real’ and plausible account of “…what works for whom, in what circumstances, in what respects and how.” (Pawson et al., 2005: 21). It does so by proposing that the outcome (O) of social programmes or interventions rest the conceptual relationship between mechanisms (M) and context (C) – expressed as the ‘O=M+C’ formula.

However, integral to mechanisms are both resources (typically the programme or intervention) and reasoning. With it sometimes hard to adequately illustrate and distinguish these two characteristics in the CMO configuration, Dalkin et al (2015) propose a new iteration of Pawson and Tilley’s (1997) original CMO formula – expressed as ‘M(Resources) + C→M(Reasoning) = O’. I’m afraid you’ll have to come and ask me in person for my CMO configuration!

In conjunction with findings and evidence from existing literature to inform research protocols, this conceptual formula is used to gather data, and interrogate to ‘scratch beneath the surface’ as to what happens in social programmes and interventions, why, for whom and in what context. Finally, and importantly to note, realist evaluation has no methodological prescriptions – although it is particularly suited to mixed methods and qualitative research methods.

The realist methodology community is a very friendly and collegiate one. Do get in touch to discuss this approach. If I can’t help you (for example, I haven’t discussed realist synthesis – a kind of systematic review approach using the realist philosophy and CMO configuration), I can pass you on to someone who might be able to (The RAMASES JISCMail list is a good start).

My next workshop has a lot to live up to!

 

 

References

Dalkin, S. M., Greenhalgh, J., Jones, D., Cunningham, B. & Lhussier, M. 2015. What’s in a mechanism? Development of a key concept in realist evaluation. Implementation Science, 10.

Danermark, B., Ekstrom, M., Jakobsen, L. & Karlsson, J. C. 2002. Explaining Society: Critical realism in the social sciences, London, Routledge.

Easton, G. 2010. Critical realism in case study research. Industrial Marketing Management, 39, 118–128.

Pawson, R., Greenhalgh, T., Harvey, G. & Walshe, K. 2005. Realist review – a new method of systematic review designed for complex policy interventions. Journal of Health Services Research & Policy, 10, 21-34.

Pawson, R. & Tilley, N. 1997. Realistic Evaluation, London, Sage.