Florentina-Ecaterina Oaie - Thesis submitted in partial fulfilment of the degree of Doctor of Clinical Psychology (DClinPsych)
Keywords: refugees
recovery
PTSD interventions
mental imagery
asylum seekers
measure development
cultural adaptations
recovery Colleges

Critical Review of the Literature
Objective: The aim of this narrative review was to identify and synthesise studies reporting on cultural adaptations to post-traumatic stress disorder (PTSD) interventions for adult refugees and asylum seekers.
Method: A comprehensive search of nine databases, including PsychINFO, MEDLINE, Embase, CINAHL, ASSIA, Sociological Abstracts, PubMed, SCOPUS, and Web of Science Core Collection, was conducted in October 2021 and updated in July 2022. Eligible studies were published in the English language, within the past 10 years, reporting on any adaptations to PTSD interventions. Inclusion criteria were limited to randomised control trials, feasibility, and longitudinal studies, conducted in both Western and non-Western countries. Unpublished dissertations, case studies, and case study series were not included. Results were synthesised using the cultural framework of Bernal & Saez-Santiago.
Results: The search strategy identified 24 studies that met inclusion criteria, conducted in countries with various income levels. The most frequently adapted interventions were cognitive - based therapies and eye movement desensitisation and reprocessing (EMDR). Commonly reported adaptations were in the dimensions of language, treatment methods, and treatment context, while adaptations in the treatment goals dimension were the least reported.
Conclusion: Studies varied in methodological quality, and the extent to which they adapted PTSD interventions for delivery in this population. Few studies provided comprehensive information regarding the adaptation process and only one study reported the framework used. This poses challenges for future research and for identifying the necessary adaptations required to increase cultural relevance, treatment acceptability, and effectiveness in refugee and asylum seeker populations.
Service Improvement Project
Objective: The current study aimed to evaluate the Oxfordshire Recovery College ORC and its stage of development from the students’ perspective. An additional aim was to evaluate the use of the Warwick Edinburgh Mental Wellbeing Scale as an outcome measure in this context.
Research Design and Methods: The study used a cross-sectional research design. Thirty-seven participants (74% female) completed an online survey, that included questions on course attendance, goals, and outcomes for attending courses, and the RECOLLECT Checklist for Recovery Colleges Student Version.
Results: Ratings on the RECOLLECT Checklist suggested that on the ‘Valuing equality’ and ‘Learning’ dimensions the ORC matches our best understanding of an ideal RC, while for ‘Community focus’ the ORC is early in its development. ‘Feeling more positive about myself’ was the most endorsed goal (78.4%) and 54.1% of the sample reported positive changes in relation to this goal following course attendance. ‘Learning in a supportive environment’ and ‘Feeling valued as a student’ were two of the most endorsed ORC-related factors contributing to positive changes. Finally, only a third of participants rated the WEMWBS as ‘moderately accurate’ in capturing improvement in wellbeing and progress towards personal goals.
Conclusions: The findings contribute to the growing evidence base on Recovery Colleges, particularly the importance of establishing individual recovery goals and utilising adequate outcome measure to capture student progress and changes.
Theoretically Driven Research Paper
Objectives: Mental imagery has been shown to play a key role in the onset and maintenance of many psychological disorders and has become the target of imagery-based cognitive interventions for the treatment of several anxiety-related conditions. However, there are currently no transdiagnostic measures designed to assess aspects of mental imagery relevant to psychopathology. The present study reports on the development and validation of the Mental Imagery Questionnaire (MIQ), a new measure assessing experiences and appraisals of both positive and negative mental imagery.
Methods: The initial item pool was generated based on a comprehensive literature review and interviews with subject-matter experts. A community sample (N = 345), recruited using an online survey platform, provided data for the exploratory factor analysis.
Results: Two reliable measures were developed – one for positive (12 items) and one for negative mental imagery (16 items). The Positive Mental Imagery Questionnaire (MIQ-P) included three subscales (Intrusiveness, Realness, and Beliefs about Mental Imagery), while the Negative Mental Imagery Questionnaire (MIQ-N) included four subscales (Intrusiveness, Controllability, Beliefs about Mental Imagery, and Realness). The two measures demonstrated good to excellent reliability, and good divergent and discriminant validity. Convergent validity with the Spontaneous Use of Imagery Scale, however, was inadequate.
Conclusions: The appraisals of mental imagery captured by the new measures are consistent with previous research on mental imagery and psychopathology. Future research will focus on confirming the factor structure of the measures using confirmatory factor analysis, prior to validation in a clinical sample.