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Engaging in psychological interventions: A Middle Eastern perspective
[Thesis]. Manchester, UK: The University of Manchester; 2018.
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Abstract
This thesis explores attitudes and decisions around engagement with mental health services of individuals in the Middle East. Paper 1 examined the attitudes towards mental health interventions of individuals living in the Middle East by systematically reviewing the literature. Thirteen quantitative studies were included and the findings synthesized using a narrative approach. The findings indicated that over half of all individuals in most studies considered seeking mental health treatment and that they would seek support first and foremost from their family and friends. Stigma was consistently found to negatively impact on attitudes towards mental health interventions. Other factors that impact on attitudes were also discussed and clinical implications highlighted. Paper 2 was an empirical study which focused on families displaced by the Syrian conflict who have resettled in the UK. Four mothers’ decision-making process to engage in a parenting group was explored in-depth using Interpretative Phenomenological Analysis. The aim was to gain an understanding of their subjective experience with regard to facilitators and barriers to engagement. The themes that emerged appeared to suggest a lack of connection, and yet wanting to connect with others. The sharing of experiences within a group setting were important to the women. They expressed uncertainty and had concerns about control within the group. Another theme was related to wanting help but feeling that services did not understand and accommodate their needs on a practical level. The data also highlighted a sense of abandonment by services on an emotional level. The mothers also reflected on feeling stuck which appeared to be a motivator to decide to take part in the parenting group. The intervention booklet was predominantly perceived positively. However, some of the mothers highlighted difficulties around implementation. These findings were discussed in light of existing literature and clinical implications included. Paper 3 is a critical appraisal of the systematic review and qualitative study and offers reflections on the research processes.