Behaviour difficulties displayed in childhood and adolescence have pervasive and long term effects into adulthood and across various domains of functioning (Healey, et al. 2004, Woodward, et al. 2002). The numbers of children who suffer with them remain worryingly high (Green et al. 2005). Children with special educational needs and disabilities (SEND) are considered particularly at risk of displaying behaviour difficulties; however, despite representing around one fifth of the school population (DfE 2011), little research to date has explicitly investigated these problems in this population. The present study therefore aimed to investigate risk, promotive and protective factors for behaviour difficulties in children with SEND across multiple ecological levels. Data were collected through a concurrent research project evaluating Achievement for All (Humphrey et al. 2011). The sample comprised children identified with SEND in years 1, 5, 7 and 10, from ten local authorities deemed representative of England. A final sample consisted of 2660 primary pupils nested in 248 primary schools and 1628 secondary pupils nested within 57 secondary schools. Predictor variables were measured at the individual and school levels at baseline, along with a teacher reported measure of behaviour difficulties which was assessed again eighteen months later. Analyses were carried out using multi-level modelling revealing that primary schools accounted for 15% and secondary schools 13% of the total variance in behaviour difficulties, with the remainder being at the individual level. Significant risk factors for these problems across both school types were: being male; eligibility for FSM; and being a bully. Risk factors specific to primary schools included being autumn born, being older in the school, having poor positive relationships, and attending schools with lower levels of academic achievement. Risk factors specific to secondary schools included being younger in the school, having poor attendance, having poor academic achievement, being a bystander to bullying and attending a larger school. Results showed evidence for a cumulative risk effect that increasing numbers of contextual risk factors, regardless of their exact nature, resulted in heightened behaviour difficulties. This relationship was non-linear with increasing risk factors in an individual’s background having a disproportional and detrimental increase in behaviour difficulties displayed. The specific type of risk was however, more important than number of risk factors present in an individual’s background in accounting for behaviour difficulties displayed. Finally, results revealed significant protective factors at the school level; specifically attending primary schools with high academic achievement and with more children on the SEND register at school action can protect against the display of behaviour difficulties when these children are at risk in terms of having poor positive relationships. Attending urban secondary schools can also protect against the display of behaviour difficulties, when these children are at risk in terms of having poor academic achievement. The implications of these findings are discussed along with directions for future research.

There is limited research into the impact of non-specific factors on the outcome of Cognitive Behaviour Therapy (CBT). This current study aimed to investigate the relationship between client and therapist attachment styles and client interpersonal problems to the therapeutic relationship and symptom reduction over eight sessions of CBT. Seventeen therapist-client dyads were asked to complete measures of interpersonal problems, attachment style and report on the therapeutic relationship. Results showed that in this small sample there was a relationship between core alliance, as rated by clients, to reduction in symptoms of depression over the course of eight sessions of CBT (TB=0.423, p<0.05) but not anxiety. Client level of confidence in relationships was negatively correlated with the reduction in anxiety symptoms over time (TB =-.320; p<0.05). The level of difference in scores on a measure of ‘confidence in relationships’ between therapists and clients was found to be positively correlated to the level of reduction in anxiety scores over eight sessions (TB = .0428; p<0.05) and negatively correlated to the therapist rated core alliance (TB=-.428, p<0.05). These results indicate that the role of attachment styles in CBT warrants further investigation and both clinical and theoretical implications of these findings are discussed. Key words: Cognitive Behaviour Therapy, therapeutic relationship, treatment outcomes, attachment, interpersonal problems Service Improvement Project Title: What is helpful about attending an Alzheimer’s café: does it do what it says on the tin? Abstract: Alzheimer’s Cafes were developed in 1997 in the Netherlands and have since been set up all over the world. They are a post-diagnostic support group for people with dementia and their families with an aim to reduce stigma around having dementia. As yet there have been very few evaluations of these cafes. This project aimed to find out what family carers of people with dementia found helpful about attending one of two Alzheimer’s cafes. Seven carers took part in a focus group and two were interviewed individually about what they found helpful about attending an Alzheimer’s Café and what they thought could be improved on in the future. Results showed that people found the opportunities to socialise with others ‘in the same boat’ the most helpful aspect as well as meeting professionals outside of the clinic. The results of this study will enable the development of a questionnaire that can be used to continue to evaluate the café and the feedback provided used to guide future service development. Key words: Alzheimer’s Café, social support, dementia, service evaluation Critical Literature Review Title: Risk and protective factors for psychological adjustment of children born with a cleft lip and/or palate and their families: A review of the literature Abstract: Research suggests that around 30-40% of children born with a cleft lip and /or palate will develop psychological difficulties. Services supporting these individuals need to be able to identify those that might be vulnerable as early as possible so that preventative support can be offered. This review summarises findings from research studies looking at within-group differences in samples of children with a cleft and their families. Risk factors found included being male, experiencing bullying or having additional difficulties. Protective factors included satisfaction with appearance and social support. The methodological strengths and weaknesses of these studies are discussed along with implications of the findings for theory and clinical practice.

Within this thesis the challenge of reducing bullying among children and adolescents in schools is reviewed (Chapter 2). The focus of this research was to examine the developmental decline in prosocial bystander responses to bullying (when a “bystander” is an individual who witnesses the bullying incident). To do so, a “developmental intergroup approach” (cf. Killen, Mulvey & Hitti, 2013; Rutland, Killen & Abrams, 2010) was applied to the context of bystander intentions. This approach suggests that intergroup factors such as group membership and identification, group norms, intergroup status and social-moral reasoning influence attitudes and behaviours during childhood and adolescence (e.g., Abrams, Rutland & Cameron, 2003; Rutland & Killen, 2011; Chapter 3). The present research examines whether this approach could shed light on why, with age, children become less likely to report helpful bystander intentions when faced with bullying and aggression among peers (e.g., Rigby & Johnson, 2006). Three studies were conducted, following an experimental questionnaire-based design (e.g., Abrams, Palmer, Rutland, Cameron & Van de Vyver, 2013; Nesdale & Lawson, 2011; Chapter 4). Study 1 (Chapter 5) showed support for examining group membership and group identification, group norms and social-moral reasoning) when understanding the developmental decline in helpful bystander responses. Two hundred and sixty 8-10 year olds and 13-15 year olds read about an incident of intergroup verbal aggression. Adolescent bystander intentions were influenced by norms and perceived severity of the incident. A significant moderated mediation analysis showed that the level of group identification among participants partially mediated the relationship between age and helpful bystander intentions, but only when the aggressor was an outgroup member and the victim was an ingroup member. Moral (e.g., “It’s not right to call them names”) and psychological (e.g., “It’s none of my business) reasoning differed by age and intention to help the victim or not. In Study 2 (Chapter 6) the role of intergroup bystander status and type of bystander response was manipulated. Two types of bystander norm (attitudinal and behavioural) were measured along with an exploratory examination of perceived leadership. Participants (N=221) read about an incident of verbal aggression where a bystander (who belonged to a high- or low-status group), either helped or walked away from an incident of verbal aggression. Helping bystanders were viewed more positively than those who walked away, but no effect of status on bystander evaluations was observed. However, moral reasoning was prioritised for high-status compared to low-status bystanders, regardless of their bystander behaviour. Additionally, bystander response (but not status) moderated the relationship between the behavioural norm and perceived leadership qualities. To further examine the role of norms a norm for helping versus not getting involved was manipulated in Study 3 (Chapter 7). Participants (N=230) read about deviant ingroup and outgroup bystanders who observed an incident of intergroup verbal aggression. Group membership was either school group or ethnicity (ingroup British and outgroup Travellers). Not only were participants sensitive to the group membership of the bystander, but they evaluated those who transgressed a helping norm more negatively than those who transgressed a norm not to get involved. Importantly this study also showed, for the first time, that children and adolescents are aware of group-based repercussions (e.g., social exclusion) if they do not behave in line with group norms. The studies presented within this thesis show strong support for considering group processes when examining the developmental decline in bystander responses to bullying and aggression and developing age-appropriate anti-bullying interventions. Further implications for theory, practitioners, policy and future research are discussed (see Chapter 8).

Research pertaining to homophobic name-calling has largely focused on prevalence rates and the negative long-term effects on Lesbian, Gay and Bisexual (LGB) populations without considering the intention behind the use of the language, leading to an assumption the language used in these incidents is intentionally homophobic. This small-scale exploratory study focused on gathering the cross age and gender perspectives of male and female young people in years 7 (age 11-12) and 10 (age 14-15) from one secondary school, to illuminate whether they perceive name-calling, involving the word ‘gay’ to be bullying, harmful and intentionally homophobic. The study adopted a qualitative approach to research methodology to gain a richer understanding of young people’s perspectives, where single–sex focus groups were used to collect qualitative data, which were analysed through thematic analysis. Key findings from the study suggest there is agreement over age and between genders that using the word ‘gay’ is not intentionally homophobic or harmful. The study also highlights that the intent of the language is complex and dependent upon a number of factors including: the relationship between the user and receiver; whether they are friends or not and how the words are said. The language can be used as a form of joking, social bonding, expressing opinions and perceived as a common discourse amongst young people where there is no associated implication to sexuality. Further implications for anti-bullying and Educational Psychology practice are discussed, with a focus on developing an understanding of the use and intent of name-calling in schools at systemic and socio-cultural levels.