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How Young People Make Sense of Developing and Getting Help for Obsessive Compulsive Disorder No 12/SC/0495

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How Young People Make Sense of Developing and Getting Help for Obsessive Compulsive Disorder No 12/SC/0495 Major Research Project How Young People Make Sense of Developing and Getting Help for Obsessive Compulsive Disorder Carly Victoria Keyes A Thesis submitted in partial fulfilment of the requirements of the University of Hertfordshire for the degree of Doctor of Clinical Psychology. The programme of study was carried out in the School of Psychology, University of Hertfordshire. June, 2015 1 Student number: 08178505 ACKNOWLEDGEMENTS I would like to thank my academic supervisor, Dr Lizette Nolte. Dr Nolte has been a rock to me throughout the whole of the Doctorate. She has provided guidance, encouragement and motivation in supporting me through this research process. I would like to thank her for being there for me through the emotional highs and lows throughout the Doctorate. I would also like to thank my field supervisor, Dr Timothy Williams for helping me access participants and for his support, guidance and enthusiasm. His level of expertise of Obsessive Compulsive Disorder (OCD) has been invaluable. I would like to thank the Health Experiences Research Group at University of Oxford who believed in my research from the beginning. The group conduct such valuable research giving voice to peoples’ experiences of physical and mental health difficulties. I would also like to thank my parents for their unconditional love. You have been there for me throughout the whole journey of reaching my dream of becoming a clinical psychologist and you haven’t stopped encouraging me. Mum, thank you for everything. Dad, thank you for coming into my life and showing me what a dad is. Thank you to Cohort 12 for your support through the laughter and the tears over the last three years. I have learned so much and been inspired by each of you. I would like to thank Joe Wells, everyone in the OCD-UK support group I visited, and the two service users who I consulted with at university for sharing your experiences with me and helping to shape the research. Finally, I would like to express my gratitude to the 10 young people who gave up their time to share their experiences with me, without whom this research would not have been possible. I dedicate my thesis to every person who have experienced or is currently experiencing OCD. 2 Student number: 08178505 Table of Contents ABSTRACT ............................................................................................................... 6 CHAPTER 1: INTRODUCTION ................................................................................ 7 Literature search strategy .................................................................................................. 7 Use of language ............................................................................................................. 7 Statement of position in research ...................................................................................... 9 What is OCD? ................................................................................................................ 9 How common is OCD? .................................................................................................... 13 Phenomenology ........................................................................................................... 15 Ideas on the development of OCD ................................................................................... 16 Psychological model for the development of OCD ....................................................... 16 Stressful life events and trauma as a context for the development of OCD ...................... 19 The link between attachment and the development of OCD ......................................... 21 Family relationships and the development of OCD .......................................................... 23 Biological explanations for the development of OCD.................................................... 25 Understandings of those who experience OCD ............................................................... 27 Treatment for OCD ...................................................................................................... 29 Help-seeking ................................................................................................................... 29 Cognitive Behaviour Therapy ....................................................................................... 29 Family involvement .......................................................................................................... 31 Pharmacological treatment .......................................................................................... 33 Rationale for the present study ........................................................................................ 34 Aims of the research and research questions .............................................................. 35 CHAPTER 2: METHODOLOGY .............................................................................. 36 Epistemology ................................................................................................................... 36 Design of the study ...................................................................................................... 36 Rationale for using a qualitative approach ....................................................................... 36 Rationale for using Thematic Analysis ......................................................................... 37 Process of analysis .......................................................................................................... 38 Quality and validity in qualitative research ................................................................... 39 Ethics .............................................................................................................................. 39 Informed consent ......................................................................................................... 40 Possibility of distress and prevention of harm .................................................................. 41 Confidentiality .............................................................................................................. 42 Right to withdraw ............................................................................................................. 43 3 Student number: 08178505 Service-user involvement ............................................................................................. 43 Recruitment of participants .............................................................................................. 44 Suggested measures and data collection ..................................................................... 50 CHAPTER 3: RESULTS .......................................................................................... 51 Traumatic and stressful life events .................................................................................. 51 Hostility in the family ........................................................................................................ 52 Illness and death .......................................................................................................... 54 Bullying and friendlessness ............................................................................................. 55 Responses to signs of OCD ......................................................................................... 58 Lack of understanding of the behaviour ........................................................................... 58 Being secretive ............................................................................................................ 61 “I thought I was going crazy” ............................................................................................ 63 Feeling different ........................................................................................................... 65 The battle of living with OCD ........................................................................................... 68 Feeling ‘right’ ................................................................................................................... 69 “I was taking on all the responsibility” ........................................................................... 71 “It’s ruined everything” ..................................................................................................... 73 “Everyday life is now in my bedroom” .......................................................................... 76 Ambivalent relationship to help .................................................................................... 78 Conflicts of exposure therapy .......................................................................................... 78 Conflicts about accommodation of the OCD ................................................................ 81 Frustrations of long waiting lists ................................................................................... 83 CHAPTER 4: DISCUSSION .................................................................................... 85 Overview of findings ........................................................................................................ 85 The current findings in relation to theoretical issues and research ............................... 88 Implications for clinical practice ....................................................................................... 95 Strengths of the study ...............................................................................................
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