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A Grounded Theory Approach to Greek Cypriots’ A GROUNDED THEORY APPROACH TO GREEK CYPRIOTS’ UNDERSTANDING OF MENTAL HEALTH AND HELP SEEKING BEHAVIOURS PANAYIOTIS PAPAHRISTOPOULOS JULY 2015 Doctoral thesis submitted in partial fulfillment of the University of East London, Professional Doctorate in Counselling Psychology U0838588 I This thesis is dedicated to my late father Michael. Your love and faith in me has been a source of strength in the most trying of times even now. I miss your earthly wisdom, your strength and your bad jokes. II Acknowledgements: A big thank you to all the participants in this research, without you this thesis would not have been possible. I would also like to thank Evangelia Prokopiou for helping me with her connections in the Greek Cypriot community in London and my research supervisor, Professor Rachel Tribe for her guidance, feedback, support and encouragement. Of course this moment would not have been possible without my family and friends. My loving wife Keathan, thank you for your love, support and patience all these years. You have been amazing and I love you so much. Nikos my best friend and koumbaros, you have been a rock all this time. I would like to thank everyone at Croydon CAMHS for their support all these years. Especially my line manager Gill Allen has been great in helping me manage the demands of a full time job and trying to complete my training. Marion Drennan my clinical supervisor for providing a very sympathetic ear in times of despair and Anneline Flood for reading drafts and giving me very useful feedback. Melissa Clapp and Jan-Sher Bhatti thank you for your help and good luck with your clinical psychology training. Charmaine Robertson-Jones and Chiluba Mashingaidze your words of encouragement have been invaluable. Last but certainly not least I would like to thank Luis Ordaz for the interesting discussions and practical help. III Summary: This research thesis explored how second generation Greek Cypriots understand issues of mental health and emotional wellbeing and their help seeking behaviours in relation to their culture. Coming from a critical realist point of view, 12 semi structured interviews were carried out and analysed using a grounded theory (GT) approach. Findings are discussed in light of current literature on cultural issues in psychology in general and Greek Cypriots in particular. In general participants saw mental health in the context of individual attributes but also equally if not more so, attributable to life circumstances and family relationships. Although compassionate towards people with mental health difficulties the majority saw themselves as resilient and able to cope and linked this to their upbringing. Four participants had had experience of therapy and all four experienced difficulties during the process relating to diversity issues. Family remains central to participants’ understanding of self and in relation to their own wellbeing. The core category was that of outlook on life as it encompasses notions of self, family and a philosophical stance in life, which filters all experiences. This outlook on life is an ever evolving concept with clear cultural origins through participants’ upbringing with an emphasis on getting on in life and appreciating what they have as opposed to that they don’t. IV List of figures Table 1: Participants information………………………. P 48 Diagram 1: Grounded theory…………………………….P 50 Diagram 2: The Core Category………………………….P 56 Table 2: The Main categories and subcategories……..P 58 V Contents 1 Introduction: ...................................................................................................................................................... 1 1.1 Personal stance: ....................................................................................................................................... 1 1.2 Background to this research thesis: ........................................................................................................ 1 1.3 The stance of counselling psychology: ................................................................................................... 2 1.4 Theoretical and methodological and application issues: ....................................................................... 4 1.4.1 Psychological constructs and theories: ........................................................................................... 4 1.4.2 Issues with research: ........................................................................................................................ 6 1.4.3 Issues with application: ..................................................................................................................... 8 1.5 Impact on ethnic minorities: ..................................................................................................................... 9 1.5.1 Addressing such issues: ................................................................................................................. 10 1.6 Greek Cypriots in the UK: ...................................................................................................................... 11 1.6.1 Brief history of Cyprus:.................................................................................................................... 11 1.6.2 Greek culture and Identity: ............................................................................................................. 12 1.6.3 Greek Cypriots in the UK: ............................................................................................................... 15 1.7 Justification for this research thesis: ..................................................................................................... 19 2 Literature review: ............................................................................................................................................ 20 2.1 The literature search: .............................................................................................................................. 20 2.2 Relevance of culture: .............................................................................................................................. 21 2.3 Definitions: ............................................................................................................................................... 22 2.3.1 Race culture and ethnicity: ............................................................................................................. 22 2.3.2 Culture: ............................................................................................................................................. 23 2.3.3 Acculturation: ................................................................................................................................... 24 2.3.4 Identity: ............................................................................................................................................. 25 2.3.5 Mental health: .................................................................................................................................. 29 2.3.6 Relevance of culture: ...................................................................................................................... 30 2.3.7 Impact on ethnic minorities: ............................................................................................................ 32 2.4 Incorporating culture in practice: ........................................................................................................... 34 VI 2.4.1 Multicultural training and practice: ................................................................................................. 34 2.4.2 Community Initiatives: ..................................................................................................................... 36 2.4.3 Greek culture and health: ............................................................................................................... 37 3 Epistemological stance and methodology: ................................................................................................... 43 3.1 Relevance to counselling psychology: .................................................................................................. 43 3.2 Definitions: ............................................................................................................................................... 44 3.3 Critical realism: ........................................................................................................................................ 44 3.4 Reflections on qualitative research methods: ....................................................................................... 46 3.5 Evaluating quality: ................................................................................................................................... 48 3.6 Constructivist Grounded Theory: ........................................................................................................... 48 3.6.1 A note on other Methods: ............................................................................................................... 50 3.7 Ethical Considerations: ........................................................................................................................... 51 3.8 Methodology: ........................................................................................................................................... 53 3.8.1 Research Reflexivity:
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