A REALISTIC EVALUATION OF A
COGNITIVE BEHAVIOUR THERAPY (CBT)
INTERVENTION TO SUPPORT AN ADOLESCENT
DIAGNOSED WITH ASPERGER SYNDROME
IN A MAINSTREAM SECONDARY SCHOOL
by
DEAN WOLITER
A thesis submitted to the
University of Birmingham
in part fulfilment of the requirements for the degree of
EdPsychD
School of Education
University of Birmingham
Birmingham
September 2012
University of Birmingham Research Archive
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ABSTRACT
The use of Cognitive Behaviour Therapy (CBT) as a means to support adolescents diagnosed
with Asperger syndrome is gaining interest and has recently been applied in a school setting
(Grieg and Mackay, 2005; Sofronoff et al., 2005). The present study explores the use of CBT
to support a pupil diagnosed with Asperger syndrome delivered by an educational
psychologist in the pupil
’
s school setting. This application of CBT employed a
‘
formulation
’
approach in which a programme was written and then adapted in situ to meet the pupil
’
s
needs. The CBT programme consisted of 7 weekly sessions of CBT lasting approximately 40
minutes each of the sessions were delivered in school in the morning prior to the start of
lessons. The findings of the present study were analysed using a novel application of
Realistic Evaluation methodology (RE) of a CBT intervention in addition to the pre and post
CBT measures RE as a methodology seeks to consider the context of an intervention and its
potential to triggering mechanisms that could facilitate or limit the progress of introduced
intervention. The present study is an exploratory case study, employing a single case design
within a realist evaluation framework, to describe the role of the context as a mediating or
limiting factor on a CBT intervention. A year 8 pupil with a diagnosis of Asperger syndrome,
referred to as B, attended a mainstream secondary school in the West Midlands. It was
observed that there were changes for B in terms of his reported social communication and
in his cognition. The exploration of the CBT intervention by RE analysis suggested that
specific mechanisms were triggered in school and contributed to the observed outcomes.
Conclusions are discussed in terms of the usefulness of this methodological approach but
also for wider EP practice.
DEDICATION
I would like to dedicate this thesis to my wife Anita,
my children Dhanni Hari and Anya Lila
and to my parents Jean and Tony
