A REALISTIC EVALUATION OF A COGNITIVE BEHAVIOUR THERAPY (CBT) INTERVENTION TO SUPPORT AN ADOLESCENT DIAGNOSED WITH ASPERGER SYNDROME IN A MAINSTREAM SECONDARY SCHOOLby 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
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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