The experience of post traumatic growth in adjusting to spinal cord injury: The role of social processes and relationships

Smith, Gemma 2022. The experience of post traumatic growth in adjusting to spinal cord injury: The role of social processes and relationships. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Acquiring a spinal cord injury (SCI) can have substantial physical, social, and psychological impacts on the individual, requiring the individual to make significant adjustments and deal with multiple losses and challenges. Research shows the potential for individuals to experience positive psychological changes in adapting to these challenges. This has attracted research interest in application of models of post traumatic growth (PTG) to the field of SCI. PTG is defined as positive psychological changes resulting from the struggle with traumatic or highly stressful life circumstances. The predominant model of PTG proposes that trauma represents a significant disruption to life goals and core beliefs about self, world, and others, triggering cognitive processes as the individual attempts to make sense of their experience and rebuild core beliefs. PTG is seen as resulting from the rebuilding of core beliefs. Research supports these processes and experiences of growth following SCI. Several studies show the role of social support and social factors in the development of PTG; however there has been an overfocus on individual factors (such as individual resilience) in the field which hinders understanding of how social processes might support or hinder the development of PTG following SCI. This thesis aimed to address this through systematic review and synthesis of the current research base and empirical study of social relationships and processes as part of the lived experience of PTG in SCI, to add to the research base and provide implications for clinical practice. Paper one is a systematic review which examines the social processes involved in the development PTG following SCI. Searches identified nine relevant studies and a meta-ethnographic approach generated four themes: Sense of Self and Identity; Close Relationships as Enablers of Growth; Connecting with the Peer Community; and Reintegrating into Society. The review identified identity reconstruction as a central pathway in the development of PTG. SCI was shown to represent a threat to identity due to imposing a new forced disabled identity, demanding processing of beliefs about disability and requiring the individual to make sense of its impact on self and relationships. This was shown to trigger cognitive and behavioural processes as the individual explored and reconstructed beliefs about disability, acceptance and belonging the in the context of their relationships and social world. The review indicated individuals are able to reconstruct a positive self-identity when they are able to challenge previously held narratives about disability and generate ideas about how disability can be integrated into personal identity. Close relationships and peers were found to play a multi-faceted role in enabling identity reconstruction and promoting the cognitive and behavioural processes of PTG. The findings are limited by a relatively small research base, highlighting the need for further research. Specifically, the review highlighted the need for research examining the role of support from others in the development of PTG following SCI. Paper two is an empirical study exploring the lived experience of PTG with 11 individuals living with SCI using a qualitative approach. The aim of the research was to understand the role of interactions and relationships with close others and peers, and how this influences cognitive processing, in the development of PTG. Semi-structured interviews were conducted and analysed using a Social Constructivist Grounded Theory approach. The results showed how SCI can disrupt beliefs about self, others, and world, which had the potential to disrupt self-identity. This triggered cognitive and behavioural re-evaluation processes to rebuild beliefs, and in turn experience PTG. Three inter-related themes of how relationships support these processes were revealed: a safe place to get back on your feet, accepting and valuing me, and enabling learning and independence. Therefore, highlighting the role relationships and interactions with peers have in promoting safety, acceptance, and enablement, as contributory to PTG. Relationships and interactions could function to enable the processes of PTG through the provision of support, as well as influence the rebuilding of beliefs in the implicit meaning that was taken from interactions. The study provided implications for clinical practice for individual, familial and systemic interventions, and in the importance of promoting learning opportunities from peers. The study brought into question the applicability of the predominant model of PTG for the context of acquired disability, suggesting the need for further theory testing and potential revision in this context.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	6 October 2022
Last Modified:	31 Jan 2024 02:30
URI:	https://orca.cardiff.ac.uk/id/eprint/152925

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