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Factors contributing towards psychological resilience in individuals with and without cleft lip and or/palate

Ridley, Matthew

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Abstract

Introduction: Cleft lip and/or palate (CL/P) is the most common congenital craniofacial condition (CFC) and those born with it are likely to face a multitude of challenges, including in relation to psychological well-being. Research to date does not explain the seemingly variable psychological well-being, or account for the processes that lead to “doing well”, among individuals with CL/P. Resilience is a popular yet conceptually vague construct, most often concerned with doing well in spite of adversity. However, resilience seems to mean different things in different contexts. Subsequently, current findings are often limited in applicability to the context from which they came. Moreover, there is a lack of evidence-based resilience-enhancing interventions – cleft-specific (or CFC or condition-specific), general resilience-based, or otherwise. The majority of existing research adopts an exclusively quantitative methodological approach, which often focuses on heterogeneous outcomes as indicators of resilience. Such approaches do not fully explain the processes that lead to resilience, and therefore are not commensurate with the development of an optimal, universal resilience-enhancing intervention that could be used across contexts (i.e., condition and non-condition groups).
Method: A qualitatively-led mixed methods design was adopted that focused on the process-based journey to resilience, using a personal meaning-oriented approach, and from a lifespan perspective. This included a narrative life story interview study with adults with CL/P (study 1), a follow-up Focus group study with cleft specialist psychologists (CSPs) (study 2), and a cross-sectional survey study measuring the resources of resilience identified in studies 1 and 2 amongst a group of adolescents/young adults (A/YAs) without CL/P or any other condition (study 3).
Results: Findings demonstrate a number of resources of resilience relevant to both condition and non-condition groups, namely: optimism, self-compassion, and positive body image. Notably, these resources were arrived at from a personal meaning-based approach, which shows promise as both an approach and also as an intervention component itself. Results also suggest the need for cognitive-behavioural/cognitive-therapy and self-compassion-based aspects in any prospective intervention, as well as highlighting the utility in targeting these using a modular, skills-based approach. The importance in including both subjective-individualised and systemic-socio-ecological aspects also emerged. The transition from adolescence to adulthood emerged as a critical timepoint requiring particular resilience.
Discussion: A framework for a novel, universal, resource-focused, modular, skill-based intervention targeting A/YAs both with and without conditions (contextualised as Self-Perceived Chronic Adversities (SPCA) related resilience) is presented. In addition, two sets of guidance are presented with regards the journey to resilience (1. CL/P-specific and 2. Universal across condition and non-condition groups; i.e., SPCA) for relevant professionals.

Citation

Ridley, M. Factors contributing towards psychological resilience in individuals with and without cleft lip and or/palate. (Thesis). University of The West of England. Retrieved from https://uwe-repository.worktribe.com/output/4773877

Thesis Type Thesis
Deposit Date Dec 5, 2019
Publicly Available Date Sep 4, 2020
Keywords resilience, psychological resilience, condition-specific resilience, personal meaning, meaning-based approach, narrative approach, mixed methods
Public URL https://uwe-repository.worktribe.com/output/4773877
Award Date Sep 4, 2020

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