Mary trained initially at the University of Liverpool (BSc) and then went on to undertake clinical training at North London Polytechnic now known as University of East London. On qualification she worked within children and young people's services initially in Kingston and then moved to Northampton to develop the service. Two years later she returned to London to work at St Georges Hospital within the behavioural medicine service for young people where she became a Consultant Clinical Psychologist.
Following a number of years of working with young people presenting with a variety of acute and chronic physical health problems as well as life limiting conditions she moved into clinical service development and management initially leading a Child Psychology Service in Kent and then taking on a number of roles within the Sussex area finally becoming Head of Psychology and Psychological services for West Sussex. Throughout this time she also contributed to the training of a wide variety of Health and social practitioners alongside a major contribution to the training of clinical Psychologists.
In 2004 she joined the University to become the Programme Director of the Clinical Psychology training course. Since that time she has worked with colleagues to develop supervision and consultation training, Cognitive Behavioural therapy practitioner training, Interpersonal psychotherapy training resulting in the development of a Surrey Sussex IPT Centre. In 2012-15 she became Deputy Head of School and Director of Teaching and Learning.
University roles and responsibilities
- Head of Department of Psychological Interventions
- Programme Leader for PsychD Clinical Psychology
- Senior Lecturer in Clinical Psychology
Business, industry and community links
14 DEC 2020
Surrey researchers secure £175,000 to develop an intervention for disordered eating in children with type 1 diabetes
My research interests have become focussed on the impact of adversity on young people and how we understand the development of self- identity including well-being, resilience or psychological distress. Part of this strategy has been to develop measures of recovery from psychological distress, ReQUEST also other psychometric instruments examining shame and guilt ASA and GSA .These two self-conscious emotions have a significant impact on how young people appraise the world and how they form a world view of themselves. In a clinical context, the resulting consequences of developmental trauma can be present across the decades unless identified and addressed.
Currently I am working with CAMHS services on how we might effectively address this issue for young people. Looked after children are also at elevated risks of experiencing difficulties with emotion regulation, educational performance and inter-personal relationships. I am working with colleagues at Sussex University and the Rees Centre oxford to examine the impact of school transition on these young people's well-being. It is anticipated that we may be able to identify those most at risk of difficulties, provide profiles where specific intervention could be targeted.
Owing to my long term interest in chronic health condition I have recently begun working with Debbie Cooke, Laura Simonds and Gareth Morgan addressing the psychological needs of young people with who are experiencing difficulties controlling their diabetes.
The other area of particular interest is how adolescent boys and men become more emotionally self-aware of their emotional distress and seek adaptive methods to secure support. Currently girls and women are over represented in the utilisation of services whilst boys and men are over represented in police engagement, and probation and prison services.
During the course of this work I employ mixed method approaches as well as both specific Qualitative quantitative analytic strategies.
- Laura Simonds and I have been exploring personal centred recovery in young people both within the general population and also in clinical contexts. She and I also work together in the area of shame and Guilt.
- Linda Morison and I work together with Bob Patton, Jason Spendelow, Eli Joubert in this field of men and boys health.
- Debbie Cooke, Gareth Morgan and Laura Simonds on facilitating engagement with diabetes self care.
- I am also working with Professor Robin Banerjee at Sussex University and Dr Nikki Luke at The Rees centre Oxford. She is a reviewer for many journals and grant givers.
- Sussex Partnership NHS Trust Own account funding stream - Developing a Mindfulness App for young people. Collaboration with Prof Robin Banerjee Sussex University. 2013 Awarded.
- Sussex Partnership NHS Trust Own account funding stream- Development of a recovery measure for young people 2009 Awarded.
Simonds. L, John, M, Fifie-Schaw. C., Willis, S., Taylor, H., Hand, H., Rahim., Winstanley, H., and Winton,H ( 2015 )Development and Validation of an Adolescent Shame -proness Scale. Psychological Assessment
John, M (2015) Working with children chapter in Clinical Psychology (Topics in Applied Psychology) Routledge
Mulligan, B., John, M., Coombes, R., Singh, R., (2014) - Developing outcome measures for a Family Intensive Support Service for Children presenting with challenging behaviours. British Journal of Learning Disabilities March
John M, Jeffries F, Acuña-Rivera M, Warren F, Simonds L. (2014) 'Development of measures to assess personal recovery in young people treated in specialist mental health services'. Clinical Psychology & Psychotherapy, 21(3) 1063-3995 doi: 10.1002/cpp.1905
Simonds LM, Pons RA, Stone NJ, Warren F, John M. (2014) 'Adolescents with Anxiety and Depression: Is Social Recovery Relevant?'. Clin Psychol Psychother, 21 (4), pp. 289-298.doi: 10.1002/cpp.1841
Atkins, E., Colville., G and John. M. A 'biopsychosocial' model for recovery: a grounded theory study of families' journeys after a Paediatric Intensive Care Admission Intensive Crit Care Nurs. 2012 Jun;28(3):133-40
John, M. Shortlisting from the Clearing House Application form: Is it fit for purpose? A commentary Psychology Learning and teaching 9 (2) 37-39
Lee, K. Vandrevela,T and John A.M (2008). The challenges and experiences of Trainees pursuing Clinical psychology training straight from and undergraduate degree
Hewitt, O and Roose, G and John, M, Yazdani, A (2006) Young people with learning disability views on mental health. Young Minds
John, A.M. and Vetere, A It's Important, and Its' One Way of Helping, and One Way of Helping Only. Clinical Psychology Forum (2008)
Vandrevala, T, Hayward, M, Willis, J. and John, M. (2007). A move towards a culture of involvement: involving service users and carer in the selection of future clinical psychologists. Journal of Mental Health Training, Education and Practice.
Carlisle A. S., John A., Fife-Schaw, .C. and Lloyd. M (2006) The Self-Regulatory Model in Women with Rheumatoid Arthritis: Relationships between Illness Representations, Coping Strategies, and Outcome. J. Health Psychology.
Hewitt, O and Roose, G and John, M, (2004) View finder User consultation is seen as key to improving outline how children and young people view mental health services. Young Minds 71
Roose, G and John, A. (2003) Young children's understanding of mental health their help seeking behaviour and ideas for a mental health service. Child Health care and development
Adams, S., Dowdney, L., John, A, and Hill, V. (2003) Expanding the profession of clinical psychology- clinical psychologists views on providing training placements. Clinical Psychology 22- February
Bradford, R., Rutherford, D. L. and John, A. (2002) Quality of life in young people ratings and factor structure of quality of life profile-adolescent version. J of Adolescence Vol 25 no 23, 261-74
Bowen, A and John, A. M. (2001) Gender differences in presentation and conceptualisation of adolescent self-injurious behaviour: implications for therapeutic practice Counselling psychology quarterly vol. 14 357-379.
Spender. Q, and John, A. (2001) Psychological and psychiatric perspectives. In Legal concepts of childhood. Editors Fionda, J. Hart Publishing
John A.M, (2001) Psychological considerations in the child patient. Introduction to podopediatrics. Editors Thompson, P and Volpe, R Churchill Livingston
Skinner, C. John, M, and Hampson, S. (1999). Social support and personal models of diabetes as predictors of self care and well being A Longitudinal study of adolescents with Diabetes. J. of Pediatric Psychology.
Tomes, J and John, A. (1994). 'The Psychological Effects of Chronic Illness on Children and their Families.' In Paediatrics for Chiropodists. Edits. Thomson P. Harcourt Brace & Jovanovich.
John A, (1993) 'Emotional Problems of Children,' In: The Royal Society of Medicine. Child Health Guide. Edited West .R. Octopus.
John, A. & Bradford, R. (1991). Integrating Family Therapy into Paediatrics. A Model. Journal of Family Therapy. Vol. 13 p 207-223.
Bradford, R. & John, A. (1991). The Psychological effects on disaster work, implications for disaster planning. Journal of Royal Society of Health. Vol. 111 June, p 107-110
Black males within Western society, who navigate recurrent racism and discrimination, have frequently been constructed as “high risk” for mental health difficulties. Research, particularly in the USA, has identified the barriers that Black males face in relation to seeking help, with research outlining the underutilisation of mental health services and overrepresentation of acute mental health diagnoses such as psychosis. Research within the UK has explored barriers to help-seeking amongst males in general, or adult Black males who are within the mental health or prison systems, yet to date little is known about the ways in which Black male adolescent youth outside of formal services understand mental health. Therefore, this paper offers a contribution to knowledge by examining the way in which young Black males in the UK make sense of mental health and associated systems of support. Data from ten interviews with males aged 16–18 from a South London school was collected and analysed using thematic analysis (TA). The young Black males’ understandings of mental health were embedded with notions of masculinity, being in control and strong, and they understood mental health as something that is experienced by other people. Formal support for mental health difficulties was constructed as an unfamiliar and unapproachable system, that is often unkind and discriminatory towards Black males. Speaking to family and friends about mental health difficulties felt more accessible for these young males, however their construct of mental health and constructs within the community provided further silencing on using this support. This study suggests important implications for understanding the experiences of mental health and seeking support amongst Black male adolescents in the UK.
Background Recovery has become a central concept in mental health service delivery, and several recovery-focused measures exist for adults. The concept's applicability to young people's mental health experience has been neglected, and no measures yet exist. Aim The aim of this work is to develop measures of recovery for use in specialist child and adolescent mental health services. Method On the basis of 21 semi-structured interviews, three recovery measures were devised, one for completion by the young person and two for completion by the parent/carer. Two parent/carer measures were devised in order to assess both their perspective on their child's recovery and their own recovery process. The questionnaires were administered to a UK sample of 47 young people (10–18 years old) with anxiety and depression and their parents, along with a measure used to routinely assess treatment progress and outcome and a measure of self-esteem. Results All three measures had high internal consistency (alpha ≥ 0.89). Young people's recovery scores were correlated negatively with scores on a measure used to routinely assess treatment progress and outcome (r = −0.75) and positively with self-esteem (r = 0.84). Parent and young persons' reports of the young person's recovery were positively correlated (r = 0.61). Parent report of the young person's recovery and of their own recovery process were positively correlated (r = 0.75). Conclusion The three measures have the potential to be used in mental health services to assess recovery processes in young people with mental health difficulties and correspondence with symptomatic improvement. The measures provide a novel way of capturing the parental/caregiver perspective on recovery and caregivers' own wellbeing. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message •No tools exist to evaluate recovery-relevant processes in young people treated in specialist mental health services. •This study reports on the development and psychometric evaluation of three self-report recovery-relevant assessments for young people and their caregivers. •Findings indicate a high degree of correspondence between young person and caregiver reports of recovery in the former. •The recovery assessments correlate inversely with a standardized symptom-focused measure and positively with self-esteem.
Social recovery has become a prominent aspect of mental health service design and delivery in the past decade. Much of the literature on social recovery is derived from first-person accounts or primary research with adult service users experiencing severe mental illness. There is a lack of both theoretical and empirical work that could inform consideration of how the concept of social recovery might apply to adolescents experiencing common (non-psychotic) mental health problems such as anxiety and depression. The current study was conducted to understand the process of experiencing anxiety and depression in young people. Semi-structured interviews were conducted with nine adolescents with anxiety and depression (seven girls and two boys aged 14-16 years) and 12 mothers who were recruited from a specialist Child and Adolescent Mental Health Service in the South of England. Thematic analysis indicated that young people do experience a process of 'recovery'; the processes participants described have some congruence with the earlier stages of adult recovery models involving biographical disruption and the development of new meanings, in this case of anxiety or depression, and changes in sense of identity. The accounts diverge with regard to later stages of adult models involving the development of hope and responsibility. The findings suggest that services should attend to social isolation and emphasise support for positive aspirations for future selves whilst also attending to young people's and parents' expectations about change. Methodological challenges face enquiry about 'recovery' given its connotations with cure in everyday language. Copyright © 2013 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Theoretical and empirical work on social recovery in young people and families is lacking. Using interviews, this study sought to understand the relevance of social recovery for adolescents with anxiety and depression and their mothers. Findings suggest some congruence with the earlier stages of adult recovery models involving meaning and identity. Findings diverge with regard to later stages of adult recovery models involving hope and responsibility. Social recovery in mental health services for young people needs significant empirical attention and critical debate.
Like other self-conscious emotions, shame takes on particular significance during late childhood and adolescence because of a developing capacity for self-reflection, self-other comparisons, and sensitivity to the views of others. Shame is a potentially important variable in adolescent well-being given its established associations with depression, reduced feelings of self-worth, and problematic anger. Three studies are reported that describe the development and validation of the Adolescent Shame-Proneness Scale (ASPS), a novel semi-idiographic measure of shame-proneness. The ASPS is a 19-item measure assessing 3 components of shame-proneness-negative self-evaluation, externalization, and emotional discomfort. Taken together, the studies support the reliability and validity of the ASPS as a semi-idiographic measure of shame-proneness in adolescents aged 11 to 18 years. ASPS scores correlate as expected with scores on existing measure of shame-proneness and with measures of anger, negative affect, and self-esteem. More important, the data suggest that ASPS scores are related to, but distinct from, guilt. Confirmatory factor analysis supported the validity of the ASPS factor structure (RMSEA = .08, SRMR = .05, CFI = .97, NNFI = .97). The ASPS represents a unique contribution to existing options for measuring shame-proneness in research and clinical contexts. Further work is required to assess the ASPS' temporal stability and its viability and psychometric properties in more culturally diverse samples. (PsycINFO Database Record
Much of the burden associated with poor mental health is associated with symptom experience in the general population. We conducted a systematic review and meta-analysis of studies conducted in non-clinical samples, evaluating Mindfulness-Based Programs (MBPs) for outcomes related to psychological health and well-being. We focussed on Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) because they have the strongest evidence base. We searched MEDLINE, PsycINFO, EMBASE and CINAHL (2006 – February, 2019) for published peer-reviewed journals articles of intervention studies evaluating MBCT or MBSR for psychological health and well-being in non-clinical samples. Data were pooled using a random-effects model and effect estimates were reported as Hedges’ g. We included 49 studies conducted in non-clinical samples (n=4733). When compared to a passive control, MBPs significantly reduced symptoms of rumination/worry (g=-1.13, [-2.17, -0.08]), stress/psychological distress (g=-0.52 [-0.68, -0.36]), depression [g=-0.45 [-0.64, -0.26]), and anxiety (g=-0.44 [-0.65, -0.23]); and significantly improved quality of life/well-being (g=0.32 [0.10, 0.54]). In general, MBCT generated larger effect sizes than MBSR for all outcomes. This study provides evidence that in non-clinical samples, MBPs are associated with benefits to health and well-being. These findings add to the growing evidence-base suggesting that MBSR and MBCT may be effective approaches for sub-clinical levels of mental ill-health and could form part of the public mental health agenda.
Background: Looked-after children (LAC) frequently experience greater mental health challenges than the general child population. There has been a call for greater focus on early preventative interventions and priority access to specialist mental health support for this population. Brief mental health screening tools often provide the gateway to services and yet there is a lack of suitable assessment tools available for LAC. The current study is the first to explore the perspectives of foster carers and CAMHS clinicians’ in relation to the use of two brief screening tools; the Strengths and Difficulties Questionnaire (SDQ) and the Brief Assessment Checklists (BAC’s). Method: Qualitative data was collected via semi-structured telephone interviews and face-to-face focus groups with female foster carers (N=13) and clinicians working in a CAMHS setting (N=9). Results: Thematic analyses generated six themes which were organised into three superordinate themes centred around: 1) relevance to LAC, 2) using measures to inform care planning and; 3) current problems when using psychometric measures within the LAC population. Foster carers and clinicians emphasised the need for a comprehensive understanding of LAC given the complexity of their difficulties. There was acknowledgement that psychometric measures could facilitate and contribute to this by highlighting difficulties, providing accurate feedback to carers and clinicians, and enabling access to support. However, both groups seldom felt that current measures were nuanced enough to adequately capture the needs of LAC. Conclusion: Screening tools play a crucial role in identifying the mental health needs of LAC and facilitating access to services. Further research is needed to establish the ability of such measures to increase the sensitivity of the complex needs’ assessment of LAC. A number of clinical recommendations are also discussed in relation to the assessment of mental health in the LAC population.
Paediatric intensive care has a significant impact on the children and families who experience it. This effect continues post-discharge as the family attempt to recover from their ordeal. This article begins with an exploration of what makes a Paediatric Intensive Care Unit (PICU) admission potentially so traumatising and then examines current models for recovery which exist in the literature. These remain sparse and do not provide a coherent model for recovery after PICU. This paper therefore presents research which aimed to develop a model to understand the recovery journey for families. Children who had been PICU patients and their parents were interviewed and the transcripts analysed using grounded theory. Participants highlighted the importance of physical, psychological and social recovery and these have been integrated into a biopsychosocial model of recovery. Finding and accepting a 'new normal' were the culmination of this biopsychosocial journey. This paper concludes that an integrated approach to recovery is necessary and makes some recommendations for further research and clinical practice. © 2011 Elsevier Ltd.
The presence of a dermatological condition may deter contact with the affected person because it falsely signals the threat of infection. The current study investigated interpersonal aversion towards individuals with the appearance of acne and psoriasis. Participants (N=196) either viewed a female face with the appearance of acne, psoriasis, or no visible dermatological condition. Participants rated the attractiveness of the person, and indicated their willingness for social and indirect contact with them. The person depicted with acne was rated significantly less attractive than the person with psoriasis or no dermatological condition. Participants reported significantly less willingness for indirect contact with the person depicted with acne or psoriasis compared to the person with no visible dermatological condition. In contrast, participants expressed more willingness for social contact with a person with acne than with the person with psoriasis or no dermatological condition. Group differences were significant when controlling for attractiveness ratings. Unwarranted fear of infection might underpin avoidance and discriminatory behaviour towards those with skin conditions. Further research is required to understand factors that influence avoidance of contact.
Objective Social and occupational functioning are important for psychological health. However, quantitative research has suggested that these areas can be adversely affected by multiple chemical sensitivity (MCS). This systematic review therefore sought to explore what qualitative research has suggested about how people with MCS perceive it to affect their social and occupational functioning. Method Journal articles were included if they were 1) peer reviewed 2) qualitative or mixed methods 3) published in English 4) reported qualitative findings relevant to the review. Studies were excluded if they were 1) descriptive only 2) primarily concerned with environmental intolerances other than chemicals or 3) focussed on specific populations such as veterans. Quality was assessed using the National Institute for Health and Care Excellence (NICE, 2018) qualitative quality criteria. However, quality was not used to determine eligibility for inclusion. Six databases (CINAHL, Medline, PsychArticles, PsychInfo, Scopus and Web of Science) were searched between the 24th of February 2019 and 2nd of March 2019. Results Having removed duplicates, database searches identified 388 potential articles. Thirteen of these articles were eligible for inclusion. Following review, no more articles were included from the reference lists of these studies. Meta-aggregation of the findings identified seven categories. These were synthesised into three themes; ‘limited access’, ‘loss & anxiety’ and ‘seeking engagement’. Conclusions The findings suggested that MCS limits some people's social and occupational functioning. The results warrant further research, and, the development of prevention and intervention strategies. Studies predominantly recruited United States and Canadian females and had several limitations.
Background: The assessment of children and young people with history of complex developmental trauma presents a significant challenge to services. Traditional diagnostic categories such as post-traumatic stress disorder (PTSD) are argued to be of limited value, and while the proposed ‘Developmental Trauma Disorder’ definition attempts to address this debate, associated assessment tools have yet to be developed. This review builds on a previous review of assessment measures, undertaken in 2005. Aim: To identify trauma assessment tools developed or evaluated since 2004 and determine which are developmentally appropriate for children or adolescents with histories of complex trauma. Method: A systematic search of electronic databases was conducted with explicit inclusion and exclusion criteria. Results: A total of 35 papers were identified evaluating 29 measures assessing general functioning and mental health (N = 10), PTSD (N = 7) and trauma symptomatology outside, or in addition to, PTSD (N = 11). Studies were evaluated on sample quality, trauma/adversity type, as well as demographic and psychometric data. Distinction was made between measures validated for children (0–12 years) and adolescents (12–18 years). Conclusion: Few instruments could be recommended for immediate use as many required further validation. The Assessment Checklist questionnaires, designed with a developmental and attachment focus, were the most promising tools.