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Superordinate themes, themes and emergent themes example

Overall Theme Emerging theme cluster Emerging theme

Managing emotional distress Ongoing emotional difficulties Ongoing emotional difficulties Lack of alternatives when people feel it isn’t

working

Lack of alternatives when people feel it isn’t working

Managing expectations and engagement The description of STEPPS felt like it was relevant

Curious about STEPPS potential for being helpful

STEPPS sounded manageable and relevant Apprehensive about attending group Apprehensive about group therapy as

previously unhelpful

Apprehensive about engaging socially in a group environment

Persevering in the face of emotion dysregulation

Frustration with slow progress Frustrating to see others progress quickly when this is not shared

Felt frustrated and guilty about slow progress as felt like hadn’t worked hard enough

Sometimes difficult to apply skills learning to real life situations

Ending as emotionally crucial Attending the friend and families evening made the ending easier

Attending the friend and families evening made the ending easier

Reassuring to know there is further help if needed

Reassuring to know there is further help if needed

A loss of routine/ having a group to go to A loss of routine/ having a group to go to Further challenges ahead Prepared to persevere with skills to see

further improvements

Prepared to persevere with skills to see further improvement

Developing trust with group members Felt comfortable in the group First session felt gentle without a pressure to talk

126 Being with other socially confident group members made her feel more comfortable and confident

Spoke up when she felt the need to Difficulties sharing personal issues Found it difficult to know when to share

experiences

Found it difficult to share personal issues in a group

Coping with difference Appreciated the range of people affected by emotional intensity

Appreciated the range of people affected by difficulties in similar ways

Developing trust with facilitators Trusted the facilitators Facilitators were respectful of individual differences

Facilitators were caring towards group members

Trusted the facilitators Shared experience helped understanding of

self

Found it easier to understand emotional intensity when shared through people’s stories

Found it easier to understand concepts of feelings embedded in embedded in peoples’ stories

Reassuring to find shared experience Reassuring to be with a group of people with similar struggles every week

Felt like the group was in the situation together

Shared experience of emotional intensity helped feeling ‘regular’

Feels like a regular person rather than a broken person

Felt she fitted in as other people were nervous too

Developed awareness and ability to manage emotion dysregulation

Developed the ability to manage behaviours and life despite intense emotions

Given names for abstract feeling helped her own understanding and ability to explain it to others

Don’t catastrophize feelings despite them still being intense

127 Helped her ability to communicate with

partner

Being able to communicated about feelings has helped them not taking over

Been able to cope with stressful work and life Developed skills in managing relationships Became socially more confident Attending the group has made it easier to talk

to people on the internet

Hearing other people sharing experiences helped overcome anxiety about speaking up Developed the ability to be assertive Dad’s noticed she’s more assertive and

positive

Terrifying to challenge others but prevents emotional difficulties

Been able to challenge other people’s negative thoughts

Developed agency and capacity to change A framework that values lived experience Liked the idea of STEPPS as a framework supported by people’s lived experience Found the group more comfortable and easier to speak up with equal facilitators

Liked the facilitators were presented as equals

Facilitators directed the group but allowed the group to experience the course on their own terms

The individuals existing skills are values Liked the concept of having the means to help herself but not knowing how

Feel empowered to manage her emotions Felt empowered by knowing she has the skills to manage, she just has to learn how

Felt empowered to support others Feel more confident in supporting other people with difficulties

128 Developed hopefulness through noticing

change in self and others

Felt hopeful when seeing other people progress

Felt hopeful when hearing other people’s abilities to persevere through adversity Reassuring to see people work through the therapeutic process at different stages Hopeful about the opportunity for further + progress

Feels hopeful about her ability to continue to progress

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Appendix J: Summary of results for respondent validation

The experience of taking part in brief group therapy (STEPPS-EI) when living with emotional intensity

Dear Participant,

I am writing to give a summary of the findings of the research project you kindly gave an interview for back in 2016/2017. Your participation has been invaluable and thank you again for taking the time to share your experiences with me. Below, I give a very brief summary of the findings. You are welcome to comment on these or ask questions if you should wish to and my contact details can be found at the end of the summary.

Summary of findings

The interviews were typed up and read multiple times to find themes within them. There were three overall themes for participants, which were as follows: an emotional journey,

developing and understanding self, and developing relationships. Within the themes a further 18 subthemes were identified and these are listed in the summary below.

An emotional journey

There was a theme around the emotional journey with participants coming from a place of distress when seeking help, then engaging and persevering with therapy, followed by looking to the future. The following seven subthemes came through the participants’ description of this journey:

 Managing emotional distress  Managing shame and stigma  Managing expectations of therapy

 Persevering in the face of emotional intensity  Revising understanding of emotional world  Ending as emotionally crucial

 Further challenges ahead

Developing and understanding self

Through their journey, most participants began understanding and developing a sense of themselves living with emotional intensity. Within this theme there were three subthemes about the way in which people felt they changed through STEPPS-EI:

 Shared experience helped understanding of self

 Developed awareness and ability to manage emotional intensity  Developed understanding of own ability to change

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Developing in relationships

The emotional journey took participants through STEPPS-EI alongside other group members. This led to a theme around participants’ experiences with relationships with group members, facilitators and people in their lives outside of the group, which were covered in the following five subthemes:

 Developing trust with group members  Coping with difference in the group

 Developing trust with facilitators (people running the group)  Questioning facilitator competence

 Changes to relationships with people outside the group

Please feel free to contact me if you would like to share your thoughts about these themes or if you have any more questions about this study.

E-mail: [email protected]

Address: Salomons Centre for Applied Psychology, 1 Meadow Road, Tunbridge Wells, Kent, TN1 2YG.

Thank you again for your time and attention. Best wishes,

Sabine Harland

Complaints procedure: If you are at all dissatisfied with the conduct of this research please first contact the researcher ([email protected], Tel.: 01227 92 7166). If you still wish to complain about any aspect of the research project, please contact Professor Paul Camic, Research Director, Dept. of Applied Psychology, at [email protected] or on 01227 92 7166. Canterbury Christ Church University is the sponsor of this research and is therefore responsible for its conduct. If you feel that you have been harmed by this research please contact Professor Paul Camic and he will discuss with you the complaints process of the university.

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Appendix K: Reflective diary and bracketing interview

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Appendix L: Health Research Authority Approval

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Appendix M: NHS trust Research and Development approval

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Appendix N: Participant consent form

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