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This thesis is concerned with the regulation of working hours in the medical profession. Specifically, the research examined the impact of the Working Time Directive on the quality of working life of doctors in Foundation Years 1, 2 and Specialty Trainee Year 1. In order to achieve this objective, the research employed a mixed-methods, cross-sectional design, using qualitative and quantitative methods over the course of four studies. Data were collected over a two year period, between August 2007 and July 2009, in order to coincide with the staged implementation of the Working Time Directive in the medical profession. The data indicated that junior doctors largely welcomed a regulation of working hours and recognised the importance of regulation within the medical profession. In this vein, participants largely viewed the Directive a welcome initiative, recognising the positive impact on health, wellbeing and work-life balance. However, concerns were raised at the impact of the Directive on training and education, with the research highlighting frustration at the means through which the Directive had been implemented particularly in terms of rota design and workforce reconfiguration. In many instances, concerns regarding the impact of the Directive stemmed from a lack of clarity in the change initiatives introduced. In turn, this resulted in confusion regarding the remit of the Directive. The research has identified concerns and negative perceptions of the Directive and considered how these may be addressed. In particular, the research has highlighted issues such as management of expectations, providing greater clarity of information and the importance of staff engagement. This thesis therefore presents a range of policy and practical implications stemming from the research.

High stress in the teaching sector may be a contributing factor to teacher turnover and low retention. Across different populations, research has found that resilience can buffer against stress, anxiety, and depression. However, there is a lack of understanding about the psychological mechanisms that maintain and predict resilience based on theoretical frameworks. The first aim of this thesis was to examine the underlying mechanisms of trainee teachers' resilience at a given time, and whether affective-cognitive mechanisms predict resilience later in teacher training and when working as newly qualified teachers (NQTs). A limitation of existing resilience interventions is that they are often not theoretically driven and do not target on the key processes of resilience. Therefore, resilience interventions have been inconsistent in yielding positive outcomes. The second aim of this thesis was to evaluate whether a mechanism-based resilience intervention is feasible and acceptable to trainee teachers during teacher training. A series of studies were conducted to examine what mechanisms are associated with teachers' resilience. First, a pilot study confirmed the assumption that interpretation bias is associated with resilience. The purpose was to evaluate whether interpretation bias could be a modifiable mechanism associated with short-term stress response, stressors, and resilience among teachers, which informs the decision to adapt a positive interpretation bias training for resilience in Study 3. Then, using a cross-sectional and longitudinal approach (Study 1 & 2), we examined whether perceived stress and cognitive-affective mechanisms (i.e., interpretation bias, emotion regulation, cognitive control, cognitive flexibility, positive affect, anticipatory pleasure, responses to positive affect, meaning in life, and positive meaning finding) are related to resilience, and whether these mechanisms predict trainee teachers' future resilience. Overall, the results suggest that perceived stress and cognitive-affective mechanisms were associated with trainee teachers' resilience cross-sectionally (while controlling for the effects of age and gender). However, they did not consistently predict trainee teachers' future resilience. Notably, interpretation bias was significantly associated with resilience among qualified and trainee teachers, and consistently predicted trainee teachers' future resilience. Based on this finding, a resilience intervention that targets interpretation bias is warranted. Therefore, in Study 3, we conducted a pilot and feasibility study to promote resilience in trainee teachers via a mechanism-focused intervention (cognitive bias modification for interpretation; CBMI). Overall, we found that the adapted CBMI was feasible and acceptable to trainee teachers. However, revising the intervention length is necessary to improve adherence rates. This thesis contributes to the literature by identifying modifiable cognitive-affective mechanisms of resilience among teachers. This thesis sets the stage for the development of effective mechanism-based resilience interventions and informs future randomised controlled trials.

Background: The teaching profession is known to be a highly pressured work environment, with a high number of teachers suffering from significant levels of work-related stress, alongside a high prevalence of depression and anxiety disorders. Together, these can have detrimental impact on teacher-related outcomes, such as low teaching self-efficacy, increased burnout and absenteeism; classroom-related outcomes, such as poor student-teacher relationships, and reduced student wellbeing. Aims: this review aims to explore, (i) whether there is a relationship between occupational stress and symptoms or diagnoses of depression and/or anxiety experienced by teachers, (ii) whether there are other factors that influence the relationship between occupational stress and depression/anxiety. Method: Four databases (Medline, PsycINFO, Education Resources Information Center, and Teacher Reference Center) were explored using the inclusion and exclusion criteria around teacher occupational stress and mental health outcomes. Eligible articles were extracted and screened by the author, and 20% by the second reviewer, at title and abstract stage and then full-text stage. All studies were quality assessed by the author and second reviewer using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The procedure for this systematic review is in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Eighteen studies over the past 30 years were identified that investigated the relationship between occupational stress and depression and/or anxiety. Seventeen of these studies identified at least one statistically significant association between experiences of work-related stress and depression and/or anxiety symptoms or disorders. Additionally, several studies identified other factors that may impact this relationship, including gender, school type (i.e., primary or secondary schoolteachers), non-restorative sleep, and burnout. Methodological considerations revealed that many studies had small sample sizes, were of cross-sectional design, and overall used a large range of occupational stress and mental health measures. Conclusion: The eligible studies, identified in this review, consistently demonstrated that teachers who perceive greater stress in the teaching environment reported greater depression and anxiety symptomology and disorders. The review explores methodological limitations and issues to consider in terms of interpretation of the findings, as well as outlining ideas for future research and intervention. It is therefore important that more research is conducted to establish predictive and mediating factors of depression and anxiety in teachers faced with high levels of work stress. This could also help support those at-risk in the teaching profession via early identification of mechanisms associated with anxiety and depression in the context of work-related stress and the development of targeted, preventative, interventions.