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Overview This study sought to further understanding within the research field of stigma resistance in people with intellectual disabilities (ID). Part 1 comprises a systematic literature review of the psychological and social impact of self-advocacy group membership on people with ID. Twelve studies were identified and evaluated. Several outcomes were reported, including empowerment, a sense of belonging and changes to self-identity. Implications of the findings of the review include a need for quantitative studies and co-construction of research agendas with self-advocates. Part 2 comprises a mixed methods uncontrolled feasibility study of a psychosocial intervention to increase the capacity of people with ID to manage and resist stigma. Sixty-eight participants from ten pre-existing groups of people with ID were recruited, along with their pre-existing facilitators. Findings indicated that all ten groups completed the intervention, with improvements in self-esteem and psychological distress. Qualitative feedback indicated factors affecting feasibility and suggested adaptations to inform the development of the intervention. Participants perceived improvements in stigma resistance and other areas. The recruitment rates and positive effects suggest it is worthwhile to proceed to a controlled trial of the intervention. This was a joint project together with another D.Clin.Psy trainee (Colman, 2018). Part 3 comprises a critical and reflective appraisal of the process of conducting the study outlined in Part 2. Issues considered include the author's professional values and theoretical influences, along with a consideration of the levels of context that influenced the qualitative data collection.

Traditional medicine use is common and diverse amongst patients in the United States. Many do not tell their healthcare providers about their traditional medicine use nor do healthcare providers typically have the time to ask. This creates a barrier to the care received because the patient and healthcare provider do not communicate fully about treatment options. The goal of this study was to increase communication about traditional and integrative medicine by putting together a survey following the analysis of these ethnographic interviews. Working within the Boston Center for Refugee Health and Human Rights at Boston Medical Center, I interviewed refugee and asylum seeking patients and their healthcare providers about traditional medicine use. This included a demographic survey and qualitative, open ended interviews. I formally interviewed 27 refugee and asylum seeking patients and spoke with several healthcare providers throughout the study. The majority of interviewees were female and from Africa, reflecting the demographic of patients throughout the clinic. Eighteen patients reported using herbal remedies at some point in their lives, more than half using herbs in the United States. Participants were much more open to discussing herbal remedies and religious healing than other practices, like ancestor worship. I hope to increase healthcare providers' awareness of these issues and help them navigate this conversation topic with patients. Demonstrated understanding of their patients' views of disease and medicine will potentially help the patients feel more comfortable in the clinic. In addition, it will enable both sides to be as open as possible with one another about treatment pathways.