The role of goal-conflict and awareness in psychological distress and recovery: A Perceptual Control Theory (PCT) perspective

  • Abigail Kay

Student thesis: Doctor of Clinical Psychology


This thesis consists of three papers, a systematic scoping review, an empirical study, and a critical appraisal of the research process. Paper one provides a systematic scoping review that sought to map out the key properties of goal conflict related to psychological distress that have been implicated in the literature. Fifty-two articles were included and a qualitative conventional content analysis identified six overarching categories. The concepts to have received the most research attention to date, in relation to goal conflict and psychological distress were, awareness, hierarchical organisation, psychological flexibility and goal integration. Both awareness and psychological flexibility have been considered in relation to increases and decreases in psychological distress. Therefore, such properties seem fruitful avenues for future research. Paper two is a randomised pilot study to assess the feasibility of a protocol to evaluate whether Method of Levels (MOL) increases awareness of higher-level goals more than other psychological therapies. The study also aimed to examine the feasibility of a novel self-report measure, the Goal-level Awareness Questionnaire (GAQ), to determine its utility for future trials. Forty participants were recruited and 87.5% were retained, exceeding planned recruitment and retention rates. The interventions were deemed acceptable by participants and the credibility and satisfaction ratings were equivalent between groups, indicating that Brief Behavioural Activation (BBA) is a suitable control condition for a future trial. However, the feasibility of delivering MOL via video-therapy and the feasibility of administering the GAQ remains to be established. Revisions to the GAQ are proposed however, validation is required prior to use in a future definitive trial. Paper three is a critical evaluation of the design and implementation of the research process. Clinical implications and personal reflections are also presented.
Date of Award31 Dec 2021
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorSara Tai (Supervisor) & Warren Mansell (Supervisor)


  • Method of Levels (MOL)
  • Goal conflict
  • Awareness
  • Perceptual Control Theory (PCT)

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