The literature supports the existence of the phenomenon termed cognitive dissonance, and one can distil the principles underlying its production, maintenance and reduction. This body of literature may provide insights into the conduct of therapy generally, as well as into the mechanisms of specific therapies which may guide modifications or development of alternative interventions.

The concept of cognitive dissonance can clearly be seen to be of use in understanding the mechanism of action of MI. It can further be of use in guiding modifications to this existing intervention. This concept, and others available through the experimental psychological literature, can be of use in all branches of clinical psychology.

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Thesis versionI confirm that the electronic copy I am depositing is the version of record. This version is as approved by the examiners at the time of the award of my degree. I understand that I can provide additional supporting documentation and multimedia as separate files. Author's rightsIn granting permission to deposit the thesis in Eprints, I am also granting permission to make the thesis available on SRI Open Access, the University of Surrey's open-access, not-for-profit repository , and the British Library EThOS repository http://ethos.bl.uk, I understand that: 2.1 Rights granted to the University of Surrey, the British Library and the user of the thesis through this agreement are nonexclusive. I retain all rights in the Work in its present version or future versions.

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DCE MRI may be more sensitive than a SQ score at detecting post-therapy synovial changes. The association between EER and symptomatic response to IACS may reflect a closer relation of this biomarker to synovial inflammation than with volumetric assessment.

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