OpenUCT :: Browsing by Author "Gibson, Kerry"

Browsing by Author "Gibson, Kerry"

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Open Access
Are you sure we're talking about the same person? different professional perspectives on a single patient : challenges for an integrative approach within the primary mental health care system
(2000) Brandt, Anneliese; Gibson, Kerry
In 1999 a system of placing intern psychologists in primary health care centres was introduced by the Department of Psychiatry of the University of Cape Town. This allowed interns the opportunity of experiencing and evaluating psychiatric services in situ at clinic level within the primary mental health care system. My own experience as an intern working at a clinic served to highlight some areas of difficulty in offering an integrated approach at a primary level. They are in particular the different perspectives brought to the provision of mental health care by the professionals, and the inequalities in status and work conditions of the partners in mental health care service provision. The differing professional perspectives and their implications for case management are explored through a case study of a single patient and her experience of the service. The study illustrates the way in which effective service provision may be compromised by the inherent differences in the perspectives of the disciplines represented by the professionals, as well as by the failure to recognise the extent and importance of the role played by the psychiatric nursing personnel. It is suggested that the system could be significantly improved by the introduction of a system of consultation between all of the partners to coordinate the care of patients in order to maximise the benefits they derive.
Open Access
Becoming a psychologist : students' accounts of their experiences of clinical training
(2001) Amien, Shoneez; Gibson, Kerry
Interviews were conducted with 14 University of Cape Town Masters' students from three consecutive years to explore their emotional experiences of the professional training in clinical psychology. A qualitative analysis was conducted to identity, in particular, what aspects of their training they found difficult and how they coped with these difficulties. It adopts a psychodynamic approach in examining and understanding the interview material. It was found that trainees struggled mostly with the pervasive feeling of 'not being good enough', feeling unsupported by staff: changes in their interpersonal relationships and challenges facing them in their personal development. Other difficulties identified ranged from trainees' unmet expectations, the heavy workload and the emotional nature of their work. The research highlights the way in which trainees hopes, fears and expectations both conscious and unconscious determines, to a large extent, the way in which the training is experienced and managed. It was identified that trainees coped with these difficulties in various ways. Mostly, however, they coped by talking to classmates and others in the profession, reassessing their expectations as well as distancing themselves emotionally from the painful and difficult experiences encountered during training.
Open Access
Becoming a psychologist : tracing life histories in South Africa
(2003) Petersen, Petal M; Gibson, Kerry
This study explores and aims to identify the narratives found amongst professional psychologists and the establishment of a professional identity in the process of becoming and being a psychologist. It is interested in this process of becoming a psychologist specifically within the South African social context, which may influence the professional development and identity of local psychologists.
Open Access
Cultural and other constraints in help seeking with abusive relationships : the narratives of Xhosa-speaking women
(2001) Mtini, Nolitha Y; Gibson, Kerry
Little is documented about Xhosa-speaking women's experiences and the social and cultural barriers they are faced with when seeking help for the abuse in their marriages. This study explores the experiences of Xhosa married women who are in abusive relationships and have sought help in a counselling organisation. It traces their path of seeking help before they reached the women's counselling centre. The study was conducted by holding in-depth interviews with eight women who live in a township and its surrounding informal settlements in Cape Town. Their narratives are presented in case studies and the discussion of significant themes is presented in a separate chapter. The study suggests that a number of factors influenced their decision to seek help. The women wanted the abuse to stop rather than to leave their marriages.
Open Access
An exploration of Rape Crisis counsellors' experiences of stress and coping in the context of their work
(1998) Hendricks, Karen Rachel; Gibson, Kerry
This study attempts to explore the experiences of stress and coping amongst volunteer counsellors in a Rape Crisis organisation in the context of their counselling work. The literature on vicarious traumatization provides a basis for understanding that trauma counselling can be stressful for counsellors. The study draws on a theoretical base which indicates that neither subjective stress nor coping experiences can be fully understood through a stance which isolates the individual's experience from its context. Informed by the theoretical review and the aims of the study it was decided that a qualitatively design would best access counsellors internal subjective as well as contextually constructed world. The methods of this study consist of a combination of methods, including individual semi-structured interviews, a focus group and accessing information about the organisation. The thematic analysis suggests that counsellors are struggling with issues which stem from the anxieties elicited by the nature of the rape trauma, as well as with parallel institutional and social issues. The themes of transgression of boundaries, the inability to speak out, power and the feminist collective seem to emerge as dominant themes in counsellors expressions of their experiences of stress and coping. These issues seem to parallel the rape, violation, domination, silence and isolation which are part of the social position of women in our society.
Open Access
"Go cry by the river" : a case study of a counselling service for abused women in rural Swaziland
(2000) Washkansky, Denise; Gibson, Kerry
In February 1999 a counselling service for women abuse survivors in rural Swaziland was evaluated. The evaluation highlighted that a number of organisational factors were undermining utilisation of the service. However, the evaluation failed to address broader contextual issues. This study, in the form of an in-depth case study, is a re-examination of the information gathered for the initial evaluation. It aims to explore the contextual issues underlying the poor utilisation of the counselling service. Within a qualitative paradigm, information for the initial evaluation was gathered through participant observation, open-ended interviews and a review of relevant documentation. A thematic analysis revealed that many perceptions about the meaning of the concept of 'women abuse' exist, both between and within the organisation and community groupings. As a result of the lack of a common definition of abuse and due to a pervasive silence around abuse in the community, it was perceived to be difficult for women to utilise local and organisational methods of healing. Furthermore, abuse in the community was perceived to be influenced by the broader context of women's inferior status in Swaziland. Recommendations are made with regard to strengthening the relationship between organisation and community. It is suggested that rather than importing organisational definitions and interventions into the community, the organisation play a facilitative role firstly, in encouraging community members to develop their own definitions of abuse - which are both guided by human rights principles and sensitive to the local context – and secondly, to devise their own strategies to deal with it.
Open Access
Human rights and mental illness : an investigation into the meaning and utility of rights for people diagnosed with mental illness
(2002) Edwards, Davyd; Gibson, Kerry
This study sought to develop an understanding of the ways in which rights are conceived of and made use of by people diagnosed with mental illness. This research sheds light on the processes involved in actualising rights in the lives of people diagnosed with mental illness. It focuses on the experiences of people diagnosed with mental illnesses living in the community.
Open Access
The impact of 'cultural difference' in the therapeutic space : a self psychology perspective on the finding of understanding
(2003) Pecego, Emilita; Gibson, Kerry
This study explored the influence of cultural difference in psychotherapy. This is an issue of particular relevance in South Africa where cross-cultural work is commonly practised. Yet there appears to be a silence surrounding the experiences of therapists who are working cross-culturally. The aim of the study was to explore, from the perspective of the therapist, how a psychoanalytic self psychology approach, allows us to engage and work with difference in the therapeutic space. The method used was a case study analysis of a psychotherapeutic relationship between the researcher, a white therapist-in-training, and a black client. The analysis drew on process notes written after the therapy sessions, and focused on the first year of the therapeutic relationship. The material was analysed using a hermeneutic-psychoanalytic theoretical framework.. Two aspects of the psychoanalytic self psychology approach were identified as potentially useful ways of working with difference: 1) the significance of the role of empathy in therapy and 2) the intersubjective stance which is inherent in self psychology. The case study analysis suggested that by paying attention to empathic processes, it becomes possible for us to track the way in which real and perceived differences between therapist and client can lead to empathic ruptures. The adoption of an intersubjective stance highlights how the therapist-client interaction constitutes the meeting of two subjective worlds which are socio-historically defined, multi-dimensional and fluid. The study suggests that in South Africa, where acknowledging racial difference runs the risk of creating divisions between people, there may be a tendency in therapy, to reframe racial difference as some other kind of difference which is less threatening such as language and/or gender difference. One of the fears behind naming and working with difference which was identified, was the fear of being part of a process that uses racial difference to oppress people. A second fear was that by naming difference, divisions would be created between therapist and client which could threaten a potential connection and jeopardise the therapeutic relationship. The study suggests that only after those unconscious threats and fears have been made conscious, does it become possible to authentically connect cross-culturally and thereafter, to begin to locate the similarities in our experiences.
Open Access
Living with a spoiled identity : HIV positive women talk of stigma
(2004) Rohleder, Poul Andrew; Gibson, Kerry
The purpose of this study is to begin to explore how women experience and deal with AIDS stigma under conditions where they have little support. In-depth, narrative interviews were conducted with ten HIV -positive women, living in a poor, black township in Cape Town. The study used both Social Constructionist and Psychoanalytic theory to understand the impact that their """"spoiled identity"""" had on the emotional lives of these women. The study elicited women's narratives as they talked about the circumstances surrounding their diagnosis, their subsequent interaction with their family and community, and their experiences of living with a spoiled identity. The analysis suggested that the women drew on negative social discourses around HIV, which were then internalized, to become part of the self. However, the narratives also indicated the women's resistance to their stigmatised identity.
Open Access
Nurses' experiences of psychiatric patients with HIV/AIDS: A study conducted in a psychiatric hospital in the Western Cape
(2002) Lengner, Viola; Gibson, Kerry
This study aims to explore the experiences of nursing staff who provide treatment and care for psychiatric patients with HIV/AIDS. The study was conducted with a view to understanding the psychological impact of caring for such patients, the additional stressors which may arise as a result of this and how these are dealt with. It was also intended to assist with identifying the needs that staff may have in order to cope with the demands of their work. Semi-structured interviews were conducted with nine nurses working in the female admission ward of a Western Cape psychiatric hospital. The interview material was analysed to identify common themes which occurred across the interviews concerning participants' experiences, their difficulties and their feelings regarding their work with HIV/AIDS patients. A number of theoretical perspectives were used in analysing and discussing the material, including theories of HIV/AIDS related occupational stress; psychodynamic theory and literature from the field of medical anthropology.The study found that overall, nursing psychiatric patients with HIV/AIDS was experienced as difficult and stressful by participants, and evoked strong emotions of fear and anxiety. The experience of stress in psychiatric HIV/AIDS care was strongly associated with the nature of the work and the anxieties evoked by nursing patients with a terminal, contagious disease. However, the difficulties experienced by participants also appeared to be related to the context of their working environment, and to extend beyond this to the broader social influences of family and community life. The absence of effective support and acknowledgement of these difficulties has resulted in physical symptoms of bum out and the adoption of individual and collective defences in an attempt to cope with the enormous personal and professional challenges of their work.
Open Access
Politics and emotion in work with disadvantaged children : case studies in consultation from a South African clinic
(2002) Gibson, Kerry; Swartz, Leslie
This thesis explores the social and psychological dynamics of consultation partnerships established between a psychological clinic and a variety of children's organisations. The research aims to develop a deeper understanding of the process of consultation by making visible the emotional and political complexities involved. This kind of work is usually informed by the broad principles of community psychology and carries a concern with the broader political context of mental health. Typically, however, this approach gives less consideration to the emotional dynamics of this kind of community work and the subtle forms in which they might appear during the intervention. In this research, the concepts of community consultation are expanded through psychoanalytic theories of group, organisational and social processes.
Open Access
A preliminary investigation into the adjustment to university of first-year students at the University of Cape Town, with particular emphasis on the relative adjustment of black students
(2000) Sennett, Justin; Gibson, Kerry; Finchilescu, Gillian; Strauss, Rosanna
The change from school to university is a major life transition to which many students experience considerable difficulty in adjusting. This process of adjustment is multidimensional requiring that students develop effective strategies for adapting to a host of new demands (Baker & Siryk, 1989) including those found in the academic, social and emotional spheres of development. Yet, in addition to factors relating to individual developmental or background variables, the interactive effects of student demographics and institutional environment may also influence a student's ability to cope effectively with adjustment to university. This may be the case particularly for students of disadvantaged or minority backgrounds, of which, the literature suggests, black African students in South Africa are a likely instance.
Open Access
Psychiatric, traditional and other interpretations of Ukuthwetyulwa : a witchcraft phenomenon in the Western Cape
(1996) Kirk, Jennifer Anne; Gibson, Kerry
This paper attempts to address the way in which a phenomenon that has been constructed within a traditional African framework, is confronted by and reinterpreted within a western psychiatric framework. This in turn may shed light on the way in which psychiatric and traditional discourses may be used in the process of the formation of a collectively accepted understanding of ukuthwetyulwa. The study provides the opportunity to explore the relationship between psychiatric and traditional discourses surrounding ukuthwetyulwa, at a moment in history when the issue of traditional healing practice and its relationship to psychiatry is increasingly on the agenda of mental health policy makers in South Africa.
Open Access
A psychodynamic understanding of trauma and adolescence : a case study exploration
(2001) Mackay, Jodie L; Gibson, Kerry
This dissertation explores the unique ways in which trauma affects adolescents as opposed to children and/or adults. This is an area of research that has not received sufficient attention. The various approaches in defining the concept of trauma are outlined. Developmental challenges and difficulties regarding the period of adolescence are discussed. Emphasis is placed on particular vulnerabilities evoked during adolescence and the importance of looking at a case in its developmental and environmental context. The impact of the environment, which forms the backdrop to the study, is addressed with reference to the South African context. It is observed how trauma and underlying conflicts augment stress already present in adolescence and complicate successful resolution of developmental tasks, such as autonomy in late adolescence. The research takes the form of a case study of an adolescent girl, who experienced a traumatic assault when she was already struggling with the demands of an unplanned pregnancy. The study illustrates the manifestations in late adolescence of the adverse effects of violence-induced trauma as well as the impact of secondary trauma on the family. The adolescent was seen in the context of exploratory family therapy, which was conducted weekly for 8 months. This offered an opportunity to gain insight into the ways she presented symptoms of trauma to other family members. In this respect a psychodynamic approach is shown as a useful way to explore the emotional features after trauma, such as loss, guilt and difficulties with trust, intimacy and safety. This approach highlights the subjective experience of unexpected violence-induced trauma that overwhelms the ego and produces a state of helplessness. Psychodynamic phenomena, such as regression, defenses and the inner world of the adolescent are discussed in relation to trauma and provides the context in which the meaning of trauma can be understood.
Open Access
This ain't a circle : the use of drama and movement therapy in providing containment to adolescents with learning difficulties within a group therapeutic intervention : a case study exploration
(2002) Schiff, Heather; Gibson, Kerry
This dissertation attempts to illustrate by way of clinical material a method of working therapeutically using drama and movement therapy with a group of adolescents with learning difficulties. The study is located within a theoretical context of an understanding of the emotional aspects of learning While many interventions with learning difficulties stress the cognitive dimension of these problems, this study explores their emotional basis and consequences. Bion's theory of thinking and the Container-Contained model of early object relations is used to formulate the idea that the adolescents participating in the study had not yet internalised an object capable of knowing, making it difficult for them to think about themselves and to express verbally their needs and feelings. An important aspect of the therapeutic function, that of providing a container within which to hold feelings and make thoughts thinkable, is thus explicated. It is further noted that the Way in which adolescents communicate their feelings in therapy is frequently beyond words, and ascertained by way of symbolic expression, non-verbal responses and projective-identiﬁcation processes. This assumption is actively engaged by establishing drama and movement therapy as the primary therapeutic mode in the work. The potential of the creative arts therapies in assisting these young people in negotiating their difficulties is explored. Through an analysis of case material, the dissertation explores how difficult feelings associated with learning problems can be enacted, named and recovered for reﬂection and expression Both the notion of the therapist as a container for the adolescents' feelings, as well as the potential usefulness of drama and movement as 'concrete' containers for the exploration of internal and external experience, are examined.
Open Access
Users' explanations of their psychoactive substance use, with a particular focus on MDMA (Ecstasy)
(1999) Zetler, Sarah Ashne; Gibson, Kerry
This study explores ten psychoactive substance users' explanations of their MDMA usage with the aim of investigating how users explain their own substance abuse, and secondly to ascertain if and/or how their accounts diverge or converge with currently used models. Thirdly, it is intended to explore the extent to which users' accounts might contribute to a deeper understanding of repeated psychoactive behaviour.
Open Access
“We are not fresh”: HIV-positive women talk of their experience of living with their spoiled identity
(2005) Rohleder, Poul; Gibson, Kerry
Women have been identified as being at greater risk in South Africa's growing HIV epidemic. Stigma contributes to the epidemic, as it makes HIV positive individuals reluctant to become identified and seek appropriate care. The purpose of this study is to begin to explore how women experience and deal with AIDS stigma under conditions where they have little formal support. In-depth, narrative interviews were conducted with ten HIV-positive women, living in a poor, black township in Cape Town. The study used both Social Constructionist and Psychoanalytic theory to understand the impact that their ‘spoiled identity’ had on the emotional lives of these women. The study elicited women's narratives as they talked about their experience of living with a ‘spoiled identity’. The analysis suggested that the women drew on negative social discourses around HIV, which were then internalised, to become part of the self. However, the narratives also indicated the women's resistance to their stigmatised identity. The narratives illustrated their attempts to fend off the 'spoiled identity' by splitting off these bad representations and projecting them outside of themselves.
Open Access
Working with Ambivalence: Finding a Positive Identity for HIV/AIDS in South Africa.
(2003) Soskolne, Talia; Stein, Joanne; Gibson, Kerry
Psychoanalytic theory draws attention to the way in which a positive identity can be asserted as a defence against underlying anxieties. Focusing specifically on the South African context, this paper highlights the way in which people attempt to forge a positive self-concept in the face of a stigmatised and self threatening HIV identity. In-depth interviews were conducted with twelve women living with HIV in a black South African township. Discursive and psychoanalytic understandings were used to explore the emotional experience of HIV/AIDS and its impact on both the participants of the study and ourselves as researchers. We elucidate the process by which our interviewees vacillated between conflicting notions of health and sickness; empowerment and disempowerment; strength and weakness; purity and contagion; and death and continuity. We argue that a more resilient self can be formed through recognition of both the positive and negative implications of an HIV diagnosis. We also maintain that it is necessary to move beyond the individualizing tendencies of mainstream psychology to recognise the social context and discursive practices which exacerbate stigma and influence the experience of those living with HIV/AIDS.

Browsing by Author "Gibson, Kerry"

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