Browsing by Author "Kaminer, Debbie"
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- ItemOpen AccessAn analysis of therapeutic failure in psychotherapy with a deaf client : a training psychologist's experience(2011) Srubisky, Catherine Filippa; Kaminer, DebbieThis mini dissertation attempts to understand the early stages of a psychotherapeutic process between a trainee psychologist and a Deaf client. Both a social constructionist perspective of the experience of being disabled/Deaf, and an intersubjective lens, have been utilized in order to understand the nature of the therapeutic failures that occurred and how they functioned. A psychoanalytic case methodology was used to analyse the first eight sessions in the psychotherapeutic process with a Deaf client and members of her family.
- ItemOpen AccessAssessing post-traumatic responses among South African adolescents : a comparison of different methods(2002) Suliman, Sharain; Kaminer, DebbieThe present study compares the use of standardised diagnostic clinical interviews, self-report scales, and unstructured interviews, to determine if these different methods of assessment elicit the same or similar information with regards to trauma exposure, post-traumatic stress disorder, and depression in adolescents. A sample of Grade ll learners was drawn from two schools in the Northern Suburbs of Cape T own. The total sample comprised of 58 learners between the ages of 16 and 18 years. Each participant was administered a demographic questionnaire, a clinical diagnostic interview, two self-report scales, and an unstructured interview. The diagnostic interview used was the Schedule for Affective Disorders and Schizophrenia for School-Aged Children - Present and Lifetime version (K-SADS-PL), and the self- report scales used were the Child and Adolescent Trauma Survey (CATS) and the Children's Depression Inventory (CD1). The demographic questionnaire and qualitative interview were devised for the study. The McNemar Chi-Square statistic was used to determine differences between the interview and self-report methods of assessment, and a content analysis of the qualitative interview was conducted. Additionally, a Receiver Operating Characteristic analysis was used to establish a CATS score, indicating a high risk of PTSD, that was more sensitive to the sample. The results indicate that even though clinical interviews and self-report scales appear to produce different information, if appropriate cut-off points are used, self-report scales can be used as a screening device to reduce the number of clinical interviews required, thus contributing to a more efficient use of resources. They also indicate that unstructured qualitative interviews can elicit useful information about post- traumatic responses that is not captured by the DSM IV criteria.
- ItemOpen AccessCaregivers' experience of caring for a family member with schizophrenia in conditions of poverty(2008) Breen, Alison; Kaminer, Debbie; Swartz, LeslieThe aim of this study was to explore the experiences of South African caregivers caring for a family member with schizophrenia, living in conditions of poverty. Of particular interest in this research was to explore the factors that present challenges to their capacity to care and the factors that facilitate coping. A qualitative methodology was utilized, making use of semi-structured interviews which were conducted with ten caregivers caring for a family member with schizophrenia. Data were analysed using analytic techniques from grounded theory. Six broad themes emerged during analysis, namely: caregivers' assistance with activities of daily living; involvement with illness management; knowledge of illness; consequences of caregiving; coping with care giving; and the impact of poverty on care giving.
- ItemOpen AccessChanges in client functioning during treatment at a secondary stage addiction facility: an analysis of case records(2014) Hazell, Nic; Kaminer, DebbieRecent findings indicate that South Africa and, in particular, the Western Cape has some of the highest prevalence of substance use disorders and substance related problems in the world. Further, in the past decade, the prevalence of poly-substance use in South Africa has grown considerably. The high prevalence of substance use disorders and related problems in the Western Cape relative to an already significant national problem highlights the importance of local research on the effective treatment of substance use disorders. While there are outcome studies supporting the effectiveness of various addiction treatment models, and much is known about the various stages of intervention at addiction treatment facilities, little is known about the processes and mechanisms of addiction treatment and recovery. Various authors have proposed that researching patient progress through treatment is essential to growing our knowledge, improving treatments and generalising them to other settings. This study aimed to investigate client case files at a secondary stage addiction treatment facility in Cape Town to explore whether there were any discernible patterns in clients' functioning across different stages of treatment. The research took the form of a case study that used thematic analysis to discern patterns in qualitative data regarding reported observations of client's behaviours, cognitions, affects and physical states at different stages of addiction treatment. Comparisons were also made between the observations of clients with Axis II personality traits and those without Axis II personality traits, and between clients recovering from stimulant addiction and those recovering from non-stimulant addiction. The participants comprised a sample of 33 clients of a secondary stage addiction treatment facility in Cape Town, South Africa. Analysis yielded a number of possible patterns in the distribution of themes across time-points, some of which resonated with previous research, particularly regarding second order change, but also regarding Protracted Withdrawal Syndrome and 'The Wall'. The comparative analysis indicated that there might be both similarities and differences between subgroups of clients that may shed light on the use of matching hypotheses in the context of addiction treatment.
- ItemOpen AccessCharacteristics associated with attendance of follow-up at a post-rape care centre in Cape Town, South Africa(2016) Ncube, Nozwelo Ntombizami; Gevers, Anik; Kaminer, DebbieBACKGROUND: Rape is associated with a range of negative health and mental health consequences. Despite the establishment of post-rape care centres in South Africa, challenges of retaining rape survivors in care continue to be faced across the country. Very little evidence on the characteristics associated with rape survivors who return for follow-up and those lost to care at post-rape care centres has been documented in South Africa. This study sought to identify the demographic factors, rape incident characteristics and social support factors that are associated with attendance of follow-up appointments at a post-rape care centre in Cape Town, South Africa. METHOD: A retrospective case file analysis was conducted on 254 files of rape survivors who presented and were given follow-up appointments at a post-rape care centre in Cape Town, South Africa from September 2010 to August 2011. Data were extracted using a data collection form which was developed using counselling and medical records in the survivors' files and analysed using SPSS version 21. Descriptive statistics were generated on the survivors' demographic information, rape incident information, medical information, and support systems. Chi-squared test and Fisher's exact test were used to test for differences between survivors who completed all their follow-up appointments, those who attended but did not complete follow-up appointments and those lost to care. RESULTS: Of the total sample 64.6% (164) attended their one week follow-up appointment. From those who attended their one week follow-up appointment, 47% (77) came for their six weeks appointment and approximately half of those who attended their six weeks appointments (51%, n=39) attended their three month appointments. Survivors of rape were significantly more likely to attend follow-up appointments if they were female, incurred injuries during the time of the rape, or received family support post-rape. CONCLUSIONS: Female gender, injury during rape and family support were associated with attendance of follow up care in this sample of rape survivors. Recommendations for future research and for enhancing attendance rates at rape treatment centres are considered.
- ItemOpen AccessChildhood sexual abuse and HIV positive status among South African women : the role of revictimization(2006) George, Meg; Kaminer, Debbie; Gobodo-Madikizela, PumlaSouth Africa has a very high rate of HIV infection, particularly among women. This exploratory study investigated the role of revictimization in the relationship between childhood sexual abuse and adult HIV positive status among women being treated at district clinics in Cape Town The present study utilized both psychological and feminist theories to understand internal psychological dynamics and contextual factors that impact on revictimization leading to increased HIV risk. A qualitative feminist methodology with a collective case study design utilizing five in-depth interviews was conducted with HIV positive women who had experienced child sexual abuse. The central findings of the study revealed psychological patterns of negative stigmatization, self-blame, mistrust and isolation which may fuel a dependent need for connection with intimate partners, thereby increasing risk for revictimization. Revictimization was pervasively present in adulthood, with HIV infection being a consequence of ongoing sexual and/or physical assault in long-term intimate relationship. Participants reported not using condoms consistently. For these participants, an incapacity to insist on condom use by partners was understood in the context of ongoing sexual and physical violence and threats by their partners, rather than unassertiveness as has been commonly noted. In essence, it was noted in this study that participants who experienced child sexual abuse were disempowered due to both psychological processes and broader social inequities which made them particularly vulnerable to contracting HIV. However, the findings are provisional due to the methodology utilized. Recommendations for future research and HIV prevention and policy are offered.
- ItemOpen AccessChildren's representations of sources of safety in a high violence community(2013) Baillie, Kim Lisa; Kaminer, DebbieSouth African youth are at risk for injury and victimisation and those living in high violence contexts are particularly vulnerable to physical threats. Insight into how children keep themselves safe has immense practical relevance, however little has been documented regarding children's perceived sources of safety. Using the methodology of Photovoice, ten children were recruited from a high violence community to take photographs of "things", "people" and "places" that made them feel safe. Interviews were then conducted with the children about their photographs. Using thematic analysis, photographs were first categorised to identify which sources of safety were most commonly represented by participants. Thereafter, the narratives of participants' photographs were analysed to develop an understanding of how and why these sources of safety were salient. In the analysis of the photographs, public spaces were more frequently represented as safe than private ones. Other children were more frequently identified as sources of safety than adults and there was a prominent concern with physical barriers and home security mechanisms. The analysis of participants' narratives revealed that the above places, people and items afford safety by providing (1) physical security (2) interpersonal connectedness (3) spiritual connectedness; and (4) the improvement of social conditions through the development of infrastructure. These findings are considered in relation to existing literature and recommendations for child safety promotion strategies and for future research are offered.
- ItemOpen AccessThe contribution of different forms of violence exposure to internalising and externalising symptoms in young South African adolescents(2013) Du Plessis, Bernice; Kaminer, DebbieStudies conducted in high income countries have increasingly recognised that youth who are violently victimised are often victimised across more than one life domain, a pattern of violence exposure termed poly-victimisation. Further, poly-vicimisation has been associated with a greater severity of internalising and externalising symptoms than single types of exposure. However, there is a dearth of studies on the rate and impact of poly-victimisation among youth in South Africa. The current study assessed the rate of exposure of younger adolescents (N = 616; mean age 12.8 years) in a high-violence, low-income community in Cape Town to domestic, community, school and sexual violence either as victims or witnesses. It further explored the independent and relative contributions of each different type of violence exposure, and of polyvictimisation, to the severity of depression, aggression and conduct problems. Participants in Grade 7 at nine schools completed questionnaires measuring demographic variables, violence exposure, and symptoms of depression, aggression and conduct problems. Almost all of the participants (98.9%) had witnessed violence in their neighbourhood, 40.1% were victims of violence in their neighbourhood, 58.6% had been victims of violence in their homes, 76% had witnessed interpersonal violence in their homes, 75% had been exposed to school violence, and 8% reported experiences of sexual abuse. The median number of violence types participants were exposed to was four, with poly-victimisation being extremely prevalent: 93.1% of the sample were exposed to more than one type of violence, with 75% having been exposed to more than three different types. In a multivariate analysis, female gender, being a victim of domestic violence and poly-victimisation each made a significant independent contribution to levels of depression; being a victim of domestic violence, witnessing community violence, being a victim or witness of school violence and being sexually violated each made a significant independent contribution to levels of aggression; and being both a victim and witness of violence in the home and in the neighbourhood, together with male gender, each made a significant independent contribution to conduct problems. Poly-victimisation did not contribute significantly to levels of aggression or conduct problems. Being a victim of violence at home conferred the most risk for depression, aggression and conduct problems. The findings indicate that for the young adolescents in this study, violence exposure can be viewed as a condition as opposed to a discrete event, and that in this context of high rates of poly-victimisation, domestic victimisation stands out as the strongest risk factor for both internalising and externalising symptoms. Intervention implications and recommendations for future research are discussed.
- ItemOpen AccessCoping strategies of community health workers providing home-based care for HIV/AIDS : a comparison of high & low burnout groups(2003) Dullabh, Kirtesh Mohan; Kaminer, DebbieThis study aims to explore the coping resources that community health workers (CHWs), providing home-based care to people with AIDS (PWAs), draw on in response to stressful work experiences. Furthermore, the study explores whether different coping mechanisms are utilised by health care workers at different points on the burnout continuum. CHWs were selected from a community outreach organisation in Cape Town. A Xhosa version of the Maslach Burnout Inventory (MBI) was administered to forty-five CHWs. From this group, twelve participants were selected for in-depth interviews, six from both the higher and lower ends of the burnout continuum. Thematic analysis of the interviews indicate that both the High and Low Burnout groups contront similar stressors as a result of going beyond the call of duty, community and familial stigmatisation and working in adverse conditions. In addition, CHWs from both groups have difficulty articulating their emotional needs. The groups differed on the number of HIV/AIDS caseloads, with the High Burnout group treating more PWAs than the Low EE group. Carers also differe in their coping styles: High Burnout participants rely more on emotion-focussed coping, denial and escape avoidance, and appear to have a limited repertoire of coping skills, while Low Burnout participants are more predisposed to using problem-focussed coping with the flexible inclusion of emotion-focused approaches. The study also highlights how the context of care affects coping. Limitations of the present study are discussed, and recommendations made for future research and practice in the field.
- ItemOpen AccessCounselling survivors of crime: the psychological impact on volunteers(2013) De Kock, Nicola; Kaminer, DebbieThe purpose of this study was to explore the negative and positive psychological impacts on victim support volunteers who counsel survivors of crime as part of the Victim Empowerment Programme (VEP). A qualitative, multiple case study research design was employed. Semi-structured interviews were conducted with 12 Cape Town based participants who are volunteer counsellors of the VEP. The data were analysed using thematic analysis. While the majority of the sample had experienced negative symptoms at some stage in their volunteering history, these symptoms were generally of a transient nature. The themes relating to these negative consequences included: continued concern for or unwanted thoughts about past clients and cases; sleep disturbances; feelings of despondency in relation to the work; avoidant behaviours; difficulty regulating emotions; and reduced empathy and tolerance for certain types of crime survivors. All of the participants reported positive consequences of a long-term nature as a result of their support work, including: the witnessing of benefits to crime survivors; the volunteers' experience of the work as rewarding and fulfilling; and, personal growth and development. A final theme which defied simple categorisation as either positive or negative was the participants' increased awareness of safety and security needs due to their volunteer work. Factors raised by participants that were considered to have an impact on their negative and positive experiences were: training and education; organisational processes and support structures; partnerships with other organisations; and individual factors. Recommendations for future research are offered, as well as suggestions regarding ways to better protect volunteers from the possible negative psychological consequences associated with their support work, and to enhance their potential to experience positive impacts.
- ItemOpen AccessAn evaluation of the Learning Support Group programme at the UCT Child Guidance Clinic(2008) Daniels, Aneesa; Kaminer, DebbieThe objective of the Learning Support Group (LSO) programme at the UCT Child Guidance Clinic (COC) is to develop the academic and psychosocial functioning of children with learning difficulties. The programme operates on the rationale that remediation alone cannot address the multiple needs of the learning-disordered child, and that psychotherapeutic intervention for the child and for his or her parents may enhance the 'child's academic, emotional and behavioural functioning. This study evaluated the programme outcomes for the child participants (n=6), and for the participating parents (n=9), of the 2006 LSO programme. A single-group pre- and post-measures design was used. Data were triangulated from multiple sources including pre- and post-intervention semi-structured interviews with the children and with their parents, qualitative reports from the children's teachers, parents' and teachers' ratings of the children's cognitive and behaviour problems on the Conners' Rating Scales - Revised, the children's school reports, and scholastic tests conducted by the LSO remedial teacher. A combination of qualitative and quantitative analytic methods were employed. Findings from the evaluation indicated a statistically significant improvement in the children's academic functioning and in their problem behaviours, and qualitative reports of progress in their social relationships. The participating parents' reported that their knowledge and understanding of learning disorders had increased, alongside the acquisition of parenting and homework strategies. Parents also experienced positive shifts in their parenting style and in their relationship with their child. Given a number of methodological limitations, the extent to which the LSO intervention is responsible for these shifts cannot be conclusively established, however, the findings suggest considerable promise for its efficacy. Recommendations for the evaluation of similar programmes are offered, based on the lessons learned from the current study.
- ItemOpen Access"A father doesn’t just have to pay the bills and be all manly" : constructions of fathering among adolescents in a low-income, high violence community in Cape Town(2015) Helman, Rebecca; Kaminer, DebbieIn light of research which suggests that father involvement is associated with positive outcomes for children, including emotional, social and financial benefits, the high rate of father absence in South Africa has been interpreted as a ‘crisis’ of fatherhood (Ratele, Shefer, & Clowes, 2012). However, there is a lack of research that explores fathering and fatherhood from the perspective of South African children. This study aimed to investigate the ways in which a group of nine female and five male adolescents in an urban, low-income community of Cape Town discursively construct the roles and responsibilities of fathers in their community. Using Photovoice methodology, participants produced photographs of ‘fathering in my community’ and then participated in a photo-elicitation interview. The interview transcripts were subjected to a discourse analysis to identify discursive constructions of fatherhood. Consistent with previous research which has been conducted with fathers, participants drew on hegemonic discourses which positioned fathers as financial providers and protectors, and mothers as ‘natural’ care-givers and nurturers. Fathers were predominantly represented as failing to fulfil their roles and responsibilities. However, there were also instances in which participants resisted these dominant discourses through drawing on a discourse of ‘involved’ fathering which positioned fathers as nurturers and carers. Participants also discursively constructed a form of non-biological ‘social father’ who could fulfil some fathering roles. In light of these findings it appears that there is a need to challenge rigid and inflexible hegemonic constructions of fathering (and masculinity more generally), and to elaborate contesting versions of fatherhood, in order to make alternative, more fluid subject positions available to men as fathers.
- ItemOpen AccessInterrogating the 'crisis of fatherhood' : discursive constructions of fathers amongst peri-urban Xhosa-speaking adolescents(2015) Malherbe, Nick; Kaminer, DebbieMass media as well as academic literature frequently refer to the high prevalence of paternal non-residence in South Africa as a 'crisis of fatherhood'. To interrogate this apparent 'crisis', this study explored how Xhosa-speaking adolescents - whose voices have been predominantly ignored in fathering literature - discursively construct fathers and fathering. Using Photovoice methodology, semi-structured photo-elicitation interviews were conducted with 17 male and female adolescents. These interviews explored fathering practices, the duty of the father, and the different kinds of fathers or fathering forms available in their community. The interviews were then analysed through discourse analysis. It was found that participants drew on eight interpretive repertoires, namely: Fatherhood as a Choice, Gendered Parenting, Maternalism as Natural Parenting, Fragmented Fatherhood, Inactive Fathering, Provider and Childrearer, Essential Father Versus the Important Father, and Collective Enterprise of Fathering. What emerged from the data was a fragmented, agentic conceptualisation of the father, who was expected to embody both 'new' and traditional parenting to varying degrees. Fathering, as well as mothering, was constructed as being performed along gendered lines, with 'good fathering' taking on an overtly active form. The discourse established the father as a secondary parent to the mother, and although biological fathering was prized over social fathering, the community father - a particular kind of social father who channels paternal energy into community concerns - was valued in a similar manner to the 'essential' or biological father. With little or vague rationalisation given to the biological father's 'specialness', the results of this study seem to indicate that the crisis of fathering is a product of a hyper-idealistic, gendered, classist conceptualisation of the nuclear family as an essential family form. The notion of the nuclear family as normative and desirable acts to limit appreciated forms of fathering to material provision, and may contribute to children feeling that they do not have a father, despite receiving adequate social fathering. Implications of these findings for future research, and for family intervention programmes in the South African context, are discussed.
- ItemOpen Access"It's not for fun anymore": perfomance of masculinity as a source of stress among professional soccer players in South Africa(2016) De Abreu, Chantelle Silva; Kaminer, DebbieYouth from lower socio-economic status communities have been reported to perceive involvement in sport, and the potential of a career therein, as important for social mobility and identity. Males from these communities have been reported to make more of an investment in sport since it is perceived as the main source of supporting a family, as well as establishing a sense of hegemonic masculinity, as other options are often limited. The research aims of this study were to determine the stressors that South African professional soccer players face, with a focus on how masculinity shapes their experience of stress. The study examined how the pursuit of hegemonic masculinity is played out amongst elite South African soccer players and how this influences the personal and professional stressors that players have to negotiate. Semi-structured interviews with ten male athletes aged between 21 and 33 years from a professional soccer club in Cape Town, South Africa were conducted. Thematic analysis, adopting the lens of masculinity theories, was used to identify themes that emerged from the data. Across the interviews what strongly emerged were the off-field performances of masculinity which indicated how gaining acceptance in professional soccer is performed through a lifestyle of consumer products, women, fame, alcohol and partying. The data indicated how soccer provides an alternative way of life to gangs and crime in which men can still attain masculinity. However, with the option of attaining masculinity through soccer, came its own set of challenges as participants indicated the disparity within a soccer player's identity between the fantasy and the reality of being a professional soccer player. In addition there were also challenges to the ability of participants to access on-field performances of masculinity. This study adds to the literature on stress amongst athletes by exploring how social identity, and particularly masculinity, mediates experiences of stress amongst professional soccer players. It highlights the opportunity and need for the development of appropriate player well-being programmes which can be used to support professional athletes.
- ItemOpen AccessMeaning making amongst South African survivors of violent crime(2007) Thacker, Mandy; Kaminer, DebbieThe aim of this study was to explore the meaning attributions, in terms of comprehensibility and significance, held by South African crime survivors in relation to the traumatic event, and to see if existing international research on meaning making and posttraumatic growth (PTG) was relevant in the South African context. A qualitative multiple case study approach was employed. Semi structured interviews were conducted with ten violent crime survivors in Cape Town. The interviews were recorded and transcripts analyzed using strategies from grounded theory. Five broad thematic areas were identified: (1) disrupted schema (2) precursors to meaning making (3) meaning making strategies (4) grappling with meaning and (5) areas of significance/benefit or posttraumatic growth. While some themes reflected previous findings in the international trauma literature, others appeared to be context-specific. The results imply several recommendations for future research and clinical practice with survivors of violent crime in South Africa
- ItemOpen AccessMeaning-making processes among bereaved mothers who have lost a child to cancer(2007) Lipshitz, Marc; Kaminer, DebbieThe loss of a child constitutes a crisis of meaning, as prior meaning structures and fundamental assumptions about the world are shattered, and the natural order of life and death is undennined. Traditional models of mourning, premised on Freud's 'grief work' approach, do not address the concept of meaning-making (cognitive mastery and renewed purpose) during the grieving process, and only recently have theoretical models begun to recognize the importance of meaning-making in adjustment postloss. Grounded theory analysis of semi-structured interviews was employed in order to learn how ten bereaved mothers, ranging from thirty-five to seventy-six years of age make sense of, and cope after, losing a child to cancer.
- ItemOpen AccessMeeting the psychosocial needs of refugees and asylum-seekers in South Africa: prespective of NGO service providers(2014) Harverson, Taryn; Kaminer, DebbieSince 1994, South Africa has become one of the major destinations for asylum-seekers and refugees from unsettled countries throughout the African continent. While the international literature has recognised that refugees and asylum-seekers across many different countries have complex psychosocial needs, there is a dearth of literature regarding the psychosocial needs of refugees and asylum-seekers in South Africa. A number of non-governmental organisations (NGOs) provide services to refugees and asylum-seekers in South Africa. However, literature documenting the psychosocial needs that refugees and asylum-seekers present with and the range of services provided by these NGOs is severely limited. In the context of this gap, this study aimed to explore the psychosocial needs that refugees and asylum-seekers in Cape Town present with when they approach an organisation for help, as well as the service provision responses to these needs. In order to do this, a qualitative study focusing on service providers' perceptions about the psychosocial needs of refugees and asylum-seekers in Cape Town, and of service responses to these needs, was conducted. A qualitative approach was used in order to elicit in-depth data from multiple perspectives. Semi-structured interviews were conducted with 14 service providers recruited from four NGOs in Cape Town. Thematic analysis was used to analyse the data generated from the semi-structured interviews. The results of this study emphasise the need to address social and material conditions resulting from conflict and displacement. These needs were perceived as most pressing and immediate. Furthermore, the service provision responses to these needs align with the ecological model, adding to literature that suggests that a multi-modal response is more appropriate for refugees and asylum-seekers than a bio-medically focused response. The findings of this study may contribute to the development of a systematic framework for understanding and responding to the needs of refugees and asylum-seekers in South Africa, and potentially other low and middle-income countries.
- ItemOpen AccessOedipal dynamics between a male-female co-therapist dyad and a group of adolescent boys with learning difficulties : a case study exploration(2005) Ismail, Faldiela; Kaminer, DebbieTheoretical literature indicates that a male-female co-therapist dyad in a psychotherapy adolescent group provides for the opportunity of parental transferences, including Oedipal conflicts, to occur. However, limited empirical data is available regarding male-female co-facilitation in therapeutic groups for adolescent boys with learning difficulties, especially concerning the re-activation of the Oedipal complex. This dissertation explored the usefulness of Oedipal theory for understanding the interactions that emerged between a group of adolescent boys with learning difficulties and a male-female co-therapist dyad. The study was located within a theoretical context of understandings of the re-activation of the Oedipal complex during the developmental stage of adolescence, and the manner in which learning difficulties contribute to and maintain difficulties in children's cognitive, social and emotional development. The research takes the form of a psychoanalytic case study. Vignettes drawn from clinical case material of the psychotherapy adolescent group of the Learning Problem Programme (LPP) at the Child Guidance Clinic of the University of Cape Town were analysed using a psychoanalytic framework. The group members consisted of 10 adolescent boys, mainly from disadvantaged communities in the 'Cape Flats' area of Cape Town. Analysis of the case material indicates that the manner in which Oedipal phenomena unfolded was influenced by multiple factors, and highlights the limitations of an interpretive therapeutic model in group work with adolescent boys who have learning difficulties. Recommendations for the LPP psychotherapy group, and for group work with adolescent boys with learning difficulties in other contexts, are offered.
- ItemOpen AccessPsychology interns' experiences of working with survivors of violence at psychiatric hospitals in Cape Town(2010) Casson-Crook, Martine; Kaminer, DebbieSouth Africa has very high rates of violence and many people who are treated within psychiatric hospitals have been exposed to interpersonal violence. However little has been documented about trauma interventions in the South African context. Twelve clinical psychology interns completing the second year of their clinical masters training at Valkenberg, Groote Schuur and Lentegeur Hospitals were interviewed. The interviews were recorded, transcribed, coded and analysed according to grounded theory methodology, in order to establish: the kinds of violent experiences to which patients are exposed; patients' presenting complaints and diagnostic trends that were noticed amongst patients; the therapeutic work that is being undertaken with patients by interns and the theoretical models on which their work is based; the various challenges that interns encounter in their work with survivors of violence, and the training issues that arose for interns during the course of their work. The findings were compared with the available literature regarding the impact of exposure to violence and models of intervention, which is based predominantly on research conducted in economically developed countries. It was established that rates of exposure to violence are very high amongst the psychiatric patients seen by these interns and multiple traumatisation was felt to contribute to the complexity of their patients' presentations. Despite having received some training in working with survivors of violence during the course of their generalist training, interns felt ill- equipped to work with many of these patients because of the degree of complexity of patients' problems, including the contextual issues which continue to impact on patients. Most interns reported that they would have benefited from more specialist training. Existing theoretical models formed the basis for the interns' understanding of the psychological impact of exposure to violence but established intervention models were felt to be mostly inadequate with this patient population. In light of these findings areas for further consideration and research are suggested.
- ItemOpen AccessRape crisis counsellors' experiences of working with rape survivors in Cape Town(2010) Gregorowski, Claire; Kaminer, DebbieThis exploratory qualitative study documents the clinical knowledges gained by Rape Crisis counsellors working with rape survivors in Cape Town. It includes a description of the demographic profile of their clients, the rape experiences that their clients report, the psychological difficulties that clients present with, the methods of treatment being offered by the Rape Crisis counsellors, and counsellors' experiences regarding the effectiveness and/or limitations of these interventions. The research is conducted from a phenomenological hermeneutic framework. A semi-structured interview was developed for the research and was administered to eight counsellors and three counselling co-ordinators across the three Rape Crisis centres in Cape Town. Data were analysed using grounded theory analysis techniques. The research found that for the survivors of rape presenting for treatment at Rape Crisis, the experience of childhood sexual assault (CSA) was common, and that many survivors have experienced multiple traumatisation, or experience multiple ongoing stressors in addition to dealing with the impact of rape or CSA. Participants reported that survivors experience similar patterns of post-rape symptomotology as described in international literature. Treatments offered by participants were guided by the principle of empowerment and closely resembled feminist counselling models. The majority of participants' counselling work focussed on the early stages of recovery from trauma described in the literature, namely establishing physical, community, interpersonal and emotional safety. Establishing physical safety required that participants draw on an extensive network of non-government and other organisations. Treatment also focused on helping survivors to talk about their traumatic experiences and facilitating their connection with others. Participants commonly reported experiencing vicarious traumatisation as a result of their work with clients. The most commonly reported barriers to treatment were clients' conditions of poverty and the limited amount of sessions participants are able to offer due to limited resources. Despite these, the participants reported observing positive change in many of their clients following treatment.