M.Ed. (Educational Psychology) / Adolescent-headed households are a rapidly growing form of family both nationally and internationally, due to increased death rates caused by HIV/AIDS, migration of labourers from rural to urban areas, and the weakened state of traditional family safety nets in taking up care. This raises responsibilities of orphaned children, with extended families no longer able to cope due to strained socio-economic circumstances. As a result, older siblings become caregivers to the younger siblings, and have to assume the role of parenting their siblings, ensuring that they are well taken care of financially, emotionally and otherwise. Resilience is needed to rise above adversity and to stand firm despite all the obstacles. This study was conducted to explore how creative expressive arts can explore the resilience of adolescents in adolescent-headed households. Creative expressive arts are a source of healing for people who may experience amongst other things emotional barriers as well as an inability to express feelings. Arts in therapy are also of exceptional value when used with people with learning difficulties. This study was based on a socio-cultural framework by Lev Vygotsky as a framework for the research with critical discussion of relevant literature on resilience, adolescent-headed households and their development, mild to moderate intellectual impairment as well as creative expressive arts. A qualitative research approach was chosen to understand the research topic from the perspective of the participants. For the purpose of the study, the interpretivist paradigm was chosen, which focused on how people create meaning out of their lives and experiences. A phenomenological design was employed and research participants included five adolescents from a school that catered for learners with mild intellectual impairments. The participants were purposefully selected. Data collection methods included semi-structured focus group interviews, artefacts and participant observation. As a method of data analysis, the Interpretative phenomenological analysis was used to identify themes that emerged, namely: “externalising their contextual stories”, “voicing” and “connecting with belief systems”. The study concludes with possible contributions, limitations and recommendations for future research.

D.Ed. (Educational Psychology) / Child-headed households are becoming increasingly prevalent in the absences of parents, especially in township and rural communities. Parents become absent for different reasons, such as needing to find employment away from home or falling ill and dying. Many extended families can no longer financially afford to care for the children within their own homes. Often different family members will take in siblings as they are unable to accommodate them all in their home due to lack of space or financial resources. As a result siblings would be scattered within the extended family. Child-headed households have become a solution whereby siblings could keep living together as a unit as well as staying within their known environment. Often, however, the responsibility of managing the households would be placed on the adolescent girls due to gender-role division. This could leave the girls vulnerable to the possibility of dropping out of school as managing a household, caring for younger siblings and keeping up with academic responsibilities places adolescent girls under intense pressure. The research focused on the gendered experiences of African adolescent girls from child-headed households in Orlando-West, Soweto. A qualitative research approach was used and the study was conducted by means of a hermeneutic phenomenological case study research design. Feminism, as a paradigm and main theoretical orientation, framed the study and findings. The data collection methods included two focus group interviews, one group of girls and one of boys. Three specifically selected girl participants living within the contexts of a child-headed home were selected. Over eight months and by means of individual interviews, the completion of a booklet and photo-voice activities the participants shared their gendered experiences with me within the contexts of a child-headed household. The findings of the data analysis indicated that adolescent girls from child-headed households specific to this study had to make meaning of their lives whilst still being influenced by patriarchal cultural practices and traditions from the past. The division of household chores in the home as modelled by parents was an instrumental factor in initiating gender inequality. The second theme related to the adolescent girls’ daily struggles in adverse circumstances as they had to make meaning and continually adjust to living arrangements that were not always stable. By virtue of their gender, dangers from the community were persistent. Living as a girl within a child-headed household also meant being confronted daily with the socio-economic hardships that influenced being able to attain academic support at school, and purchasing toiletries, food and daily necessities for their families.

In recent years, the move toward a more holistic perspective in health care has led to social scientists investigating psychosocial factors in chronic illness, such as the different languages used by health professionals when talking about nonhealth. However, there has been little inquiry into caregivers' illness experiences of stroke and Alzheimer's disease (AD). This study therefore explores the illness experiences of seven caregivers whose spouses are stroke or AD patients. A hermeneutic approach was adopted and two relatively unstructured interviews were conducted with each caregiver. Using Kleinman's work on illness narratives as an interpretive framework, it was found that - except for people questioning the authenticity of AD caregivers' experiences - similarities in caregivers' experiences outweighed differences. All described the extent to which their lives had been damaged by the illness and their reparation attempts. Critique of the research is presented and the findings' implications for treatment are suggested / M.A. (Clinical Psychology)

In recent years, the move toward a more holistic perspective in health care has led to social scientists investigating psychosocial factors in chronic illness, such as the different languages used by health professionals when talking about nonhealth. However, there has been little inquiry into caregivers' illness experiences of stroke and Alzheimer's disease (AD). This study therefore explores the illness experiences of seven caregivers whose spouses are stroke or AD patients. A hermeneutic approach was adopted and two relatively unstructured interviews were conducted with each caregiver. Using Kleinman's work on illness narratives as an interpretive framework, it was found that - except for people questioning the authenticity of AD caregivers' experiences - similarities in caregivers' experiences outweighed differences. All described the extent to which their lives had been damaged by the illness and their reparation attempts. Critique of the research is presented and the findings' implications for treatment are suggested / M.A. (Clinical Psychology)

Text in English / With the Acquired Immune Deficiency Syndrome (AIDS), first recognised in 1981 as a new disease that subsequently took on pandemic proportions, home-based caregivers became instrumental to ensure that, notwithstanding the encumbered health care systems, people living with HIV and AIDS (PLWHA) receive care, support and treatment within their households to live prolonged dignified lives. Despite their pivotal role in the field of HIV and AIDS care, there seems to be a dearth of literature, and research locally and internationally, from the ambit of Social Work on the topic of how HBCGs manage and cope with the work-related challenges they experience when caring for PLWHA and their need for Social Work support. Through this exploratory, descriptive, contextual and phenomenological qualitative study, I scrutinised the HBCGs’ experiences and associated challenges and the coping strategies they employ to address these challenges as well as their views on how social workers could support them in overcoming these challenges in the specific case on home-based care to PLWHA. Twenty-five HBCGs were identified and recruited through purposive and snowball sampling techniques from twelve home-based care organisations in South African provinces, namely, North West, Limpopo and Gauteng. Data was collected through individual face-to-face semi-structured interviews using an interview-guide. Data analysis was conducted through Tesch’s eight steps (in Creswell 2014:189) while Guba’s model (in Shenton, 2004) was adopted for data verification. Cast against Loretta Williams’ (2014) middle range theory of caregiving dynamics (Williams 2014), the coping theory of Lazarus and Folkman (1984) and the strength-based perspective (Saleebey, 2013) adopted as theoretical frameworks for this study, the following findings were revealed. The HBCGs were motivated by, among other factors, their mere desire to care for PLWHA; their personal experiences of caring for an ill relative; and future career aspirations to become involved in this care work. HBCGs were found to face various work-related challenges in connection with reactions from community members, the patients and their relatives; their unsafe working conditions; as well as from their colleagues, other role players and their own organisations. It was found that for most of the HBCGs their care work saddened, pained and discouraged them. In the midst of feeling sorry for their patients, they feared getting infected themselves, in addition to their work-related challenges that caused them to experience feelings of failure. The strategies adopted to cope with their work-related challenges included getting support from employers, receiving counselling and becoming involved in support groups. Finally, several suggestions were directed to the management structures of HBC organisations, the HBCGs themselves and social workers on how they could address the work-related challenges. Based on the research findings, some recommendations are forwarded concerning guidelines for Social Work support directed at work practice, policies and programmes; associated education and training endeavours; and continuous professional development initiatives, as well as avenues for further research. / Social Work / D. Phil. (Social Work)