Aim: According to the existing evidence-base, the experience of the death of a therapy client (from a cause other than suicide) for Clinical Psychologists is substantially under researched. Moreover, previous studies into the experience of patient or client death for healthcare professionals indicate this may be an important focus for research. The present study aimed to explore the often unheard, lived experiences of client death for Clinical Psychologists at the beginning of their career. It was hoped that these research findings may assist training courses, clinical supervisors and other Psychologists of all grades to make sense of this experience in greater depth. Method: A qualitative approach was adopted for this study. Semi-structured interviews were conducted with nine female junior Clinical Psychologists (Trainee, Newly Qualified) who had experienced the death of a client. The accounts were analysed using IPA, which attempts to illuminate the lived experience of a phenomenon for small samples of individuals. Results: The analytic procedure highlighted three main themes as emerging from participants’ accounts in the context of their client’s death: Connected and affected: Being unprepared for initial reactions to the client's death; "we do it so why can't you?" facing institutional denial and avoidance; "It's not something I've forgotten about", The lasting impact of client death: Learning reluctant lessons and experiencing continuing bonds. Implications: This study highlights the importance of recognising the impact of client death on Clinical Psychologists in particular, and healthcare professionals in general. Client death, by all causes, appears much overlooked within the current research base, which may have led to a self-perpetuating cycle of hidden and unspoken stories. The findings indicate death needs to be on the research and teaching agenda within the institution of Clinical Psychology. As a result we may be able to begin to break the current cycle of silence which has served to potentially disservice us as professionals, our teams and most importantly our clients.

Thesis (Ph.D. (Psychology)) -- University of Limpopo, 2023 / With the realisation that both the traditional and western health care systems are consulted in South Africa, the Traditional Health Practitioners Act, No 22 of 2007 was promulgated. In addition to the Act, there was a growing body of literature proposing the integration of the two health systems to improve the overall South African health system. This study explored the possibility for such collaboration by investigating case formulation by western-trained clinical psychologists and traditional health practitioners regarding selected cases of mental disorders. A qualitative research design, specifically a case study method was used in the present study. Six clinical psychologists and six traditional health practitioners were selected through purposive sampling and were requested to participate in the study. The researcher further sampled two vignettes of Major Depressive Disorder and Schizophrenia for data collection purposes. Data was collected through semi-structured interviews and vignettes and analysed through Braun and Clarke‟s thematic content analysis steps. Six main themes that related to case formulations by clinical psychologists emerged. These themes were: a). Collateral information as a major determinant in the assessment and treatment of mental illness; b). Classifications of mental illness; c). The symptomatology of mental illness; d). Causes of mental illness; e). The multidisciplinary approach in the treatment of mental illness; and f). Views regarding the collaboration of Clinicians and Traditional Health Practitioners. On the other hand, eight themes that related to the case formulations by traditional health practitioners were identified. These themes were: a) Divination as the main process of enquiry, b) Descriptive names of mental illnesses, c) Conceptualisations of stress related and depressive disorders by Traditional Health Practitioners, d) Views on causes of mental illness, e) The effectiveness of the Western approach in the treatment of some forms of mental illness, f) The relationship between religion and African traditional practices; g) A calling as symbolised by symptoms of mental illness, and, h) Traditional health practitioners‟ views on the collaboration between themselves and western health practitioners. The study has further revealed that there are some similarities as well as differences in the way clinical psychologists and traditional health practitioners formulate cases. The convergences in their formulations were revealed in the following themes; a). The conceptualisation of stress and related conditions; b). The western system is the most appropriate in the management of stress-related and depressive disorders and c). The benefits of the collaboration between western and African healing systems. The following divergences were further identified from the way clinical psychologists and traditional health practitioners formulate their cases: a). The conceptualisation of the presenting symptoms from the two cases; b). The causal factors of mental health conditions; c). The initial methods of enquiry; and d). The management of mental health conditions. The study has further revealed that both traditional health practitioners and clinical psychologists have positive views regarding the collaboration of western and African traditional health systems, especially in the management of mental disorders. The study has further uncovered the convergences and divergences in the conceptualisation of mental health conditions between traditional health practitioners and clinical psychologists.

Clients diagnosed with Borderline Personality Disorder (BPD) interact with healthcare professionals in compelling ways. By virtue of the symptoms that define BPD, it is likely that the client will challenge the therapist with regards to their theoretical approach or therapeutic style. In addition, clients with BPD are likely to project their need for a therapeutic interaction that is both genuine, empathic and at the same time, flexible. In light of this, it is not uncommon for healthcare practitioners to consider clients with BPD as “difficult” in some way or the other. This study explores how clinical psychologists in Gauteng conceptualise and manage a “difficult” client presenting with Borderline Personality Disorder. Further, coping strategies of the clinician will also be explored. The qualitative study, couched in a social constructionist paradigm, involved interviewing seven clinical psychologists practicing in Gauteng, South Africa. The transcripts of the semi-structured interviews were thematically analysed. The findings of the current study indicated that the difficulties experienced are reflective of the general criteria of the disorder. The picture of the difficult client is painted by personal experience, as well as stereotypes gained from interactions with colleagues and other healthcare professionals. It was further found that management of these patients were viewed and implemented based on the nature of the disorder. In addition, management by the clinician often included supervision and leisure activities. / Psychology / M.A. (Clinical Psychology)