Thesis (Ph.D.)--Pacific Graduate School of Psychology, 1993. / Source: Dissertation Abstracts International, Volume: 54-06, Section: B, page: 3345.

Thesis (Ph.D.)--Pacific Graduate School of Psychology, 2003. / Source: Dissertation Abstracts International, Volume: 64-06, Section: B, page: 2924. Adviser: Stephen Hibbard.

Thesis (Ph.D.)--Indiana University, Dept. of Psychological and Brain Sciences, 2008. / Title from PDF t.p. (viewed on May 14, 2009). Source: Dissertation Abstracts International, Volume: 69-09, Section: B, page: 5767. Adviser: Amy Holtzworth-Monroe.

This study is motivated by the fact that half the clients attending a drug counselling centre in Cape Town, dropped out of treatment before the fourth interview. The study examines and describes the factors which contribute towards this dropout behaviour. Literature describing dropout behaviour and patterns of illicit drug abuse identified multiple factors influencing dropout behaviour. The present study utilizes four such categories: a) motivation factors, which include the pressure that families or employers exert on clients to attend treatment; b) client factors, including aspects of demography, symptomology and personality; c) treatment factors, such as evaluation methods, the initial contact, client expectations of the agency and treatment effectiveness; and d) therapist factors including therapist attributes, contracting and response to dropout behaviour. In order to explore factors contributing to dropout behaviour, an initial sample of 32 subjects was selected of which fourteen were interviewed by means of a structured questionnaire. An analysis of the results gives rise to the following important findings: Families do not influence the dropout to continue with treatment. Dropouts tend to have unrealistic treatment expectations, such as immediate medical relief from drug related symptoms. Dropouts also tend to have lower educational status and are more frequently employed in relation to the average client. The dropouts experience anxiety during the initial contact, which is often met by uncaring therapist attitudes. Finally, the study demonstrates that inflexible agency hours and a lack of therapist contracting also contribute toward dropout behaviour.

Includes bibliographical references. / The purpose of this study was to explore the value of a particular theoretical framework in terms of several issues relating to clinical social work practice. The selected theoretical framework was that of Object Relations theory, specifically the works of Melanie Klein and Margaret Mahler. The method of inquiry was that of a single case study. The investigation centred around the theories' usefulness in clinical social work practice regarding: assessment, particularly in terms of the development of insight into and understanding of human psychological development, and guiding practice and informing intervention. The selected theoretical framework was also evaluated according to: its sufficiency, in and of itself, and the extent to which its utilization facilitates avoidance of stereotyping and pathologizing. The study was undertaken in a psychiatric unit, run according to the principles of a therapeutic milieu, in a local hospital. The subject of the study had been admitted to the unit after a parasuicide attempt. He manifested many of the affects and behaviours associated with Borderline Personality Disorder, and was a transsexual who had undergone reassignment surgery. Ongoing assessment and intervention were undertaken in the residential unit on an individual basis and in group activities. Reference to literature, the writings of Klein and Mahler in particular, was a crucial and essential aspect of the study. The selected theoretical framework was found to be of great value in terms of the development of insight into and understanding of human psychological development, which in turn aided the assessment process. Whilst neither Klein nor Mahler wrote extensively or specifically of intervention, a model compatible with their opinions was identified in the literature and effectively used for this purpose. The approach used, both from a theoretical and a practical standpoint, encouraged expression and maintenance of individual uniqueness. The study highlighted the importance of a sound theoretical knowledge base underpinning clinical practice, particularly when practitioners are challenged by difficult cases. In addition, the need for practitioners to assume responsibility for continued dynamic learning, and the significant role of supervision were apparent. Further avenues for study and research were also identified.

Bibliography: pages 106-121. / The aim of this paper is to elucidate an object relations approach to therapeutic work with children. The study is conducted by means of a critical theoretical evaluation of psychoanalytic and object relations conceptualisations of the nature of the primary biological mother-child relationship; an in depth theoretical exploration of the mother's involvement in and contribution to both optimal and pathological development in the child, and of her role in the child's treatment. The theoretical exposition is supplemented by the presentation and examination of clinical material derived from a child treatment case in clinical practice. Child treatment is located within an historical context; the role of parents in child treatment is addressed and divergencies in technical approaches to their inclusion in child treatment are reviewed. The nature of the primary biological mother-child relationship - its evolution, unconscious interrelational processes, optimal and pathological vicissitudes and its implications for child treatment - is explored. Simultaneous treatment of mother and child is offered for consideration, as an object relations approach which addresses the operation of both conscious and unconscious processes within the mother-child relationship, the vicissitudes of developmental disturbances and how these manifest in the therapeutic situation. The conclusion drawn is that an in-depth understanding of the primary relationship and its unconscious processes is of crucial importance in the assessment, diagnosis and treatment of children and that in many instances the mother needs to be directly involved in the treatment endeavour. It is further concluded that simultaneous treatment of mother and child is valuable in highlighting points of interaction between the disturbances of mother and child, and facilitates an understanding of the unconscious meanings and associations held by the mother in connection with her child, as well as the ways in which her unconscious expectations are fulfilled by the symptomatic child.

Includes bibliographical references. / This phenomenological study seeks to understand challenges and resilient adaptations of parents of children with ADHD at a Primary School in Cape Town, and to examine the role of the school and the school social worker in supporting parents not only in developing parental resilience, but also developing resiliency in their relationships with the school as an adjunct to forging effective parent- school partnerships. The macro systemic background to this study is the Department of Basic Education’s policy on Inclusive Education, which calls for parent-school partnerships in educating vulnerable children. Two theoretical frameworks guide this study: resiliency theory, given the increasing calls for resiliency research in resource- poor contexts; and Bronfenbrenner’s bio-ecological framework, as ADHD is a complex phenomenon in which parents and school, both micro- and meso-systemically, buffer the impact of ADHD. The research methodology is an exploratory qualitative cross-sectional single case design with multiple respondents. Eighteen parents were the unit of study, selected according to a purposive and discriminant sampling design. Data was collected using a semi-structured interview schedule, and recorded during an in-depth interview. This study confirmed chronic and overwhelming personal and parenting challenges, but also challenges around medication, and parent-school interaction. Participants struggled more than they felt they succeeded, as adaptations shadowed and were overshadowed by, challenges. Participants increasingly used the services of the school social worker, and preferred to access personal help via their children’s mental health provider, underlining the importance of the school as an intervention site. Participants indicated that school social work services should provide counselling, a support group for parents, advocacy and mediation between parent and teacher/school, and develop opportunities for parent-school partnerships. School social work services were valued because they were based on knowledge and experience. Relationships with the school were tempered by ambivalence and frustration; participants wanted proactive teachers providing in-depth and accessible contact and trained in ADHD classroom management. Implications of this study for the school, the social work profession and the Department of Basic Education are discussed.

Includes bibliography. / The problem of initially engaging clients in counselling, at an agency offering marriage counselling services, is complex. It is often difficult to motivate the couple to come together to the first interview. Many clients book appointments which they do not keep, and others attend only one interview. The aim of this .study was to identify specific factors likely to influence the initial engagement of clients with marital problems in an agency setting. A literature survey was done and four groups of factors likely to influence the initial engagement of clients in counselling were identified. These factors are: client factors, including demographic, problem related and expectation related factors, actuarial factors, including waiting time for the first appointment, agency hours and agency fees, interactional factors, including agency-client interaction in the initial telephone contact and in the first interview, and counsellor factors.

Includes bibliographical references (leaves 48-55). / This research report was an undertaking to gain insight into the influence of family dynamics, developmental experiences and environmental precipitatory factors on the potential link between early school drop-out and youth awaiting trial in the Western Cape secure care centres. The objectives of the study were threefold: to explore the different family dynamics that may contribute to early school-leaving and youth awaiting trial; to explore the different early developmental experiences that may contribute to an early school-Ieaver and youth awaiting trial; to investigate what environmental precipitatory factors may contribute to early school-leaving and youth awaiting trial.

This study sought to understand the experiences and challenges of parents caring for a child living with autism spectrum disorder (ASD). A qualitative research design was used to explore the stressors faced, coping strategies used, and support mechanisms needed by parents caring for a child living with ASD within South Africa. Non-probability sampling was used to select 20 respondents, initially using purposive and then snowball sampling techniques, until the target sample size was reached and data saturation had occurred. Respondents consisted of South African mothers who care for a child living with ASD, and who live in Cape Town, Johannesburg, or Durban. Data was collected with the use of semi-structured one-on-one interviews, and was analyzed according to Tesch's (1990) eight steps of analysis. The study found that there were various practical stressors for respondents regarding caring for a child living with ASD. This included the stressors of managing their child's difficult behaviours, respondents' high levels of anxiety as a result of these behaviours, and difficulties communicating with their child. Stressors also included the high cost of care and interventions, difficulty finding appropriate schooling, and the need to consult multiple professionals before receiving the diagnosis. The respondents' psychological stressors included experiencing grief and loss once their child was diagnosed, hurt from other's lack of understanding of ASD, and their concerns about their child's future. Various coping mechanisms were found to be used by respondents, including accepting the child with their diagnosis, increasing in patience and empathy, and attempting to manage and prevent their child's difficult behaviours. Another coping mechanism was to utilize a blend of interventions, for example Occupational and Speech Therapy, which catered to their child's unique ASD-presentation. Support mechanisms that were found to be beneficial to respondents were informal and consisted of support from family and from other parents caring for a child with ASD. This study concluded that caring for a child with ASD has many challenges, especially when one is the child's parent and primary caregiver. It also concluded that respondents displayed resilience towards these challenges by utilizing various coping and support mechanisms available to them. Numerous recommendations arose from this study, the most salient of which was for health care professionals (HCPs), which included social workers, as well as parents caring for a child living with ASD to educate themselves and others with regards to ASD. Another recommendation was for HCPs to link these parents with affordable and appropriate education and intervention options for their children.