Bibliography : leaves vii-xiii. / The present quasi-experimental study was conducted in ward G22, a milieu therapy unit at Cape Town’s Groote Schuur Hospital. It examines self-esteem of patients prior to and subsequent to completion of the therapeutic milieu programme, using a self-report questionnaire, the Rosenberg Self-Esteem Scale. This questionnaire was used to measure the level of self-esteem after completion of a 9-12 week stay in G22. The questionnaire was administered to twenty-three successive patients admitted to the unit. Of these one terminated prematurely by committing suicide, while the questionnaire was re-administered to the remaining twenty-two subjects in the final week of their treatment. Protocols were computer scored and quantitatively analysed using Wilcoxon Rank Sum and Signed Rank tests of significance. This analysis indicated that there was a general improvement in self-esteem of subjects after completion of the therapeutic milieu programme, while there was a significant improvement in self-esteem of older subjects when compared with the younger subjects. Other variables such as language, gender and length of stay did not significantly affect the results.

Bibliography: pages 140-149. / This exploratory study tracks the experience of nine infertile couples on the In Vitro Fertilization-Embryo Transfer (IVF-ET) programme at a provincial hospital. Various theoretical perspectives are explored vis a vis the role of women in society in relation to their infertility status. Quantitative data was obtained from questionnaires completed; and qualitative data was obtained through the use of in-depth interviews. The study supports the notion that infertility has both a medical and a psychological component, the latter being unaddressed by the infertility team. Infertility is a couple issue and needs to be addressed as such. The study provides guidelines for future service delivery and therapeutic interventive strategies, and concludes that for effective service delivery, a holistic interventive approach with the inclusion of a clinical social worker is imperative.

Bibliography: leaves 68-73. / This study aims to understand the difficulties students are experiencing within the separationindividuation process of adolescence which could be impacting on their optimal process of growing up. The rationale for doing this research arose from the researcher's work with adolescents, in a school setting, who were presenting with difficulties in a number of areas. Bios' (1967, 1979) theory of adolescence, as a second separation-individuation process of development, provided a useful basis for understanding and examining the difficulties with which the students were dealing. The literature review traces a developmental process, drawing on Psychoanalytic and Object Relation Theorists, towards adolescence. This process highlights the links between early and later development and the importance of optimal early development on later developmental processes. Adolescence, as a second separation-individuation stage of development, is discussed.

Bibliography: pages 136-141. / This study examines the experiences of 12 parents at a Children's Home, whose children were removed from their custody in terms of the Child Care Act. Act 74/83, and placed into residential care. The statutory removal of children from the custody of their parents is defined as a traumatic event with an active shaming component. It is hypothesised that such trauma results in high levels of stress and that the respondents will meet the criteria for a diagnosis of Post-Traumatic Stress syndrome or a Traumatic Stress reaction. An associated hypothesis is that such a trauma leads to a severe blow to the Self of the Parent, resulting in either fragmentation, enfeeblement, or self-depletion. Characteristic affects will be strong feelings of shame and humiliation related to the placement. This blow to the sense of Self will be associated with a rage response to that self-injury which does not necessarily result in the total breakdown of the cohesion of the Self. A second hypothesis is that the psychosocial need pattern of the parents will reflect a high level of concern with self-esteem and social belonging, safety and security and self-actualisation. The experiences of these parents and their responses to the research hypotheses can best be understood and made sense of within a conceptual framework that facilitates an understanding of the Self, and how it responds to the impact of a trauma that is characterised by an active shaming component.

This study explores the attitudes of clinicians towards women and postulates that these attitudes may be transmitted in the therapeutic relationship with female patients. The rationale for exploring this aspect emanated from two factors: firstly, the view that women patients tend to be treated differently to male patients, a view seemingly supported by literature; secondly, the increasing literature supporting the view that therapy is never "value free" and that values may be influential in determining aspects of therapy. In addition, this study aimed to explore clinician's characteristics which may play a role in determining their attitudes. A theoretical analysis of women's role in society was traced, with some mention made of the contribution by the Feminist Movement and the realities of the South African context. The literature survey further highlighted aspects of therapy with female patients that were relevant for the focus of this study. The primary method of data collection was by means of questionnaires which were circulated to the sample, which comprised 82 state-employed clinicians which included psychiatrists, psychiatric registrars, psychologists, social workers and occupational therapists. In addition, five individual interviews were conducted with the view to examining therapy with female patients. Findings indicated that clinicians held a continuum of attitudes to women ranging from traditional to liberal. Clinicians felt that women should feel free to pursue a career, but should remain at home for a time after the birth of a baby. Both the literature and the empirical study indicated that there were differences in the therapeutic encounter between male and female patients. Implications for therapy are highlighted: these include recommendations that clinicians need to adopt a non-judgemental, objective stance, as well as a constant awareness of their own value base as it could influence and permeate the therapeutic relationship. It is recommended that training and supervision need to emphasise the importance of these aspects and it is suggested that further study be undertaken in this regard.

Includes abstract. / Includes bibliographical references. / Young coloured women, particularly within the South African post-Apartheid generation, face a number of psycho-social and economic events and circumstances which are unfavourable, more commonly known as risk factors. These factors include risk of physical harm, the phenomenon of teenage pregnancy, economic and physical deprivation, racial and gender stereotypes, unequal roles and responsibilities between girls and boys, family dysfunction and exposure to or involvement in substance abuse. The community of Mitchell’s Plain in the Western Cape, with its’ historical origin as a ‘dumping site’ for the coloured people of Cape Town during the implementation of the Group Areas Act, is one that is particularly characterized by these many social challenges. Nevertheless, some children and young people do well in life, especially in academic domains, in spite of inadequate, traumatic or less opportune experiences. They have proved themselves to be resilient. The researcher aimed to understand the factors which act as both hindering and supportive elements in a young women’s capacity to overcome these difficulties and excel academically, demonstrating academic resilience. These supportive elements are theoretically described as protective factors.

Bibliography: pages 80-88. / This study explores family satisfaction with services provided to them on their relatives' admission to Valkenberg Psychiatric Hospital in Cape Town. The rationale for doing this research arose from the researcher's encounters with families of psychiatric patients and the perceived lack of involvement of the professionals with the families. In addition, a needs assessment was done to establish the need for family groups. The literature review traced the psychiatric services from the earlier custodial orientation, the subsequent deinstitutionalisation of the services resulting in the families becoming the primary caregivers of their mentally ill relatives, to the emphasis of the biopsychosocial model in the recently established community services. Review of the treatment models indicated supportive family education as the primary form of intervention to ensure compliance, aid the recuperation process, enhance the quality of life for the patient and their families and to equip the families to cope with the illness. A survey method was employed to gather quantitative and qualitative data via questionnaires and face-to-face interviews with 31 relatives of 24 patients who had been admitted during January, February, and in March 1995 to the male and female admission units (wards 9, 10, 14, 15 and 16) at Valkenberg psychiatric hospital in Cape Town. A non-probability convenience sampling procedure, based on the availability and accessibility of the relatives to attend an office interview, was used. Findings from prior studies as well as from this current study have shown a lack of professional involvement with the families in relation to the treatment programme of their mentally ill relatives. The majority of the respondents were not informed about the implications of the illness and the effect of treatment and most of the respondents lacked guidance on how to cope with their mentally ill relatives. Other findings indicated that families are the most concerned about the lack of supported housing, rehabilitation services, adequate financial assistance, day care centres, sheltered employment for their mentally ill relatives and difficulties in relation to admission procedures. More than three quarters of the respondents were interested in family groups and there was a definite need for professional counselling for the parents and siblings. In response to the findings a number of recommendations are made to improve services to families, including the formation of family groups where the relatives of mentally ill people can receive psychoeducation and practical guidance. The need for further research has been identified.

Untreated postnatal depression may have serious and long-lasting consequences for mother and infant. These range from feelings of inadequacy and worthlessness in the mother to social, emotional, cognitive and behavioural disturbances in her child. Postnatal depression is also associated with maternal and infant death. In South Africa, postnatal depression is not screened for as a matter of routine and many women go undiagnosed and untreated. The research was conducted at a community health centre using a mixed methodology of quantitative and qualitative techniques. A sample of six women with postnatal depression participated in a group intervention programme for eight sessions. A single system design was used to quantitatively determine whether a change had occurred, and to what extent, in the mothers' depressive symptoms and attitude towards mothering at the conclusion of the group intervention. Baseline measures on the Edinburgh Postnatal Depression Scale and the Maternal Attitudes Questionnaire were compared with these scores measured at the conclusion of the intervention. A focus group was held at the conclusion of the intervention to gather qualitative data on the mothers' experience of the group processes and personal outcomes. The results of this study demonstrate that mothers' moods and maternal attitudes improved as a result of this therapeutic group intervention, although they still remained above the diagnostic cut-off threshold for postnatal depression. The intervention was also noted by mothers to be a desirable method of treatment for postnatal depression. Further research is indicated to test whether the positive outcomes hold over a period of time.

Includes abstract. / Includes bibliographical references (leaves 82-86). / In this study the researcher aims to explore the child right violations and psychosocial risks experienced by children orphaned primarily as a result of HIV/AIDS in Lesotho. Lesotho ranks in at number three in the world of countries most ravaged by the HIV/AIDS pandemic. Of its 2.2million citizens, 17% are orphans, and half of them have been orphaned as a result of HIV/AIDS (United Nations Program on HIV/AIDS, 2004) (UNAIDS). According to the Non-Governmental Coalition on the Rights of the child, (2000), the number of orphans in Lesotho continues to increase on daily basis resulting in the country being under enormous strain and these vulnerable children at increased risk. The research design used in this study is the qualitative research design and research was conducted using face to face in depth interviews. A semi structured interview schedule was constructed and the researcher also used a tape recorder. Purposive sampling technique was used to obtain a sample size of 12 adolescent orphans at a High School in Maseru Lesotho. Data analysis is done according to Tesche’s steps of interview analysis, in which the main themes and categories are drawn from the interviews and discussed. The main findings were that most of the orphans who participated in the study had a poor quality of life but maintained a positive outlook in terms of the future. Most of the orphans were living in child headed households that had no electricity. There was no evidence of physical abuse amongst the respondents. In terms of psycho social risks, most orphans did not suffer from depression or severe anxiety. A small percentage of orphans did experience suicidal ideation in response to the death of their parents and their current circumstances. The main conclusions were that orphans in Lesotho are experiencing child right violations especially poor quality of life and that orphans in this study did not experience severe psycho social risks. From these findings, it is recommended that there is a need for more non-profit organizations that address the child right violations and psycho social risks experienced by orphans in Lesotho as well as a need for awareness campaigns on the plight of orphans to be generated. It is also recommended that the Lesotho government continue to fund the education costs of orphans as well as offer transportation to school.

This study sought to explore the transitional experiences of students from a disadvantaged background at the University Cape Town (UCT). It set out to examine how students from previously disadvantaged backgrounds negotiated hardships stemming from their historically deprived backgrounds in their transition to university. Purposive sampling was employed in this study and seventeen first year humanities students from rural and township backgrounds were interviewed using a semi-structured interviewing schedule. Interviews were recorded on a digital recorder, transcribed and analysed using qualitative methods drawing on Tesch's eight step model, (cited in De Vos et al , Strydom, Fouche and Delport, 2005).