The primary objective of this research was to initiate exploratory research into the challenges that trainee therapists face in the first interview. This research focused on determining what aspects of the first interview the trainee therapists found challenging and exploring what it was about these aspects which made them challenging to the trainees. Further the research sought to explore what coping mechanisms the trainees employed during the first interview in order to negotiate these challenges as well as what effect these challenges had on the experience of the trainees. The research sought to gain an understanding of what it was about these challenges which made them difficult for the trainees. The research is situated within Ronnestad and Skovholt?s (2003) model of professional therapist development whereby the difficulties faced by the novice/trainee therapist can be understood within the framework of the developmental path of the professional therapist. This framework was used to understand the nature of the difficulties encountered at this stage of training. Interpersonal Process Recall (IPR) (Kagan, 1976; Kagan, 1980; & Kagan, 1984) was employed in interviews with 8 Masters first year students following the completion of a first interview with a role play client. The data was analysed using Grounded Theory Analysis and Strauss and Corbin?s (1990, as cited in McLeod, 2001) method of qualitative analysis was employed to analyse and interpret the data. The main findings indicated the pervasive presence of anxiety in novice therapists? experiences of the first interview. In particular this anxiety was generated through a preoccupation with the evaluative component of the exercise which brought to the fore the dynamic internal conflict between the personal, private self and the professional self as the novice attempts to establish a working professional identity. This conflict is played out in the context of the first interview with specific reference to issues around self focus, management of the interview and difficulties with the role-played nature of the exercise. The difficulties encountered tended to generate further anxiety forming a negative feedback loop. Positive coping strategies were employed using „self talk? which led to an increased perception of self-efficacy. Negative coping strategies such as reverting to rigid structured processes resulted in a negative experience and escalated anxiety resulting in perceptions of poor selfefficacy. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Durban, 2010.

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Thesis (Ph. D.)--University of Wisconsin--Madison, 1960. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph. D.)--University of Wisconsin, Madison, 1973. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

This thesis combines a theoretical perspective and a methodological technique in order to clarify the concept of negotiation. The theoretical perspective represents a merging of a formal analysis as suggested by Georg Simmel and Erving Goffman and an interactional emphasis upon reciprocity of actions as proposed by Herbert Blumer. Accordingly, a methodological scheme was constructed to examine negotiations in terms of their forms and content.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: It is more than 18 years since South Africa became a democratic country. However, many South Africans are still discriminated against when accessing state services, such as healthcare services (Drennan, 1999). The problem is that healthcare practitioners, in the higher positions of the healthcare system, are commonly made up of professionals who speak only one or at most two of South Africa’s official languages (Swartz, 1998). Due to the lack of funding ad hoc arrangements are made for interpreter-services (Drennan, 1999). Anyone available that can speak even a fragment of the patient’s language, such as nurses, household aides and security guards are called to act as interpreters (Drennan, 1999; Smith, 2011). In many clinical settings, although not ideal, it is possible to treat patients even if there are minimal shared communicative resources (Anthonissen & Meyer, 2008). However, in psychiatric care, language is the primary diagnostic tool, and is one of the central instruments through which patients voice their symptoms (Westermeyer & Janca, 1997). In the Western Cape (one of the nine provinces in South Africa), clinicians working in psychiatric care are mainly fluent in English and Afrikaans. Many Black isiXhosa-speaking patients are not proficient in these languages. The aim of this dissertation is to gain a better understanding of the language barriers facing isiXhosa-speaking patients by focusing on natural conversations, which take place during psychiatric interviews within a particular psychiatric institution in the Western Cape. I made video-recordings of interpreter-mediated psychiatric interviews (n=13) as well as psychiatric interviews (n=12) conducted without the use of an interpreter. In addition, I had discussions (i.e. through semi-structured interviews) with registrars, interpreters and patients to understand their views about issues related to language barriers and interpreting practices. I used an ethnographic approach and the method of Conversation Analysis to understand the study findings. The findings, derived from the psychiatric interviews that were not interpreter-mediated, suggest that the Limited English Proficient (LEP) patients had great difficulty communicating with the registrars. The findings (emerging from the interpreter-mediated encounters and semi-structured interviews), strongly suggest that the haphazard use of hospital employees, who are not trained and employed to act as interpreters, have a significant impact on the goals of the psychiatric interview. In some instances, the use of ad hoc interpreters positively contributed to the successful achievement of the goals of the psychiatric interview. In most instances, the use of ad hoc interpreters inhibited the successful achievement of the goals of the psychiatric interview. One of the most significant findings was that interpreters’ interpretations of patients’ words at times suggest that patients appear to be more psychiatrically ill (increasing the risk for over-diagnosis) than it appears when looking at patients’ original responses. In essence, the lack of language services is unjust towards patients, clinicians, hospital staff acting as ad hoc interpreters, and LEP patients caught in a system, which construct them as voiceless, dependent, powerless, healthcare users. / AFRIKAANSE OPSOMMING: Suid-Afrika is vir die afgelope 18 jaar `n demokratiese land, maar ongeag die afskaffing van apartheid word daar steeds teen baie Suid-Afrikaners gediskrimineer. Dit is veral die geval wanneer Suid-Afrikaners gebruik maak van gesondheidsdienste (Drennan, 1999). Baie gesondheidspraktisyne of dokters is alleenlik vaardig in een of op die meeste twee offisiële Suid-Afrikaanse tale (Swartz, 1998). Ongelukkig weens `n gebrek aan fondse, is die meeste hospitale nie instaat om amptelike tolke in diens te neem nie. Gevolglik word ad hoc reëlings getref wanneer pasiënte tolkdienste benodig. Gewoonlik word enige iemand, insluitende verpleegsters, skoonmakers en sekuriteitswagte, wat selfs net tot `n sekere mate die pasiënt se taal kan praat, gebruik as tolke (Drennan, 1999; Smith, 2011). Die gebrek aan tolkdienste is veral problematies wanneer dit kom by psigiatriese dienste. Dit is omdat in psigiatrie word taal en kommunikasie as primêre diagnostiese instrument gebruik, en pasiënte gebruik hoofsaaklik taal om hul simptome en ervaringe met die dokter mee te deel (Westermeyer & Janca, 1997). In die Wes-Kaap (een van Suid-Afrika se nege provinsies) is die meeste dokters wat in psigiatriese instansies werk hoofsaaklik Engels en / of Afrikaans-sprekend. Baie Swart isiXhosa-sprekende pasiënte, wat gebruik maak van psigiatriese staatsdienste, is egter nie vlot in Afrikaans en Engels nie. Die doel van my proefskrif is om hierdie probleem, wat baie siXhosa-sprekende pasiënte in die gesig staar, beter te verstaan. Ek het besluit om dit te doen deur te fokus op `n spesifieke aspek – natuurlike gesprekke tussen dokters en isiXhosa-sprekende pasiënte. Dokters en pasiënte kommunikeer onder andere gedurende psigiatriese onderhoude, en ek het besluit om video opnames van psigiatriese onderhoude te maak. Ek het die video opnames in `n spesifieke hospitaal in die Wes-Kaap gemaak. Die video opnames het ingesluit psigiatriese onderhoude (n=12) waarin die dokter en pasiënt in Engels kommunikeer, sowel as onderhoude (n=13) waarin die dokter en pasiënt deur middel van (d.m.v) `n ad hoc tolk kommunikeer. Ek het ook gesprekke gevoer (deur middel van semi-gestruktureerde onderhoude) met pasiënte, dokters, en ad hoc tolke om hulle insigte en opinies rakende die bogenoemde taalkwessies beter te verstaan. Verder het ek `n ethnografiese benadering en gespreksanaliese gebruik om die data te benader en verstaan. Die bevindinge wat voortgevloei het uit die psigiatriese onderhoude (beide waarin daar nie `n tolk gebruik was nie, sowel as die waarin daar `n tolk gebruik was) suggereer dat die gebrek aan tolkdienste dikwels die doel van psigiatriese onderhoud ondermyn. Dit komvoor dat in die psigiatriese onderhoude, waarin daar nie tolk gebruik was nie, die pasiënte dit baie moeilik gevind het om met die dokters in Engels te kommunkeer. Dit is waarskynlik omdat hulle nie oor die nodige taalvaardighede beskik om hulleself ten volle in Engels uit te druk nie. Dit kom wel voor dat in sommige gevalle gedurende die psigiatriese onderhoude, waarin die dokters en pasiënte d.m.v.`n tolk gekommunikeer het, het die gebruik van `n tolk `n positiewe impak gehad. Die probleem is egter dat in baie gevalle het dit geblyk het die gebruik van tolke `n ongewenste impak gehad. Een van die belangrikste voorbeelde hiervan is dat die tolke se weergawes van die pasiënte se woorde, dit dikwels laat voorkom asof pasiënte nie juis veel insig in hulle psigiatriese versteurings gehad het nie. Wanneer daar egter gekyk word na die pasiënte se oorspronklike weergawes is dit duidelik dat sommige pasiënte wel insig gehad het. Die bevindinge suggereer hoofsaaklik dat die gebrek aan offisieel en opgeleide tolkdienste onregverdig is teenoor die pasiënte, ad hoc tolke, en die dokters. Dit dra ook by tot `n gesondsheids-sisteem waarin isiXhosa-sprekende pasiënt uitgebeeld word as afhanklik, tot `n groot mate magteloos en sonder `n sê.

Call number: LD2668 .T4 1984 E86 / Master of Science

Research has yet to identify any characteristics of clients, therapists, or treatment dyads which consistently identify those clients most likely to drop out of treatment. A frame of reference which may prove useful in identifying such clients is the social psychological construct of selfmonitoring. This theory proposes that individuals involved in any social encounter differ from each other in their approach to constructing a relevant self-presentation. High self-monitors emphasize matching their behavior to situational cues while low self-monitors match their behavior to perceived internal values and traits. The present study demonstrates the effects that selfmonitoring styles of therapists and clients have on the effectiveness of a therapeutic intake interview and the client's decision whether or not to return for treatment. Additionally examined are the effects of therapist selfmonitoring style on theoretical orientations toward psychotherapy. The hypothesis that pairings of high self-monitors would be most effective is tested by Chi-square and found to be nonsignificant. Using the Chi-square test, low self-monitoring therapists are found to endorse a single approach to therapy and to strongly endorse the psychoanalytical orientation. Low self-monitors are found to be eclectic in approach. Satisfaction with the interview is examined using ANOVA. Results are nonsignificant with the exception that low self-monitoring therapists are more satisfied with the intake interview than are high selfmonitoring therapists. Finally, within-cell Pearson correlations are examined to measure agreement about satisfaction between therapist and client. Pairs of high self-monitors show the highest rate of agreement. Implications for further research in this area are discussed.