Research report submitted to the Faculty of Education, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master of Education (Educational Psychology) Johannesburg 1994. / This thesis discusses the need for research paradigms within the human sciences which will address human development needs with in the South African context. it documents a research methodology designed to address the development of human relations in organizations so as to facilitate the construction of nurturing and learning environments. The concept of mental health and its interconnection with the development of human relations in organizations is explored to enhance the understanding of the needs of employees in organizations within the South African context. The research process advocates consultation and negotiation of issues relating to human relations and mental health, It also provides opportunity for the exploration and co-creation a bridge between mental health, development of human relations in organizations and research. The research was conducted within the parameters of the ecosystemic paradigm and influenced by social construction theory. It incorporates both quantitative and qualitative methods. / AC2017

Xhosa psychiatric nurses stand unique at the interface between Western mental health care and indigenous healing in South Africa. They stem from a cultural history that is embedded within traditional health care discourses and yet are trained and work within a Western psychiatric model. In embodying the intersection between these two paradigms, they are faced with the challenge of making sense of such an amalgamation. These nurses' views are thus valuable in reflecting this intersection and illustrating many of the central concerns that surround it. This study explicates the views of these nurses toward traditional healers and their potential role in mental health care in South Africa. In addition, it illuminates some of the cultural dynamics at work amongst these subjects as they struggle to make sense of their unique cultural position. Using a questionnaire-based methodology, the views of Xhosa psychiatric nurses in a psychiatric hospital in the Eastern Cape, toward traditional healers and their role in mental-health care, were examined. The findings reveal that the vast majority of these nurses believe in traditional cosmology, involve themselves in traditional ritual practices and regularly visit traditional healers as patients. In suggesting ways in which indigenous healing and Western mental health care can work together, 75% of the nurses were in favour of a general referral system between the hospital and traditional healers, most (77%) agreed that certain patients would be better off being treated by both the hospital and traditional healers than they would if they were only being treated by the hospital alone, and 85% of the subjects agreed that patients who are already seeing traditional healers should check if psychiatric medication might help them. These findings indicate that these nurses operate across two healing systems which are at this point not conceptually compatible. This results in deep cultural tension for the nurses. In being entangled in the dialectical tension created in this context, the nurses manage the incongruencies in three general ways: a) Most, in one form or another, incorporate beliefs from both systems into an integrative model, b) some assimilate their cultural belief system into the Western mental health paradigm, throwing off their beliefs in traditional healing, and c) others remain ambivalent in the dialectic between traditional and Western health care discourses. Although this may suggest that these nurses reside within a cultural milieu that is somewhat unhealthy, at another level, in managing and containing the incompatibility between the two systems, these nurses ensure a space for on-going and healthy critique of the underlying assumptions involved in this health care malaise.

Thesis (DMed (Psychiatry))--University of Stellenbosch, 2005. / BACKGROUND Schizophrenia is a heterogeneous disorder, which has been shown to have both environmental and genetic risk factors. Since family history (genetic loading) of psychosis appears to be one of the strongest risk factors for the development of schizophrenia, the investigation of affected sib pairs can be used to explore shared familial factors. The Xhosa-speaking inhabitants in the Western, Eastern and Southern Cape provinces, an African population of relatively homogeneous ethnicity, provided a sample of the first large clinical phenotype of schizophrenia. AIM The main aim of this study was to identify shared symptoms or symptom clusters in a sample of Xhosa-speaking sib pairs, with the aid of structured assessment tools.

Background: Orphanhood is a major consequence of the HIV/AIDS epidemic in sub-Saharan Africa. There is little evidence concerning psychological problems for AIDS-orphaned children. This thesis explores the relationship between orphanhood status and mental health. It also examines mediating influences of environmental risk and protective factors, and interactions between factors, on children’s psychological problems. Methods: 1200 isiXhosa-speaking children were interviewed, using standardised questionnaires, in deprived urban settlements of Cape Town. A qualitative stage with 60 AIDS-orphaned children, 42 caregivers and 20 professionals explored participant perceptions of risk and protective factors. A quantitative stage compared 1025 AIDS-orphaned children to control groups of other-orphans and non-orphans. Data were analysed with t-tests, chi-sq, anovas, regression and log-linear analyses. The study took place in collaboration with Cape Town Child Welfare. Results: AIDS-orphaned children reported more depression (p<.001), peer relationship problems (p<.001), post-traumatic stress (p<.001), suicidal ideation (p<.05), delinquency (p<.001) and conduct problems (p<.001) than other-orphans and non-orphans. Anxiety showed no differences. Compared to Western norms, AIDS-orphaned children showed higher levels of internalising problems and delinquency, but lower levels of conduct problems. These differences remained when controlling for socio-demographic factors. A number of factors strongly mediated the relationship between AIDS-orphanhood and mental health. These include poverty-related factors (food, education and social security, p<.001). caregiving-related factors (caregiver illness, p<.001, excessive housework p<.001, being a streetchild, p<.001) and AIDS-related stigma (p<.001). Cumulative effects were also found. Food insecurity and AIDS-related stigma interacted to raise likelihood of disorder from 19% to 83%, and orphanhood status and bullying interacted to raise likelihood from 12% to 76%. Conclusions: This thesis shows clear evidence of heightened psychological problems amongst AIDS-orphaned children. It also indicates mediating factors and points to areas of possible intervention. The South African Ministry of Social Development plans to scale up the study to a national survey of AIDS-orphanhood.

D.Ed. (Educational Psychology) / The problem of strikes in South Africa has infiltrated the whole work industry, and has led to the Municipalities also participating in strike action; this affects service delivery and often has a negative impact on the mental health of those who participate. The overall goal of this study is to develop and describe a psycho-educational model to be used as a framework of reference to facilitate the mental health of workers involved in strike action, before during and after strikes. The research also focused on developing guidelines for operationalisation of the model for impact and sustainability of the therapeutic interventions after the termination phase. Garber's (1972) (in Myburgh, Niehaus &Poggenpoel2000: 150-156) psychoeducational developmental model was employed as a departure premise to for this study in order to capacitate the workers with the skills to manage the effects of strike action. Focus groups as well as individual interviews were held with workers and worker representatives of a Metropolitan Municipality respectively to identify empirical evidence and the central concepts for the model. A theory generative design that is, qualitative, explorative, descriptive and contextual in nature was used to develop the model and the operational guidelines. The model was developed according to the approach of Chinn and Kramer (1991); Walker and Avant (1995) of theory generation, which embraces the following steps: Concept analysis which includes identification of the central concepts for the model through conducting a field study to explore and describe the lived experiences of the workers as well as the worker representatives ...

Thesis (M.A.(Industrial Psychology)--University of the Witwatersrand, Arts Faculty, 1996 / At a primary level the current study sought to investigate the post-traumatic stress responses of a sample of black township residents who were victims and witnesses of continuous civil violence [Abbreviated abstract. Open document to view full version]

Thesis (MComm))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Farming is often perceived to be associated with an idyllic lifestyle and many city-dwellers secretly dream of owning a farm where they can escape the city and its stressful lifestyle. The reality associated with farming however is very different from the perception. Research conducted overseas found that the unique challenges farmers face in their everyday business subjects them to high levels of stress. The American Institute for Occupational Health and Safety ranks farming in the top ten percent of the most stressful occupations while research in the United Kingdom shows that the occurrence of suicide amongst farmers are significantly higher than for the rest of the population. Stress can manifest in health, emotional and physical problems and can have a dramatic impact on quality of living. This in turn negatively influences personal and work performance. Taking into account that farming plays a vital role in the global economy and in combating food shortage; the prevalence of stress amongst farmers is worrying. In South Africa little research has been conducted into the psychological wellbeing of farmers and the possible impact stress might have. Viticulture and the wine industry are major contributors to the economy and tourism industries of the Western and Northern Cape provinces. It would thus be in the interest of the country and its labour force to investigate the impact of stress on farmers in these regions and to find ways to mitigate the experience of stress. A qualitative study amongst wine growers (N=24) resulted in the identification of possible stressors along with demographic, biographic and personality symptoms that may potentially influence the impact of stress. The Agricultural Stress Questionnaire was developed considering overseas literature and information gathered from the qualitative interviews. Sense of coherence and organisational trust between farmers and management of the cellar they deliver products to, were identified as possible factors influencing the impact of stress. Quantitative research was conducted by means of questionnaires sent to a convenience sample of wine growers. The Organisational Trust Inventory was used to measure the level of organisational trust, while the Orientation to Life Questionnaire was used to evaluate sense of coherence. The 28-item version of the General Health Questionnaire was used as a measure of psychological wellbeing. In total 132 respondents were recruited from the sample of more than 1 000 wine growers. Data gathered was subjected to statistical analysis and results showed that all measuring instruments had excellent psychometric properties. This was also true for the Agricultural Stress Questionnaire that was used for the first time. Multiple regression analysis showed that organisational trust does not act as a moderator in the relationship between agricultural stress and psychological wellbeing. Sense of coherence was however found to be a strong moderator of the interaction between agricultural stress and psychological wellbeing. Some demographic and biographic factors also proved to influence the impact of agricultural stress on psychological wellbeing. Stressors were ranked to show which caused the most stress amongst South African wine growers. Proposals for possible interventions were made along with recommendations for future research. / AFRIKAANSE OPSOMMING: Boerdery word dikwels geag 'n idilliese beroep te wees en menige stedelinge droom van 'n plaas waar hulle kan ontspan en vlug van die stad se stresvolle leefstyl. Die realiteit is egter ver verwyder van hierdie siening en buitelandse navorsing toon dat landbouprodusente aan hoë vlakke van stres blootgestel word vanweë uitdagings uniek aan hul beroep. Die Amerikaanse Instituut van Beroepsveiligheid en –Gesondheid plaas boerdery onder die boonste tien persent van stresvolle beroepe, en navorsing in die Verenigde Koningryk het gevind dat selfmoord onder landbouprodusente baie meer dikwels voorkom as in die res van die bevolking. Stres kan manifesteer in gesondheid-, gedrags-, en emosionele probleme en veroorsaak verlaagde lewenskwaliteit wat 'n dramatiese impak op persoonlike prestasie, maar ook werksprestasie, het. Gegewe die rol wat landbou in die globale ekonomie speel en die noodsaaklikheid van landbou vir voedselvoorsiening, is die hoë voorkoms van stres in die landbou-industrie, en die impak daarvan, 'n bron van kommer. In Suid-Afrika was die streservaring van landbouprodusente, en die uitwerking daarvan op hul sielkundige welsyn, egter nog nie die fokus van navorsing nie en dus is literatuur oor stres onder landbouprodusente in Suid-Afrika beperk. Wingerdbou en die wynbedryf dra betekenisvol by tot die ekonomie, werkskepping en toerisme in die Wes- en Noord Kaap van Suid-Afrika. Indien daar die moontlikheid bestaan dat wingerdprodusente onder die uitwerking van stres gebuk gaan, is dit dus in die belang van Suid-Afrika en die arbeidsmag om die probleem te identifiseer en die impak van stres te beperk. Na aanleiding van kwalitatiewe onderhoude met wingerdprodusente (N = 24) is „n lys van moontlike stressors geïdentifiseer, asook moontlike demografiese, biografiese en persoonlikheidsfaktore wat die impak van stres kan beïnvloed. Die Landboustressor-vraelys is ontwikkel op grond van inligting verkry uit oorsese navorsing, asook vanuit die kwalitatiewe onderhoude. Die vlak van organisasievertroue tussen wingerdprodusente en bestuur van die kelder waaraan hul lewer, asook koherensiesin, is ondersoek as faktore wat die streservaring, en die impak daarvan, kan modereer. Kwantitatiewe navorsing is uitgevoer deur 'n vraelys aan 'n gerieflikheidsteekproef wingerdprodusente te stuur. Die Organisasievertroue-vraelys is aangewend om die vlak van vertroue te evalueer, terwyl die 28-item Algemene Gesondheidsvraelys (GHQ-28) gebruik is om die sielkundige welsyn van wingerdprodusente te ondersoek. Antonovsky se Lewensoriëntasie-vraelys is gebruik om koherensiesin te meet. In totaal is 132 respondente gewerf vanuit 'n steekproef van meer as 1 000 wingerdprodusente. Die data is statisties verwerk en die resultate toon dat die psigometriese eienskappe van die meetinstrumente deurgaans bevredigend was, ook van die Landboustressor-vraelys wat die eerste keer aan statistiese ontleding onderwerp is. Meervoudige regressie het getoon dat organisasievertroue nie 'n moderator is in die interaksie tussen landboustres en geestesgesondheid nie. Koherensiesin is egter wel bevind om 'n sterk moderator in die interaksie te wees. Sekere biografiese en demografiese faktore het ook die effek van stres op geestesgesondheid beïnvloed. 'n Rangorde van stressors is saamgestel om te toon watter faktore die meeste stres onder Suid-Afrikaanse wingerdprodusente veroorsaak. Aanbevelings is gemaak ten opsigte van moontlike intervensies wat wingerdprodusente kan ondersteun in die hantering van landboustres, asook voorstelle vir toekomstige navorsing.

This work documents the treatment of a 20-year-old male suffering from Post Traumatic Stress Disorder as a result of his experience during two years of national service as an Operations "Ops" Medic in the South African Defence Force. The literature review is drawn largely from the body of work emerging from the Vietnam War, and in particular the work of Robert Lifton and Erwin Parson is considered. The case study consists of a detailed synopsis of the treatment based upon material from the therapy sessions. This section hopes to accurately convey the experience of working with someone suffering from Post Traumatic Stress Disorder and provide insight into the dynamics of such a therapeutic relationship. Finally the discussion examines the links between the theory and the treatment and attempts to understand the various factors which shaped and influenced the final outcome of the therapy. Special consideration is given to showing how essentially cognitive restructuring techniques are successfully utilised within a more existential, psychodynamic framework. Furthermore, there is a paucity of literature on the subject of combat-related Post Traumatic Stress Disorder in South Africa and it is hoped that this work will both point to a need for further research in this field whilst simultaneously provide guidance for those who wish to become involved in working with individuals suffering from Post Traumatic Stress Disorder.

A clinic survey was undertaken to investigate the nature of psychiatric problems experienced by the primary health care (PHC) patient population in the Bisho-King William's Town area of the Eastern Cape Region. The study took as its point of departure research findings which attest to the high rate of psychiatric distress amongst this population group in different parts of the world and ohservations regarding the form of presentation in terms of physical complaints. Hypotheses posited relationships between psychiatric problems experienced by patients attending PHC clinics in the study area and four types of variables, namely; somatic complaints, socio-demographic characteristics, patterns of health service utilisation and patient satisfaction with health services. Using a quasi-experimental descriptive approach, a two-stage screening procedure sorted the patient sample into three groups on the basis of the degree of psychiatric symptomatology experienced. The triangulation of the results of between-groups analyses with case materials recorded during psychiatric interviewing provided for an ethnographic account of the cultural experience of distress in the study area. The screening process used standard instruments, the Self-Reporting Questionnaire (SRQ) in the first stage and the Present State Examination (PSE) in the second stage. A pilot study was conducted prior to the fieldwork for the main study. Using the SRQ, thirteen psychiatric paticnts and 31 general PHC patients were sampled for the pilot study and 148 PHC patients were sampled for the main study. Using the PSE, 11 and 57 PSE interviews were conducted in the pilot and main studies respectively. Between-groups analyses used chi-square and F-statistics to investigate possible associations with identified patient correlates (P<0.5). These were socio-demographic, utilisation and satisfaction variables, measured by a separate face-valid self-response instrument compiled for the purposes of this study. Psychiatric symptomatology was found to be statistically significantly related to age, marital status and educational level. Further, patients experiencing more psychiatric symptomatology reported significantly more illnesses requiring treatment, longer consultation periods and a greater number of sick bed days. No statistically significant relationships were found between psychiatric symptomatology and number of children, number of failures at school, amount of treatment utilised, number of consultations, or patient satisfaction with services. Descriptive analyses of symptom and syndrome profiles found certain somatic complaints to be particularly prevalent amongst the patient sample. These include headaches and various tension pains, decreased energy levels and digestive problems. Qualitative analysis of interview data found that many somatic and psychiatric problems experienced constitute culturally defined and meaningful experiences, especially 'umbilini' (or nerves), 'ufufunyana' (a possession state), and accusations of witchcraft. Interpretation of complaints from the local traditional healing perspective, revealed a more complex mode of communication between patients and the health delivery system than may be accounted for in terms of a simple biomedical model. The interpretive analysis in the study showed that some forms of presentation incorporating somatic symptoms, such as 'nerves' may he viewed as help seeking behaviour of the socially unempowered. Implications of the results are discussed in relation to the need for improved identification and management of psychiatric distress at PHC level facilitated by a better developed referral network and closer interaction between biomedical and anthropological perspectives.

This dissertation explores discourses about culture and illness in the talk of mental health professionals and indigenous healers. It represents an attempt to situate the issue of indigenous healing in South Africa within a particular strand of critical discourse analytic research. In the context of current deliberations on the value, or otherwise, of indigenous healing in a changing health and specifically mental health system, the talk of both mental health practitioners and indigenous healers as they conceptualise “disorder”, and discuss possibilities for collaboration, is chosen as a specific focus for this study. Disputes over what constitutes “disorder” both within mental health, and between mental health and indigenous healing are an important site in which the negotiation of power relations between mental health professionals and indigenous healers is played out. The results of this study suggest that despite the construction of cogent commendations for the inclusion of indigenous healing in mental health, it remains largely marginalised within talk about mental health practice. While this study reproduces to some extent the marginalisation of indigenous healing discourse, it also examines some of the discursive practices and methodological difficulties implicated in its marginalisation. However, in the context of “cultural pride strategies” associated with talk about an African Renaissance, indigenous healing may also function as a site of assertion of African power and resistance in its construction as an essentially African enterprise. At the same time, it may achieve disciplinary effects consonant with cultural pride strategies, in constructing afflictions in terms of neglect of, or disloyalty to cultural tradition. These results are discussed in terms of the methodological difficulties associated with interviewing and discourse analysis of translated texts, which contributes to difficulties with articulating indigenous healing discourse in a way that challenges the dominant psychiatric discourses implicated in its marginalisation within mental health. It concludes with recommendations for future research which addresses indigenous healing discourse in its own terms, and examines its operation as a disciplinary apparatus in South African society.