D.Litt. et Phil. / A plethora of research has been conducted on victims of township violence, detention and political unrest, but there is no research on car hijack victims or the prevalence of Post-Traumatic Stress Disorder (PTSD), which could result from this crime. The implications of this lack of research are important because people are confronted by trauma on a daily basis but there are few guidelines for providing treatment. Hijackings are a somewhat recent phenomenon unlike other traumas such as wars and natural disasters, but the effects of hijacking are no less severe. Post-Traumatic Stress Disorder (PTSD) always requires an initiating event which is assumed to be traumatic. The context in which car hijackings occur in South Africa can be considered to meet the criteria for what constitutes a traumatic event, which could possibly lead to the development of PTSD (Myerson, 1995). Not all crime victims who need professional assistance will enter therapy. This is often due to the victim's self-perception of weakness, feelings of embarrassment, or the perception that others will not understand their experience. A group-based intervention offers the advantages of reducing isolation, providing comfort and support, and eliminating feelings of stigma. For this reason it was important to analyse the nature of PTSD and how to intervene to aid the recovery from PTSD, in the South African context. The literature points to the recovery from PTSD as being contingent upon the psychotherapeutic input that the traumatised individual receives. This research focused on the development of a group-based cognitive behaviour intervention programme for victims who developed Post-Traumatic Stress Disorder as a result of car hijackings. Cognitive behavioural therapy is the only treatment modality that is supported by objective measures of success (Peterson, Prout & Schwartz, 1991) and has been found to be one of the most effective treatments (Kaplan & Sadock, 1993). In order to test the hypotheses, the Beck's Depression Inventory was used to measure the level of depression, the Spielburger's Stai Anxiety scale was used to measure the level of anxiety, and the CAPS and PCL were used to determine whether Post-Traumatic Stress Disorder existed in the individuals who participated in the study and the intensity and frequency of the symptoms.

This research report documents the therapeutic intervention undertaken with a 23-year-old Swazi rape victim. The format of this research report takes the form of a case study that follows the principles proposed by Fishman (2005). Its aim is to document the treatment process of an individual of African decent in order to establish whether the treatment model can be effective in clinical settings and in contexts and cultural settings different from that in which it was developed. The Ehlers and Clark (2000) cognitive therapy model for post-traumatic stress disorder (PTSD) was utilised to assess, conceptualise, and treat the case. The client entered therapy three years after being raped for a third time. The case formulation identified factors maintaining the disorder as well as how other traumatic and abusive events earlier in her life influenced her response to the rapes. Data consisted off audio-tape recordings and detailed written synopses of each assessment and therapy session, psychometric measurement instruments and self-report scales completed throughout the intervention, material written by the client, and a research interview conducted by an independent party. She was treated for PTSD and comorbid depression over a period of five months in accordance with the principles described by Ehlers and Clark and a narrative of the treatment process was written. The case narrative in conjunction with quantitative data suggested that this model assisted the client in initiating a healing process. As such the model was found to be both effective and transportable to an African context. Various points of discussion are highlighted, including the challenges of working with PTSD and comorbid major depression, the client-therapist relationship, and that a client and therapist from different cultures, backgrounds, and with different home languages can work together effectively using the Ehlers and Clark model.

This study employed a case-based research design to document the psychological assessment and treatment of Zanele, a 15-year-old black Xhosa speaking female who was raped twice in 2006 by the same perpetrator. The aim of the study was to explore whether, the model for assessment and intervention for posttraumatic stress disorder (PTSD) developed by Ehlers and Clark (2000) was effective and transportable to the South African context. Zanele had a sufficient understanding of English for assessment to proceed without use of an interpreter. She reported a number of PTSD symptoms which were causing her significant distress and had impacted on her social and educational functioning. These included flashbacks of the perpetrator's face when she looked at the faces of black men, nightmares about the traumas she had endured and feeling isolated from others. A number of cognitive techniques were utilised in this study, however the central interventions included working with triggers, imagery rehearsal techniques with a focus on nightmares, and reliving with cognitive restructuring within and outside reliving. Psychoeducation and increasing her social support were also important components of the intervention. Her progress was monitored by means of several self-report measures which were displayed in graphic and tabular form. In addition, a thematically selective narrative of the assessment and first 23 sessions of the intervention was written which documents some of the central processes set in motion by the interventions. These results provide evidence that this model was both effective and transportable to the South African population. In addition, the study demonstrated that it is possible for a white English speaking clinician to work with a black Xhosa speaking individual and make substantial therapeutic gains.

Bakgrund: Personalen är den viktigaste tillgången inom vården och därför är det viktigt att de får det stöd som de behöver för att undvika stress och psykisk utmattning. Personal som arbetar i arbetsmiljöer där kritiska och traumatiska händelser uppstår löper en större risk att drabbas av psykisk ohälsa i form av utbrändhet, depressioner samt stress och även posttraumatisk stressyndrom (PTSD). Personalstöd har visat sig leda till såväl lägre sjukfrånvaro som mindre personalomsättning. Det finns olika former av personalstöd, ute i verksamheterna används oftast kamratstöd, avlastningssamtal och debriefing. Syfte: Syftet med denna studie var att undersöka förekomst av riktlinjer samt att beskriva dess innehåll för personalstöd efter kritiska och traumatiska händelser på ett antal anestesiavdelningar i Sverige. Metod: Metoden som användes var av kvantitativ och kvalitativ ansats och analysen genomfördes med manifest innehållsanalys. Resultat: 28 frågeformulär skickades ut, av dessa erhölls fjorton svar och sju utav dessa hade avdelningsspecifika riktlinjer för personalstöd. Riktlinjerna granskades och tre kategorier urskiljdes; syfte och mål med riktlinjerna, förebygga och stödja samt arbetsmiljö. De stödåtgärder som framkom var avlastningssamtal, debriefing, krisstöd, enskilt krisstöd, ceremonier samt emotionellt stöd och eftersnack. Avlastningssamtal var den vanligaste stödåtgärden. Slutsats: Ungefär hälften av de anestesiavdelningarna som erhöll frågeformulär valde att inte medverka i studien. Endast sju anestesiavdelningar av de som medverkade hade riktlinjer trots att lagar och föreskrifter säger att arbetsgivaren ska tillhandahålla riktlinjer för personalstöd. Klinisk betydelse: Förhoppningen är att denna studie ska vara ett stöd för verksamheter vid utformning av riktlinjer samt vid uppdatering av befintliga riktlinjer för personalstöd efter kritiska och traumatiska händelser. / Background: The personnel are the most important asset in health care and it is therefore important that they receive the support they need to avoid stress and mental fatigue. Personnel which works in environments where critical and traumatic events occur is at a higher risk of mental illness in form of burnout, depression, stress and also post-traumatic stress disorder (PTSD). Support to personnel has been found to contribute both to lower absenteeism as well as a lower personnel turnover. There are various forms of personnel support, the most commonly used types within operations are co-worker support, relief conversations and debriefing. Aim: The aim of this survey was to investigate the presence of guidelines and its contents for personnel support after critical and traumatic events in a number of anesthesia departments in Sweden Method: The method used was quantitative and qualitative approach, and the analysis was performed with manifest content analyze. Result: 28 questionnaires were sent out, of these were fourteen responses received and seven of these had guidelines for personnel support. The guidelines were reviewed and three categories were distinguished; purpose and goals of the guidelines, prevention and support, and work environment. Support methods that emerged was relief conversations, debriefing, crisis support, individual crisis support, ceremonies, emotional support and after talk. Relief conversations were found to be the most common method. Conclusion: Approximately half of the anesthesia departments that received questionnaires decided to don’t participate in the study. Only seven anesthesia departments of those who participated had guidelines, despite the fact that laws and regulations say that the employer shall provide guidelines for personnel support. Clinical significance: It is wished that this study will provide support for activities when developing guidelines, and also when updating already existing guidelines for personnel support after critical and traumatic events.

Experts in traumatology have postulated traumatized children play differently than non-traumatized children. These differences are called posttraumatic play and include the behaviors of intense play, repetitive play, play disruption, avoidant play and negative affect. The purpose of this study is the continued development of the Trauma Play Scale through the addition of a normative sample. The Trauma Play Scale is an observation-based instrument designed to distinguish the play behaviors of children in play therapy with a history of interpersonal trauma when compared to non-traumatized children. The present study compares two samples of children. One group (n=6) currently in play therapy with a history of interpersonal trauma and another group (n=7) considered normally developing (cognitively, emotionally, socially, and physically) by their parents with no known history of interpersonal trauma. Trained raters blind to the trauma history of the children rated a series of eight consecutive video-recorded play therapy sessions for each participant. One-way analysis of variance statistics, including effect sizes were compute to determine the discriminant validity of the Trauma Play Scale. Traumatized children scored significantly higher on the Trauma Play Scale than non-traumatized children on all domains of the scale as well as the overall Average Trauma Play Scale score. Large effect sizes indicated strong relationships between group membership (trauma history versus normally developing) and scores on the Trauma Play Scale.

Eye Movement Desensitization and Reprocessing, EMDR, is a new clinical treatment shown to be effective for victims of trauma. EMDR is a time efficient, comprehensive methodology backed by positive, controlled research, for the treatment of disturbing experiences that underlie many pathologies. An eight phase treatment approach that includes using eye movements or other left-right stimulation, EMDR helps victims of trauma reprocess disturbing thoughts and memories. The purpose of this research project was to describe and explore the utilization of EMDR by licensed clinical social workers who were registered as members of the National Association of Social Workers.

Researchers have found an overlap of psychological symptoms in victims of Post-Traumatic Stress Disorder and Continuous Traumatic Stress. Although the circumstances inducing the psychological reactions are different, the symptoms mimic one another without a clear cut demarcation, calling for practitioners to be cautious of contexts inducing psychopathology that is triggered through re-experiencing of past trauma when they are assessing and intervening with ongoing trauma-exposed communities. This study explored the subjective experiences of 15 local Non-Governmental Organization (NGO) administrators in Nigeria across 5 states, including the federal capital Abuja, about the intersectionality of their clients' persistent trauma experiences and their program planning and intervention strategies. The study leveraged complexity and organizational change models, using qualitative inquiry with open ended interview questions and purposive sampling. Questions probed administrators' modalities, orientations, and perceptions that inform organizational planning and interventions. Open-ended interviews of top local NGO administrators provided contrasting insights on current interventions. Data were collected and analyzed using constant comparative content analysis. Findings suggest that local NGO administrators currently lack the awareness and capacity to address their clients' psychosocial, behavioral, and mental health issues that are related to continuous, direct, and indirect violence. The study impacts social change by identifying gaps in current NGO administrators' efforts to reduce effects of violence and support peace in affected communities.

No description available.

The subject of Attention Deficit Hyperactivity Disorder (ADHD), and Ritalin as a method of treatment, has received a lot of media attention in recent years as it appears to be the most “popular” diagnosis for children who are difficult, who struggle to pay attention and who are impulsive and hyperactive. Some medical professionals are of the opinion that incidences of the disorder are increasing, while others believe that the disorder is being misdiagnosed. There is a significant overlap in the symptoms of ADHD and those of Post-traumatic Stress Disorder (PTSD). In South Africa, where many children are exposed to traumatic stimuli on a regular and ongoing basis, health care professionals cannot afford to overlook the possibility that children exhibiting symptoms of ADHD may, in fact, be traumatised. However, when examining the criteria for PTSD we find that the DSM-IV (Diagnostic and Statistical Manual IV) does not adequately describe the differences between adult and childhood PTSD and also does not adequately account for children who may be in an almost continuous state of traumatic stress. Since there is increasing evidence of the interaction between mind/emotions and body, it is plausible that the emotions of children with ADHD play an important role in their condition, particularly if the child has suffered traumatic stress. The researcher believes that children who experience continuous traumatic stress may develop maladaptive responses which may eventually become traits, and that ADHD may be one such response. The goal of this exploratory study was to gain insight into the thoughts and feelings of a few children (case studies) who have been diagnosed with ADHD and who are in the middle childhood phase of development. The first objective was to gather knowledge regarding ADHD, traumatic stress, biological responses to trauma and to describe middle childhood and gestalt play therapy. In the empirical study, gestalt play therapy techniques were used to assess whether children with ADHD had suffered traumatic stress (particularly the loss of safety and security) prior to the diagnosis and whether they are able to express their thoughts and emotions appropriately. Since the study was qualitative, the researcher made use of observation and unstructured interviews (including play therapy sessions) to obtain background information from the parents and to explore the thoughts, feelings and behaviours of children with ADHD from their perspective. This study falls under applied research, undertaken with a view to creating preventative measures and improving interventions for children with ADHD and children who have suffered traumatic stress. The final objective of the study was to draw conclusions and make recommendations in order to promote awareness of the likelihood of traumatic stress in children with ADHD in South Africa. The researcher concluded that the respondents in this study have indeed suffered traumatic stress in the form of loss of safety and security, related to an inadequate bond with a responsive, nurturing caregiver. In addition, they have difficulty expressing their thoughts and emotions. / Dissertation (Magister Socialis Diligentiae (Play Therapy))--University of Pretoria, 2007. / Social Work and Criminology / unrestricted

Terapeuter ingår i riskgruppen för utvecklandet av psykisk ohälsa. Det finns både risk- och skyddsfaktorer som påverkar compassion fatigue (CF) - empatitrötthet - och sekundär traumatisk stress (STS) hos terapeuter. Forskningen visar att traumaarbete upplevs såväl positivt som negativt. Syftet i föreliggande studie var att beskriva terapeuters upplevelser om CF och STS. Därtill att ta reda på om detta kunde relateras till terapeuten själv och arbetsvillkoren samt vad som tycktes ha betydelse för att undvika CF och STS. En litteraturstudie gjordes där artiklarna analyserades genom kvalitativ innehållsanalys. Resultatet innehåller ett huvudtema; Att arbeta med människors trauma är ett privilegium, samtidigt har det sitt pris och sju subteman. I studien diskuteras CF och STS utifrån att det som terapeut i traumaarbete är oundvikligt att drabbas samt att dessa fenomen behöver vara pratbara. Dessutom framkom källor till resiliens. / Therapists are at risk of developing mental illness. Research shows that working with traumatreatment gives both positive and negative experiences. There are both risk and protective factors that affect Compassion Fatigue (CF) and Secondary Traumatic Stress (STS). The aim of this study was to describe therapists' experiences of CS and STS. Furthermore finding out if they could be related to the therapist in person and working conditions as well as if certain elements were important to avoid CF and STS. A literature study was carried out where articles were analyzed using a qualitative content approach. The result includes a main theme; “Working with people ́s trauma is a privilege, at the same time it has its price” and seven subthemes. CF and STS are thereafter discussed based on the idea of the importance that these phenomena are known and that as a traumatherapist it is inevitable to be affected. In addition sources of resilience emerged.