Afrikaans text / Die studie ondersoek die leemte aan teoreties gefundeerde riglyne om pleegouers in die bekendmakingsproses van hulle kind se MIV-positiewe status te ondersteun Die studie geskied binne die teoretiese raamwerk van ʼn intervensienavorsingsmodel. In die empiriese navorsing is die vrese en probleme van pleegouers by die bekendmakingsproses ondersoek. Daar is bevind dat hierdie vrese en probleme in ag geneem moet word in die beoogde riglyne. Die kognitiewe ontwikkeling van die kind is deur middel van ʼn literatuurstudie ondersoek om vas te stel watter kennis, denke en inligting die kind op verskillende ouderdomme begryp. Daar is bevind dat kinders wat MIV-positief is, moontlike agterstande ondervind en dat die riglyne gevolglik gebaseer moet word op die toenemende ontwikkeling van die kind, met begrip vir individuele ontwikkelingsverskille. Voorts is bevind dat pleegouers se eie gereedheid ʼn belangrike rol speel. Alhoewel die pleegouer die bekendmakingsproses self moet aanvoer en hanteer is dit belangrik dat die pleegouers deur ʼn interdissiplinêre span ondersteun en begelei sal word. / This study investigates the absence of theoretical grounded guidelines to support foster parents when disclosing paediatric HIV. The study was done within the theoretical framework of an intervention research model. The empirical research investigated the fears and problems experienced by foster parents during the disclosure process. It was found that these fears and problems should be taken into account when compiling guidelines. The child‟s cognitive development was researched by way of a literary study in order to determine what knowledge, thoughts and information the child is able to grasp at different ages. It was found that children who are HIV positive could possibly lag behind and that the guidelines should therefore be based on the accumulative development of the child, with consideration given to individual developmental differences. Furthermore, it was established that foster parents‟ own readiness plays an important role. For this reason the foster parents should be supported and guided by an interdisciplinary team, but that they themselves should take care and execute the process of disclosure. / Social Work / M. Diac. (Spelterapie)

Objetivos: Realizar uma avaliação das reações dos pais à internação do filho em unidade de terapia intensiva e desenvolver uma proposta de apoio psicológico. Casuística: Foram entrevistados 48 pais em unidade de terapia intensiva pediátrica e 27 em unidade de terapia intensiva neonatal, além dos pais que participaram nos grupos de pais. Métodos: 1) Realização de entrevistas semi-dirigidas com os pais, utilizando questionários previamente elaborados, à admissão do paciente e durante sua internação; 2) Avaliação do nível de ansiedade dos pais à internação do filho, pela aplicação do Inventário de ansiedade traço-estado; e 3) Realização de grupos de pais em unidade de terapia intensiva pediátrica, com a participação de equipe multiprofissional. Resultados: Em ambas as unidades de terapia intensiva as reações mais freqüentemente citadas pelos pais ao início da internação foram de desespero e tristeza, e citaram as necessidades de apoio psicológico como as mais importantes neste momento. Os principais sentimentos relatados no decorrer da internação foram de preocupação, medo e tristeza, e a maioria dos pais em ambas as UTIs ficaram assustados com a aparência do filho. Os níveis de ansiedade mostraram-se significativamente elevados à ocasião da internação do filho, não havendo diferença entre os pais em UTI pediátrica e neonatal. O grupo de pais revelou-se uma técnica eficaz de apoio psicológico em UTI. Conclusões: Há necessidade de apoio psicológico aos pais de pacientes pediátricos internados tanto em UTI pediátrica como neonatal, pelo elevado nível de ansiedade, desespero e tristeza que apresentam à internação do filho. As entrevistas semidirigidas com a aplicação dos questionários propostos para 11 avaliação dos pais mostraram-se estratégias adequadas para a investigação do estado emocional desses pais e constituem formas eficientes de fornecer apoio psicológico durante a realização das mesmas. O grupo de pais possibilitou o contato direto com profissionais de diversas áreas, com disposição a escutá-los, valorizá-los, compreender seus sentimentos e esclarecer suas dúvidas. Permitiu o convívio com outros pais em fases diferentes da mesma situação, mobilizando recursos para lidar com o período crítico da doença e internação e o apoio no processo de luto do filho saudável para conseguirem um vínculo satisfatório com o filho doente. A questão da morte, as dificuldades com a equipe, a falta de apoio de familiares e outras questões extremamente angustiantes puderam ser ampla e abertamente discutidas nos grupos, trazendo esclarecimentos e alívio. A reunião com a equipe após os grupos mostrou-se de extrema importância para a uniformização de condutas, entendimento das reações dos pais, e discussões relativas ao relacionamento entre eles e a equipe. Em relação às entrevistas individuais semi-dirigidas, o grupo de pais mostrou-se uma estratégia complementar, já que os mesmos problemas e queixas são discutidos de formas diferentes nos dois tipos de intervenção. / Objectives: Assessment of parents reactions to the admission of their child into an ICU and development of a proposal of psychological support. Sample: 48 interviewed parents in pediatric ICU and 27 in neonatal ICU were included besides the participants of the groups of parents. Procedures: 1) Semi-directed interviews were performed with parents, with the application of previously elaborated questionaires; 2) Assessment of the parents anxiety at the admission of the child in ICU, with the application of the State-Trait Anxiety Inventory; and 3) lead groups of parents were performed in pediatric ICU with the participation of multidisciplinary staff. Results: The most frequent reactions cited by the parents to the admission of the child in an ICU were despair and sadness. Moreover, psychological support was the most essencial need at that moment. The most important feelings cited during hospitalization were worry, fear and sadness, and most parents in both ICU were very scared of the appearance of their children. There was a significant increase in parents anxiety at the admission of the child, and there were no differences between the scores of parents anxiety in pediatric or neonatal ICU. The group of parents was a good technique of psychological support in ICU. Conclusions: Psychological support to parents of pediatric patients admitted to an ICU is necessary, because of high anxiety level, dispair and sadness that parents show at the admission of their child to an ICU. The semi-directed interviews with the appication of the proposed questionaires to the assessment of parents were good techiques for the investigation of the emotional state of these parents and constituted efficient ways of giving them psychological support. The group of parents permitted the direct contact with professionals of various areas, willing to listen to them, value them, understand their feelings and clarify their doubts. They permitted contact with other parents in different phases of the same situation, mobilizing resources for dealing with the critical period of the disease and admission, and giving support in the mourning process of the healthy child so that they could get a satisfactory attachment to the sick one. The subject of death, the difficulties with the staff, the lack of support from relatives and other highly anxious questions could be discussed during the group sessions widely, bringing clarity and relief. The meetings with the staff after the group sessions were very important to unify the procedures, understand the parents reactions, and discuss the relationship between them and the staff. In relation to the individual semi-directed interviews, the parents group revealed a complementary technique, as the same problems and complaints were discussed in different ways in both forms of intervention.

Objetivos: Realizar uma avaliação das reações dos pais à internação do filho em unidade de terapia intensiva e desenvolver uma proposta de apoio psicológico. Casuística: Foram entrevistados 48 pais em unidade de terapia intensiva pediátrica e 27 em unidade de terapia intensiva neonatal, além dos pais que participaram nos grupos de pais. Métodos: 1) Realização de entrevistas semi-dirigidas com os pais, utilizando questionários previamente elaborados, à admissão do paciente e durante sua internação; 2) Avaliação do nível de ansiedade dos pais à internação do filho, pela aplicação do Inventário de ansiedade traço-estado; e 3) Realização de grupos de pais em unidade de terapia intensiva pediátrica, com a participação de equipe multiprofissional. Resultados: Em ambas as unidades de terapia intensiva as reações mais freqüentemente citadas pelos pais ao início da internação foram de desespero e tristeza, e citaram as necessidades de apoio psicológico como as mais importantes neste momento. Os principais sentimentos relatados no decorrer da internação foram de preocupação, medo e tristeza, e a maioria dos pais em ambas as UTIs ficaram assustados com a aparência do filho. Os níveis de ansiedade mostraram-se significativamente elevados à ocasião da internação do filho, não havendo diferença entre os pais em UTI pediátrica e neonatal. O grupo de pais revelou-se uma técnica eficaz de apoio psicológico em UTI. Conclusões: Há necessidade de apoio psicológico aos pais de pacientes pediátricos internados tanto em UTI pediátrica como neonatal, pelo elevado nível de ansiedade, desespero e tristeza que apresentam à internação do filho. As entrevistas semidirigidas com a aplicação dos questionários propostos para 11 avaliação dos pais mostraram-se estratégias adequadas para a investigação do estado emocional desses pais e constituem formas eficientes de fornecer apoio psicológico durante a realização das mesmas. O grupo de pais possibilitou o contato direto com profissionais de diversas áreas, com disposição a escutá-los, valorizá-los, compreender seus sentimentos e esclarecer suas dúvidas. Permitiu o convívio com outros pais em fases diferentes da mesma situação, mobilizando recursos para lidar com o período crítico da doença e internação e o apoio no processo de luto do filho saudável para conseguirem um vínculo satisfatório com o filho doente. A questão da morte, as dificuldades com a equipe, a falta de apoio de familiares e outras questões extremamente angustiantes puderam ser ampla e abertamente discutidas nos grupos, trazendo esclarecimentos e alívio. A reunião com a equipe após os grupos mostrou-se de extrema importância para a uniformização de condutas, entendimento das reações dos pais, e discussões relativas ao relacionamento entre eles e a equipe. Em relação às entrevistas individuais semi-dirigidas, o grupo de pais mostrou-se uma estratégia complementar, já que os mesmos problemas e queixas são discutidos de formas diferentes nos dois tipos de intervenção. / Objectives: Assessment of parents reactions to the admission of their child into an ICU and development of a proposal of psychological support. Sample: 48 interviewed parents in pediatric ICU and 27 in neonatal ICU were included besides the participants of the groups of parents. Procedures: 1) Semi-directed interviews were performed with parents, with the application of previously elaborated questionaires; 2) Assessment of the parents anxiety at the admission of the child in ICU, with the application of the State-Trait Anxiety Inventory; and 3) lead groups of parents were performed in pediatric ICU with the participation of multidisciplinary staff. Results: The most frequent reactions cited by the parents to the admission of the child in an ICU were despair and sadness. Moreover, psychological support was the most essencial need at that moment. The most important feelings cited during hospitalization were worry, fear and sadness, and most parents in both ICU were very scared of the appearance of their children. There was a significant increase in parents anxiety at the admission of the child, and there were no differences between the scores of parents anxiety in pediatric or neonatal ICU. The group of parents was a good technique of psychological support in ICU. Conclusions: Psychological support to parents of pediatric patients admitted to an ICU is necessary, because of high anxiety level, dispair and sadness that parents show at the admission of their child to an ICU. The semi-directed interviews with the appication of the proposed questionaires to the assessment of parents were good techiques for the investigation of the emotional state of these parents and constituted efficient ways of giving them psychological support. The group of parents permitted the direct contact with professionals of various areas, willing to listen to them, value them, understand their feelings and clarify their doubts. They permitted contact with other parents in different phases of the same situation, mobilizing resources for dealing with the critical period of the disease and admission, and giving support in the mourning process of the healthy child so that they could get a satisfactory attachment to the sick one. The subject of death, the difficulties with the staff, the lack of support from relatives and other highly anxious questions could be discussed during the group sessions widely, bringing clarity and relief. The meetings with the staff after the group sessions were very important to unify the procedures, understand the parents reactions, and discuss the relationship between them and the staff. In relation to the individual semi-directed interviews, the parents group revealed a complementary technique, as the same problems and complaints were discussed in different ways in both forms of intervention.

The purpose of this study was to develop and test the efficacy of a short-term structured play therapy treatment program for latency-aged children of divorce between six and twelve years of age. Following parental divorce latency-aged children often manifest disturbed emotional and behavioural functioning in several areas of their lives including issues such as self-image problems and poor academic functioning. In many instances, problems are acute and necessitate effective help in a relatively short time. Several play therapy modalities exist for children with some focusing on problems stemming from divorce. However, due to their complex, unstructured and lengthy nature, most of the treatment programs reviewed were relatively ineffective for most social workers. Increasingly families have little time and/or limited financial resources to commit to long-term therapy. A literature review showed a clear need for a shorter, less complex treatment program to solve the problem of limited finances and time constraints of parents seeking help for their children. A seven-stage, short-term structured play therapy program was developed for this study, including a pre-and post-treatment assessment, which focused on the main areas of dysfunction prominent among latency-aged children of divorce. The program was implemented by treating a female latency-aged child from a divorced family. The findings showed that the short-term structured play therapy program developed for this study appears to be effective in dealing with necessary and important psychological tasks facing children of divorce. The treatment program worked effectively with a female latency-aged child and facilitated psychological and emotional movement in a relatively short period of time. For social workers specialising in child play therapy the treatment program will be easy to use since all activities are clearly structured and explained with materials utilised in the sessions easy to obtain. As such, it could be a necessary and effective addition to the social work profession. / Social Work / D. Phil. (Social Work)

The prevalence of divorce within society is reflected in the rising divorce rate worldwide. Consequently, divorce has become more accepted, although adolescents from divorced families are considered at risk for maladjustment. The aim of this study is to give a voice to adolescents who have experienced their parents' divorce and to highlight their resilience despite the challenges they faced. The epistemological framework is social constructionism. In-depth interviews with two adolescents who have experienced the divorce of their parents were undertaken. The method of analysis used was `Thematic content analysis'. The participants' stories were recounted through the lens of the researcher in the form of themes. Recurring themes in these stories were elucidated and linked with the literature. This study allowed rich and detailed descriptions about adolescents' experiences to emerge, which the researcher hopes will broaden the therapeutic understanding of the complexities of divorce for the adolescents who survive it. / Psychology / MA (Clinical Psychology)

Afrikaans text / Die studie ondersoek die leemte aan teoreties gefundeerde riglyne om pleegouers in die bekendmakingsproses van hulle kind se MIV-positiewe status te ondersteun Die studie geskied binne die teoretiese raamwerk van ʼn intervensienavorsingsmodel. In die empiriese navorsing is die vrese en probleme van pleegouers by die bekendmakingsproses ondersoek. Daar is bevind dat hierdie vrese en probleme in ag geneem moet word in die beoogde riglyne. Die kognitiewe ontwikkeling van die kind is deur middel van ʼn literatuurstudie ondersoek om vas te stel watter kennis, denke en inligting die kind op verskillende ouderdomme begryp. Daar is bevind dat kinders wat MIV-positief is, moontlike agterstande ondervind en dat die riglyne gevolglik gebaseer moet word op die toenemende ontwikkeling van die kind, met begrip vir individuele ontwikkelingsverskille. Voorts is bevind dat pleegouers se eie gereedheid ʼn belangrike rol speel. Alhoewel die pleegouer die bekendmakingsproses self moet aanvoer en hanteer is dit belangrik dat die pleegouers deur ʼn interdissiplinêre span ondersteun en begelei sal word. / This study investigates the absence of theoretical grounded guidelines to support foster parents when disclosing paediatric HIV. The study was done within the theoretical framework of an intervention research model. The empirical research investigated the fears and problems experienced by foster parents during the disclosure process. It was found that these fears and problems should be taken into account when compiling guidelines. The child‟s cognitive development was researched by way of a literary study in order to determine what knowledge, thoughts and information the child is able to grasp at different ages. It was found that children who are HIV positive could possibly lag behind and that the guidelines should therefore be based on the accumulative development of the child, with consideration given to individual developmental differences. Furthermore, it was established that foster parents‟ own readiness plays an important role. For this reason the foster parents should be supported and guided by an interdisciplinary team, but that they themselves should take care and execute the process of disclosure. / Social Work / M. Diac. (Spelterapie)