Magister Psychologiae - MPsych / South Africa is a country with one of the highest crime rates in the world, resulting in much violence and trauma. Trauma debriefing models are used with groups and individuals in an attempt to facilitate the trauma recovery process and prevent the development of post-traumatic stress disorder (PTSD). There has been much debate on the efficacy of trauma debriefing over the past two decades with few qualitative studies exploring the utility of debriefing. A phenomenological methodology was used in this study, with the aim of understanding how participants experienced the process of trauma debriefing and what aspects were perceived as helpful or unhelpful. Semi-structured in- depth interviews were conducted with six adults who received debriefing following a single traumatic event, by volunteer lay counsellors from the Community Intervention Centre (CIC) based at the Milnerton Medi-Clinic.

Certain individuals, such as police officers, are exposed to traumatic events as part of the occupational roles they fulfill. In order to prevent psychological illnesses; namely the Post-Traumatic Stress Disorder (PTSD) that results from work-related traumatic incidents, psychological interventions have been developed such as Critical Incident Stress Debriefing. The aim of the study was to explore the experiences and the perceptions of police members stationed at the South African Police Service (SAPS) Head Office in Pretoria, regarding the effectiveness of Trauma Debriefing within the SAPS environment. The researcher was motivated to choose this subject as a result of the challenges he faced while working as a Psychometrist and a Debriefer within the SAPS. Furthermore, the lack of research and literature studies concerning the effectiveness of trauma debriefing motivated the researcher to conduct the study. The qualitative approach was utilized in this study, and interviews were used to gather data about the experiences and perceptions of police members regarding the effectiveness of trauma debriefing. Utilizing an interview schedule, the researcher interviewed 10 respondents who were functional members of the SAPS. A systematic sampling method was used to select suitable respondents for the study. The type of research used was that of applied research, as the intention was to answer practical questions about the effectiveness of trauma debriefing within the SAPS. The exploratory design was utilized in this study, since there was limited information about the experiences and perceptions of police members in existence. The purpose of using this design was thus to explore the perceptions and experiences of police members regarding the effectiveness of trauma debriefing in order to provide new information about the topic. The researcher believes that this research will provoke some thought about new scientific research into this field of study. A discussion on the theoretical overview on trauma debriefing focused on the goals and theories of debriefing. In addition, a theoretical overview of the debriefing model adopted by the SAPS, the benefits of debriefing, the diagnostic criteria for PTSD and critical perspectives with regard to the effectiveness of trauma debriefing. The research findings indicated that trauma debriefing has been viewed and experienced by most respondents as good. Most police members perceived trauma debriefing as effective. Furthermore, police members perceived trauma debriefing as management=s support. The research findings however also indicated that trauma debriefing should be pro-active rather than reactive. Some respondents felt that debriefing should include an element of monitoring members, in order to check their progress. In addition, the study showed that there is a lack of follow-up services to debriefing cases attended. / Dissertation (MSoc.Sci (Employee Assistance Programme))--University of Pretoria, 2006. / Social Work / unrestricted

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

Magister Commercii (Industrial Psychology) - MCom(IPS) / The current crime rate in the Western Cape plays a crucial role in the exposure of police officers to stressful and traumatic events. The intensity and frequency of this exposure, if not treated, could lead to police officers experiencing comorbid disorders such as post-traumatic stress disorder (PTSD). This leads to an increased need for trauma intervention strategies to be offered, to assist police officers who are exposed to trauma in the South African Police Service (SAPS). Although trauma intervention programmes are established within SAPS, a difference in perception about their effectiveness and service offering are presented. The purpose of this study was to investigate the differences in perception toward stress and trauma intervention strategies within the SAPS in the Western Cape. In order to achieve the purpose of the study, the researcher, tapped into the lived experiences of current police officers and Employee Health and Wellness (EHW) staff, employed by SAPS through semi-structured interviews. Through a comparative design, the study will add value to the current body of knowledge, as differences and similarities between two of the primary role players in the trauma debriefing process within the SAPS are explored. The research sample, recruited by means of convenience sampling, consisted of seven EHW staff members who had experience with dealing with stress and trauma-related programmes, and eight visible policing police officers who had experienced some form of trauma-related incident. The researcher made use of an in-depth interview guide as the research instrument for this study, which consisted of audio-recorded semi-structured interviews with the participants. The audio recordings were transcribed, and then analysed by means of thematic analysis. The findings showed that a difference in perception exists between police officers and EHW staff members toward the effectiveness of trauma intervention strategies offered in the SAPS. The findings also suggest that the majority of police officers do not make use of the trauma intervention programmes in the SAPS, in comparison to EHW staff reporting on good attendance by police officers at the service offerings. Similarities in perception between the two groups presented itself in the form of how trauma is defined, the different responses to trauma and coping mechanisms employed by police officers. The implications of this study include a contribution toward policy and structural amendments of the Employee Assistance Programme (EAP) framework within the SAPS, as well as a motivation for implementing a compulsory trauma counselling programme for police officers.

No description available.

Text in Afrikaans / Die studie fokus op die effek van krisiswerk op die helper in terme van stres, die uitbrandingsindroom en posttraumatiese stresversteuring (PTSV). Salutogeniese konstrukte as moderatorveranderlikes in die stres-siekte-verhouding word ook ondersoek. 'n Beskikbaarheidsteekproef van 52 ambulansmanne en 52 kontrolegroepwerkers is verkry. Biografiese, koherensie-, uitbrandings-, PTSV- en stresvraelyste is ingevul en statisties verwerk. Resultate dui daarop dat ambulansmanne hul werk as buitengewoon stresvol beleef en dat meer ambulansmanne diagnoseerbare PTSV vertoon. Daar blyk geen verskil tussen die twee groepe te wees nie met betrekking tot die voorkoms van uitbranding en streservaring. 'n Negatiewe verband tussen koherensiebelewing en die voorkoms van stressimptome en uitbranding is verkry. Ambulansmanne het 'n buitengewoon stresvolle werk en vertoon meer simptome van stresversteurings as mense in ander beroepe. Aanbevelings word gedoen oor hoe om die negatiewe konsekwensies van stres te verminder. / The study focuses on the effect of crisis work on the assistant in terms of stress, the burnout syndrome and post-traumatic stress disorder (PTSD). Salutogenic constructs as moderator variables in the stress-illness relationship are also investigated. An availability sample of 52 ambulancemen and 52 control group workers was obtained. Biographic, coherence, burnout, PTSD and stress questionnaires were completed and statistically processed. Results indicate that ambulancemen experience their work as exceptionally stressful and that more Ambulancemen display diagnosable PTSD. There appears to be no difference between the two groups in respect of the incidence of burnout and experience of stress. A negative connection between the experience of coherence and the incidence of stress symptoms and burnout was obtained. Ambulancemen have an exceptionally stressful job and display more symptoms of stress disorders. Recommendations are made on how to reduce the negative consequences of stress. / Industrial and Organisational Psychology / M. Com. (Bedryfsielkunde)

Text in Afrikaans / Die studie fokus op die effek van krisiswerk op die helper in terme van stres, die uitbrandingsindroom en posttraumatiese stresversteuring (PTSV). Salutogeniese konstrukte as moderatorveranderlikes in die stres-siekte-verhouding word ook ondersoek. 'n Beskikbaarheidsteekproef van 52 ambulansmanne en 52 kontrolegroepwerkers is verkry. Biografiese, koherensie-, uitbrandings-, PTSV- en stresvraelyste is ingevul en statisties verwerk. Resultate dui daarop dat ambulansmanne hul werk as buitengewoon stresvol beleef en dat meer ambulansmanne diagnoseerbare PTSV vertoon. Daar blyk geen verskil tussen die twee groepe te wees nie met betrekking tot die voorkoms van uitbranding en streservaring. 'n Negatiewe verband tussen koherensiebelewing en die voorkoms van stressimptome en uitbranding is verkry. Ambulansmanne het 'n buitengewoon stresvolle werk en vertoon meer simptome van stresversteurings as mense in ander beroepe. Aanbevelings word gedoen oor hoe om die negatiewe konsekwensies van stres te verminder. / The study focuses on the effect of crisis work on the assistant in terms of stress, the burnout syndrome and post-traumatic stress disorder (PTSD). Salutogenic constructs as moderator variables in the stress-illness relationship are also investigated. An availability sample of 52 ambulancemen and 52 control group workers was obtained. Biographic, coherence, burnout, PTSD and stress questionnaires were completed and statistically processed. Results indicate that ambulancemen experience their work as exceptionally stressful and that more Ambulancemen display diagnosable PTSD. There appears to be no difference between the two groups in respect of the incidence of burnout and experience of stress. A negative connection between the experience of coherence and the incidence of stress symptoms and burnout was obtained. Ambulancemen have an exceptionally stressful job and display more symptoms of stress disorders. Recommendations are made on how to reduce the negative consequences of stress. / Industrial and Organisational Psychology / M. Com. (Bedryfsielkunde)

Thesis (Ph.D. (Social Work)) -- University of Limpopo, 2021 / An Emergency Medical Service (EMS) is considered one of the most stressful work environments. Copious literature has demonstrated that emergency service work has an undesirable impact on the health and wellbeing of personnel. In South Africa, research findings described that emergency services personnel are among the highest group of professionals at risk of suffering from job-related stress. In spite of the fact, previous studies have examined the association between critical incidents and Post Traumatic Stress Disorder (PTSD) symptoms including the psychological influence of trauma, a minority studies have explored the EMS personnel’s traumatic experiences and the subsequent coping strategies applied. This study sought to explore and describe the lived experiences of Emergency Medical Personnel in Capricorn District and to develop a user led model for mitigating occupational stress among EMS personnel. The principal aim of this study was achieved through the following objectives; to profile work related stress and the lived experiences of EMS personnel in Capricorn District, to Identify and appraise coping strategies employed by EMS personnel, to establish how accessible and user friendly EAP services are to EMS personnel, to determine the nature of social support (colleagues and supervisors) EMS personnel receive and to develop a user-led model for EMS personnel. This study was rooted in three theories, namely; trauma theory, resilience theory and the strengths perspective theory. The three theories were appropriate in this study to offer a perspective of situation and to analyse the situation under study to provide an understanding into the way in which EMS personnel make sense of their situation of the challenges they come across and make use of the available resources. The three theories interlaced together played a critical role in this study as they both align with building resilience, recognise individual’s innate strengths and coping in the face of hardship. Owing to the inimitability role of the emergency personnel and the services’ work context, the study adopted a qualitative approach. The purpose of the study was exploratory descriptive in nature. Exploring both their experience of critical incidents and the coping strategies employed by them to mitigate work-related stress and traumatic incidents from this qualitative perspective allowed the researcher to employ phenomenological research design for this study. A sample size of 21 emergency employees comprising 7 station managers and 14 EMS personnel) was obtained through purposive sampling technique. Thematic analysis was used to analyse data.  The findings suggest that life in the emergency field can possibly have an undesirable long-term effect on employees’ overall health and welfare and higher risk of PTSD. The distressing incidents were those in which the participants experienced feelings of vulnerability and had no control of the situations. The study established that emergency personnel find it most hard to deal with incidents involving children and colleagues. Emergency personnel suffer from emotional and physical stress owing to high job demands and repeated exposure to traumatic incidents. Regardless of the traumatic nature of emergency work and the inimitable role of emergency personnel, this study discovered that fact several stressors originate from organisational failure such lack of involvement in decision-making process, lack of training and shortage of staff. Unsupportive work environment, Lack of personal and job resources were found to be the extensive contributory factors to the job pressure experienced by which lead to compassion fatigue and exhaustion. It was also discovered the current EAP programme in the Department of Health (DoH) is not known and inaccessible to EMS personnel. The coping strategies utilised by emergency personnel were not adequate to prevent the aftermath of critical incidents. However collegial and social support from supervisors were found helpful in dealing with work-related stress. The study findings revealed that emergency personnel were unaware of the available support services within the DoH in Capricorn District. Collectively, the findings confirm that there is a need for an extensive marketing strategy of the EAP services and the user-led model which will be implemented by the organisation. The researcher recommends that EAP policies should form part of package given to new recruits during induction or orientation programme and diverse marketing strategies should be adopted to familiarise employees with EAP services available to them. The DoH should consider decentralisation of EAP services to enhance accessibility.

Objective: Many women experience traumatic events already prior to or during pregnancy, and delivery of a child may also be perceived as a traumatic event, especially in women with prior post-traumatic stress disorder (PTSD). Birth-related PTSD might be unique in several ways, and it seems important to distinguish between lifetime PTSD and birth-related traumatization in order to examine specific consequences for mother and child. This post-hoc analysis aims to prospectively examine the relation of both, lifetime PTSD (with/without interpersonal trauma) and birth-related traumatization (with/without postpartum depression) with specific maternal and infant outcomes. Methods: In the prospective-longitudinal Maternal in Relation to Infants’ Development (MARI) study, N = 306 women were repeatedly assessed across the peripartum period. Maternal lifetime PTSD and birth-related traumatization were assessed with the Composite International Diagnostic Interview for women. Maternal health during the peripartum period (incl. birth experience, breastfeeding, anxiety, and depression) and infant outcomes (e.g., gestational age, birth weight, neuropsychological development, and regulatory disorders) were assessed via standardized diagnostic interviews, questionnaires, medical records, and standardized observations. Results: A history of lifetime PTSD prior to or during pregnancy was reported by 25 women who indicated a less favorable psycho-social situation (lower educational level, less social support, a higher rate of nicotine consumption during pregnancy). Lifetime PTSD was associated with pregnancy-related anxieties, traumatic birth experience, and anxiety and depressive disorders after delivery (and in case of interpersonal trauma additionally associated with infant feeding disorder). Compared to the reference group, women with birth-related traumatization (N = 35) indicated numerous adverse maternal and infant outcomes (e.g., child-related fears, sexual problems, impaired bonding). Birthrelated traumatization and postpartum depression was additionally associated with infant feeding and sleeping problems. Conclusion: Findings suggest that both lifetime PTSD and birth-related traumatization are important for maternal and infant health outcomes across the peripartum period. Larger prospective studies are warranted. Implications: Women with lifetime PTSD and/or birth related traumatization should be closely monitored and supported. They may benefit from early targeted interventions to prevent traumatic birth experience, an escalation of psychopathology during the peripartum period, and adverse infant outcomes, which in turn may prevent transgenerational transmission of trauma in the long term.

Introduction : La gestion d'une urgence vitale requiert la réalisation de gestes techniques et une communication entre les soignants en condition de stress. La simulation permet cet enseignement en sécurité.Objectif : Analyser l'association entre stress et performance et l'effet de la simulation répétée. Méthodes : Deux groupes expérimental et contrôle de 6 équipes pluri-professionnelles de SAMU (n = 48), avaient respectivement 9 (1/6 semaines) et 3 (1/6 mois) simulations, avec 3 scénarios communs : initial, intermédiaire à 6 mois, final à 1 an. Le stress a été évalué par la fréquence cardiaque et sa variabilité, le cortisol salivaire et des paramètres psychologiques (échelles de : stress aigu STAI et SOM ; stress post-traumatique IES-R et PCLS) ; la performance technique par les scores de pose de voie intra-osseuse (VIO), de performance globale (TAPAS) ; la performance non-technique par les scores BAT du leader, CTS de l'équipe.Résultats : Le stress augmentait durant la simulation (p < 0,02) et baissait lors du débriefing (p < 0,01) quelle que soit la fréquence de répétition, sans stress post-traumatique. Les performances étaient corrélées entre elles (p < 0,001) avec un lien étroit entre les scores BAT (leader) et CTS (équipe) (R² = 0,93). Stress et performance n'étaient pas corrélés. La performance était supérieure dans le groupe expérimental dès le scénario intermédiaire pour les scores techniques (TAPAS : p = 0,02, VIO : p = 0,03) et pour tous les scores lors du scénario final (TAPAS et IO : p = 0,01, CTS : p = 0,03, BAT : p = 0,02).Conclusion : La répétition de séances de simulation toutes les 6 semaines apportait un bénéfice majeur. La performance d'équipe était liée à celle du leader. / Introduction: The management of a life-threatening event by caregivers requires technical and non-technical skills under stress conditions. Simulation-based education allows this training in a safe environment. Objective: To analyze the association between stress and performance and the effect of repeated simulation.Methods: Two experimental and control groups of 6 MDTs of EMS (n=48) had respectively 9 (1session/6 weeks) and 3 (1session/6 months) simulations with 3 common sessions: initial, intermediate after 6 months, and final session after 1 year. Stress was assessed by heart rate and variability, salivary cortisol and psychological parameters (acute stress: STAI and SOM, and PTSD: IES-R and PCLS). The technical performance was evaluated by Intra-Osseous Access Performance Assessment Scale (IO), overall performance (TAPAS); non-technical performance by BAT score for leader and CTS score for teamwork.Results: Stress increased during simulation (p<0.02) and decreased during debriefing (p<0.01) regardless of the frequency of repetition. There was no PTSD. The performances were correlated between each other (p<0.001) with a strong link between the non-technical performance of leader and team (R²=0.93). Stress and performance were not correlated. The performance was higher in the experimental group during the intermediate scenario for technical scores (TAPAS: p=0.02, IO: p=0.03) and for all scores during the final scenario (TAPAS and IO: p=0.01 CTS: p=0.03, BAT : p=0.02).Conclusion: The benefit was greater when performing simulations every six weeks in terms of technical and non-technical performance. The team performance was linked to the leader performance.