The present study presents three individual cases; all three clients had endured a traumatic event, namely rape, and all three met the criteria for PTSD. Despite the fact that each of the clients was initially assessed as being a suitable candidate for psychological treatment, none of the cases proceeded to the therapy phase of treatment. A number of obstacles, both personal and contextual, were encountered during treatment implementation, preventing or limiting a successful outcome of psychological treatment in each case. An examination of these cases highlights a few of the many obstacles frequently faced when delivering psychological treatment to the South African context. In so doing, this research provides an opportunity to consider the possible reasons for the limited documentation of treatment efficacy within the South African context, as well as to enhance our understanding of and sensitivity towards the cultural and contextual factors playing a role in psychological treatment.

Increasing violence in the work environment created a need for an effective intervention to debrief traumatised workers. The aim of this study is to compile a profile of an effective trauma debriefer that can be used as a criterion for the selection of trauma debriefers. The task description of the trauma debriefer is based on the literature studied. The profile of the trauma debriefer was compiled using the characteristics of a self-actualised person, as described by the Humanism, as well as the skills based on Ivey's Microskills Hierarchy Model. Structured, non-directive interviews were conducted with five experts on the training of trauma debriefers. A qualitative analysis was made of the interviews, based on the personality characteristics and skills identified in the literature. A profile of an effective trauma debriefer that can be used as criterion during the selection of trauma debriefers, was compiled. Conclusions and recommendations were made and limitations were identified. / Toenemende geweld in die werksomgewing het gelei tot 'n behoefte aan 'n koste- effektiewe intervensie vir die ontlonting van getraumatiseerde vverkers. Die doei van die navorsing is die samestelling van 'n profiel van 'n effektiewe traumaontlonter, ten einde die profiel as kriterium vir die keuring van traumaontlonters te gebruik. Die taakbeskrywing van 'n traumaontlonter, gebaseer op relevante literatuur, is opgestel. Die profiel van 'n effektiewe traumaontlonter is aan die hand van die persoonlikheidskenmerke van die selfaktualiserende persoon, soos vervat in die Humanism©, en die vaardighede, gebaseer op Ivey se Mikrovaardighede Hierargiese Model, saamgestel. Gerigte, nie-direktiewe onderhoude is met vyf kundiges op die gebied van opleiding van traumaontlonters, gevoer. Die onderhoude is kwalitatief ontleed aan die hand van die persoonlikheidskenmerke en vaardighede vanuit die literatuur. 'n Profiel, wat as kriterium vir die keuring van effektiewe traumaontlonters gebruik kan word, is saamgestel. Gevolgtrekkings en aanbevelings is gemaak en beperkinge is geidentifiseer. / Summaries in English and Afrikaans / Industrial & Organisational Psychology / M.A. (Industrial Psychology)

The purpose of this study is to tell the story of lay trauma counsellors - how the work they do affects them, what helps them to cope and what hinders their coping. The epistemological framework of this study is constructivism. This study involved in-depth interviews with three lay trauma counsellors from different cultural backgrounds who counselled for a minimum of one year. Hermeneutics was the method used to analyse the data. The stories of participants were recounted through the researcher’s lens in the form of specific themes that emerged for individual participants. Recurring themes evident in the stories of all three participants were discussed and compared with the literature. The information gleaned could be valuable to organisations considering setting up lay trauma programmes, to those with established programmes, as well as to prospective and experienced lay counsellors. / Psychology / M.A. (Psychology)

This qualitative study illustrates that a narrative approach to pastoral therapy can guide collaborative co-authoring of alternative ways of living after trauma. The research emanates from postmodern epistemology and related discourses of social construction and post-structuralism, as well as a contextual approach to practical theology. The narrative practices of enrolling people in their own knowledges, of creating communities of concern, of honouring people, of celebration and joy, and of co-authoring alternative histories are illustrated through descriptions of how narrative maps guided one-to-one pastoral therapy as well as group work with people who have experienced trauma. The concept "resilience" is deconstructed so as to be understood as those personal actions which do not conform to pathologising predictions of the effects of trauma. / Hierdie kwalitatiewe studie illustreer dat 'n narratiewe benadering tot pastorale terapie die ko-konstruksie van alternatiewe leefwyses na trauma kan fasiliteer. Die navorsing spruit voort uit 'n postmoderne epistemologie en die verwante diskoerse van sosiale konstruksie en post-strukturalisme, asook 'n kontekstuele benadering tot praktiese teologie. Die narratiewe praktyke van ontginning van mense se kennis en vaardighede, van die skepping van gemeenskappe van sorg, van vreugde en waardering, en van die mede-skryf aan alternatiewe stories word geillustreer. Dit word gedoen deur beskrywings van die wyse waarop narratiewe kaarte individuele sowel as groepsterapie met getraumatiseerde persone kan begelei. Die konsep "weerstandsvermoee" ("resilience') word gedekonstrueer sodat dit verstaan word as daardie persoonlike ervarings wat patologiserende voorspellings oor getraumatiseerde persone weerspreek. / Philosophy, Practical & Systematic Theology / M.Th. (Practical Theology, with specialisation in Pastoral Therapy)

There is currently a crisis in military veteran mental health care. At 5-30% of veterans receive a PTSD diagnosis. Veterans face a large gap that exists in accessing and receiving high quality care. One intervention that is becoming more popular is equine assisted counseling (EAC). The purpose of the present study was to examine the effectiveness of Relational Equine-Partnered Counseling (REPC) in reducing symptoms of PTSD in military veterans. I also examined specific PTSD symptom clusters including intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. The present study utilized a single-case design consisting of a baseline phase, intervention phase, and post-intervention phase. Participants included four military veterans presenting for war zone-related PTSD: four males and one female, aged 32-67 years, two White/European non-Hispanic, one African American non-Hispanic, and one mixed ethnicity. Symptoms were assessed weekly using the Clinician-Administered PTSD Scale and the PTSD Checklist (PCL-5). The data were analyzed by visual analysis and statistical effect size. The results were mixed across the participants. All participants experienced decreased means between the baseline and intervention phases. However, interpretation of the results indicated that the intervention was effective in some areas for some of the participants. All participants reported that the intervention was beneficial in targeting specific symptoms. Overall, the results indicated that REPC may have some benefit in reducing distress related to PTSD. More research is needed to further explore the effectiveness of REPC on the reduction of PTSD-related distress.

This study discusses the assessment and treatment of a 21-year old male who had suffered multiple traumas, which had culminated in the death of his younger brother. He presented with Acute Stress Disorder. The literature review examines a diverse range of theorists and discourses, that have addressed the psychological consequences of trauma and highlights the complexity of the phenomena involved. The case study, located in the South African context, aims to sensitise the reader to the unique dilemmas facing each trauma survivor, and serves to highlight specifically those areas, which are pertinent and further more contribute significantly to the recovery process. The case narrative consists of a detailed synopsis of the therapy process, extracted from the session record notes documented at the time. Several other sources of information, including contributions from the participant, were used to verify and validate the accuracy of the data included. The narrative is written in a style that conveys the intensity of the nature of trauma work and the manner in which both patient and clinician are frequently confronted with very difficult emotional work. Finally the discussion examines the case narrative through the use of a set of carefully selected hermeneutic questions. These focused on (I) key concepts from the work of Robert Lifton who highlights the existential dimensions of the impact of trauma; (2) the role of the image in encapsulating the complex traumatic and post-traumatic experience of the survivor as well as facilitating the emotional processing of the trauma is examined; (3) the contribution to the process of therapy of aspects of the therapeutic relationship; and (4) the concept of recovery in relation to the question of what constitutes 'trauma work'. In conclusion, several meta-theoretical issues related to trauma, the strengths and weaknesses inherent to the research and relevant future areas of research are highlighted.

Increasing violence in the work environment created a need for an effective intervention to debrief traumatised workers. The aim of this study is to compile a profile of an effective trauma debriefer that can be used as a criterion for the selection of trauma debriefers. The task description of the trauma debriefer is based on the literature studied. The profile of the trauma debriefer was compiled using the characteristics of a self-actualised person, as described by the Humanism, as well as the skills based on Ivey's Microskills Hierarchy Model. Structured, non-directive interviews were conducted with five experts on the training of trauma debriefers. A qualitative analysis was made of the interviews, based on the personality characteristics and skills identified in the literature. A profile of an effective trauma debriefer that can be used as criterion during the selection of trauma debriefers, was compiled. Conclusions and recommendations were made and limitations were identified. / Toenemende geweld in die werksomgewing het gelei tot 'n behoefte aan 'n koste- effektiewe intervensie vir die ontlonting van getraumatiseerde vverkers. Die doei van die navorsing is die samestelling van 'n profiel van 'n effektiewe traumaontlonter, ten einde die profiel as kriterium vir die keuring van traumaontlonters te gebruik. Die taakbeskrywing van 'n traumaontlonter, gebaseer op relevante literatuur, is opgestel. Die profiel van 'n effektiewe traumaontlonter is aan die hand van die persoonlikheidskenmerke van die selfaktualiserende persoon, soos vervat in die Humanism©, en die vaardighede, gebaseer op Ivey se Mikrovaardighede Hierargiese Model, saamgestel. Gerigte, nie-direktiewe onderhoude is met vyf kundiges op die gebied van opleiding van traumaontlonters, gevoer. Die onderhoude is kwalitatief ontleed aan die hand van die persoonlikheidskenmerke en vaardighede vanuit die literatuur. 'n Profiel, wat as kriterium vir die keuring van effektiewe traumaontlonters gebruik kan word, is saamgestel. Gevolgtrekkings en aanbevelings is gemaak en beperkinge is geidentifiseer. / Summaries in English and Afrikaans / Industrial and Organisational Psychology / M.A. (Industrial Psychology)

The purpose of this study is to tell the story of lay trauma counsellors - how the work they do affects them, what helps them to cope and what hinders their coping. The epistemological framework of this study is constructivism. This study involved in-depth interviews with three lay trauma counsellors from different cultural backgrounds who counselled for a minimum of one year. Hermeneutics was the method used to analyse the data. The stories of participants were recounted through the researcher’s lens in the form of specific themes that emerged for individual participants. Recurring themes evident in the stories of all three participants were discussed and compared with the literature. The information gleaned could be valuable to organisations considering setting up lay trauma programmes, to those with established programmes, as well as to prospective and experienced lay counsellors. / Psychology / M.A. (Psychology)

This qualitative study illustrates that a narrative approach to pastoral therapy can guide collaborative co-authoring of alternative ways of living after trauma. The research emanates from postmodern epistemology and related discourses of social construction and post-structuralism, as well as a contextual approach to practical theology. The narrative practices of enrolling people in their own knowledges, of creating communities of concern, of honouring people, of celebration and joy, and of co-authoring alternative histories are illustrated through descriptions of how narrative maps guided one-to-one pastoral therapy as well as group work with people who have experienced trauma. The concept "resilience" is deconstructed so as to be understood as those personal actions which do not conform to pathologising predictions of the effects of trauma. / Hierdie kwalitatiewe studie illustreer dat 'n narratiewe benadering tot pastorale terapie die ko-konstruksie van alternatiewe leefwyses na trauma kan fasiliteer. Die navorsing spruit voort uit 'n postmoderne epistemologie en die verwante diskoerse van sosiale konstruksie en post-strukturalisme, asook 'n kontekstuele benadering tot praktiese teologie. Die narratiewe praktyke van ontginning van mense se kennis en vaardighede, van die skepping van gemeenskappe van sorg, van vreugde en waardering, en van die mede-skryf aan alternatiewe stories word geillustreer. Dit word gedoen deur beskrywings van die wyse waarop narratiewe kaarte individuele sowel as groepsterapie met getraumatiseerde persone kan begelei. Die konsep "weerstandsvermoee" ("resilience') word gedekonstrueer sodat dit verstaan word as daardie persoonlike ervarings wat patologiserende voorspellings oor getraumatiseerde persone weerspreek. / Philosophy, Practical and Systematic Theology / M.Th. (Practical Theology, with specialisation in Pastoral Therapy)

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.