Text in Afrikaans / Summaries in English and Afrikaans / Die dood van 'n ouer he! 'n effek op die totale lewe van die kind en dompel die kind in emosionele nood wat terapeutiese begeleiding noodsaak. Na afloop van die afsterwe van 'n ouer, vind daar fisieke, emosionele, sosiale en kognitiewe veranderinge in die kind se lewe plaas waarop hy nie voorbereid is nie, en wat hy ook nie verstaan nie. Hierdie veranderinge veroorsaak dat die kind se leefwereld in so mate verander dat sy funksionering benadeel word. Daar is met hierdie studie gepoog om vas te stel watter effek die dood van 'n ouer op die kind he! en tot watter mate terapeutiese begeleiding die kind se emosionele nood kan verlig. Daar is in die studie gevind dat rou inderdaad 'n gekompliseerde proses is wat lei tot die ontstaan van talle onbeantwoorde vrae, gevoelens van magteloosheid en emosionele pyn. Kinders wat in rousmart verkeer word dikwels deur die samelewing misgekyk en kry as gevolg hiervan nie voldoende hulp nie. Di! lei tot die ontstaan van persoonlikheidsontwikkelingsprobleme, relasionele probleme en intra-psigiese probleme soos 'n swak selfbeeld, ego-verdedigingsmeganismes, persoonlike kwesbaarheid, ongunstige betekenisgewing en ongunstige belewenisse. Hierdie probleme veroorsaak dat die kind in sy selfaktualisering gerem word en as gevolg hiervan nie sy gegewe moontlikhede verwerklik nie. Die studie het verder bewys dat die kind wat 'n ouer aan die dood afgestaan het, wel deur middel van terapeutiese begeleiding deur 'n sielkundige gehelp kan word om die verlies van 'n ouer in so 'n mate te hanteer dat die faktore wat die kind se selfaktualisering rem, opgehef kan word. Die studie voorsien die sielkundige van riglyne ten opsigte van die proses van terapeutiese begeleiding aan die kind wat 'n ouer aan die dood afgestaan het. Riglyne word gebied ten opsigte van die hantering van die kind se onmiddellike situasie, die evaluasie van die kind-inrousmart, die vasstelling van doelstellings en doelwitte vir terapeutiese begeleiding, die selektering van terapeutiese tegnieke, die terapeutiese hulpverlening aan die kind, die hulpverlening aan die oorblywende ouer en die hulpverlening aan die onderwyser wat gemoeid is met die kind-in-rousmart. Riglyne word ook gebied ten opsigte van die terminering van terapie. / The death if a parent has an influence on the total life of a child and causes emotional trauma that necessitates therapeutic guidance. After the death of a parent, physical, emotional, social and cognitive changes occur in the child's life for which he is not prepared and that he also does not understand. These factors cause such a change in the child's life-world that his functioning is hampered. In this study it was endeavoured to determine what effect the death of a parent has on a child's life and to what extent therapeutic guidance can alleviate the child's emotional trauma. In this study it was found that mourning is indeed a complicated process that gives rise to countless unanswered questions, feelings of helplessness and emotional pain. Children suffering grief in mourning are often ignored by society and as result of this, they do not receive adequate assistance. This leads to problems concerned with the development of the personality, relational problems and intrapsychological problems such as a poor self-concept, ego defence mechanisms, personal vulnerability, negative ways of acquiring meaning and unfavourable ways of experiencing life. These problems give rise to the hampering of the child's selfactualisation and because of this he cannot realise his potential. The study has furthermore proved that the child who has lost a parent through death, can be helped by a psychologist. This can be done by means of therapeutic guidance so that the child can handle the loss of a parent to such an extent that the factors that hamper his self-actualisation can be removed. The study provides guidelines for therapeutic guidance to the child who has Jost a parent through death. Guidelines are given on handling the child's immediate situation, the evaluation of the child in mourning, the determination of aims and objectives for therapeutic guidance, the selection of therapeutic techniques, therapeutic assistance to the child, assistance to the remaining parent and assistance to the educator who is involved with the child in mourning. Guidelines are also given for the termination of therapy. / Educational Studies / D.Ed (Clinical Psychologist)

Text in Afrikaans / In today's society our children are being incredibly exposed to trauma and death. Parents want to protect their children against hardship and loss and it is evident that todays society is characterized by social pathology. In view of the above the researcher studied literature extensively to investigate the affect of the phenomenon of death and trauma in the life of the young child. In order to establish the availability of therapy programs for the young child in childcare whose parents died in an unnatural way. It was evident that the present South African society is indeed characterized by conflict, homicide and violence. The death of a parent is a traumatic experience for the young child (aged two to seven years). VVhen death occurs suddenly it was found that the grief process is more complex. Through the process of literature study and empirical investigation it seems that many young children, who lost their parents through unnatural death, are placed in childcare institutions. In this study it was established that the fact that children were placed in childcare did not always imply that therapeutic intervention took place. Limited financial support and social services contributed to insufficient therapeutical intervention. Furthermore it was found that the investigated childcare institutions couldn't provide the researcher with therapeutic programmes. This study therefore indicates that there is a need for the development of therapeutic programmes for the young child in childcare. whose parents died in an unnatural way. / In die hedendaagse samelewing blyk dit dat kinders al hoe meer aan dood en trauma blootgestel word. Hoewel ouers graag hulle kinders wil beskerm teen hartseer en verlies, blyk dit dat vandag se samelewing gekenmerk word deur 'n vorm van sosiale patologie. In die lig van voorafgaande, het die navorser literatuurstudie onderneem om die teenwoordigheid en die fenomeen van dood en trauma in die lewe van die jong kind te ondersoek. 'n Verdere literatuurstudie is ook onderneem om die rou ervaring van die jong kind te ondersoek. Die navorser wou ook in hierdie studie vasstel of daar terapeutiese begeleiding aan die jong kind in kindersorg, wie se ouers op 'n onnatuurlike wyse gesterf het, beskikbaar is. Daar is in die studie gevind dat die huidige Suid-Afrikaanse samelewing inderdaad gekenmerk word deur konflik, moord en misdaad. Die afsterwe van 'n ouer is 'n traumatiese ondervinding vir die jong kind (twee tot sewe jaar). Wanneer die dood skielik en onverwags intree, is bevind dat die rouproses gekompliseerd is. Deur die proses van literatuurstudie en empiriese ondersoek blyk dit dat verskeie jong kinders wie se ouers op 'n onnatuurlike wyse gesterf het, in kindersorginstansies geplaas word. Daar is in hierdie studie bewys dat hoewel die kind in kindersorginstansies geplaas word, terapeutiese begeleiding nie altyd plaasvind nie. Hierdie gebrekkige terapeutiese begeleiding word toegeskryf aan die feit dat nie voldoende finansiele ondersteuning en maatskaplike dienste is nie. Daar is verder gevind dat kindersorginstansies, wat aan die studie deelgeneem het, nie oor traumaterapie programme vir terapeutiese begeleiding beskik nie. Hierdie studie toon dus dat daar 'n behoefte is vir die ontwikkeling van terapeutiese programme vir die jong kind in kindersorg wie se ouers op 'n onnatuurlike wyse gesterf het. / Educational studies / M. Ed. (Voorligting)

In Suid-Afrika word kinders dikwels opgeneem in die Intensiewesorgeenheid na 'n traumatiese gebeurtenis. Die Kerk het die opdrag om vir hierdie kinders te sorg en wel in die vorm van pastoraat. In die praktyk ontvang kinders egter nie altyd die sorg waarop hulle geregtig is nie. Een van die faktore waarom dit nie altyd gebeur nie, is omdat daar gebruik gemaak word van 'n intervensie metode wat steun op verbale kommuniekasievaardighede. Die ses stappe van intervensienavorsing is gebruik om 'n pastorale praktykmodel in die vorm van 'n kursus te ontwikkel. Die aanvanklike praktykmodel is in gevallestudies getoets en later verfyn. Die klem van hierdie praktykmodel is die gebruik van spel as modus van intervensie vanuit 'n Gestalt benadering. Die kursus sal pastors en geestelike werkers in staat stel om effektief vir kinders te sorg. Die hoofkonsepte van die navorsing vorm die vertrekpunte van die kursus saam met praktiese oefeninge in spelterapietegnieke. / Many children in South-Africa are admitted in the Intensive Care Unit after a traumatic event. The Church is called to care for these children in the form of pastoral care. In practise children are often neglected and do not receive the care that they are entiteld to. One of the main reasons is because pastors and religious workers use an intervention method that depends mainly on the verbal skills of the child. The six steps of intervention research was used to develop a pastoral model in the form of course. The innitial intervention model was tested in case studies and refined. The focus of this model is to use play as a mode of intervention from a Gestalt approach. The course will enable pastors and religious workers to care for children more effectively. The main concepts of the research forms the basis of this model with practical excercises. / Social Work / D. Diac. (Spelterapie)

Objectives: This study documented events contributing to historical trauma among American Indian mission boarding school survivors, described residual effects of that trauma, and verified the Dream Catcher-Medicine Wheel model as a culturally appropriate tool that enhanced storytelling. Research Design and Methods: Nine women from two Upper Plains tribes were located through snowball sampling and participant referrals. A descriptive exploratory qualitative approach facilitated them in relating their survival stories. Seven were tape-recorded and two were hand-written on the Dream Catcher-Medicine Wheel, a model specifically designed for this study; this, combined with traditional spiritual grounding ceremonies, enhanced perspective for researcher and participants alike. Data Analysis: Liehr and Smith's (2008) Story Theory guided the methodology in the data gathering and analysis process using the Dream Catcher-Medicine Wheel combined with taped and written storytelling sessions. Major themes were categorized and supported with interview quotes through inductive analysis of the two research questions: What were the health challenges faced by survivors of American Indian mission boarding schools over time?, and, How have American Indian mission boarding school survivors resolved the health challenges they have faced over time? The first theme, subdivided into Breaking and Silencing of Spirit, examined physical, mental, and sexual abuse. The second theme, Survival of Spirit, examined relationships/parenting, coping/substance abuse, and spirituality. Findings: The seven dimensions described in Lowe and Struthers' (2001) Nursing in Native American Culture Conceptual Framework provided the value structure used for interpretation of findings. Implications for practice and research were related to the seven dimensions as culturally appropriate parameters for nursing. / Data analysis identified disturbing themes; unanticipated candor emerged, possibly owing to the fact that the researcher is a historical trauma survivor. Despite having survived historical trauma through the survival of the spirit, each participant struggles to resolve health challenges to this day. Unable to voice mission boarding school experiences for most of their adult lives, each affirmed the rediscovery of Native spirituality empowering; all expressed appreciation for traditional methods woven into storytelling sessions, particularly the Dream Catcher-Medicine Wheel, and all indicated they experienced release and healing through telling their stories. Key words: American Indian; historical trauma; nursing; boarding school; Dream Catcher-Medicine Wheel. / by Barbara K. Charbonneau-Dahlen. / Thesis (Ph.D.)--Florida Atlantic University, 2010. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2010. Mode of access: World Wide Web.

This dissertation is a qualitative secondary content analysis of clinical records collected for the Spokane Safe Start Project in Spokane, Washington, a program designed to offset trauma in children exposed to domestic and intimate partner violence (IPV). The Centers for Disease Control and the World Health Organization have identified intimate partner violence (IPV) as a health policy issue. Most studies of intimate partner violence and children exposed to violence have used samples from domestic violence shelters, large phone-based community surveys, or convenience samples such as college students. Currently, studies of families that have experienced intimate partner violence and received services in their homes do not exist. As such, the process and effects of intimate violence in families residing in their homes have not been identified. The purpose of this study was to identify the structural issues, factors affecting service engagement, family characteristics, and factors promoting resiliency in families that experienced intimate partner violence and were served by the Spokane Safe Start Project in Spokane, Washington, a program designed to offset trauma in children exposed to caregiver intimate partner violence. To this end, the four research questions were: 1) What are the underlying structural problems that affected these families? 2) Is family functioning at intake associated with the length of time with the program? 3) Of the families that engaged with Safe Start for at least five face-to-face contacts, what are the caregiver and/or family characteristics that seem to indicate the presence or absence of resilience in the caregivers? This study involved the analysis of the clinical case records of 30 families that received Spokane Safe Services. The primary source of data for this study came from the narrative portions of the electronic ACCESS and written client clinical records. The Spokane Safe Start clinical narratives served as a record of clinician observations, interactions, and service delivery to families greatly affected by intimate partner violence. Using the bio-ecological perspective and family systems theory as the theoretical frameworks to understand intimate partner violence and its effects on children, data analysis and synthesis, I used qualitative content analysis thematic analysis, and data matrices. In essence, this is a multiple case study producing "context-dependent knowledge" that is vital to develop ecologically sound interventions to address intimate partner violence and its effects on families (Flyvbjerg, 2006, p. 221). This study revealed three main findings. Families encountered roadblocks in the form of environmental and individual obstacles. These obstacles included family-of-origin dynamics, severe financial problems, and individual issues such as relationship ambivalence and substance abuse that posed serious limitations to developing resilience. Parent-child interactions were strained and difficult in most families. The majority of children experienced chronic IPV and many had a history of maltreatment as well. Although many parents were concerned about the future wellbeing of their children, they also had difficulty reflecting on their children’s emotional needs and experiences. Evidence of resilience in the case narratives was quite limited. There was evidence, one particular clinician's model of service provision was more successful at engendering resilience than that of the other clinicians. Results were triangulated with the extant literature and previous quantitative studies conducted by Washington State University on the Spokane Safe Start data indicating the results of this study are trustworthy and credible. This study makes an important contribution to the family violence literature and may serve as a resource for policy and program development. / Graduation date: 2012

Text in Afrikaans / In today's society our children are being incredibly exposed to trauma and death. Parents want to protect their children against hardship and loss and it is evident that todays society is characterized by social pathology. In view of the above the researcher studied literature extensively to investigate the affect of the phenomenon of death and trauma in the life of the young child. In order to establish the availability of therapy programs for the young child in childcare whose parents died in an unnatural way. It was evident that the present South African society is indeed characterized by conflict, homicide and violence. The death of a parent is a traumatic experience for the young child (aged two to seven years). VVhen death occurs suddenly it was found that the grief process is more complex. Through the process of literature study and empirical investigation it seems that many young children, who lost their parents through unnatural death, are placed in childcare institutions. In this study it was established that the fact that children were placed in childcare did not always imply that therapeutic intervention took place. Limited financial support and social services contributed to insufficient therapeutical intervention. Furthermore it was found that the investigated childcare institutions couldn't provide the researcher with therapeutic programmes. This study therefore indicates that there is a need for the development of therapeutic programmes for the young child in childcare. whose parents died in an unnatural way. / In die hedendaagse samelewing blyk dit dat kinders al hoe meer aan dood en trauma blootgestel word. Hoewel ouers graag hulle kinders wil beskerm teen hartseer en verlies, blyk dit dat vandag se samelewing gekenmerk word deur 'n vorm van sosiale patologie. In die lig van voorafgaande, het die navorser literatuurstudie onderneem om die teenwoordigheid en die fenomeen van dood en trauma in die lewe van die jong kind te ondersoek. 'n Verdere literatuurstudie is ook onderneem om die rou ervaring van die jong kind te ondersoek. Die navorser wou ook in hierdie studie vasstel of daar terapeutiese begeleiding aan die jong kind in kindersorg, wie se ouers op 'n onnatuurlike wyse gesterf het, beskikbaar is. Daar is in die studie gevind dat die huidige Suid-Afrikaanse samelewing inderdaad gekenmerk word deur konflik, moord en misdaad. Die afsterwe van 'n ouer is 'n traumatiese ondervinding vir die jong kind (twee tot sewe jaar). Wanneer die dood skielik en onverwags intree, is bevind dat die rouproses gekompliseerd is. Deur die proses van literatuurstudie en empiriese ondersoek blyk dit dat verskeie jong kinders wie se ouers op 'n onnatuurlike wyse gesterf het, in kindersorginstansies geplaas word. Daar is in hierdie studie bewys dat hoewel die kind in kindersorginstansies geplaas word, terapeutiese begeleiding nie altyd plaasvind nie. Hierdie gebrekkige terapeutiese begeleiding word toegeskryf aan die feit dat nie voldoende finansiele ondersteuning en maatskaplike dienste is nie. Daar is verder gevind dat kindersorginstansies, wat aan die studie deelgeneem het, nie oor traumaterapie programme vir terapeutiese begeleiding beskik nie. Hierdie studie toon dus dat daar 'n behoefte is vir die ontwikkeling van terapeutiese programme vir die jong kind in kindersorg wie se ouers op 'n onnatuurlike wyse gesterf het. / Educational studies / M. Ed. (Voorligting)

In Suid-Afrika word kinders dikwels opgeneem in die Intensiewesorgeenheid na 'n traumatiese gebeurtenis. Die Kerk het die opdrag om vir hierdie kinders te sorg en wel in die vorm van pastoraat. In die praktyk ontvang kinders egter nie altyd die sorg waarop hulle geregtig is nie. Een van die faktore waarom dit nie altyd gebeur nie, is omdat daar gebruik gemaak word van 'n intervensie metode wat steun op verbale kommuniekasievaardighede. Die ses stappe van intervensienavorsing is gebruik om 'n pastorale praktykmodel in die vorm van 'n kursus te ontwikkel. Die aanvanklike praktykmodel is in gevallestudies getoets en later verfyn. Die klem van hierdie praktykmodel is die gebruik van spel as modus van intervensie vanuit 'n Gestalt benadering. Die kursus sal pastors en geestelike werkers in staat stel om effektief vir kinders te sorg. Die hoofkonsepte van die navorsing vorm die vertrekpunte van die kursus saam met praktiese oefeninge in spelterapietegnieke. / Many children in South-Africa are admitted in the Intensive Care Unit after a traumatic event. The Church is called to care for these children in the form of pastoral care. In practise children are often neglected and do not receive the care that they are entiteld to. One of the main reasons is because pastors and religious workers use an intervention method that depends mainly on the verbal skills of the child. The six steps of intervention research was used to develop a pastoral model in the form of course. The innitial intervention model was tested in case studies and refined. The focus of this model is to use play as a mode of intervention from a Gestalt approach. The course will enable pastors and religious workers to care for children more effectively. The main concepts of the research forms the basis of this model with practical excercises. / Social Work / D. Diac. (Spelterapie)

Indiana University-Purdue University Indianapolis (IUPUI) / Epidemiologic studies suggest that depression is an independent risk factor for cardiovascular disease (CVD). Although several possible mediators of this association have been proposed, few studies have examined the role of moderators. Accordingly, I examined adverse childhood experiences (ACE) as a potential moderator of the depression-CVD association, given that individuals with a history of ACE show a greater inflammatory response to depression, and inflammation plays a role in the development of CVD. Data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were analyzed. Participants were 29,282 adults (58% female, 42% non–white) aged 18–97 years, free of CVD diagnoses at baseline. Lifetime depressive disorder (LDD) was assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule–IV (AUDADIS–IV), and adverse childhood experiences (abuse, neglect, and household dysfunction), and CVD were assessed during separate interviews. The primary outcome was incident CVD (n = 1,255), defined as nonfatal arteriosclerosis, angina pectoris, myocardial infarction, and/or stroke reported during the Wave 2 interviews. All analyses were adjusted for demographic and traditional CVD risk factors. Logistic regression models revealed that both LDD (OR = 1.44, 95% CI: 1.28–1.62, p < .001) and any ACE (OR = 1.25, 95% CI: 1.16–1.35, p < .001) were independent predictors of incident CVD. Interactions between LDD x any ACE (p = .024), LDD x neglect (p = .003), and LDD x household dysfunction (p < .001), but not LDD x abuse (p = 0.16), were detected. Analyses stratified by the ACE variables revealed that LDD was a predictor of incident CVD among adults with a history of (1) any ACE (OR = 1.51, 95% CI: 1.32–1.73, p < .001), but not among those without a history (OR = 1.15, 95% CI: 0.87–1.50, p = .332); (2) neglect (OR = 1.59, 95% CI: 1.36–1.87, p < .001) and among those without a history (OR = 1.25, 95% CI: 1.07–1.62, p = .005); (3) household dysfunction (OR = 1.73, 95% CI: 1.46–2.04, p < .001), but not among those without a history (OR = 1.18, 95% CI: 0.96–1.43, p = .11). Overall, the present findings suggest that depression may be a stronger risk factor for CVD among adults with a history of ACE, especially neglect and household dysfunction, than among adults who did not have these experiences.

Text in German, summaries in German and English / Includes bibliographical references (leaves 190-197) / In dieser Forschungsarbeit wird untersucht, ob und inwieweit transgenerationale Übertragungsprozesse als Folge von psychischen Traumata, welche Vertriebene in und nach dem Zweiten Weltkrieg erlebten, heute noch bei Nachfahren in der Kriegsenkelgeneration eine Rolle spielen. Dabei wird unter anderem untersucht, wie sich das Ereignis der Vertreibung mit Blick auf psychische Traumata konkret auswirkte und zu welchen, auch heute noch spürbaren, Symptomen es geführt hat. Auf Grund der Symptome wurden in einer empirischen Untersuchung fünf sogenannte Kriegsenkel interviewt, um zu erfahren, wie Betroffene die Auswirkungen dieser Symptome im Alltag beschreiben und welche Rolle dabei geistliche Erfahrungen spielen. Die Ergebnisse dieser Interviews führen zum Abgleich der Thesen und sollen schlussendlich helfen, praktische Konsequenzen für die Seelsorgearbeit zu ziehen und eine Hilfestellung in der Problemdiagnose zu geben. / This thesis explores if and how transgenerational transfer processes which are a consequence of mental traumata of displaced people in and after World War II still play a role in the lives of their descendants in the generation of the “grandchildren of war”. For one thing it looks at how the event of forced displacement specifically has had an impact on mental traumata and which symptoms have resulted, that are still perceptible today. Based on the symptoms five of the so called “grandchildren of war” have been interviewed in an empirical survey, in order to find out how those affected describe the effects of these symptoms on their everyday lives and which is the role of spiritual experiences. The findings of these interviews are compared to the theses and finally, should help to draw practical conclusions for councelling and offer help to diagnose problems. / Practical Theology / M. Th. (Practical Theology)

Summary in Afrikaans and English / Although the rights of children in South Africa are being regulated by legislation, statistics prove that statutory services on behalf of children annually increase. Scientific accountable information regarding the child can be obtained by the assessment of the child. The purpose of this investigation was to identify the gaps in the existing assessment guidelines, as well as the needs of social workers regarding assessments. The sequential exploratory strategy was utilized, as quantitative data supported qualitative findings. The investigation showed that minimal assessment literature is available in South Africa and internationally, although assessment is the basis evidence of the social worker. The biggest gap in assessment guidelines is that assessment does not carry weight in the court. There is a need for social workers to be trained in relevant assessment skills based on a specific frame of reference. Gestalt therapy can provide a suitable theoretical frame of reference for assessment, and can serve as scientific foundation for social workers during the statutory process. A framework for an assessment guideline was thus proposed. / Ten spyte daarvan dat die regte van kinders in Suid-Afrika deur wette gereguleer word, bewys statistiek dat statutere dienste aan kinders jaarliks toeneem. Wetenskaplik verantwoordbare inligting ten opsigte van die kind kan bekom word deur die kind te assesseer. Die doel van hierdie ondersoek was om leemtes wat in bestaande assesseringsriglyne is vas te stel, asook die behoeftes wat by maatskaplike werkers ten opsigte van assessering bestaan. Die opeenvolgende verkennende strategie is tydens hierdie ondersoek gevolg, aangesien kwantitatiewe data gebruik is om die kwalitatiewe bevindings te ondersteun. Die ondersoek het getoon dat min literatuur ten opsigte van assessering in Suid-Afrika en internasionaal beskikbaar is, ten spyte daarvan dat assessering die basis van die getuienis van die maatskaplike werker vorm. Die grootste leemte wat in assesseringsriglyne ge'identifiseer is, is die feit dat assessering nie gewig in die hof dra nie. 'n Behoefte ten opsigte van opleiding in toepaslike assesseringsvaardighede vanuit 'n spesifieke teoretiese verwysingsraamwerk bestaan. Gestaltterapie kan 'n teoretiese verwysingsraamwerk vir assessering bied en kan dien as wetenskaplike fundering vir optrede van maatskaplike werkers tydens die statutere proses. 'n Raamwerk vir 'n assesseringsriglyn is voorgestel. / Social Work / M. Diac. (Play Therapy)