Thesis (D. Min.)--Erskine Theological Seminary, 2008. / Abstract. Includes bibliographical references (leaves 131-134).

The study sought to analyse the referrals received by a psychiatric unit in a general hospital in the Western Cape by studying the referral letters and the referral responses. The study sought to determine which departments were referring patients and which patients were being referred. The completeness and appropriateness of the referrals were also studied. The major inferences drawn from this study are that health care workers have a poor concept of what information the psychiatric units needs and about the scope and function of the unit. The poor feedback from the psychiatric unit to the referral source is indicative of the poor communication amongst the health care team members. / Health Studies / M.A. (Advanced Nursing Sciences)

M.Cur. (Psychiatric Nursing) / The psychiatric nurse, as a member of the multiprofessional mental health team, utilises a goal directed approach to assist the psychiatric patient to mobilise resources to promote, restore and maintain his mental health as an integral part of his quest for wholeness. This goal directed approach is the nursing process which comprises assessment, planning, implementing and evaluation. All four steps of the nursing process and the nurse's interaction wi th the patient are dependent upon therapeutic communication between the nurse and the patient to elicit the necessary information so as to be able to formulate the nursing diagnosis, nursing actions and the patients' outcomes. Therapeutic communication remains important as the core of all nurse-patient interactions. Lack of therapeutic communication with the patient can cause conflict in the patient's internal and external environments since he will be unable to communicate his needs and problems and this will delay the mental health promotion, restoration and maintenance phases. Currently much attention is paid to the pharmacological treatment of the patient as more and more sophisticated psychotropic drugs are produced, and yet the other aspect of the patient's treatment which is equally important is neglected, namely his communication during hospitalisation, especially with the psychiatric nurse as she is the person in direct contact with him and should spend most of her time interacting with him.

Aims: It is argued that one’s sense of self is threatened and eroded by mental illness. According to the narrative perspective, one’s personal life narrative is displaced and maintained by a story of illness. However, dialogical self theorists argue that mental illness limits the number of ‘I’ positions available within an individual, resulting in the positions/voices becoming rigid and being dominated by a singular, monological position. The aims of this qualitative study are to attempt to understand and examine psychiatric inpatients’ personal lived experiences of an art group. The goal of the study is to focus on the impact of the art-making process on these patients with regards to the construction of their sense of self. Design: A qualitative research design was used in the study. Method: Four psychiatric in-patient art group members – three male and one female, between the ages of 27 and 40 – were interviewed. A semi-structured interview schedule consisting of sixteen questions focusing on the interviewees’ experiences of the art group was used. The interviews were analysed using an interpretive phenomenological analysis. Results: Three superordinate themes emerged: What the Participants Gained From the Art Group, Sense of Community and Leaving a Mark, and The Experience of Self in the Art group. All three Superordinate themes fall within the participants’ experience of the art group. Conclusion: All four of the participants expressed positive feelings and enjoyment towards the art group. Participation in the art group provided the participants with a sense of pride, achievement and hope within their lives. As a result of participation on the art group, one of the four participants was able to construct a thin alternative experience and sense of self.

The purpose of this study was to qualitatively examine the meaning that psychotherapeutic patients associate with their self-esteem in order to contribute to a better understanding of what these patients' views of low and high self-esteem entail. A study of literature was conducted to expose different aspects of the term 'self-esteem' from several theoretical approaches. Furthermore, the substructure of the hypno-therapeutic approach (of which the medical hypno-analytical model was the main approach) was especially analysed to ground the psychotherapeutic treatment received by the research participants. Eleven research participants were involved in the study according to the extreme, as well as the confirming and disconfirming case methods of sampling. They were selected on the basis of homogenous characteristics, namely: white, Afrikaans-speaking men in the low to high average socio-economic sphere. This study was done within a qualitative or interpretive paradigm - the study therefore focuses on the understanding (verstehen) of the meaning individuals attach to their self-esteem and not on the explanation (erklärung) thereof. The data gathering techniques were the basic individual interview, the self-esteem induction and observation. The textual data, transcribed from audiocassettes, was analysed qualitatively with the help of the ATLAS.ti-program according to the principles and procedures of grounded theory (including open, axial and selective coding). Data analysis led to, amongst other things, the co-construction of 23 categories (with numerous subcategories) of which the central phenomenon was identified as 'low self-esteem'. Relations could be drawn between the core category and other categories and the following storyline, which could suggest a possible theory, was conceptualised: -Negative suggesting in the patient's past leads to low self-esteem, which is unhealthily handled within his emotional problematics by means of a negative thinking scheme for which therapy is received from a medical hypno-analytical perspective to treat the negative labels in order to facilitate attachment of positive meaning to his self-esteem. The meaning(s) ascribed by psychotherapeutic patients to their self-esteem seem to be, in accordance with the post-modern spirit of the age (Zeitgeist), holistic in nature. / Die doelstelling van hierdie studie was om die betekenis wat psigoterapeutiese pasiente met hul selfagting assosieer, kwalitatief te ondersoek ten einde 'n bydrae te maak tot 'n beter begrip van wat psigoterapeutiese pasiente se siening van lae en hoe selfagting behels. 'n Literatuurstudie is uitgevoer om die onderskeie aspekte met betrekking tot die begrip 'selfagting' vanuit verskillende teoretiese benaderings te belig. Verder is die onderbou van veral die hipnoterapeutiese benadering (waarvan die mediese hipnoanalitiese model die hoofbenadering was) ge-analiseer om die psigoterapeutiese behandeling wat die navorsingsdeelnemers ontvang het, te fundeer. Elf navorsingsdeelnemers is volgens die ekstreme, sowel as die bevestigende en niebevestigende gevallemetodes van steekproeftrekking, by die studie betrek. Hulle is op grond van homogene eienskappe gekies, naamlik: blanke, Afrikaanssprekende mans binne 'n laag tot hoog gemiddelde sosio-ekonomiese sfeer. Hierdie studie is binne 'n kwalitatiewe of interpretatiewe paradigma gedoen - die studie fokus dus op die verstaan (verstehen) van die betekenis wat individue aan hul selfagting heg en nie op die verklaring (erklarung) daarvan nie. Die data- insamelingstegnieke was die basiese individuele onderhoud, die selfagtinginduksie in hipnoterapie en observasie. Die data is as tekstuele data, wat vanaf klankkassette getranskribeer is, op kwalitatiewe wyse met behulp van die ATLASJi-program aan die hand van die beginsels en prosedures van gegronde teorie (waaronder oop, aksiale en selektiewe kodering) ontleed. Data-ontleding het onder andere gelei tot die ko-konstruksie van 23 kategoriee (met talle subkategoriee) waarvan die sentrale verskynsel as 'lae selfagting' geidentifiseer is. Verbande kon tussen die kernkategorie en ander kategoriee getrek word, en die volgende gekonseptualiseerde storielyn wat op 'n moontlike teorie kan dui, is gekokonstrueer: - Negatiewe suggerering in die pasient se verlede lei tot sy lae selfagting wat hy binne sy emosionele problematiek deur middel van 'n negatiewe denkskema ongesond hanteer en dan psigoterapie ontvang vir die behandeling van sy negatiewe etikette sodat 'n positiewe betekenisgewing aan sy selfagting vanuit 'n mediese hipno-analitiese perspektief gefasiliteer kan word. Die betekenis(se) wat die psigoterapeutiese pasiente aan hul selfagting gee, blyk, in ooreenstemming met die postmodernistiese tydgees, holisties van aard te wees. / Psychology / D. Litt. et Phil. (Psychology)

The purpose of this study was to develop a medico-judicial framework for the rehabilitation of forensic psychiatric patients in Zimbabwe. The study used the grounded theory approach utilising a mixed sequential dominant status design. Purposive sampling of key stakeholders was the primary method and theoretical sampling became necessary as the study evolved in the qualitative phase. A confirmatory retrospective document review of 119 files of patients was done in the quantitative phase. Pierre Bourdieu’s conceptual canon of field, habitus and capital was utilised as the theoretical point of departure for the study. Findings and results showed dislocation and dissonance between and within the habitus of social fields the judiciary, health (medical) and the prison systems with an ensuing hysteretic effect that negatively affected the outcome of forensic psychiatric rehabilitation in special institutions in Zimbabwe. Forensic psychiatric patients were caught up in a double bind situation of aligning to both of the contradictory functions of the medical and the prison systems. The result of this hysteretic scenario seemed to breed some kind of rehabilitative schizophrenia. The developed medico-judicial framework is projected to transform the libido dominandi of the present into a widened scope of therapeutic jurisprudence. The medico-judicial framework is forwarding the forensic psychiatric practitioner to a new address since it has changed its residence from the special institution to the forensic psychiatric hospital. It is inviting the person involved with forensic psychiatric rehabilitation to begin again, inciting him or her to be open to the possibilities of mapping a path through the tangled growth of current realities into an increased width and depth of comprehensive forensic psychiatric practice that follows an empowering legislative prescript / Health Studies / D. Litt. et Phil. (Health Studies)

The purpose of this study was to develop a medico-judicial framework for the rehabilitation of forensic psychiatric patients in Zimbabwe. The study used the grounded theory approach utilising a mixed sequential dominant status design. Purposive sampling of key stakeholders was the primary method and theoretical sampling became necessary as the study evolved in the qualitative phase. A confirmatory retrospective document review of 119 files of patients was done in the quantitative phase. Pierre Bourdieu’s conceptual canon of field, habitus and capital was utilised as the theoretical point of departure for the study. Findings and results showed dislocation and dissonance between and within the habitus of social fields the judiciary, health (medical) and the prison systems with an ensuing hysteretic effect that negatively affected the outcome of forensic psychiatric rehabilitation in special institutions in Zimbabwe. Forensic psychiatric patients were caught up in a double bind situation of aligning to both of the contradictory functions of the medical and the prison systems. The result of this hysteretic scenario seemed to breed some kind of rehabilitative schizophrenia. The developed medico-judicial framework is projected to transform the libido dominandi of the present into a widened scope of therapeutic jurisprudence. The medico-judicial framework is forwarding the forensic psychiatric practitioner to a new address since it has changed its residence from the special institution to the forensic psychiatric hospital. It is inviting the person involved with forensic psychiatric rehabilitation to begin again, inciting him or her to be open to the possibilities of mapping a path through the tangled growth of current realities into an increased width and depth of comprehensive forensic psychiatric practice that follows an empowering legislative prescript / Health Studies / D. Litt. et Phil. (Health Studies)

The purpose of this study was to qualitatively examine the meaning that psychotherapeutic patients associate with their self-esteem in order to contribute to a better understanding of what these patients' views of low and high self-esteem entail. A study of literature was conducted to expose different aspects of the term 'self-esteem' from several theoretical approaches. Furthermore, the substructure of the hypno-therapeutic approach (of which the medical hypno-analytical model was the main approach) was especially analysed to ground the psychotherapeutic treatment received by the research participants. Eleven research participants were involved in the study according to the extreme, as well as the confirming and disconfirming case methods of sampling. They were selected on the basis of homogenous characteristics, namely: white, Afrikaans-speaking men in the low to high average socio-economic sphere. This study was done within a qualitative or interpretive paradigm - the study therefore focuses on the understanding (verstehen) of the meaning individuals attach to their self-esteem and not on the explanation (erklärung) thereof. The data gathering techniques were the basic individual interview, the self-esteem induction and observation. The textual data, transcribed from audiocassettes, was analysed qualitatively with the help of the ATLAS.ti-program according to the principles and procedures of grounded theory (including open, axial and selective coding). Data analysis led to, amongst other things, the co-construction of 23 categories (with numerous subcategories) of which the central phenomenon was identified as 'low self-esteem'. Relations could be drawn between the core category and other categories and the following storyline, which could suggest a possible theory, was conceptualised: -Negative suggesting in the patient's past leads to low self-esteem, which is unhealthily handled within his emotional problematics by means of a negative thinking scheme for which therapy is received from a medical hypno-analytical perspective to treat the negative labels in order to facilitate attachment of positive meaning to his self-esteem. The meaning(s) ascribed by psychotherapeutic patients to their self-esteem seem to be, in accordance with the post-modern spirit of the age (Zeitgeist), holistic in nature. / Die doelstelling van hierdie studie was om die betekenis wat psigoterapeutiese pasiente met hul selfagting assosieer, kwalitatief te ondersoek ten einde 'n bydrae te maak tot 'n beter begrip van wat psigoterapeutiese pasiente se siening van lae en hoe selfagting behels. 'n Literatuurstudie is uitgevoer om die onderskeie aspekte met betrekking tot die begrip 'selfagting' vanuit verskillende teoretiese benaderings te belig. Verder is die onderbou van veral die hipnoterapeutiese benadering (waarvan die mediese hipnoanalitiese model die hoofbenadering was) ge-analiseer om die psigoterapeutiese behandeling wat die navorsingsdeelnemers ontvang het, te fundeer. Elf navorsingsdeelnemers is volgens die ekstreme, sowel as die bevestigende en niebevestigende gevallemetodes van steekproeftrekking, by die studie betrek. Hulle is op grond van homogene eienskappe gekies, naamlik: blanke, Afrikaanssprekende mans binne 'n laag tot hoog gemiddelde sosio-ekonomiese sfeer. Hierdie studie is binne 'n kwalitatiewe of interpretatiewe paradigma gedoen - die studie fokus dus op die verstaan (verstehen) van die betekenis wat individue aan hul selfagting heg en nie op die verklaring (erklarung) daarvan nie. Die data- insamelingstegnieke was die basiese individuele onderhoud, die selfagtinginduksie in hipnoterapie en observasie. Die data is as tekstuele data, wat vanaf klankkassette getranskribeer is, op kwalitatiewe wyse met behulp van die ATLASJi-program aan die hand van die beginsels en prosedures van gegronde teorie (waaronder oop, aksiale en selektiewe kodering) ontleed. Data-ontleding het onder andere gelei tot die ko-konstruksie van 23 kategoriee (met talle subkategoriee) waarvan die sentrale verskynsel as 'lae selfagting' geidentifiseer is. Verbande kon tussen die kernkategorie en ander kategoriee getrek word, en die volgende gekonseptualiseerde storielyn wat op 'n moontlike teorie kan dui, is gekokonstrueer: - Negatiewe suggerering in die pasient se verlede lei tot sy lae selfagting wat hy binne sy emosionele problematiek deur middel van 'n negatiewe denkskema ongesond hanteer en dan psigoterapie ontvang vir die behandeling van sy negatiewe etikette sodat 'n positiewe betekenisgewing aan sy selfagting vanuit 'n mediese hipno-analitiese perspektief gefasiliteer kan word. Die betekenis(se) wat die psigoterapeutiese pasiente aan hul selfagting gee, blyk, in ooreenstemming met die postmodernistiese tydgees, holisties van aard te wees. / Psychology / D. Litt. et Phil. (Psychology)

Nearly 700,000 suspects with mental disorders are arrested and Mirandized each year. The current study systematically examined the effects of cognitive deficits and psychological symptoms on both Miranda comprehension and reasoning. The current sample was comprised of 85 adult psychiatric inpatients recruited from University Behavioral Health (UBH), a private psychiatric hospital in North Texas. Unexpectedly, most inpatients demonstrated pervasive deficits in their immediate recall of a representative Miranda warning, omitting approximately four-fifths of its content. In addition, the majority of inpatients evidenced damaging errors in their reasoning about waiver decisions. As a result, 64.7% waived and subsequently confessed after only a 3-5 minute interrogation. Interestingly, impaired verbal ability but not the severity of their symptoms predicted greater deficits in Miranda comprehension.

MCur / Department of Advanced Nursing Science