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A study on the influence of psychosocial factors on 30 schizophrenic patients was undertaken. The patient population was selected on the basis of : (a) being resident in the Pietermaritzburg area. (b) having one or more admissions to the psychiatric hospital (Fort Napier ) . (c) having a diagnosis of schizophrenia. The social questionnaire was completed after home visits were made to the patient and his family. The initial hypotheses: (a) poor psychosocial factors result in readmission to the hospital; (b) adequate facilities would result in the readmission rate of the mentally ill decreasing; (c) patients who lived in high EE homes have a higher relapse rate than those returning to low EE homes; have been confirmed in the study. The study has shown that the psychosocial aspects of schizophrenia must receive attention, together with medical treatment if relapse is to be prevented. The success of rehabilitation rests largely on finding the optimal balance for each patient. Better co-ordination of referrals should increase the number of people who establish outpatient contacts and more important, increase the number of visits each person makes. / Thesis (M.Sc.)-University of Durban-Westville, 1985.

published_or_final_version / Social Work / Master / Master of Social Work

The purpose of this study was to determine, under experimental conditions, which of two treatments (overt or covert rehearsal in conjunction with instruction, live modeling and reinforcement) would help chronic schizophrenic undifferentiated type inpatients learn new assertive behaviors (volume of speech and gaze) and transfer them to unfamiliar situations in the laboratory.The research was conducted at Dayton Mental Health Center, Dayton, Ohio. The sample population consisted of 30 subjects who were randomly divided into three groups of 10 subjects each. The groups were Treatment I (overt rehearsal), Treatment II (covert rehearsal) and No-Treatment (control). All subjects volunteered for the study. They were screened with the Wolpe-Lazarus Assertiveness Training Questionnaire; however, the results were discarded because many scored lower than the desired range. Subjects were videotaped at the end of the study.The two treatment groups were conducted twice weekly for a total of eight sessions in one month. Each session lasted about 45 minutes. Positive reinforcers such as cookies and cigarettes were provided to encourage attendance. The group leaders were two pairs of male and female psychology assistants and trainees. All were qualified for their randomly selected tasks. The treatment consisted of eight behavior situations designed by the writer based on the Behavior Assertiveness Test - Revised (BAT-R). Attendance was imperfect during the sessions as some subjects occasionally resisted groups. Following completion of the treatment, only 27 subjects accepted to be videotaped for testing; three refused to be taped.A posttest-only design was used in this study. Posttesting consisted of videotaped responses to a confederate who presented four trained and four untrained situations. Two qualified psychologists collected data by rating the subjects' behaviors on the video tape. The specific behaviors, volume of speech and gaze, were rated on the Qualitative Rating Scale for both the trained and untrained situations across all three groups. The effects of treatment were analyzed through several statistical steps:1. Three t-tests on pairs were used to analyze means between trained and untrained situations for both treatment groups and the No-Treatment group.2. Two separate one-way analyses of variance were computed on volume of speech and on gaze across all three groups. Scores of trained and untrained situations were summed for each variable.3. Four separate one-way analyses of variance were computed for volume of speech and gaze in each of the trained and untrained situations across all three groups.The results were not statistically significant at the .05 level. Thus, there were no differences between the treatment groups and the No-Treatment group with respect to untrained situations. Also, there were no differences between treatment groups and the No-Treatment group in the learning of new behaviors. These findings did not lend efficacy to the treatments or instruments used in this study. It is possible that those treatments may not succeed with lower functioning subjects such as those used in this sample.Recommendations for future research were to include longer treatment conditions and to use more sensitive training and testing instruments. Other suggestions included familiarization of subjects with videotaping prior to posttesting, inclusion of more variables and the use of pre-post measures as well as follow up measures.

published_or_final_version / Mental Health / Master / Master of Social Sciences

published_or_final_version / Psychiatry / Master / Master of Philosophy

Bibliography: pages 181-192. / Continued study towards understanding schizophrenia and the impairments it can cause, is regarded as essential in the meaningful fulfilment of the educative and diagnostic contributions which the social worker can make in a comprehensive treatment and rehabilitation programme (involving patients and their families). The first section of this descriptive dissertation focuses on aspects like terminology, definition, and the most recent diagnostic criteria, in an endeavour to contribute theoretically towards understanding the illness. The complexity of the diagnostic process is emphasized, and the recent revision of the criteria (1987) is seen as indicative of continuous efforts towards improved diagnosis, treatment and rehabilitation. Previous studies, improved pharmacology and more sophisticated neurophysiological examining led to a change in focus with regard to aetiology and the development of the vulnerability-stress-coping-competence model which brought new hope with regard to outcome of treatment. Section Two highlights several interventions which the clinical social worker can undertake as psychotherapist, group and family therapist, as well as educator on primary, secondary and tertiary levels, from this model and within the psycho-educative perspective. The Neuro B programme, Stikland Hospital, Bellville, is described in section Three, as an example of a presently operating, comprehensive programme where these interventions can be holistically implemented. Particulars about 56 patients who have been involved in the programme are highlighted in Section Four, while Section Five deals with the opinions of former patients and their families concerning involvement in the programme - elicited by two sets of questionnaires. The final chapter focuses on a summary of the dissertation, conclusions and implications for practice.

published_or_final_version / Social Work / Master / Master of Social Work

published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

The purpose of this study was to assess the utility of task analyses and self-recording procedures in increasing and maintaining apartment -cleaning behaviors with adults diagnosed with schizophrenia in an independent living environment. A task analysis was used to define the specific behaviors needed to clean the participants apartments, and to prompt the cleaning behavior. Also, participant-made task analyses and self-recording procedures were used in an effort to maintain these behaviors. Six participants diagnosed with schizophrenia, who also demonstrated a need for improvement in apartment cleanliness, were chosen for this study. A multiple baseline design across participants was used for this study. Results indicated that, for the three participants that completed the study, their cleaning behavior improved from baseline to the introduction of the intervention, and maintained during the 4-month maintenance period. Self-recording and cleaning were not correlated, and consequently self-recording did not prove to be self-reinforcing.