M.Ed. / The world today is filled with instability and uncertainty. This is especially true to South Africa. Many experience difficult circumstances, and sometimes struggle to work through these negative and destructive motions. The meaning in life is something that most people start to explore at a young age (Kinnier, Kernes, Tribbensee & Puymbroeck 2006:7). People have searched for the answers in many places and in doing so, have sometimes experienced more harm than good. Ultimately, not finding meaning in life can be detrimental to a person's mental health. Much earlier, researchers such as Bollnow (1950), Garbers (1957), and others have researched this phenomenon in Europe, especially after the Second World War. However, not much research has been done in the field of late adolescents in the South African context. The purpose of this research study was to provide psycho-educational guidelines for late adolescents, to clarify what their meaning in life is. This can sometimes be a difficult concept to explore, as not all people have certainty of what gives them meaning. This is why a purposive selection of participants was chosen. These participants were between the ages of 18 and 24 years. All of them should have undergone an existential crisis at least 6 months prior to the study. This, in theory, ensures that the participants were in a place in their lives where they had questioned the meaning in life, and had time to process their findings, if any. One open ended question was asked: "What gives you meaning in your life?" The findings can be summed up as follows: Meaning in life equals relationship.

Over the last 20 years, Iceland has made major progress in reducing substance use among its youth. Many credit this impressive reduction to implementation of the Youth in Iceland (YiI) Model. YiI programming aims to prevent substance use by increasing youth social support through strengthening family relationships, peer relationships, community connection, and community engagement. It involves a wide variety of relevant stakeholders, including policymakers, teachers, parents, and youth workers. Specific programming ranges from recreational sports teams to parental neighborhood watches. While studies have indicated that YiI programming has greatly reduced substance use among youth, new data have suggested that mental health problems are rising among Icelandic adolescents. Despite an increase in the prevalence of mental health problems, no studies have explored the impact of YiI programming on Icelandic youth mental health. This mixed-methods project consisted of three studies that evaluated the effect of YiI Model programming on Icelandic adolescent mental health. In the first study, a secondary data analysis of cross-sectional YiI Survey data of all 8th to 10th grade students enrolled in Icelandic public schools was performed to explore the relationship between the YiI Model components and self-reported mental illness symptoms. The annual transnational YiI Survey collects data on demographics, behavior, and other social variables. In the second and third studies, focus groups and interviews were conducted with adolescents and key stakeholders to collect feedback on the YiI Model programming and identify barriers and resources for adolescent mental health. For the secondary data analysis of the YiI Survey data, a multivariate logistic regression model was constructed to relate YiI and mental health scores, including terms for covariates that may confound or bias. To supplement the quantitative component, a content analysis of the transcribed focus groups and interviews was performed to elucidate key themes and patterns surrounding Icelandic adolescent mental health and the YiI model. Study results suggest that more engagement in the YiI programming may be associated with fewer symptoms of anxiety and depression. Focus group and interview results pointed to a possible fifth YiI Model domain, and highlighted barriers to adolescent mental healthcare.

This study was conceptualised to explore the life experiences of adolescent sex offenders with the aim of obtaining insight into factors that contributed to their sexually offensive behaviour, especially those factors within the context of the family. The study was approached from an ecosystemic perspective to probe circumstances within and outside the family that may have had an impact on the functioning of the family. The research was characterised by qualitative research methodology. A predominant feature that emerged in the study was the exposure of the adolescent to abusive situations. However, this was not the only contributory factor to sexual offending and had to be seen in the context of the adolescents' ability to cope with the abuse. The characteristics of the individual and familial factors were identified. The study reflected the complex and compelling situations of the adolescent offender. The process of data collation was a comprehensive, intensive process. The sensitivity of the issue required the development of a trusting, long-term relationship to ensure the gradual disclosure of intimate information about the self and family. Data was obtained through 25 case studies, all of which were male, as male sexual offenders constitute the dominant population at Childline Family Centre, KwaZulu-Natal. The adolescent, family members and other referral sources of information were interviewed to compile the in-depth and rich information obtained in the analysis. The therapeutic group, which all the adolescent offenders were involved in, was also used as a context for data gathering. Data were thus obtained over an extended period of time. The QSR NUD*IST software programme was used as a tool to analyse the large quantity of data that the interviews yielded. It is based upon these insights that recommendations were made for the way forward. / Thesis (M.A.)-University of Natal, Durban, 2002.

Friendships are a mental health resource for adolescents. Their availability and strength have been shown to predict lower levels of depression, higher self-esteem, and higher life satisfaction. They can also alleviate the stress that often leads to negative mental health outcomes. However, studies examining the stress process rarely consider the fact that social networks like friendship groups are not a static resource that effects all people the same way. Rather, demographic characteristics of both the individual and their friends could change the role of friendship networks within the stress process. In this thesis, I investigate the importance of one such demographic characteristic: race. Racial and ethnic diversity continues to grow in the United States, contributing to an increase interracial and interethnic friendships. It is important to understand what impact racial difference might have on the stress process. In addition to using Leonard Peralin's stress process model to understand these potential effects, I draw upon Gordon Allport’s Contact theory to inform my analysis. Contact Theory attempts to explain why and how intergroup contact leads to changes in racial attitudes. Increases in positive racial attitudes may lower unique stressors often experienced my racial minorities such as racial prejudice and acculturation. This research project provides a starting point for deeper analyses examining how contact theory and the stress process function together. I ask if racially diverse friendship networks affect adolescent mental well being (as measured by mental health and self-esteem) and if the race of the respondent moderate the effects of racial diversity in friendship networks on mental well-being. To answer these questions, I perform secondary data analysis of survey responses from The National Longitudinal Study of Adolescent to Adult Health. I use public-use, cross-sectional data of adolescents from Wave 1 ('94-'95). Linear regression models predicting adolescent mental health found that racial difference in friendship networks is negatively associated with mental health for white adolescents. For Asian respondents, linear regression models found that racial difference in friendship networks was positively associated with both mental health and self-esteem. Results on Hispanic, Black, and "Other" race adolescents were non-significant. These results suggest that racial difference in friendship networks have varying associations on mental well-being that depend on the race of the adolescent. White adolescents with more diverse friend groups may experience increased stress resulting from an increased awareness of the racial prejudice that affects their friend's lives. Asian adolescents may benefit from more diverse friend groups because it allows them to find a "sense of belonging" in environments where there is less opportunity to have same-race friendship networks. They also might face less discrimination from different-race peers, allowing the social support benefits of a racially different friendship networks to outweigh any increases in perceived discrimination from peers. The results indicate that future studies should continue studying how demographic characteristics influence the stress process, including the role of social networks. Policies should aim to provide educational resources teaching adolescents how to handle experiences of prejudice and to create positive points of contact for different race peers. Future studies should assess the validity of these results by performing longitudinal analyses that can provide information on how racially different friendship networks buffer specific stressors and discover if the relationships found in this analysis change over time.

A day treatment program is an important component on the continuum of care for young people with moderate to severe mental health issues. The aim of this research was to investigate whether adolescents who participate in a structured day treatment program demonstrate greater mental health gains than adolescents receiving less intensive outpatient treatment. In addition, the research investigated whether mental health gains were related to intake diagnosis and whether parents reported higher levels of mental health gain than the client in their self-report ratings. The setting for the research was The Cottage, an adolescent day treatment program, run by the Child and Adolescent Mental Health Service (CAMHS) in the Australian Capital Territory. The program provides intense multi-faceted treatment within a therapeutic milieu environment for clients aged 12-18 years with moderate to severe mental health issues. The study involved a Day Program group of 22 clients from The Cottage and included a comparison group of 20 outpatient clients from CAMHS. Results indicated that individuals in both treatment approaches had statistically significant reductions in anxiety and depression symptomology and improvements in outcome measures, but there were no significant differences between the two treatment groups. The data indicated a statistically significant difference in return to school rates, whereby approximately 82% of individuals in the day treatment program had returned to school/employment, whilst only 30% of individuals in outpatient treatment had returned to school/employment within three months post treatment. The results did not demonstrate that the degree of mental health gain was dependent upon intake diagnosis and although not statistically significant, parents rated their children as more severe in terms of psychopathology than the client.

published_or_final_version / Public Health / Master / Master of Public Health

Aim of the study: to evaluate teenagers mental health care needs and correspondence to their expectations. Methods: Participants were 15-16 years old (9-10 form) schoolchildren from Kaunas town and region secondary schools. Respondents were interviewed by anonymous questionnaire. We examined 1000 participants. The response was 80,8 percents, but 759 cases were analysed. There were used Epi-Data and SPSS 11.5 statystical programs to count the data. Chi-criteria and correlated analysis methods were used to ensure statistical reliability. Statistical conclusion was confidential at p £0,05. Results: Teenagers mental health conception and official mental health definitions were different. In qualitying mental health schoolchildren mostly emphasized inner shape; 21,6 percent associated it with reason, 10 percent- with behaviour and reaction to surroundings, 8 percents- brains and nervous activity. Some of respondents mixed up mental health concept with mental non-health and then they emphasized particular physical complaints, malfunction of nervous system and etc. The fifth (23 percent) of schoolchildren had various mental health complaints, 16,3 percent- problems in family, 12,8 percent- in school and 10,8 percent had difficulties in relations with friends. Teenagers didn’t attributed subjective problems to the problems group, which would be the reason to go to specialists. Girls used specialists favours more often as boys. Teenagers, who lived in region, had bigger needs... [to full text]

This study focused on youths’ experience of receiving school-based mental health services and community-based mental health services. This qualitative study utilized a sample of eight girls and boys, ages 15-17 years old, who attended school within the district of Timmins. Data was collected using individual interviews and analyzed using thematic analysis. Results of the study revealed benefits to services, limitations to services, and some recommendations for changes to services. This research helped to explain what the participants, who have had experiences with mental health services, thought about the services they have had; it also provided some recommendations the participants made for changes to the mental health services based on their experiences. The conclusion of this study involved a connection between this study and social work practice, and offered suggestions for future research in the field of children’s mental health services.

xvii, 93 p. : ill. (some col.) / Since Rosenzweig's "Dodo Bird Verdict" in 1936, the "common" versus "specific" factors debate has continued to polarize the field of psychotherapy. Treatment expectancy is an important but often overlooked common factor. The current study investigated the role of treatment expectancy in the Treatment of Adolescents with Depression Study (TADS). Four-hundred three adolescents ( M age =14.62, SD =1.56) filled out the Treatment Expectancy for Adolescents (TEA) measure prior to treatment randomization to one of four treatments: fluoxetine (FLX), cognitive behavior therapy (CBT), their combination (COMB), and placebo (PBO). Adolescents randomized to CBT or COMB also filled out the CBT Rationale Acceptance and Expectation for Improvement (C-RAEI) form during their second session of CBT. Before finding out their treatment assignments, adolescents endorsed higher treatment expectancies for COMB than CBT and medication only. Family income levels below $75,000 and higher levels of depression severity, hopelessness, and suicidality were associated with lower expectations for improvement with CBT. The presence of a comorbid anxiety disorder diagnosis was associated with lower expectations for medication without CBT. Separate random coefficients and logistic regression models identified treatment expectancy as a predictor of outcome for three primary outcome measures in TADS, irrespective of treatment assignment. Severity of depression moderated this relationship; mild to moderately depressed adolescents appeared to be more sensitive to the effects of treatment expectancy than marked to severely depressed adolescents. The opposite results were found for the self-rated outcome measure in TADS based on the C-RAIE. For marked to severely depressed adolescents assigned to CBT or COMB, acceptance of treatment rationale and expectancy for improvement were associated with treatment response. These results suggest that treatment expectancy is an important common factor of treatment for mild to moderately depressed adolescents prior to treatment initiation, although it may be especially important for initially skeptical, marked to severely depressed adolescents to "buy in" to treatment after treatment initiation. Treatment effects were still found after controlling for the effects of treatment expectancy on outcome. It seems that both the "common" factor of treatment expectancy and the "specific" factor of treatment assignment contributed to outcome in TADS. / Committee in charge: Anne D. Simons, Chair; Gordon Nagayama Hall, Member; Holly Arrow, Member; Jeffrey Todahl, Outside member

D. Cur. / The greatest potential developed by mankind this century is the increasing awareness of one's portfolio of rights. Amongst the many rights expressed verbally, is the right to mental health. Adolescents whose parents abuse substances also qualify for this right. Fortunately, rights can be earned. Adolescents can acquire the right to mental health if they act in such a way that this will persuade others to notice and listen to them. The reality is that all efforts made towards promoting mental health of these adolescents will improve their general well-being. Mental health is generally regarded as an integral component of a human's emotional, social, spiritual and physical well-being. There is substantial evidence that adolescents living in families whose members abuse substances have difficulty in facilitating their own self-development. As a result, they are deprived of the capacity to mobilise their inner resources promoting their mental health. The study utilised a theory generative, qualitative, explorative, descriptive and contextual design. Two main samples were used. Firstly, adolescents in Grade 11 whose parents abuse substances, who at that time lived in and around rural villages within a 20 km radius of Mafikeng in the North West Province participated as respondents. The second group consist of key community leaders which consisted of groups from the Chiefs Council, police officers, community nurses and ministers of the Christian congregations. The main question that was posed during in-depth group interviews was, "How can adolescents whose parents abuse substances improve their life situations?" Adolescents and traditional healers were interviewed on a one-to-one level. A central question that adolescents had to answer was: "How can you be assisted to improve your day-to-day life?" Informed consent had been obtained from all participating adolescents and their "gatekeepers" (Cresswell, 1994: 142) and the reasons for conducting the research study were explained to all of them. The theory for this thesis has been derived inductively from data obtained from interviews with adolescents, key community people and field notes. Approaches that were used to generate theory are those suggested by Chinn and Kramer (1991: 80-108). In addition, the reasoning strategies that were employed are the analysis, synthesis, inductive and deductive methods described by Tesch (in Creswell, 1994: 155). The results were verified during literature control. Emerging from the results is a strong belief that adolescents selfdevelopment will assist them to overcome the difficulties related to their parents' substance abuse. They can do that by becoming actively involved in the process of improving their social, physical, psychological and spiritual dimensions. Concepts obtained from the results of the interviews were defined according to the steps described in Wandelt and Steward (1975: 64-69), Chinn and Kramer (1991: 84) and Copi (1987: 169). In relation to this, the term self-development was examined by using dictionary definitions, subject definitions and a model case description. Self-responsibility, facilitation and conscious-awareness were identified as essential criteria to selfdevelopment. Measures that were used to maintain trustworthiness in this thesis are truthvalue, applicability, consistency and neutrality (Guba & Lincoln, 1985: 290). The model of self-development therefore emphasises the active participation of adolescents in self-development to develop self-responsibility in their own empowerment. It is envisaged that as adolescents take self-responsibility they will discover the inherent capacities based on their body-mind-spirit and thereby improve their locus of control. Undoubtedly people can gain these capacities through their acquisition of skills, beliefs, attitudes, thoughts and values which enable them to step beyond the environment of substance abuse. This thesis therefore proposes a model of self-development on which guidelines for the advanced psychiatric nurse practitioner can be operationalised. This will assist adolescents to become self-aware and reorganise themselves in order to continue in the lifelong process of self-development.