"The Clinic's interest in the problem of withdrawals led to the development of this study. The purpose was to attempt to discern some of the possible factors pertaining to the failure of forty-eight patients to return to the Clinic following the evaluation interview and offer of treatment. It was believed that an analysis of certain data obtained from the case records of the Clinic through use of a case reading schedule of eleven items and follow-up interviews with a group of twenty patients who did not return to the Clinic for the recommended treatment, would give some indication of the possible factors involved. An analysis of these data may lead to more knowledge of some of the factors involved when patients fail to return and will aid the Clinic in ascertaining whether the loss of patients was due to procedures within the agency setting, factors within the patient and his environment, or perhaps a combination of both"--Introduction. / Typescript. / "June, 1961." / "Submitted to the Graduate School of Florida State University in partial fulfillment of the requirements for the degree of Master of Social Work." / Advisor: Helen M. Manahan, Professor Directing Study. / Includes bibliographical references (leaves 73-75).

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The issue investigated in this thesis concerned the adaptive coping strategies that caregivers of the mentally ill adopt at different stages of encounter with their family member’s illness. Specifically, family caregivers’ responses to the illness were investigated within the parameters of the Spaniol and Zipple (1994) 4-stage model of the evolution of caregivers’ responses to mental illness. The accuracy of the model’s representation of the experience of caregivers across all kinship relationships to the care-recipient was evaluated. Spaniol and Zipple proposed four stages which they termed (1) Discovery/Denial, (2) Recognition/Acceptance, (3) Coping and (4) Personal/Political Advocacy. The first stage is characterised by persistent denial of mental illness and seeking answers from multiple sources. The second stage involves caregivers’ expectations of professionals providing answers when the illness is recognised. At this stage caregivers experience guilt, embarrassment and blame. The cyclical nature of the illness impedes acceptance and caregivers experience a deep sense of loss and crisis of meaning as they gradually accept the reality of the situation. In the third stage coping replaces grieving and the issues encountered include loss of faith in professionals, disruption to family life and recurrent crises. Belief in family expertise grows and the focus of coping changes. The fourth stage proposes that caregivers become more assertive, self-blame decreases and the focus is upon changing the system. New meanings and values are integrated. This study found that the model did not accurately describe the experience of all caregivers. Caregiver did not deny mental illness and adaptive coping occurred throughout all stages. Coping evolved as the issues encountered changed and was independent of resolution of grief. The issues encountered were more extensive than the model proposed and differed according to kinship relationship to the care recipient. The ways in which adaptive coping evolved were identified, as were the issues and their accompanying responses. Caregivers coped by adaptively responding to the requirements of care provision, maintaining a sense of self worth and generating positive effect.

Thesis (M. Soc. Sc.)--University of Hong Kong, 2006.

Thesis (M. Soc. Sc.)--University of Hong Kong, 2006.

Thesis (M. Soc. Sc.)--University of Hong Kong, 2003.

Thesis (M. Soc. Sc.)--University of Hong Kong, 2003.

Thesis (Ph. D.)--University of Chicago, School of Social Service Administration, June 2001. / Includes bibliographical references. Also available on the Internet.