This research was directed at determining the value of Gestalt play therapy for the high school learner with Spina Bifida. By undertaking a literature study regarding the child with Spina Bifida, as well as Gestalt play therapy, it was possible to determine what needs and difficulties these learners experience and how Gestalt play therapy can be implemented to address these needs and difficulties. The researcher concludes that any high school learner experiences a lot of developmental changes, but for the learner with Spina Bifida there are not only the social, personal, physical and emotional changes, but also the fact that because of the disability, more support and help structures are needed. It became evident that, for these learners, Gestalt play therapy is a very effective and useful intervention technique. Learners were guided towards awareness of themselves, as well as their inner strength to face the unfinished business in their lives. / Social work / M. Diac (Play Therapy)

No description available.

This study examined scientific evidence of animal-supported work in connection with the therapeutic relationship. The study aimed to investigate whether animal-supported work has any impact on the therapeutic relationship. The study also aimed to examine in what way animal-supported work impacts the therapeutic relationship and whether the effects could be explained by relevant theories. Literature review was chosen as the method of study to fulfil the objectives of this study and data was analysed through thematic analysis. The data used in this study was found in articles through a structured search of the databases PubMed and Psycinfo. In summary, the study found that there is scientific evidence that animal-supported work does impact the therapeutic relationship. The study also found that evidence suggest that animal-supported work impacts the therapeutic relationship in many ways, most of which are positive. The study found that one viable way of explaining the effects of animal-supported work is through the neurobiological theory of oxytocin. The effects could also be explained by the developmental psychological attachment theory. The result of this study points to a need for further research of the effects of animal-supported work on the therapeutic relationship.

Missbruk medför samhällsproblem i flera avseenden och innebär en social utsatthet för individen. Ansvaret för utförande av missbruksbehandling ligger delvis inom socialt arbete. Tolvstegsbehandling av alkohol- och narkotikamissbruk är en av Socialstyrelsens rekommenderade behandlingsformer. Denna Studie utforskar hur tolvstegsbehandlare påverkas av sina tidigare erfarenheter av missbruk i utvecklingen av professionell expertis, identitet och i det behandlande arbetet. Fyra kvalitativa djupintervjuer analyserades med hjälp av en fenomenologisk analysmetod. Studiens resultat visar hur behandlare med egen erfarenhet av tidigare missbruk arbetar för att uppnå och bibehålla en professionell expertis och professionell identitet. Kunskap genom utbildning, praktisk kunskap och personliga erfarenheter blir grundläggande, samtidigt som bearbetning av erfarenheter och självreflektion är särskilt avgörande för ett gott behandlande arbete. Resultaten visar på att den egna erfarenheten har en positiv inverkan på behandling och behandlingsrelationen genom att öka delaktighet, mottaglighet och nyttjandet av behandlarens förebildsroll. Däremot utgör den egna erfarenheten risker som kan inverka på behandling och behandlarens känslotillstånd genom överidentifikation. Tidigare erfarenheter kan även skapa konflikt mellan professionell och privat roll, både utifrån tidigare kännedom om klienten och utifrån fortsatt medverkan i tolvstegsmöten som privatperson. Respondenterna delar en öppen syn på behandlingsmetoder, samtidigt som de delar en icke-flexibel syn vad det gäller medicinering. Resultaten är genomsyrade av vikten att arbeta med sig själv genom handledning, egenvård och fortsatt engagemang i tolvstegsrörelsen. Resultaten diskuteras utifrån tidigare forskning, teorin för psykosocialt arbete och de teoretiska begreppen dubbel relation, förebild, professionell expertis, kunskap, situerat lärande och identitet. / Substance abuse results in several different societal problems and leaves the individual in question socially vulnerable. Responsibility for substance abuse treatment partially lies in the hand of social work. Twelve-step treatment is one recommended form of treatment for substance abuse by The National Board of Health and Welfare. The present study explores how recovered twelve-step counselors are affected by their previous experiences of substance abuse in the development of professional expertise, identity and in their treatment work. Four qualitative in-depth interviews were analysed using a phenomenological analysis method. The results of the present study show how recovered counselors work to achieve and maintain professional expertise and a professional identity. Knowledge through education, practice and personal experience is fundamental, and to continuously process ones previous experiences and engage in self-reflection is crucial for recovered counselors to be able to work within their professional role. Results further show that the previous experiences has a positive impact on treatment and the client-counselor relationship by increasing engagement, receptivity and motivation through role-modeling. However, the previous experiences also infers risks that can have a negative effect on treatment and the counselors emotional state through overidentification. Another risk is the conflict between the counselors professional and private role, due to prior knowledge of clients or through engagement in twelve-step meetings. The present study’s participants share an open attitude towards the use of different treatment methods, while sharing a non-flexible attitude towards medical treatment. Something that has permeated the present study’s results was the importance of continuously working with yourself through supervision, self-care and continued engagement in the twelve-step movement. Results are discussed in relation to previous research, the theory of psycosocial work and the theoretical terms double relationship, role-modeling, professional expertise and knowledge, situated learning and identity.

Hintergrund: Die therapeutische Allianz wird seit vielen Jahrzehnten intensiv hinsichtlich ihres Einflusses auf den Therapieerfolg erforscht. Sie gilt inzwischen als empirisch gut gesicherter Einflussfaktor auf den Therapieerfolg, wobei sich in Metaanalysen kleine bis mittlere Effekte zeigen. Gleichzeitig zeigt sich in Metaanalysen jedoch oft eine große Varianz, was auf mögliche moderierende Einflussfaktoren hinweist. Hierbei können Faktoren sowohl auf Seiten des Patienten 1 als auch des Therapeuten und bezogen auf das Therapiesetting beteiligt sein, die in der bisherigen Forschung vielfach noch nicht ausreichend untersuchtwurden. Im ersten Teil der vorliegenden Arbeit soll die Bedeutung initial besonders gering eingeschätzter therapeutischer Allianz hinsichtlich des Zusammenhangs mit späterem Therapieerfolg analysiert werden. Im zweiten Teil der Arbeit sollen dann Unterschiede im Zusammenhang von therapeutischer Allianz und Therapieerfolg im Bereich verschiedener Persönlichkeitsstörungen betrachtet werden. Fragestellung: Im ersten Teil der Arbeit wurde als zentrale Fragestellung untersucht, inwiefern die Beziehungszufriedenheit in verschiedenen Teilstichproben unterschiedlich zufriedener Patienten eine vergleichbar bedeutsame Rolle als Prädiktor von Therapieerfolg hat. Darüber hinaus sollte anhand der Gesamtstichprobe der Zusammenhang von therapeutischer Allianz und Therapieerfolg in einem naturalistischen, tagesklinischen Setting repliziert werden. Im zweiten Teil der Arbeit wurde der Zusammenhang von therapeutischer Allianz und Therapieerfolg vergleichend anhand zweier Teilstichproben von Patienten mit Borderline Persönlichkeitsstörung respektive zwanghafter Persönlichkeitsstörung untersucht, mit der Hypothese, dass die prädiktive Validität einer singulären Erfassung der Qualität der therapeutischen Beziehung bei Patienten mit zwanghafter Persönlichkeitsstörung größer ist als bei Patienten mit Borderline Persönlichkeitsstörung. Material und Methoden: Grundlage der Arbeit ist eine Gesamtstichprobe von insgesamt n = 809 Patienten (Durchschnittsalter 34 Jahre, 72,6% Frauen), die sich zwischen November 2008 und April 2017 in tagesklinischer Behandlung in der Allgemeinen Tagesklinik der Klinik und Poliklinik für Psychotherapie und Psychosomatik am UKD Dresden befanden. Die Allgemeine Tagesklinik behandelt vorrangig Patienten mit Persönlichkeitsstörungen bzw. Achse-I-Störungen, bei denen eine Thematisierung der hintergründigen Persönlichkeitsakzentuierung therapeutisch sinnvoll ist, in einem multimodalen, multiprofessionellen Setting mittels dialektisch behavioraler und schematherapeutischer Therapiemethoden. Die Behandlungszeit betrug durchschnittlich elf Wochen. Die Diagnosevergabe erfolgte nach klinischer Urteilsbildung auf Grundlage strukturierter bzw. standardisierter Diagnostikinstrumente. Die verwendeten standardisierten Selbstbeurteilungsverfahren zur Erfassung von Symptombelastung (Brief Symptom Inventory-18) und Qualität der therapeutischen Allianz (Helping Alliance Questionnaire) waren Teil des internen klinischen Qualitätsmanagements mit den drei Erhebungszeitpunkten Therapieaufnahme, Zwischenerhebung und Entlassung. In der statistischen Prüfung der Hauptfragestellungen kamen vor allem multiple, lineare Regressionsanalysen zum Einsatz. Ergebnisse: In der Gesamtstichprobe (n = 809 Patienten) war die Qualität der therapeutischen Allianz nach drei Wochen ein signifikanter Prädiktor von Therapieerfolg. In der Extremgruppe des Dezils mit der initial niedrigsten Beziehungszufriedenheit zeigte sich dieser Zusammenhang als statistisch signifikant und stark, jedoch aufgrund des breiten Konfidenzintervalls nicht praktikabel zur Prädiktion individueller Fälle. Dagegen ergab sich für die übrigen 90% der Fälle für die Beziehungszufriedenheit keine über die Aufklärung durch die Erfolgszufriedenheit hinausgehende Varianzaufklärung beim Therapieerfolg. Bezüglich der Substichproben von Patienten mit Borderline Persönlichkeitsstörung sowie zwanghafter Persönlichkeitsstörung zeigte sich über den Therapieverlauf insgesamt eine statistisch signifikante Symptomreduktion. Es fanden sich keine signifikanten Gruppenunterschiede in der Symptomschwere und der Einschätzung der therapeutischen Allianz zu den verschiedenen Erhebungszeitpunkten. Die nach drei Wochen erfasste therapeutische Allianz erwies sich als statistisch signifikanter Prädiktor der Symptomreduktion, allerdings nur in der Gruppe der Patienten mit zwanghafter Persönlichkeitsstörung. Schlussfolgerungen: Die Ergebnisse stützen zunächst die bisherigen Forschungsbefunde, die einen grundsätzlichen positiven Zusammenhang zwischen der Güte der therapeutischen Allianz und dem Therapieerfolg postulieren. Sie zeigen zudem, dass auch in einem teilstationären Behandlungssetting, in dem die zwei Einzelsitzungen pro Woche nur einen Teil der stattfindenden Interventionen während der Therapie ausmachen, der Qualität der therapeutischen Beziehung zum Bezugstherapeuten eine bedeutsame Rolle zukommt. Die Ergebnisse des Extremgruppenvergleichs weisen zum einen darauf hin, dass bei früh etablierter, ausreichend guter Beziehungszufriedenheit andere Prozessfaktoren von größerem prädiktivem Wert bzgl. des Therapieerfolgs sind. Zum anderen verweisen sie auf die hohe Bedeutung der Beziehungszufriedenheit bzgl. des Therapieerfolgs bei mit der Beziehung zu ihrem Bezugstherapeuten sehr unzufriedenen Patienten. Hier zeigt sich als praktische Implikation die Wichtigkeit, eine sich ungünstig entwickelnde therapeutische Beziehung frühzeitig zu erkennen und ihr entsprechend zu begegnen. Dabei gilt es zunächst, den Empfehlungen der „APA Task Force on Evidence-Based Relationship and Responsiveness“ folgend, den therapeutischen Wert einer standardisierten Erfassung von Therapiebeziehungsvariablen auch jenseits des forschungsorientierten universitären Kontextes zu betonen und breiter zu etablieren. Aufgrund des erhöhten Anteils von Patienten mit der Diagnose einer Persönlichkeitsstörung in der Substichprobe von Patienten mit besonders geringer Beziehungszufriedenheit, wurden im Rahmen des zweiten Papers Substichproben von Patienten mit Borderline Persönlichkeitsstörung und zwanghafter Persönlichkeitsstörung hinsichtlich des Zusammenhangs von therapeutischer Allianz und Therapieerfolg untersucht. Eine mögliche Erklärung dafür, dass die therapeutische Allianz in unserer Stichprobe nur bei Patienten mit zwanghafter und nicht bei Patienten mit Borderline Persönlichkeitsstörung einen Prädiktor des Therapieerfolges darstellte, könnte in den unterschiedlichen Mustern der Allianzentwicklung liegen, die für diese Persönlichkeitsstörungen charakteristisch sind. Die Ergebnisse der vorliegenden Arbeit zeigen, dass die einmalige Messung der therapeutischen Allianz in einer frühen Phase der Therapie einen guten Prädiktor für Therapieerfolg bei Patienten mit zwanghafter Persönlichkeitsstörung darstellt und somit auch aus therapiepraktischer Sicht gewinnbringend Verwendung finden könnte, um mögliche, eventuell verdeckt gebliebene Konflikte in der therapeutischen Beziehung frühzeitig zu erkennen. Bei Patienten mit Borderline Persönlichkeitsstörung scheint die einmalige Erfassung der therapeutischen Allianz bzgl. des späteren Therapieerfolges einen begrenzten prädiktiven Wert zu besitzen, weshalb hier eine kontinuierlichere Messung der therapeutischen Allianz ratsam ist. / Objective: The therapeutic alliance has been intensively researched for many decades with regard to its influence on therapeutic success. It is now considered to be an empirically well-established influencing factor on therapeutic success, with meta-analyses showing small to medium effects. At the same time, however, meta-analyses often show a large variance, which points to possible moderating effects. This may involve factors on the side of the patient, the therapist and related to the setting, which have not yet been sufficiently investigated in existing research. In the first part of the present work, the role of therapeutic alliance, which is initially assessed as particularly low, will be investigated with regard to its association with therapeutic success. In the second part, differences in the relationship between therapeutic alliance and therapeutic success in the context of different personality disorders will be analysed. Hypotheses: In the first part of the work, the central question investigated was to what extent relationship satisfaction has a comparably important role as a predictor of therapeutic success in different subsamples of differently satisfied patients. In addition, the relationship between therapeutic alliance and therapeutic success was replicated in a naturalistic, day hospital setting. In the second part of the work, the relationship between therapeutic alliance and therapeutic success was comparatively analysed using two subsamples of patients with borderline personality disorder and obsessive-compulsive personality disorder, respectively, with the hypothesis that the predictive validity of a singular assessment of the quality of the therapeutic alliance is greater in patients with obsessive-compulsive personality disorder than in patients with borderline personality disorder. Material and Methods: The work is based on a total sample of n = 809 patients (average age was 34, 72.6% women) who were treated in the Allgemeine Tagesklinik of the Department of Psychotherapy and Psychosomatics at the UKD Dresden between November 2008 and April 2017. The Allgemeine Tagesklinik primarily treats patients with personality disorders or Axis I disorders, in whom a focus on the underlying personality accentuation is therapeutically important, in a multimodal, multiprofessional setting using dialectical behavior and schema therapeutic methods. The average treatment duration was eleven weeks. Diagnoses were based on clinical judgment utilizing a structured or standardized diagnostic tool. The standardized questionnaires used to assess symptom burden (Brief Symptom Inventory-18) and the quality of the therapeutic alliance (Helping Alliance Questionnaire) were part of the internal clinical quality management with three survey points: therapy admission, interim survey after three weeks and discharge. Multiple linear regression analyses were primarily used in the statistical analyses of the main hypotheses. Results: In the total sample (n = 809 patients), the quality of the therapeutic alliance after three weeks was a significant predictor of treatment success. In the extreme group of the decile with the initially lowest relationship satisfaction, this relationship was found to be statistically significant and strong, but not feasible for predicting individual cases due to the large confidence interval. In contrast, for the remaining 90% of cases, there was no variance explanatory effect on treatment success beyond that explained by satisfaction with therapy success. Regarding the subsamples of patients with borderline personality disorder as well as obsessive-compulsive personality disorder, there was a statistically significant overall symptom reduction over the course of therapy. No significant group differences were found in symptom severity and assessment of therapeutic alliance at the different time points. Therapeutic alliance assessed after three weeks proved to be a statistically significant predictor of symptom reduction, but only in the group of patients with obsessive-compulsive personality disorder. Conclusion: The results support previous research postulating a generally positive correlation between the quality of the therapeutic alliance and therapy success. In addition, they show that also in a day-care setting the quality of the therapeutic relationship plays a significant role with regard to the success of therapy. Firstly, the results of the extreme group comparison indicate that in the case of sufficiently good relationship satisfaction established at an early stage, other process factors are of greater predictive value with regard to the success of the therapy. Secondly, they point to the high importance of relationship satisfaction with regard to therapy success in patients who are very dissatisfied with the relationship to their therapist. The practical implication of these findings is the need to recognize an unfavorably developing therapeutic relationship at an early stage and to address it appropriately. Following the recommendations of the 'APA Task Force on Evidence-Based Relationship and Responsiveness', the therapeutic benefit of a standardized assessment of therapeutic relationship variables should be emphasized and established beyond the research-oriented university context. Due to the increased percentage of patients with the diagnosis of a personality disorder in the subsample of patients with particularly low relationship satisfaction, the second paper examined subsamples of patients with borderline personality disorder and obsessive-compulsive personality disorder with regard to the relationship between therapeutic alliance and therapy success. One possible explanation for the fact that therapeutic alliance was a predictor of treatment success in our sample only in patients with obsessive-compulsive personality disorder and not in patients with borderline personality disorder may be found in the different patterns of alliance development characteristic of these personality disorders. The results show that the one-time measurement of therapeutic alliance in an early phase of therapy is a good predictor of therapeutic success in patients with obsessive-compulsive personality disorder and thus could be profitably used from a clinical point of view to identify possibly hidden conflicts in the therapeutic relationship at an early stage. In patients with borderline personality disorder, the one-time measurement of the therapeutic alliance seems to have a limited predictive value with regard to later therapy success, which is why a more continuous measurement of the therapeutic alliance is advisable for these patients.

Text in Afrikaans / This study is about the provision of a prototype court preparation programme for the primary school child that had been sexually assaulted. The programme is developed from a Gestalt approach. Literature regarding several existing court preparation programmes was studied and compared in order to identify certain themes for the child's preparation. Knowledge regarding the court, procedures and the functions of the various role players was conveyed to the child with emphasis on the child's role as witness. The research strategy utilised in the study was that of the intervention research and specifically the D&D-model that comprises six phases. The study incorporates the first three phases plus the first step of the fourth phase. Semi-structured interviews and focus groups were utilised to establish which themes could be addressed to support the child towards being a credible witness. These themes are summarised in the court preparation programme and are addressed from the Gestalt approach. / Social Work / M.Diac. (Spelterapie)

Movement in Gestalt therapeutic intervention, using structured activities and free improvisations, is a successful alternative to punishing adolescents with disruptive behavioural tendencies in the classroom. An overview of the existing literature regarding the therapeutic value of movement in Gestalt therapeutic intervention for adolescents with disruptive behavioural tendencies is firstly presented. Various techniques supporting the adolescent in his quest to achieve equilibrium, ultimately improving his relationships with others and his environment, are described. A case study, involving eight adolescents with disruptive behavioural tendencies in group therapy follows, which indicates that movement in Gestalt therapy is an alternative to punishment. In the light hereof it is suggested that movement in Gestalt therapy could be implemented successfully in the formal school environment. This form of intervention can contribute to the adolescent's growth, his ability to communicate and his relationships with self, others and the environment, culminating in improved behavioural tendencies. / Social Work / M. Diac. (Play Therapy)

The interview is considered to be a critical technique in the therapeutic process. The effective (and by implication, the ineffective) use thereof determines to a great extent the outcome of the therapeutic process. Training in therapeutic interviewing forms an integral part of the training of counsellors and therapists. This study was prompted by BEd (Specialisation in Guidance and Counselling) students' need for a structured and systematic approach to training in therapeutic interviewing skills. A literature study of the phenomenon therapeutic interviewing revealed firstly that the skills needed for effective therapeutic interviewing can be identified and operationally defined and secondly that these skills can be systematically trained. Having a repertoire of interviewing skills is however not a guarantee that therapy or counselling will have a positive outcome. The therapist must be able to create a therapeutic relationship with the client and in this regard the therapist's personality and attitudes, including empathy, warmth, respect, genuineness and unconditional positive regard for the client, are of major importance in helping to create an atmosphere wherein the client can feel free to discuss his problems and innermost feelings and thoughts. In the design of a model to train therapeutic interviewing, consideration must be given to both content and procedure. Not only were interviewing skills addressed in this model, but also skills to communicate empathy, warmth, respect, genuineness and unconditional positive regard. For the purposes of this study, the therapeutic interview was divided into six stages. Skills used in each stage were identified, defined and discussed. A pilot study was conducted to evaluate the effectiveness of the training model. Subjects were trained in accordance with the proposed training procedure. In order to evaluate the subjects' progress and thus also the effectiveness of the training procedure, each subject's pre- and post-training interviews were compared. An evaluation scale was designed for this purpose. The results of the pilot study indicated an improvement in the subjects' interviewing skills. It is hoped that this study will pave the way for innovation in the training of counsellors and therapists in therapeutic interviewing. / Die onderhoud word as 'n kritieke tegniek in die terapeutiese proses beskou. Die effektiewe (en by implikasie, die oneffektiewe) gebruik daarvan bepaal tot 'n groot mate die uitkoms van die terapeutiese proses. Opleiding in terapeutiese onderhoudvoering vorm 'n integrale deel van die opleiding van terapeute en voorligters. BEd (Spesialisering in Skoolvoorligting)studente het 'n bepaalde behoefte aan 'n gestruktureerde en sistematiese benadering tot die opleiding van terapeutiese onderhoudvoeringsvaardighede uitgespreek. 'n Literatuurstudie oor die fenomeen terapeutiese ondemoud het eerstens aan die lig gebring dat vaardighede onderliggend aan die terapeutiese onderhoud geidentifiseer en operasioneel gedefinieer kan word en tweedens dat hierdie vaardighede sistematies aangeleer kan word. 'n Repertoire van onderhoudvoeringsvaardighede is egter nie 'n waarborg dat terapie 'n positiewe uitkoms sal he nie. Die terapeut moet 'n terapeutiese verhouding met die klient kan stig en in hierdie opsig is die terapeut se persoonlikheid en sy houding van empatie, warmte, respek, egtheid en onvoorwaardelike agting van kritieke belang in die skep van 'n atmosfeer, waarbinne die klient vry kan voel om sy probleme, diepste gevoelens en gedagtes te kan bespreek. In die ontwerp van 'n model vir opleiding in terapeutiese onderhoudvoeringsvaardighede moet aandag aan beide inhoud en opleidingsprosedure geskenk word. In hierdie model word nie net die vaardighede vir terapeutiese onderhoudvoering aangespreek nie, maar ook vaardighede om empatie, warmte, respek, egtheid en onvoorwaardelike positiewe agting aan die klient te kommunikeer. Vir die doeleindes van hierdie studie is die terapeutiese onderhoud in ses fases verdeel. Vaardighede wat in elke fase gebruik word, is gerdentifiseer, gedefinieer en bespreek. 'n Loodsondersoek is ondemeem om die effektiwiteit van die opleidingsmodel te evalueer. Proefpersone is aan die hand van die voorgestelde opleidingsprosedure opgelei. Ten einde die proefpersone se vordering en so ook die effektiwitieit van die model te evalueer, is elke proefpersoon se voor- en naopleiding onderhoude vergelyk. 'n Evalueringsskaal is vir hierdie doel ontwerp. Die resultate van die loodsondersoek het getoon dat die proefpersone se onderhoudvoeringsvaardighede verbeter het. Die hoop word uitgespreek dat hierdie studie die weg sal baan vir vernuwing in die opleiding van voorligters en terapeute in terapeutiese onderhoudvoering. / Psychology of Education / D. Ed. (Psychology of Education)

No description available.

Movement in Gestalt therapeutic intervention, using structured activities and free improvisations, is a successful alternative to punishing adolescents with disruptive behavioural tendencies in the classroom. An overview of the existing literature regarding the therapeutic value of movement in Gestalt therapeutic intervention for adolescents with disruptive behavioural tendencies is firstly presented. Various techniques supporting the adolescent in his quest to achieve equilibrium, ultimately improving his relationships with others and his environment, are described. A case study, involving eight adolescents with disruptive behavioural tendencies in group therapy follows, which indicates that movement in Gestalt therapy is an alternative to punishment. In the light hereof it is suggested that movement in Gestalt therapy could be implemented successfully in the formal school environment. This form of intervention can contribute to the adolescent's growth, his ability to communicate and his relationships with self, others and the environment, culminating in improved behavioural tendencies. / Social Work / M. Diac. (Play Therapy)