M.A. / The purpose of this research study is to explore and identify a knowledge contents base needed for the development of a competency-based stress-coping program for traumatized adolescents. The aim of a competency-based stress-coping program is to address the inadequacy of the traumatized adolescent to cope with stress, and the need to channel their inability to cope with stress, thus enabling them to channel stress adequately. To accomplish this aim, an in-depth study is made into the competency-based approach, as well as the exploration of stress and traumatized adolescents. The research process of Mouton and Marais (1991) is followed and four data collection methods are utilized in the study. The research process is initiated by a literature study and is supplemented by (a) semi-structured interviews with experts in the field of Competency Based Training; (b) the use of a focusgroup with social workers in practice with traumatized adolescents and (c) group-administered questionnaires completed by traumatized adolescents receiving social work services. The study is not conducted and tested on a large scale due to the qualitative research undertaken. Data collected is analyzed by inductive reasoning and the processing of data through the utilization of the SPPC computer program which is used for the questionnaires completed in this study. Results show that a prerequisite for the utilization of the Competency-Based Approach entails the preliminary training of presenters of programs based upon this approach. Furthermore adolescents need to have certain intellectual and emotional abilities at their disposal which enables them to participate in a program based upon the Competency Based approach. Results show that traumatized adolescents who participated in this study have been exposed to a number of stress factors, mainly related to the relationships they are involved in, and indicate a need to participate in a stress-coping program. In a competency based stress coping program for adolescents it is necessary to identify between the cognitive outcomes and the behaviour or social outcomes that are intended.

M.A. (Psychology) / Human suffering and death are an intrinsic part of the work of emergency response personnel. Emergency workers are not immune to the stresses of emergency situations, and it is therefore understandable that those dealing with the critically ill or injured will experience feelings like anger, anxiety and sadness. Gibbs, Drummond and Lachenmeyer (1993) cite some characteristic responses ofemergency workers in their reaction to the daily experience oftrauma. These responses include increased anxiety, tension and feelings of distress, and cognitive deficiencies. Physical symptoms and the abuse of alcohol are also common. Despite the considerable body of knowledge regarding stress in emergency workers, most intervention strategies to alleviate the long-term consequences of mental trauma on these workers have been prophylactic in terms of future service. Little has been done to validate such efforts (Dunning, 1990). Within the South African context research in this field is also scant, yet the overwhelming evidence ofthe reactions cited in research (Hetherington, 1993a; Gibbs et al, 1993; Mitchell, 1985, 1982, 1984b; Sparrius, 1992 and Mitchell and Bray, 1990), both local and international, would indicate that such reactions exist in South Africa and should therefore be extensively investigated. It would therefore be necessary to implement an intervention programme for this group and systematically evaluate it. However, the nature of PTSD on its own, and how it relates to the emergency worker needs to be discussed...

Currently some confusion exists as to how health professionals should best respond to the psychological needs of those affected by disasters. Some have argued that early psychological intervention is essential and others have argued that early formal psychological interventions have no useful role in post trauma response. This study highlights the importance of considering both counselling and non-counselling factors as potentially influencing the psychosocial response of disaster victims. Although posttraumatic stress disorder (PTSD) is not the only mental disorder that can develop as a result of exposure to disasters, it is probably the most frequent and debilitating psychological disorder associated with traumatic stress. In this exploratorydescriptive study the researcher aimed to explore and describe psychologists’ perceived influences of early strategies on the psychosocial response to those affected by disaster. The researcher used non-probability snowball sampling to access participants. The sample consisted of 5 participants. Semi structured interviews were conducted. Content analysis was used to analyse the data obtained from interviews. Results that emerged from the data suggest that there are many factors that influence the psychosocial response to those affected by disasters. These factors include the screening process, needs of survivors, the method of choice for treatment, the timing of intervention, pharmacology, the South African context, training and planning. The study makes a contribution to the growing knowledge of early strategies in response to those affected by disasters.

In a world where insecurities, violence and disasters seem to be increasing on a daily basis, compassion, a moral sentiment of co-suffering and motivation to alleviate it, plays an important role, especially in humanitarian action. However, compassion is not a constant feeling, and our emotions and compassion towards tragedies do not always resonate with egalitarian principles. This thesis seeks to explore the potential relationship between field experience, in humanitarian action, and compassion satisfaction and compassion fatigue. Departing from two contrasting hypotheses, grounded in theories of compassion, it investigates the factors, relating to field experience, that affect this moral sentiment, in a single case study of the Network on Humanitarian Action (NOHA). Through a quantitative survey design, combined with semi-structured interviews, the study finds that there exists no isolated correlation between field experience and compassion fatigue or satisfaction. However, the study concludes that compassion is affected by several intervening variables, relating to field experience, which can result in either compassion fatigue or satisfaction, resonating with both hypotheses.

Purpose: To conduct an educational intervention to reduce compassion fatigue among Arizona transplant nurses. Background: Burnout, secondary traumatic stress, and loss of compassion satisfaction raise the risk of compassion fatigue. Transplant nurses support the patient continuum of life and death, and often experience emotional and physical exhaustion and grief when dealing with poor outcomes or patient loss. When patients disregard the value of their new organ or are non-compliant with medications, nurses may feel conflicted. There is a paucity of research as to how those situations are experienced among transplant nurses. Method: Two workshops were conducted to reduce the risk of compassion fatigue among transplant nurses (n=7) through the delivery of educational and skills training. Education included symptoms, perceptions, triggers and outcomes of compassion fatigue. Skills to reduce compassion fatigue were outlined, such as self-reflection, mindfulness, healthy boundaries, and reaching out. Discussion content was analyzed for commonalities. Findings: Participants reported an overall high level of personal satisfaction within their specialty, relating this to the improved quality of life for patients who otherwise faced terminal illness or imminent death. Burnout and secondary traumatic stress experiences were deemed as inherent within this nursing practice. Symptoms of headaches, nausea, joint pain, and extreme fatigue were described as occurring in times of increased stress. Triggers reported for these symptoms included poor teamwork, lack of management support, and high nurse-to-patient care ratios. Ethical and moral dilemmas were unanimously reported as causing the highest levels of stress and professional dissatisfaction. Implications: Burnout among transplant nurses is perceived as inherent to this specialty due to associated challenges with a life and death continuum of patient care. Participants asserted that the nurse-to-patient relationship remains rewarding, which helps to prevent the onset of compassion fatigue. Participants conveyed that the term compassion fatigue is viewed as negative and does not accurately represent compassion levels when feeling fatigued from providing patient care.

Purpose: The purpose of this project was to conduct an educational workshop among ICU nurses working in rural areas, to reduce risk of compassion fatigue. Background: Compassion fatigue is a job-related hazard unique to professionals in caring professions such as nursing. Rural ICU nurses represent a population that may encounter unique triggers for the risk of compassion fatigue due to professional isolation, less resources and more risk of knowing the patient as a community member. A review of literature reveals limited research related to compassion fatigue development in rural ICU nurses. Method: Two educational workshops were conducted among rural ICU nurses (N=3). Workshop content included discussion about symptoms, triggers, and outcomes of compassion fatigue, as well as positive coping strategies. Participants journaled physical and emotional responses to situations such as ethical or moral dilemmas, boundary issues, and aspects of self-care. Each workshop included time to discuss the educational content and participant experiences; the resulting narratives were analyzed for commonalities. Findings: Universally, burnout was viewed as inherent to the profession. All participants recounted past traumatic patient encounters that preoccupies their thinking when in similar situations. Symptoms identified as compassion fatigue included chronic, constant, generalized pain, symptoms of depression, isolation, withdrawal and lack of interest in enjoyable activities. Triggers were prolonged patient hospitalizations due to lack of resources, lack of supporting services, lack of leadership support, unexpected patient loss, witnessing patient trauma and grief, caring for patients who did not seem to really need ICU, social situations surrounding patients 10 and floating to different departments. Increased alcohol intake, sarcasm, and venting were the most reported mitigation strategies among participants. Implications: Compassion fatigue negatively impacts the lives of rural ICU nurses on many dimensions, although it is perceived as inherent to the profession. These participants desired support from nursing leadership and a supportive work environment. Participants expressed they continued to feel compassion, despite experiencing the phenomenon described as compassion fatigue. A less stigmatizing term might better capture the phenomenon now labeled as compassion fatigue.

Vicarious traumatization (VT) describes the gradual, transformative shifts in internal experience that occur as a result of cumulative exposure to clients’ trauma material. VT is thought to develop in the therapist due to empathic engagement with clients, resulting in profound disruptions in frame of reference. Because VT is conceptualized as a condition that develops due to frequent exposure to clients’ traumatic material, a rapidly emerging body of theoretical literature suggests that clinicians can safeguard against VT by maintaining a more balanced workload (i.e., a caseload of clients with a variety of presenting problems) and limiting the number of trauma cases. However, the quantitative research base on VT is limited and has been plagued by several methodological shortcomings, most notably the lack of comparison groups of non-trauma clinicians. As such, a primary aim of the present study was to characterize the prevalence and severity of VT among one group of clinicians treating predominantly traumatized populations, and one group providing treatment for a wider variety of presenting issues. Further, a secondary aim of this project was to identify both therapist-level and occupational-level contributors to VT. In our cross-sectional, online survey study of 114 generalist mental health providers (Mage = 33.36, 75.4% female, 88.6% Caucasian) and 107 trauma clinicians (Mage = 42.66, 81.3% female, 86.9% Caucasian) recruited from various professional organizations, levels of VT were low and not significantly different between the two provider groups. Risk factors for VT included fewer years of experience, having a greater personal history of trauma, and a personal distress empathy style. Protective factors included a perspective-taking empathy style, problem-focused and emotion-focused coping styles, and high-quality supervision. When the VT construct was examined alongside similar (but conceptually different) occupational stress constructs of secondary traumatic stress and burnout, there was a high degree of overlap, indicating that VT may not be a distinct phenomenon or unique to working with trauma clients. Results suggest that claims about the deleterious effects of trauma therapy are likely overstated, thereby refuting the original conceptualization of VT. Future research directions and implications for prevention and intervention are discussed.

M.A. (Psychology) / Post-traumatic Stress Disorder has been used to describe an individual's reaction to an event "outside the range of usual human experience". South African society is one fraught with violence, to the point where authors have contended that South Africans have become accustomed to a "culture of violence". Children and Adults are victims of this violence, whether they be directly or indirectly affected by it. In such an unstable society the school can provide children with a setting which offers them stability and a normative influence. In order to make the school effective in the aid it offers its students, teachers have to be assisted in developing and strengthening already existing con-structive ways of detecting and handling of children's problems. Teachers themselves also need to be provided with support in order to assist them with their own personal problems. This study examines the effects of trauma on the teacher-pupil relationship by providing Work, for teachers in order to learn from them and guide them in the assistance they give to children who have been profoundly affected by the violence in their environment being direct or indirect victims thereof. It is my hope that this exploratory study will broaden the understanding of Post-traumatic Stress Disorder and provide useful guidelines in an understanding of the impact violence has on children.

M.A. (Psychology) / Post-traumatic Stress Disorder has been used to describe an individual's reaction to an event "outside the range of usual human experience". South African society is one fraught with violence, to the point where authors have contended that South Africans have become accustomed to a "culture of violence". Children and Adults are victims of this violence, "whether they be directly or indirectly affected by it. In such an unstable society the school can provide children with a setting which offers them stability and a normative influence. In order to make the school effective in the aid it offers its students, teachers have to be assisted in developing and strengthening already existing constructive ways of detecting and handling of children's problems. The teachers themselves also need to be provided with support in order to assist them with their own personal problems. This study examines the effects of trauma on the teacher-pupil relationship by providing workshops for teachers in order to learn from them and guide them in the assistance they give to children who have been profoundly affected by the violence in their environment being direct or indirect victims thereof. It is my hope that this exploratory study will broaden the understanding of Post-traumatic Stress Disorder and provide useful guidelines in an understanding of the impact violence has on children.

M.A. (Psychology) / The aim of the research conducted was to analyze and evaluate the prevalence of Posttraumatic Stress Disorder (PTSD) in emergency workers. A literature study was formulated in which PTSD, and comorbid symptoms of Anxiety, Depression, Stress and Burnout were defined. These are seen as secondary symptoms to the overall effect of PTSD. Data was collected through the use of psychometric tests. These were administered to two main groups. The experimental group reflected the results of the emergency medical worker, while the control group reflected thescores attained by the emergency worker. Both groups were made up of a sample of 30 individuals (n= 30) making the full total of persons studied 60 (n=60). To evaluate for any level of significant difference t-tests for independent groups were administered. Scores found to be significant were trait anxiety scores and burnout scores. All other scores were found to be nonsignificant in a comparison of the two' groups.