This study was of a group of street children who had run away from home. The writer sought to discover factors that led to their running away. Interviews were conducted with both the boys and their mothers (or mother substitutes). Interview schedules with both open-ended and closed questions were used to obtain certain demographic characteristics of the families, the runaway episodes and the causes for the runaway behaviour as perceived by the runaways and their mothers. The study revealed that multiple interrelated factors within the families, the boys and society seemed to contribute either directly or indirectly to their runaway behaviour. Homes were marked by conflict, instability, alcohol and physical abuse, deprivation and neglect. The runaways in turn responded to their stressful home life by running away. The runaways in contrast to their mothers, predominantly perceived factors within the home as causing them to leave home, whereas the mothers tended to externalize these causes to peer group influences.

This study investigates the training offered to community-based rehabilitation workers in the field of mental handicap to ascertain whether the training provided has been perceived as appropriate in assisting with their tasks and functions. Further investigation is done into the underlying theoretical approaches used in training, curricula designs, training objectives, location and training periods, the community-based rehabilitation workers level of participation and involvement in planning of the training programme, and whether creative, pragmatic and participatory training methods, techniques and materials were used. The nature of supervision was also explored. The historical development of community-based rehabilitation, the lack of trained personnel, and the disparity in the provision of services in South Africa and the function of the community-based rehabilitation are discussed. It is against this background that the historical emergence and need for training of community-based rehabilitation workers are highlighted. Different theoretical approaches to the development and presentation of training are discussed due to the considerable influence they have on the value base upon which training programmes are built. This includes an overview of the philosophy of Paulo Freire. The research method used is of a qualitative nature. The researcher employs an exploratory - descriptive design to gain insight into an area which is relatively uninvestigated. By using this design, the researcher hopes to build a foundation of ideas and tentative theories which could later be tested through more complex methods. The first population chosen included the total population of community-based rehabilitation workers employed at the South African Christian Leadership Assembly Health Project, (seven) and Cape Mental Health Society (two). The second population were the trainers associated with these organisations and the specific projects in which the community-based rehabilitation workers are employed. One trainer from each organisation was included. Both organisations chosen are engaged in direct service delivery to the mentally handicapped in socially deprived communities in the Western Cape. The primary source of data collection was acquired in two phases:- Phase one - An interview schedule which included structured & unstructured questions was administered by the researcher to the community - based rehabilitation workers. The information was gathered with the assistance of an interpreter. Phase two - A detailed self-administered, semi-structured questionnaire was completed by the trainers. The data in these two phases was presented in a descriptive manner due to the size of the population. The study found that there is no consensus regarding appropriate training models. Courses are often loosely structured with no theoretical base. A comprehensive-generic approach which includes promotive, curative, preventative, and rehabilitative aspects is suggested. In this study, the course focused mainly on curative and rehabilitative aspects to assist with tasks while promotive and preventative skills were neglected. No prescribed training period can be stipulated. Constraints of distance and location would determine the duration of the training while the location of training should be within the confines of the community to prevent isolation and an unnatural environment. More creative and pragmatic methods and techniques should be carefully selected. All components of supervision should be given priority and provided regularly in pragmatic and innovative ways. Furthermore, trainers, trainees and communities need to have equal participation and involvement in all spheres of training.

This phenomenological study seeks to understand the perceptions and attitudes of Social Work students towards mental health at the Catholic University in Malawi. This study explores perceptions and attitudes towards persons with mental health problems; effective intervention strategies for mental health problems and help seeking behavior. These objectives are supported by two theoretical frameworks: Recovery Theory in relation to mental health and the Attitudes Theory. The research method is an exploratory qualitative design with multiple participants. Seventeen Social Work students were the unit of study, selected according to a purposive and discriminant sampling design. Data was collected using a semi-structured interview schedule, and recorded during an in-depth interview. This study brought to the fore the perceptions and attitudes of Social Work students of mental health. Participants indicated that they perceive mental health problems as a real illness citing genetics and biological factors; drug and alcohol abuse; and witchcraft/spirit possessions as the causes of mental health problems, with the commonality of mental health problems consolidating them as a real disease. Participants cited cognitive abilities and normality as indicators of mental health problems. Participants felt that recovery; interpersonal relationships and inclusion are significant aspects of mental health problems. Participants felt that effective treatment was dependent on the severity of the mental health problem, citing link to services and counseling as the roles of Social Workers in providing effective intervention. Participants indicated that they would seek professional help as well as encouraging their clients to seek professional help. Participants indicated that discrimination and segregation presents as a barrier for disclosure of mental health problems as well as treatment. Participants also indicated aggression and awareness as aspects of mental health problems. Participants stated that they can easily recognize psychosis.

Includes bibliographical references. / Factitious disorder is characterised by a compulsion with an unconscious motivation to intentionally fabricate signs and symptoms of physical or psychological illness. Factitious disorder by proxy is a form of abuse which usually presents as a parent portraying their child as being ill. Factitious behaviour indicates severe psychological dysfunction, and these clients could pose a danger to themselves as well as their families. There is limited research on factitious disorder in social work practice. This study aimed to explore social workers’ knowledge of factitious disorder, the presentation and prevalence of factitious disorder in social work practice, the experience of social workers with clients with factitious behaviour, and social workers’ approach to the assessment and treatment of factitious disorder. This study used a qualitative exploratory research approach with a phenomenograpy design that enabled the researcher to explore the variation in social workers’ knowledge, experience and approach to factitious disorder.

. / A trauma can be defined as an event which attacks the defences and psychological well-being of the person (Mitchell & Everly 1997). Trauma has the capacity to significantly disrupt a trauma victim 's life and many authors describe the impact that a traumatic event can have on an individual. Trauma counselling is often required to assist the victim to return to their premorbid levels of functioning. This study provides the reader with relevant literature into the subjects of trauma and trauma counselling. There were two research questions which formed the basis of the study and these research questions focussed on how the respondents experienced the trauma counselling they had received and how they felt that the counselling assisted them with achieving post-traumatic growth.

Bibliography: pages 119-133. / The idea of racial and cultural integration in children's residential facilities has been taboo in South Africa until recently, as a result of the racial policies of the current and previous governments. Since 1990 the government has repealed most of its apartheid legislation. Integration of residential facilities is only now able to be considered as a possible solution to the accommodation crisis of black disadvantaged children. The aim of the present research study was to use an exploratory -descriptive design to ascertain the attitudes of child care practitioners regarding racial and cultural integration in residential facilities. A questionnaire was constructed and completed by respondents from the two purposive sample groups viz. the Principals Group and the Child Care Workers Forum of the National Association of Child Care Workers. A total of 68 questionnaires was distributed of which 46 were returned Findings indicated that 70% of the Child Care Workers are working with children of other race groups. Although 94 % of the Child Care Workers and all of the Principals (100%) felt that children would gain much from an integrated living environment, 45 % of the Child Care Workers and 55% of the Principals felt that residential facilities should remain racially exclusive. The implications of such findings are that the preparation for racial and cultural ·integration of staff and children is foreseen. Indications are given that extra resources would be required i.e. money, time, staff. In view of the current and anticipated needs of residential care for disadvantaged children in South Africa, it is recommended that all child care practitioners participate in some form of ethnic and culturally sensitive training programme in order to adequately prepare them for work with children of other races and cultures.

Bibliography: leaves 71-79. / In this study the use of feminist psychotherapy with a woman who has had an abortion is explored. A survey of the literature shows that this approach to psychotherapy is based on a philosophy that women's pathology is inextricably linked to the patriarchal influences of society that have devalued and disempowered women. Abortion, as a specific women's issue, is contextualised within this framework, illustrating that these influences compound women's physical and psychological distress when having an abortion. The case study method is employed to explore the use of this feminist approach in a four month period of psychotherapy with a woman who had an abortion. This highlights how patriarchal influences in the family and religion create major stress factors that affect women's experience of abortion. In particular, the conflicts that centre around women's sexuality that are evoked by the abortion are addressed. The study also demonstrates how the use of this approach may bring out the positive meaning of the abortion for women, as in this case where the abortion was seen as the beginning of the important process of separation. The study concludes that feminist psychotherapy is a beneficial approach to utilise when working with women who have had an abortion.

Bibliography: pages 162-180. / We live in an 'age of accountability.' Social work literature of recent decades abounds with references to the need for adequate evaluation of social work effectiveness, particularly in the light of the dismal findings of early effectiveness studies. However, it is no easy task to operationalise a definition of service effectiveness. This study seeks to evaluate the effectiveness of the counselling service of the Parent Centre, a primary preventive service of the Child Welfare Society, Cape Town. Counselling is provided in order to meet the stated goal of strengthening the effectiveness and self-confidence of parents by providing them with support and information on child development and child management skills. This is offered in the recognition· that parenting, for all that it is a normative life transition, is also a life crisis, and in the further recognition of the significance of the early years in a child's life. The study was located within a limited overview of research literature pertaining to effectiveness studies. It highlighted, moreover, the significance of client studies m contributing to research into outcome of social work intervention. In order to establish the effectiveness of the counselling service, the research took the form of a retrospective semi-structured telephonic survey of a random sample of 55 first-time clients seen at the Parent Centre between January and June, 1994. The sample was drawn from a population of 501 clients. An interview schedule was devised in consultation with colleagues, clients, professionals and after searching relevant literature. It was pilot-tested before being implemented. Fifty-one usable responses were obtained. Since global satisfaction ratings are of little use in evaluation, information was analysed in terms of four categories: demographic, management, process, and outcome information. Both closed- and open-ended questions were used, providing quantifiable as well as qualitative results. Whilst findings need to be interpreted with an awareness of methodological limitations, the results of this survey indicate overwhelmingly that the counselling service at the Parent Centre is experienced by clients to be effective. The question found to be the best discriminator in terms of effectiveness was that asking whether clients' expectations had been met. Significant associations with the clients' feelings that expectations had been met were found with respect to the client's feeling that the counsellor understood the problem and that the counsellor shared personal experiences of parenting. No apparent association was found between this key indicator of effectiveness and income levels or with the counsellor and client having a shared perspective with respect to the presenting problem. Some recommendations based on the findings of the study are suggested for consideration by agency decision makers.

Includes bibliographical references (leaves 70-75). / The research investigated the perceptions of the challenges faced by grandmothers caring for AIDS orphans in Khayelitsha, a township on the outskirts of Cape Town. The aim of this study was to make a contribution to an understanding of the challenges faced by grandmothers who are performing a surrogate parent role. The research focused on the grandmothers? perceptions of the types of challenges they faced in caring for AIDS orphans as well as their perceptions of the causes of these challenges. Lastly the research aimed to investigate the strategies employed by the grandmothers in dealing with these challenges and to ascertain whether or not grandmothers are aware of existing resources that are available to assist them with their challenges.

Bibliography : leaves vii-xiii. / The present quasi-experimental study was conducted in ward G22, a milieu therapy unit at Cape Town’s Groote Schuur Hospital. It examines self-esteem of patients prior to and subsequent to completion of the therapeutic milieu programme, using a self-report questionnaire, the Rosenberg Self-Esteem Scale. This questionnaire was used to measure the level of self-esteem after completion of a 9-12 week stay in G22. The questionnaire was administered to twenty-three successive patients admitted to the unit. Of these one terminated prematurely by committing suicide, while the questionnaire was re-administered to the remaining twenty-two subjects in the final week of their treatment. Protocols were computer scored and quantitatively analysed using Wilcoxon Rank Sum and Signed Rank tests of significance. This analysis indicated that there was a general improvement in self-esteem of subjects after completion of the therapeutic milieu programme, while there was a significant improvement in self-esteem of older subjects when compared with the younger subjects. Other variables such as language, gender and length of stay did not significantly affect the results.