In the South African public health care system, HIV Counselling and Testing (HCT) has become a function that is routinely entrusted to lay counsellors. These counsellors are expected to educate clients about HIV and AIDS, encourage them to be tested and convince them to change risky behavioural practices. They have to convey the clients’ test results and assist those who test HIV-positive and their families to cope with the psychological challenges associated with the diagnosis. The counsellors occupy the front line of HIV and AIDS service delivery, even though they are not formally employed in the health care system. They only have basic training and are not adequately remunerated. The counsellors are confronted with psychological and structural stressors in their work. Psychological stressors include the impact of emotionally challenging work, the lack of appropriate training, debriefing and supervision. Because they are not formally employed in the health care system, there is a lack of formal supervision or channels to discuss their frustrations. This research focuses on the stressors which HIV counsellors experience, how they cope, and the impact it has on their psychological well-being. As part of the mixed methods approach 50 HCT counsellors working at the City of Tshwane clinics completed the Bar-On Emotional Quotient Inventory, the Maslach Burnout Inventory for Human Services Survey (MBI- HSS), the Centre for Epidemiologic Studies Depression scale (CES-D), and the Brief COPE scale to assess their psychological well-being. In addition, they participated in focus group discussions. EQ-i scores indicated that counsellors reported below average emotional skills, with the overall group score of (88.76). Scores that indicated average emotional skills were Self-Regard (101), Interpersonal Relationships (100.12), and Impulse Control (102.66). Scores that indicated low emotional skills were Independence (86.66), Self-Actualization (88.28), and Reality Testing (83.94). Although they reported high levels of Emotional Exhaustion (27.66), they also have a sense of high Personal Accomplishment (38.64) (MBI-HSS). Counsellors reported an overall CES-D score which was indicative of mild depression (26.08). Counsellors used mostly positive coping skills that included religion, planning, and direct action in coping with stressors in their lives. In a regression analysis with depression as the dependent variable, there was a positive relationship between depression and depersonalization and a negative relationship with positive or active coping and assertiveness. It was concluded that counsellors experienced some depression, emotional exhaustion, and lower than average levels of emotional well-being. Despite that, they reported positive ways of coping and high levels of personal accomplishment. Counsellors were motivated by their sense of altruism, compassion towards their clients, the positive changes they see in client’s lives as well as the reciprocal relationships they have formed with their clients. Counsellors thus have strengths to cope with the high level of stressors and challenges related to their work. It can be concluded that their state of mental health is in line with Keyes’ proposal that mental health forms a continuum. They fluctuate between mental well-being and mental ill-being. However, it is necessary to assist HCT counsellors to develop their emotional capacities to enable them to enhance their ability to counsel their clients effectively. / Dissertation (MA)--University of Pretoria, 2013. / gm2014 / Psychology / unrestricted

In South Africa the idea of a peer helping service has gained impetus and is viewed as a viable option given the fact that there is a shortage of professional school-counsellors and complementary care-givers in the public school environment. This research emanated from an awareness that there was a need to develop an objective assessment tool regarding the identification of peer-counsellors. This instigated an investigation of the essential criteria, predominant characteristics and requirements of effective peer-counsellors. The primary focus of this research has been to develop a self-assessment instrument that will assist in the identification and selection of potential peer-counsellors. The self-assessment instrument proved to be a valuable tool in discriminating between good, average and weak peer-counsellors. Findings indicate that the self-assessment instrument should be used in conjunction with other modes of assessment such as the self-report data, teacher ratings and peer ratings. / Psychology of Education / M. Ed. (Guidance and Counselling)

In South Africa the idea of a peer helping service has gained impetus and is viewed as a viable option given the fact that there is a shortage of professional school-counsellors and complementary care-givers in the public school environment. This research emanated from an awareness that there was a need to develop an objective assessment tool regarding the identification of peer-counsellors. This instigated an investigation of the essential criteria, predominant characteristics and requirements of effective peer-counsellors. The primary focus of this research has been to develop a self-assessment instrument that will assist in the identification and selection of potential peer-counsellors. The self-assessment instrument proved to be a valuable tool in discriminating between good, average and weak peer-counsellors. Findings indicate that the self-assessment instrument should be used in conjunction with other modes of assessment such as the self-report data, teacher ratings and peer ratings. / Psychology of Education / M. Ed. (Guidance and Counselling)

This study examines the design, implementation and evaluation of a communication skills training programme for adherence counsellors in a paediatric HIV clinic. Effective communication is a pre-requisite skill for any counselling interaction. For both prevention and treatment, counselling is a critical component of the healthcare team response to the HIV epidemic. Given the shortages of healthcare workers in sub-Saharan Africa, task-shifting of the counselling role to less-trained cadres of workers is commonplace. In the multilingual, multicultural South African context, taskshifting coupled with the complexity of the message in paediatric HIV presents enormous challenges. In-service support for counsellors is lacking. Counsellor burn-out and fatigue is commonplace affecting the quality of counselling interactions. Measuring the quality of communication in a multilingual context poses ethical and methodological challenges and is a neglected area of research. Traditional communication and counselling assessments appear to be largely taxonomic; lack cultural and linguistic sensitivity; and fail to acknowledge communication as a dynamic, two-way process. Mindful of these issues, this study utilized a non-taxonomic approach. Verbal and non-verbal communication was analysed before and after the implementation of in-service training which was tailored to the specific research context. The training comprised a two day multidisciplinary team workshop followed by individual training. This consisted of video feedback and analysis of counsellors’ own sessions and was attended by four counsellors. Results were recorded over an eighteen month period. Twenty-two consultations between counsellors and caregivers were video-recorded, transcribed verbatim and analysed using a hybridized form of linguistic analysis. Findings that demonstrated consensus, substantiation and cross-consultation occurrence were triangulated with thematically analysed interview data, patient questionnaires and researcher reflections. These methods are more sensitive to process than checklist approaches and individualised, complex dynamics emerged. Communication barriers and facilitators were identified before training. Variations in communicative competence between counsellors appeared to be unrelated to prior training. After training, counsellors asked more open-ended questions, encouraged caregivers more, provided simpler explanations of treatment regimens and checked understanding more effectively. In response, caregivers initiated more questions. These findings suggest that communication training improves treatment literacy and results in interactions that are more patient-centered. Despite this evidence, the results suggest limitations to the impact of communication training given the lack of agency of women in South Africa. Interactions included frank and open discussion about cultural beliefs. However, this benefit may be lost due to poor healthcare team cohesion. In their roles as mothers and caregivers themselves, counsellors are effective patient advocates and bring their own lifeworld experience to the counselling interaction. These shared stories are testimonies to the resilience of women living in poverty. Whilst allowing for greater exploration of patients’ cultural beliefs and explanatory models, communication training has limited impact in assisting counsellors with dealing with issues such as disclosure, non-adherence and scepticism about biomedicine. Results indicate conflict between patient-centeredness and perceived desired medical outcomes. Caregivers and counsellors appeared to engage in ritualistic dialogue when discussing certain topics suggesting that a shared lifeworld between caregiver and counsellor is insufficient to overcome barriers from the meso (institutional) and macro (broader socio-political) context. An awareness of the impact of context is critical to our understanding of communication in a clinical setting. The results from this research have implications for the role of the counsellor within a multidisciplinary team and establish a need for communication specialists to work in a clinical setting within the HIV epidemic.

Este estudo analisou a experiência de construção da participação social no Sistema Único de Saúde, tendo como objeto de estudo o Conselho Municipal de Saúde de Ribeirão Preto, no período de 1991-1998. Construiu-se o referencial teórico a partir da redemocratização do país e da Reforma Sanitária, abordando o objeto de estudo nas dimensões: Direito à Saúde, Participação, Controle Social e Cidadania. A metodologia foi o Estudo de Caso, na abordagem qualitativa da pesquisa em saúde. Procurou-se, a partir de Análise documental e de Entrevistas com Conselheiros e ex-Secretários Municipais de Saúde, através da técnica de Análise Temática, identificar relações estabelecidas entre os sujeitos sociais que compõem o Conselho, projetos de interesse e concepção de Direito à Saúde; buscou-se apontar limites e potencialidades do espaço de participação para a construção da cidadania. Principais limites: os temas são levados ao Conselho, apenas para aprovação, não oportunizando discussões prévias; a vinculação do Fundo Municipal de Saúde à Secretaria da Fazenda, impede Gestor e Conselho de terem autonomia na decisão do uso dos recursos; alguns segmentos não levam para o Conselho suas demandas, utilizando outros canais; o corporativismo de alguns segmentos, impede a publicização de projetos de interesse. Como potencialidade, verificou-se que os entrevistados têm no Conselho, o fórum político legítimo, para discutir e deliberar as diretrizes políticas para a saúde no município, legitimando-o, enquanto espaço público de construção do Direito e da Cidadania. Isto permitiu o funcionamento, nestes 8 anos, sem solução de continuidade. / This study analysed the experience of building social participation in the Unique Health System (Sistema Único de Saúde), having as its study object the Municipal Health Council of Ribeirão Preto, during the period of 1991 - 1998. The theoretical reference was built from the county’s redemocratization and the Sanitary Reform, broaching the study object in the dimensions: the Right to Health, Participation, Social Control and Citizenship. The methodology was Case Study, in the qualitative aspect of health research. We sought, from document analysis and interviews with Counsellors and former Municipal Healt Secretaries, through the technique of Thematic Analysis, to identify relations established among the social subjects which compose the Council, projects of interest and the conception on the Right to Health; we sought to point out limits and potencialities of the space of participation for the construction of citizenship. Main limits: the themes are sent to the Council for aprovement only, not allowing previous discussions; the bond between the Municipal Health Fund and the Secretary of Treasure, obstructs Manager and Council of having autonomy in the decision on the use of resources; some segments don’t take their pleas to the Council, using other channels; the corporativism of some segments don’t allow publicizing projects of interest. As potentiality, we observed that those interviewed have in the Council, the legitimate political forum to discuss and deliberate on the political directions for health in the Municipality, legitimating it as a public space for the construction of Rights and Citizenship. This allowed its functioning, during 8 years, without interruption.

This thesis contends that trainee counsellors are disempowered when they are expected to conform to the patterns provided by the trainer or agency. Empowerment results from the encouragement of the trainee to develop his/her own eclectic approach to their counselling, and this is only possible if a range of elective training programs are made available. This thesis also contends that no one agency or trainer is in a position to provide such a range of counselling approaches, and trainees should be motivated to use the service of other agencies, as well as being involved in independent studies. This inquiry proposes that one of the most effective foundations for the development of effective counsellors is the active encouragement of the trainee's self-awareness and the exploration of the trainee's inner life. If the success or failure of counselling depend on the ability of the counsellor to create an environment in which the client can explore his/her own issues, then it requires counsellors who have been empowered to make this discovery for themselves. This thesis also shows the author's own transformational journey, from a directed learner to a self-directed learner, and this paradigm shift in his own life has become the motivating force for empowering others to move into a position where they can exercise their own choices, and be empowered through participatory and transformative learning approaches. / Master of Science (Hons)

The purpose of this study was to determine whether the Adaptive Behaviour group intervention effected a greater immediate positive change on 'poorly adapted' student locus of control, self esteem, group evaluation and perceived behaviour than Helping Skills, Relaxation Training or No Intervention group after eight weeks. The three independent variables - Adaptive Behaviour, Helping Skills and Relaxation Training Group Interventions - were devised and led by the Researcher and two school counsellors respectively. Measurement of the dependent variables was by the use of the following instruments pre-test and post-test: Locus of Control Scale for Children (Nowicki Strickland 1972); Coopersmith Self Esteem Inventory (Coopersmith, 1982); and researcher designed questionnaires. A pre-test post-test group design was used in the study. The subjects were years 7-9 High School students identified by Student Year Advisers and the Assistant Principal Student Welfare as being 'poorly adapted' and 'well adapted' to the school environment. Students were randomly allocated - in year groups - to the intervention and control groups. Results indicated no short term significant positive change in locus of control for any intervention or controlgroup; no short term significant positive change in self esteem for any intervention group; no significant correlation between locus of control and self esteem scores for any intervention group; positive pre and post-test group evaluations for all groups; some positive short term change in teacher and student perceptions of student behaviour in regard to all three interventions. In some cases students' behaviour in the experimental group (Group A) was perceived more positively by teachers and students. Some recommendations for further research are: replication of the study over a longer period of time with some modification to the experimental programme, the research design and methods of measurement.

Research has suggested that the identity of the school counsellor is inevitably determined by what they do or are perceived to do, rather than by what they would like to do or ought to do. Thus the perception held by students, counsellors and teachers are of paramount importance in attempting to define the role and function of the counsellors. This study attempts, by a descriptive approach to determine what their perceptions are, and in addition to determine what effect, if any, the administration of a school can have on the perception held by the counsellor of that school. A questionnaire was distributed to a randomly selected sample (N-223) of students from a secondary school within the ACT, whose total population was 750. The results were shown in their-raw score form, percentage form and in years and sex. The same method was used to ascertain the perceptions held by stuff and administration of this school, and results were shown in raw score and percentage form. Similarly counsellors' perception of their role and function were obtained, although counsellors themselves were able to comment upon the design of the questionnaire before the final format was given to them. The results tend to show that counsellors within the ACT system were similar to those in the USA, in that their identity was determined by what they were perceived to do. The second part of the study used a causal - comparative approach to determine the effect of school administration on counsellors. The results of this showed that this body can potentially exert an extremely powerful influence upon the role and function of counsellors. The implications of the study for the ACT system are great. If the counsellors are to be used to their maximum, greater support must be given to them, and teachers at all levels should undergo some training to aid them in understanding and thus utilizing the counsellors to their fullest potential.

The aim of the Narrabundah Companionship programme was to provide young children ("Kids") from deprived cultural backgrounds with opportunities to learn appropriate social behaviours by pairing them with older students ("Companions") for activities involving social interactions. Unlike the typical work of the School Counsellor, which tends to be problem centered and crisis oriented, the Companionship programme is seen as a preventive activity which uses "peer helpers" as a means of extending the outreach services of the School Counsellor. The effects of this programme on the Companions, rather than on the Kids, was the focus of this study. The purposes of the present investigation were: a) to identify characteristics of A.C.T. secondary college students who volunteered to be Companions; b) to identify appropriate Companion selection procedures; c) to assess the effects of communications skills training on an initial group of Companions in comparison to late-entering Companions who did not receive such training; d) to assess the drives and sentiments which motivated college students to volunteer for the programme and to ascertain any changes in those drives and sentiments which might occur during the programme; e) to determine whether the Companionship experience influenced a change in vocational preference toward a career in social service; and, although not the major thrust of the study, f) to assess the effects of the Companionship experience on the Kids' social adjustment. After pilot programmes in 1978 and 1979, the present study was undertaken during Terms One and Two, 1980. Thirteen A.C.T. secondary college students volunteered to become Companions. Eleven A.C.T. primary school students and one junior secondary school student were selected to participate as Kids in the programme. Prior to active participation, volunteers completed the Kuder Preference Record - Vocational (Kuder) and the Motivation Analysis Test (MAT). The teachers of the Kids assessed them using the Bristol Social Adjustment Guide (BSAG) and completed a brief questionnaire to aid the Researcher in his pairing of Kids with Companions. The Companions attended six (1 1/2 hour) sessions of a communications skills training programme adapted from the Peer Counselling Student Training Course (Varenhorst & Hamburg, 1972). Based on perceptions formed during the training period, the Companions then rated each other using the Group Assessment of Interpersonal Traits (GAIT) developed by Goodman (1972). The Researcher also made a subjective ranking of each participant in relation to his perception of the individual's potential to be an effective Companion. Contrary to expectation, only two new Companions joined the programme at the beginning of Second Term. The Companionship activities terminated after two school terms, at which time all Kids were reassessed by their teachers on the BSAG and post-measures on the Kuder and MAT were completed for those Companions remaining in the programme. Four Companions who had left the programme before the termination of activities had completed these measures at the time of their withdrawal . The results of the present investigation included: a) Significantly more females than males volunteered to become Companions, and their family birth-order position as last-born was highly significant. b) The results of the ratings for potential effectiveness as a Companion on the GAIT and on subjective ranking by the Researcher produced a highly significant correlation (.01 level), indicating that either method of selection is appropriate. c) Because only two new Companions joined the programme at the start of Term Two, it was not possible to adequately compare the effects of training versus no training. d) As a group, there were two significant changes in the motivations of the older students. There were increases in MAT scores measuring the drive "Narcism-Comfort" and the sentiment "Sweetheart- Spouse," significant at the .05 level. e) The results of the initial administration of the Kuder revealed that volunteers already had a high preference for careers in social service areas. There was no significant change in this orientation following participation in the Companionship programme. f) The second administration of the B3AG revealed no significant changes in the teachers' perceptions of the Kids' social adjustment. The Companionship programme is considered to have been beneficial to both Kids and Companions. Although there were no statistically significant changes in the Kids in the short term of this study, it appears likely that there is potential for long term benefits. Several of the relationships are continuing on an informal basis. Companions spontaneously expressd the enjoyment and personal growth they had derived and their willingness to participate in the next programme. Some parents of Kids were enthusiastic in their evaluations and have sought to keep in touch with the Companion. The Companionship programme is seen to have been a valuable preventive programme in community mental health.

<p>&nbsp / </p> <p align="left">This study aimed to establish the effect of the training that was provided by <i><font face="Times New Roman">PASHA </font></i><font face="TimesNewRomanPSMT" size="3"><font face="TimesNewRomanPSMT" size="3"><font face="Times New Roman">on the knowledge and attitudes of school counsellors regarding </font>HIV/AIDS. The research was conducted as a quantitative, observational KA(knowledge, attitude) study in 57 schools (37 or 32 % of the intervention schools,20 non-intervention schools) in Tanga region, using questionnaires to compare the knowledge and attitudes of trained counsellors with those of untrained counsellors towards HIV/AIDS, sexuality and reproductive rights of their students. Questionnaires were pre-tested and then administered face-to-face over a four week period in 2007. Eighty five counsellors were interviewed, 56 of these had received in-service training as counsellors, while 29 had not received any training by </font></font><i><font face="Times New Roman" size="3"><font face="Times New Roman" size="3">PASHA</font></font><font face="TimesNewRomanPSMT" size="3"><font face="TimesNewRomanPSMT" size="3">.</font></font></i></p>