Die gesin is die sentrum waarbinne die kind se vorming tot volwaardige volwassenheid plaasvind. Indien een van die ouers met 'n chroniese fisieke siektetoestand gediagnoseer word, mag dit moontlike implikasies inhou vir die ouer, die kind, maar ook ander gesinslede. Die chroniese siektetoestand en die implikasies wat dit vir die siek persoon inhou is bestudeer. Daarbenewens is die dinamiek van die gesin, waarbinne die ouer en die kind met mekaar in interaksie is, ontleed. Om te bepaal wat die effek van die chroniese fisieke siektetoestand van die ouer op die kind is, is 'n literatuurstudie onderneem. Dit is daarna geverifieer met gevallestudies wat ondemeem is. Die gevallestudies het die bevindinge van die literatuurstudie bevestig. Dit blyk dat die chroniese siektetoestand van die ouer 'n invloed op die wording van die kind het. Die siektetoestand is 'n voortdurende stressor binne die gesin, wat veroorsaak dat kind(ers) affektiewe-, kognitiewe-, gedrags- en sosiale probleme manifesteer. Daar moet aanpassings gemaak word om die stres binne die gesin te minimaliseer. Riglyne is saamgestel om die terapeut, wat hierdie kind(ers) en gesinne begelei, te help. / The family is the system within which the child develops and eventually attains maturity. When a patient is diagnosed with chronic disease, it has certain implications not only for the parent, but also for children and other members of that family. A liteature study was undertaken to determine the impact of the chronically ill parent on the child. This study was then verified with specific case studies done by the author. These case studies confinned the findings of the literature study. It would seem that the chronic illness of a parent has a definite impact on the development of a child. The parent's illness is a constant stressor within the family, causing children to manifest affective, cognitive, behavioral as well as social problems. Certain adjustments have to be made to minimize stress within such a family. Guidelines are provided to assist the therapist in dealing with these children and families. / Psychology of Education / M. Ed. (Voorligting)

How people survive and thrive through adversity is a question which has prompted much research. There is little agreement on the definition of resilience beyond the basic idea of "bouncing back", resulting in many studies which offer contradictory and confusing information. This study sought to organise the literature into broad conceptual categories, and attempted to explain some of the differences in definitions and research methods at the level of paradigm. A need to reconceptualise resilience was identified and undertaken in view of input from ecosystemic, cybernetic and postmodem paradigms. Attention was given especially to the role oflanguage, meaning and description, and the role of the observer/researcher in such a reconceptualisation. Guidelines were offered for approaching research in future. Finally, the context of the researcher was examined in an attempt at self-reflexivity as part of the process of research as proposed in the reconceptualisation. / Psychology / M.A. (Clinical Psychology)

This study was designed to investigate the effectiveness of a filial therapy training model with high school students enrolled in a Peer Assistance Leadership (PAL) program. Specifically, this study was designed to determine the effectiveness of filial therapy in: (1) increasing observed empathic behavior with children, (2) increasing acceptance toward children, (3) increasing the ability to allow children self-direction, and (4) increasing the level of involvement with children. Additionally, this study was designed to determine the effectiveness of filial therapy in facilitating healthy parenting attitudes of nonparenting adolescents. A research question was presented to determine if a relationship exists between empathy, acceptance, involvement and allowing children self-direction and other factors considered to be healthy parenting attitudes. An Analysis of Covariance on post-test scores revealed significant findings in the high school students ability to demonstrate empathy towards children, allowing the child self direction, communication of acceptance, and involvement as measured by the Measurement of Empathy in Adult-Child Interactions (MEACI). An Analysis of Covariance on post-test scores revealed no significant changes in parenting attitudes as measured by Adult- Adolescent Parenting Inventory (AAPI-2). A Bivariate Correlation revealed a statistically significant correlation between the Empathy, Acceptance, Allowing the Child Self-Direction and Involvement scales on the Measurement of Empathy in Adult-Child Interactions (MEACI) and the Oppressing Children's Power and Independence scale on the Adult-Adolescent Parenting Inventory (AAPI-2). This study supports the use of filial therapy as an effective training model for increasing high school students' empathic behavior with children. Filial therapy training offers significant possibilities for future use in high school curricula to facilitate the development of healthy parenting attitudes and interactions between future parents and children.

Introdução: A Anorexia Nervosa é um transtorno alimentar grave que costuma se manifestar na adolescência. Historicamente, intervenções psicoterapeuticas destinados a essa população têm incluído a família como protagonista no tratamento. No entanto, o foco é psicoeducativo e no manejo comportamental dos pais com objetivo de normalização do peso do adolescente, sem abarcar características das famílias consideradas um fator de risco para a seleção e manutenção dos comportamentos verificados na Anorexia Nervosa, tais como os estilos e práticas parentais inadequados. Essas intervenções têm apresentado resultados modestos e, por isso, estudos recentes têm apontado para a necessidade de intervenções psicológicas que abarquem tanto o restabelecimento de peso dos filhos quanto o desenvolvimento de habilidades socioemocionais e educativas dos pais que respondam adequadamente às necessidades emocionais de seus filhos. O objetivo geral do presente estudo foi desenvolver e avaliar os efeitos de uma intervenção psicoterápica, de orientação Analítico-Comportamental, destinada a adolescentes com Anorexia Nervosa e a seus pais. Método: o delineamento do estudo foi de coletânea de casos. Participaram da pesquisa cinco tríades, compostas do adolescente com Anorexia Nervosa e de seus pais. Foram realizados, ao longo de seis meses, de 20 a 25 encontros com cada família, incluindo avaliação inicial, final e de seguimento. Na avaliação inicial os pais preencheram os seguintes instrumentos: Inventário de Autoavaliação para Adultos (ASR), Inventário de Percepção de Suporte Familiar (IPSF) e Questionário Sociodemográfico. Os filhos foram submetidos ao exame antropométrico, realizado por uma nutricionista especialista em transtornos alimentares, e preencheram os seguintes instrumentos: Questionário sobre Alimentação (EDE-q), Escala de Responsividade e Exigência (ERE), Inventário de Autoavaliação para Adolescentes (YSR) e o IPSF. A intervenção psicoterápica envolveu: (a) psicoeducação sobre Anorexia Nervosa para adolescente e pais; (b) manejo comportamental dos pais para recuperação do peso de seus filhos e (c) treinamento de habilidades socioemocionais e educativas. Todas as fases do tratamento tiveram como guia o livro Anorexia Nervosa na adolescência: como a família pode ajudar?, elaborado pelo autor desta tese. A avaliação final envolveu os mesmos instrumentos da etapa inicial, acrescidos do Inventário de Satisfação com a Intervenção, também elaborado pelo autor, destinado aos pais. A avaliação de seguimento, agendada três meses após a avaliação final, envolveu nova aplicação dos mesmos instrumentos e entrevista devolutiva aos pais e ao adolescente. Paralelamente à etapa de tratamento foram realizados acompanhamentos nutricional e psiquiátrico. Os dados provenientes da aplicação dos instrumentos de avaliação psicológica foram analisados por meio de suas padronizações específicas. Foram conduzidas análises descritivas de frequência simples dos comportamentos dos pais, mães e adolescentes, adotando-se os participantes como seus próprios controles. Resultados: quatro famílias finalizaram o tratamento. A aderência foi de 100%, sem faltas ou interrupções embora o nível de engajamento tenha variado entre as famílias e dentro da própria família. Ao final do tratamento e em seguimento todas as adolescentes estavam com o peso adequado e com menstruação regular. O tratamento produziu melhora expressiva dos indicadores de gravidade do transtorno alimentar de todas as adolescentes participantes. Houve melhoras no funcionamento adaptativo e nos problemas de comportamento referidos pelas adolescentes. Indicadores de funcionamento adaptativo e de problemas de comportamento referidos pelos pais, estilos parentais e suporte familiar percebido mudaram de maneira menos consistente, com tendência de piora após a intervenção e melhora em seguimento. Conclusão: a modalidade de psicoterapia testada se mostrou viável e produziu efeitos positivos. Novos estudos são necessários para solidificar as evidências produzidas nesta pesquisa, sobretudo quanto aos achados sobre suporte familiar e estilos parentais / Introduction: Anorexia Nervosa is a severe eating disorder that usually manifests during adolescence. Historically, research protocols directed to this population include the family as the protagonist of the treatment. These protocols, however, focus on the psycho-educational and behavioral management on the part of parents to normalize adolescents bodyweight, without addressing the characteristics of families that are considered risk factors for the selection and maintenance of Anorexia Nervosa behaviors, such as inappropriate parenting practices and styles. These interventions achieve modest results. For this reason, recent studies highlight the need for psychological interventions to focus on the reestablishment of patients bodyweight and the development of socio-emotional and parenting skills for them to respond properly to their childrens emotional needs. This studys general objective was to develop and assess the effects of a psychotherapeutic intervention with an Analytical-Behavioral approach, directed to adolescents with Anorexia Nervosa and their parents. Method: the studys design was a collection of cases. Five families, each composed of an adolescent with Anorexia Nervosa and her parents, participated in the study. Twenty to twenty-five meetings were conducted over a period of six months with each family, including initial and final assessment and follow-up. The parents completed the following instruments: Adult Self-Report (ASR), Inventário de Percepção de Suporte (IPSF) and a Sociodemographic Questionnaire. The adolescents were given an anthropometric assessment conducted by a nutritionist who was an expert on eating disorders, and completed the following instruments: Eating Disorder Examination Questionnaire (EDE-q); Escala de Responsividade e Exigência (ERE); Youth Self-Report (YSR), and the IPSF. The intervention included: (a) psycho-education addressing Anorexia Nervosa directed to adolescents and parents; (b) behavioral management directed to parents to support their childrens bodyweight recovery; and (c) training focused on parents socio-emotional and child-raising skills. All the treatment phases were based on the book Anorexia Nervosa na adolescência: como a família pode ajudar?, written by the author. The final assessment included the same instruments used in the initial phase, along with a questionnaire to assess the satisfaction of parents with the intervention, also developed by the author. The follow-up interview was scheduled with parents and adolescents three months after the final assessment and the same instruments were applied. Nutritional and psychiatric monitoring was performed concomitantly with psychotherapy. Data concerning the psychological assessment were analyzed using the instruments specific standards. Descriptive analysis included the simple frequency of the behaviors of fathers, mothers and adolescents, while the participants were their own controls. Results: Four families completed treatment. There was 100% adherence to the intervention, with no absences or interruptions, though the level of engagement between and within families varied. All the adolescents reached an appropriate bodyweight and had their periods regulated at the end of the treatment and in follow-up. The treatment produced expressive improvement of indicators concerning the severity of the eating disorder among all the adolescents. Adaptive functioning and behavior problems reported by the adolescents improved. Indicators of adaptive functioning and behavior problems reported by the parents, parenting styles and perceived family support presented a less consistent change, tending to worsen after the intervention and improve during follow-up. Conclusion: the psychotherapy modality tested was viable and produced positive effects. Further studies are needed to consolidate evidence found in this study, especially in regard to the findings concerning family support and parenting styles

Dissertation (Ph.D.) -- The Institute for Clinical Social Work, 1999. / A dissertation submitted to the faculty of the Institute of Clinical Social Work in partial fulfillment for the degree of Doctor of Philosophy.

Die gesin is die sentrum waarbinne die kind se vorming tot volwaardige volwassenheid plaasvind. Indien een van die ouers met 'n chroniese fisieke siektetoestand gediagnoseer word, mag dit moontlike implikasies inhou vir die ouer, die kind, maar ook ander gesinslede. Die chroniese siektetoestand en die implikasies wat dit vir die siek persoon inhou is bestudeer. Daarbenewens is die dinamiek van die gesin, waarbinne die ouer en die kind met mekaar in interaksie is, ontleed. Om te bepaal wat die effek van die chroniese fisieke siektetoestand van die ouer op die kind is, is 'n literatuurstudie onderneem. Dit is daarna geverifieer met gevallestudies wat ondemeem is. Die gevallestudies het die bevindinge van die literatuurstudie bevestig. Dit blyk dat die chroniese siektetoestand van die ouer 'n invloed op die wording van die kind het. Die siektetoestand is 'n voortdurende stressor binne die gesin, wat veroorsaak dat kind(ers) affektiewe-, kognitiewe-, gedrags- en sosiale probleme manifesteer. Daar moet aanpassings gemaak word om die stres binne die gesin te minimaliseer. Riglyne is saamgestel om die terapeut, wat hierdie kind(ers) en gesinne begelei, te help. / The family is the system within which the child develops and eventually attains maturity. When a patient is diagnosed with chronic disease, it has certain implications not only for the parent, but also for children and other members of that family. A liteature study was undertaken to determine the impact of the chronically ill parent on the child. This study was then verified with specific case studies done by the author. These case studies confinned the findings of the literature study. It would seem that the chronic illness of a parent has a definite impact on the development of a child. The parent's illness is a constant stressor within the family, causing children to manifest affective, cognitive, behavioral as well as social problems. Certain adjustments have to be made to minimize stress within such a family. Guidelines are provided to assist the therapist in dealing with these children and families. / Psychology of Education / M. Ed. (Voorligting)

How people survive and thrive through adversity is a question which has prompted much research. There is little agreement on the definition of resilience beyond the basic idea of "bouncing back", resulting in many studies which offer contradictory and confusing information. This study sought to organise the literature into broad conceptual categories, and attempted to explain some of the differences in definitions and research methods at the level of paradigm. A need to reconceptualise resilience was identified and undertaken in view of input from ecosystemic, cybernetic and postmodem paradigms. Attention was given especially to the role oflanguage, meaning and description, and the role of the observer/researcher in such a reconceptualisation. Guidelines were offered for approaching research in future. Finally, the context of the researcher was examined in an attempt at self-reflexivity as part of the process of research as proposed in the reconceptualisation. / Psychology / M.A. (Clinical Psychology)

The purpose of this study was to determine the effectiveness of filial therapy in: (a) increasing Chinese parents' empathic behavior with their children; (b) increasing Chinese parents' attitude of acceptance toward their children; and (c) reducing Chinese parents' stress related to parenting. The experimental group, consisting of 18 Chinese parents, received 10 weekly 2-hour filial therapy training sessions and conducted a weekly 3 0-minute play session with one of their children. The control group, consisting of 16 Chinese parents, received no treatment during the ten weeks. All the parents were videotaped playing with their child before and after the training as a means of measuring change in empathic behavior. The two written self-report instruments completed for pretesting and posttesting purposes were the Porter Parental Acceptance Scale and the Parenting Stress Index. Analyses of Covariance revealed that the Chinese parents in the experimental group had significant changes in all 12 hypotheses, including (a) a significant increase in their level of empathic interactions with their children; (b) a significant increase in their attitude of acceptance toward their children; and (c) a significant reduction in their level of stress related to parenting. This study supports filial therapy as an effective intervention for Chinese parents and their children. Filial therapy equips Chinese parents with healthy parenting skills and knowledge and indirectly empowers Chinese children who experience an increase in parental empathy and acceptance. Thus, filial therapy offers significant possibilities for promoting the parent-child relationship and well-being of Chinese families.

The marriage and family therapy profession is comprised mostly of European-American clinicians. Although all academic programs accredited by the American Association for Marriage and Family Therapy (AAMFT) are required to demonstrate effort in recruiting African-American students, these efforts do not appear to be successful. This study was designed to provide suggestions for recruiting and supporting African-American students in marriage and family therapy programs based on perceptions of faculty and current African-American students. Data for this study are based on survey questionnaires received from 25 of 29 directors of AAMFT accredited academic programs and telephone interviews followed by survey questionnaires completed by 15 of the 20 African-American graduate students enrolled in these programs during the 1989-90 academic year. Results indicated that African-American students and faculty are grossly under represented in these programs. Many current African-American students report feeling isolated, alienated and lonely, as well as disappointed with the lack of African-American peers and faculty in their program. Specific suggestions are offered by students and faculty for improving recruitment and retention of African-American students. Suggestions for improving program sensitivity to cultural and racial issues which may impede the full integration of the African-American student into the academic program and the profession are also offered. / Master of Science

Informed by constructivist and social constructionist theory, a qualitative research study was conducted applying Andersen’s (1991) reflecting team model to explore use of self themes in the supervision process. A male and female Supervisor were paired with a male and female therapist to form two person supervision and reflecting teams. Four RTS sessions were conducted. Each RTS session involved three phases: 1) supervision of a case with the reflecting team observing, 2) reflecting team discussion of their observations with the supervision team observing, and 3) supervision follow-up by the supervision team with the reflecting team observing. The three phases of the RTS process led to three derivations of the original therapist story. The RTS process was discussed after each session in the post-session discussion. Utilizing the reflections of the reflecting team from Phase 2, a difference that makes a difference was introduced into the supervision story. In Phase 3, the supervision follow-up, the supervisor helped the therapist explore previously non-conscious use of self themes in the supervision narrative and construct a different narrative about him/herself and the case brought for supervision. The nature of the points of connection established in the socially constructed conversation between the therapist and client(s) was pertinent to the establishment of a "relational distance" between the client and the therapist that was too close or too distant. The supervisor not only helped the therapist become aware of the points of connection but also helped introduce a difference that allowed the therapist to be more maneuverable. All three phases of RTS are important to a supervision process. The role of the reflecting team in uncovering the "unsaid," and the supervisor in creating a difference possibly become less critical as supervisors develop reflexivity and incorporate these two phases into their typical supervision process. / Ph. D.