‘Patients bring more than just their bodies and diseases’ (Baker et al 1999: 173) The study explores what may be the nature of the need, if any for counselling/psychotherapy for older people who suffer a debilitating physical injury or illness. This is explored within medical settings where the emphasis is on the physical functional rehabilitation of people who have suffered a variety of physical traumas. The theoretical issues related to this are the ageing process and old age, the body, the ‘self’ and, the impact of the trauma. The literature review, whist acknowledging that people do suffer emotional and psychological reactions, offers very little literature on both the practicalities and theoretical orientation of work with people with chronic physical illness or injuries and, in particular, with older people within medical settings. It is documented that depression influences a person’s engagement with rehabilitation and delays discharge, plus increases use of medication. This study shows an awareness of these issues and of counselling/psychotherapy approaches that may be helpful in these circumstances.

Traumatic death survivors are an at-risk population that could benefit from social work interventions. This action research study explored social work perspectives on crisis practice with traumatic death survivors in acute medical settings. The research questions focused on whether early crisis interventions by social workers would benefit traumatic death survivors, which interventions were recommended in crisis practice with this population, the potential effects of repeated trauma exposure on the social workers providing the crisis interventions, and recommendations to manage this professional exposure to trauma. The purpose of the study was to explore social work perspectives on potential benefits of crisis interventions with traumatic death survivors and potential effects of crisis practice on the social workers providing the services. Crisis theory and family systems theory informed the study. Participants were selected from a convenience sample of licensed social workers, and data were collected in 1 focus group and 3 in-depth interviews. Data were analyzed using descriptive and thematic analysis. Findings supported the benefits of social work crisis interventions for traumatic death survivors and the need for self-care, self-awareness, and support to reduce the risks of negative effects of crisis practice on social workers. Specific crisis interventions recommended for practice include the roles of advocate and guide, grief support, viewing of the body, and explanation of next steps. An increase in knowledge and recommendations for future practice based on study findings might promote positive social change by raising awareness about the problem and improving social work practice with traumatic death survivors.

The aim of this study was to develop a Gestalt play therapy based hospital preparation program for children undergoing the surgical procedures of grommet insertion, or grommet insertion and adenoidectomy, at Tygerberg Hospital. Literature was reviewed according to relevant topics, namely otitis media in children, Gestalt play therapy, theories of child development, and children's experience of illness and hospitalisation. Semi-structured interviews were conducted with four subject groups and the data obtained was qualitatively analysed. Research findings were discussed and integrated with reference to the literature. This information was applied in the development of the proposed program. The aim, underlying principles, objectives and components of the program were discussed and guidelines for implementation were provided. The program was implemented and evaluated in a single subject pilot study, which yielded a positive response. Recommendations for both practical implementation in a therapeutic context and further study in a research context were made. OPSOMMING Die doel van hierdie studie was om `n Gestalt spelterapie-gebaseerde hospitaalvoorbereidingsprogram te ontwikkel vir kinders wat die chirurgiese prosedures van ventilasiebuis-plasing of ventilasiebuis-plasing en adenoïdektomie by Tygerberg-hospitaal ondergaan. `n Literatuurstudie is uitgevoer rakende relevante onderwerpe; naamlik, otitis media in kinders, Gestalt spelterapie, kinderontwikkelingsteorieë, en kinders se ervaring van siekte en hospitalisasie. Semi-gestruktureerde onderhoude is met vier subjekgroepe uitgevoer en die data wat verkry is, is kwalitatief geanaliseer. Navorsingsbevindinge is bespreek en geïntegreer met verwysing na die literatuur. Hierdie inligting is toegepas in die ontwikkeling van die voorgestelde program. Die doel, onderliggende beginsels, doelstellings en komponente van die program is bespreek en riglyne vir die implementering daarvan is verskaf. Die program is geïmplimenteer en geëvalueer in `n enkelsubjek loodsstudie, waar `n positiewe respons verkry is. Aanbevelings vir beide praktiese implementering in `n terapeutiese konteks en verdere studie binne navorsingskonteks is gemaak. / Social Work / M.Diac.

The aim of this study was to develop a Gestalt play therapy based hospital preparation program for children undergoing the surgical procedures of grommet insertion, or grommet insertion and adenoidectomy, at Tygerberg Hospital. Literature was reviewed according to relevant topics, namely otitis media in children, Gestalt play therapy, theories of child development, and children's experience of illness and hospitalisation. Semi-structured interviews were conducted with four subject groups and the data obtained was qualitatively analysed. Research findings were discussed and integrated with reference to the literature. This information was applied in the development of the proposed program. The aim, underlying principles, objectives and components of the program were discussed and guidelines for implementation were provided. The program was implemented and evaluated in a single subject pilot study, which yielded a positive response. Recommendations for both practical implementation in a therapeutic context and further study in a research context were made. OPSOMMING Die doel van hierdie studie was om `n Gestalt spelterapie-gebaseerde hospitaalvoorbereidingsprogram te ontwikkel vir kinders wat die chirurgiese prosedures van ventilasiebuis-plasing of ventilasiebuis-plasing en adenoïdektomie by Tygerberg-hospitaal ondergaan. `n Literatuurstudie is uitgevoer rakende relevante onderwerpe; naamlik, otitis media in kinders, Gestalt spelterapie, kinderontwikkelingsteorieë, en kinders se ervaring van siekte en hospitalisasie. Semi-gestruktureerde onderhoude is met vier subjekgroepe uitgevoer en die data wat verkry is, is kwalitatief geanaliseer. Navorsingsbevindinge is bespreek en geïntegreer met verwysing na die literatuur. Hierdie inligting is toegepas in die ontwikkeling van die voorgestelde program. Die doel, onderliggende beginsels, doelstellings en komponente van die program is bespreek en riglyne vir die implementering daarvan is verskaf. Die program is geïmplimenteer en geëvalueer in `n enkelsubjek loodsstudie, waar `n positiewe respons verkry is. Aanbevelings vir beide praktiese implementering in `n terapeutiese konteks en verdere studie binne navorsingskonteks is gemaak. / Social Work / M.Diac.