Bakgrund. Föräldrar till barn som har cancer upplever en livssituation som präglas av osäkerhet och oro och de ställs inför sociala och känslo­mässiga utmaningar. Jämfört med föräldrar till friska barn, upplever de också högre stress och drabbas i större utsträckning av posttraumatiska stres­symptom. Trots att information om barnets sjukdom är ett centralt behov för föräldrarna, upplever de otillfredsställelse med den information som ges. Syfte. Syftet med denna avhandling var att inom barnonkologisk vård beskriva vårdares och föräldrars upplevelser av information, studera deras inbördes interaktion samt beskriva upplevelser och effekter av en intervention för personcentrerad information till föräldrar. Metod. I delstudie I–III användes fokusgruppintervjuer (I, II), individ­uella intervjuer (II, III) och deltagande observationer (III). Deltagarna bestod av 20 vårdare (I), 14 föräldrar till barn med cancer (II) respektive 25 vårdare och 25 föräldrar (III). Data analyserades med kvalitativ innehållsanalys (I, II) och diskurspsykologi (III). I delstudie IV testades en intervention för per­son­cen­tre­rad information på åtta föräldrar med hjälp av en experimentell single-case-design. Data samlades in med kvalitativa intervjuer och internetenkäter. Upplevd stress, kroppsliga symptom på stress, ångest, nedstämdhet och tillfredsställelse med information var utfallsmått. Resultat. I delstudie I bestod resultatet av två teman: anpassa mängden information till föräldrarnas behov, som handlade om skillnader i hur mycket information som gavs till föräldrarna utifrån vårdarnas bedömning av föräldrarnas behov, och navigera i en vag struktur, som handlade om brister i ansvar, miljö, tajming och språk när informationen lämnades. I delstudie II konstruerades två teman. Känna sig bekräftad som en viktig person handlade om att föräldrarna kände sig trygga, kunde hålla hoppet uppe och fick stöd från andra föräldrar. Temat var mer framträdande under behandlingens tidiga skeden. Det andra temat var känna sig som en objuden gäst vilket handlade om att kännas övergiven vid viktiga milstolpar, att tvingas tjata sig till information och att belastas av att själv behöva informera andra inom sjukvården. I delstudie III använde vårdarna tolkningsrepertoarer som var barn-, föräldra- eller familjeorienterade, vilket avspeglade deras primära fokus i interaktionen. Föräldrarna använde tolkningsrepertoarer som talesperson, observatör eller familjemedlem. Hur dessa kombinerades inbördes påverkade interaktionen. I delstudie IV erfor föräldrarna stor tillfredsställelse med den per­son­cen­tre­rade informationen och upplevde att de hade nytta av att på egen hand få diskutera barnets sjukdom och ställa frågor de annars inte skulle ställt. Interventionen visade ingen effekt på stress eller kroppsliga symptom på stress, ångest och nedstämdhet. Slutsatser. För att förbättra information till föräldrar som har barn med cancer är det en central uppgift att bedöma hur mycket och vilken information som ska ges vid varje tillfälle, att uppmärksamma att föräldrarna kan ha andra informationsbehov än barnet och att möten med föräldrarna ska ske i lugn och ro samt att organisera vården så att ansvaret är tydligt. I synnerhet bör det ske förbättringar kring det som föräldrarna upplever som viktiga milstolpar under barnets sjukdomstid. Interventionen för per­son­cen­tre­rad information uppskattades av föräldrar som har barn med cancer men effekten på föräldrarnas psykosociala välbefinnande behöver utforskas ytterligare. / Background. Parents of children with cancer experience a life situation characterised by uncertainty and worries, and they face ongoing social and emotional challenges. Compared to parents of healthy children, they also experience increased levels of perceived stress and they suffer to a greater extent from post-traumatic stress symptoms. Even though information about the child’s disease is crucial for parents, they still experience low satis­faction with the information given to them. Aim. The aim of this thesis was to, within the field of paediatric oncology care, describe health care professionals’ and parents’ experiences from infor­mation, study their joint interaction and describe experiences and effects from an intervention based on person-centred information to parents. Methods. For study I–III, focus group interviews (I, II), individual inter­views (II, III), and participant observations (III) were used. Participants were 20 health care professionals (I), 14 parents of children with cancer (II) and 25 health care professionals and 25 parents (III). Data were analysed by qualitative content analysis (I, II) and discursive psychology (III). In study IV, an intervention for person-centred information was tested on 8 parents using a single-case experimental design. Data were collected with qualitative interviews and web questionnaires. Outcome measures were perceived stress, physical symptoms from stress, anxiety, depression, and satisfaction with information. Results. In study I, the analysis resulted in two themes, Matching the amount of information to the parents’ needs, which dealt with differences in the amount of information provided to parents according to the health care professionals’ assess­ment of parental needs, and Navigating through a vague structure, which was about shortcomings in responsibilities, setting, timing, and language when parents were informed. In study II, two themes were constructed. Feeling acknowledged as a person of significance was about feeling safe and secure, having one’s hopes supported and getting relief from other families. This was accentuated early in the treatment trajectory. Feeling like an unwelcome guest was about feeling abandoned at important milestones, feeling forced to nag for information and being burdened by informing others. In study III, the health care professionals used interpretative repertoires that were child, parent, or family oriented, which mirrored the primary focus of the inter­action. Parents used repertoires as a spokesperson, an observer, or a family member. The combination of the repertoires steered the interaction. In study IV, parents reported a high satisfaction with the person-centred information intervention and perceived benefits from having their own time to discuss the child’s disease and pose questions that they otherwise would not have an opportunity to ask. No effects from the intervention were demon­strated on perceived stress, physical symptoms of stress, anxiety, and depressive mood. Conclusion. To improve information to parents of children with cancer, a central task is to assess the amount of and what information given to parents, pay attention to possible differences in infor­mation needs between parents and children, as well as to organise the care so that the respon­si­bilities are clear and that parents are met in a calm setting. Improvements at important milestones during the illness period should be pri­ori­tised. A person-centred information inter­ven­tion is perceived as bene­ficial by parents, however, its effect on perceived parental stress has further to be investigated.

The purpose of this study is to describe trauma in the lives of social work students studying at Unisa South Africa. It explores how they describe trauma, what traumatic experiences they have gone through, the effect these experiences had on them, what they did to cope and how these experiences impacted their work as aspiring social workers. A case study was conducted with fourth-level students at Unisa South Africa. The theoretical framework adopted for the research was the person-centred approach. The research involved both focus group interviews and a survey. Both quantitative and qualitative data were generated. Descriptive statistics were used to create a profile of the participants. Qualitative data were analysed using a hermeneutic method. The perceptions of the participants were re-told by the researcher in the form of specific themes that emerged from the data. These themes were discussed and compared with the literature. Implications for the students’ work as social workers were discussed. The study accessed unique aspects of trauma that are grounded in the South African context. The description of trauma that emerged from the research created a new definition of the meaning of trauma. The research discusses the effects of trauma on the emerging professional self of the social work student. Recommendations are made that could be valuable to social work educators wishing to further the personal and professional growth of social work students. The research is also of value to those working with traumatised people. / Social Work / D .Litt. et Phil. (Social Work)

This thesis explores the position of Person-Centred Approach (PCA) in the practice of Czech clinical psychologists and psychiatrists who went through the PCA psychotherapy training and they use this approach in their current clinical practice. The main principles of PCA theory (1), principles of biomedical model in which clinical practice is rooted (2) and the new forms of person-centred psychopathology and psychodiagnosis (3) are the theoretical background of the following research. Based on the qualitative analysis of five recorded interviews (three clinical psychologists, two psychiatrists) the experience of the respondents is organised as comprehensive concepts concerning various areas and topics of the clinical practice (diagnosis, psychotherapy, dealing with PCA, dealing with biomedical model, therapeutic relationship, relation to the profession). Several common mechanisms are identified in the concept's dynamics. Through these mechanisms Person-Centred Approach is applied in areas and activities mentioned. The concepts based on experience and the PCA application mechanisms enrich the theories and ongoing research of PCA practice in the Western mental health care. Key words: Person-Centred Approach, Client-Centred Therapy, psychiatry, clinical psychology, psychotherapy, psychodiagnosis,...

This autoethnography tells the story of my faith journey with a special focus on my years as a Catholic seminarian and the change towards embarking on a career as a clinical psychologist. Pertinent childhood experiences are also shared to contextualise my story. The narrative, “Wrestling Heart”, is the centre and the produced data of this autoethnography. As an “evocative” narrative, it independently seeks to fulfil many of the goals of an autoethnography, such as being therapeutic for both writer and readers, and imbuing culture with critical thinking. The sharing of the narrative is augmented with a thematic analysis of it and Carl Rogers’ Person-Centred Approach is mainly used to comprehend the gleaned themes. The movement towards a comprehension of my experience is consistent with the philosophical foundation of this study: phenomenology. It is envisaged that the utility of this study lies primarily in its interrogation of the relationship between religion and mental health, its in-depth depiction of an individual grappling with their faith in relation to mental health, and the way in which the writing of this autoethnography therapeutically fostered greater congruence for me the writer, as I prepare to work as a clinical psychologist. / Psychology / M.A. (Clinical Psychology)

Afrikaans text / Kreatiwiteit is die sentrale tema van hierdie navorsing. Die doel van die navorsing was om die relevansie en waarde van kreatiwiteit in spelterapie met seksueel-misbruikte kinders in die multi-kulturele konteks van Suid-Afrika, te ondersoek en te beskryf. Die navorsing is vanuit „n konstruktivistiese epistemologiese fundering en „n eksistensieel-fenomologiese paradigma gedoen, deur uitgebreide teoretiese en empiriese navorsing. Die teoretiese navorsingproses het eerstens op die holistiese impak van seksuele misbruik op kinders, te midde van hul spesifieke verhoudings- en omgewingskonteks gefokus. Dit het duidelik geword dat seksuele misbruik ernstige trauma by kinders veroorsaak, wat alle modaliteite van die kinders affekteer. Die voorkoms van komplekse posttraumtiese stresversteuring, vanweë langdurige seksuele misbruik, is teoreties beskryf en ook empiries bevestig. „n Sintese van gestalt-, persoonsgesentreerde en logoterapeutiese teorieë, is deur die navorser ontwikkel om die traumatiese nagevolge van die seksuele misbruik kreatief aan te spreek in spelterapie. Die verband tussen en vervlegting van kreatiwiteit en spelterapie is ondersoek en beskryf. Ook die bemagtigende waarde van kreatiwiteit om die kompleksiteit van hierdie kinders se trauma te hanteer is teoreties én empiries nagevors. Die oënskynlik teenstrydige prosesse van kreatiwiteit as „n intuïtiewe, artisitieke, én logiese, kognitiewe proses is ondersoek, om die waarde daarvan vir die navorsingsdoel te bepaal. Die aard en waarde van kreatiewe aktiwiteite en die uitdagings wat gestel word aan die terapeute om kreatief te werk te gaan om die komplekse proses van seksueel-misbruikte kinders aan te spreek, is verder teoreties en empiries nagevors en beskryf. Die noodsaaklikheid van die ondersteunende sisteme vir die kind en terapeut, in belang van „n suksesvolle afloop van terapie, is ook ondersoek, beskryf en beklemtoon.In die empiriese navorsingsproses is veelvuldige gevallestudies, met behulp van vyf deelnemende veldnavorsers gedoen, waar elkeen „n terapeutiese proses gevolg het, volgens riglyne en onder leiding van die navorser, met „n seksueel-misbruikte kind. Die benutting en waarde van kreatiwiteit is ondersoek, beskryf en geëvalueer in die samelopende proses van die navorser met elke deelnemende navorser en kind binne die diverse kulturele konteks in Suid-Afrika. Die teoretiese raamwerk van die navorser en die riglyn vir kreatiewe spelterapie met seksueel-misbruikte kinders is sodoende getoets, verfyn en afgerond as hulpmiddel in die breër Suid-Afrikaanse konteks. Die navorsingsbevinding was dat kreatiwiteit onontbeerlik is in spelterapie met kinders wat seksueel misbruik is in „n multi-kulturele konteks soos Suid-Afrika. / Creativity is the central concept of this research. The goal of the research was to explore the value of creativity in play therapy with sexually abused children in the multi-cultural South-African context. The research was done from a constructivistic epistemological foundation and existential-phenomological paradigms. Extensive theoretical research was supported and substantiated by empirical research. The theoretical research process focused on the holistic impact of sexual abuse on children in and as part of their specific context (field). It became clear that sexual abuse implies severe trauma for the child, and affects all of their modalities, and their functioning in their field. The impact of severe and ongoing sexual abuse on children, as complex post-traumatic stress disorder, was described to clarify their therapeutic needs. A synthesis of gestalt-, person-centred- and logotherapy to address the traumatic after-effects of sexually abused children creatively in play therapy, was developed and described and motivated in the research paper. The concept of creativity was defined and extensively explored an applied in the context of therapy with sexually abused children. Creativity as a cognitive process, a problem solving process, and an artistic process is explored and applied in this context. The value of creative activities, the challenges of being a creative therapist, the supportive role of the supervisor and the systems in society, was explored and described. The empirical research process was done in a participatory way in the form of a multiple case study. Five therapists followed a therapeutic process, according to the guideline, guidance and supervision of the researcher, with a child who had been severely sexually abused. The results from the research confirmed the value and necessity of creativity in dealing with the severe trauma of sexually abused children and bridging gaps in a multi-cultural setting. The theoretical framework of the researcher and a guideline for creative therapy with sexually abused children was tested in the empirical research process, and could be refined and finalised. It was concluded that the use of creativity is crucial in play therapy with sexually abused children in a multi-cultural context, such as South Africa. / Social Work / D. Diac. (Spelterapie)

Afrikaans text / Kreatiwiteit is die sentrale tema van hierdie navorsing. Die doel van die navorsing was om die relevansie en waarde van kreatiwiteit in spelterapie met seksueel-misbruikte kinders in die multi-kulturele konteks van Suid-Afrika, te ondersoek en te beskryf. Die navorsing is vanuit „n konstruktivistiese epistemologiese fundering en „n eksistensieel-fenomologiese paradigma gedoen, deur uitgebreide teoretiese en empiriese navorsing. Die teoretiese navorsingproses het eerstens op die holistiese impak van seksuele misbruik op kinders, te midde van hul spesifieke verhoudings- en omgewingskonteks gefokus. Dit het duidelik geword dat seksuele misbruik ernstige trauma by kinders veroorsaak, wat alle modaliteite van die kinders affekteer. Die voorkoms van komplekse posttraumtiese stresversteuring, vanweë langdurige seksuele misbruik, is teoreties beskryf en ook empiries bevestig. „n Sintese van gestalt-, persoonsgesentreerde en logoterapeutiese teorieë, is deur die navorser ontwikkel om die traumatiese nagevolge van die seksuele misbruik kreatief aan te spreek in spelterapie. Die verband tussen en vervlegting van kreatiwiteit en spelterapie is ondersoek en beskryf. Ook die bemagtigende waarde van kreatiwiteit om die kompleksiteit van hierdie kinders se trauma te hanteer is teoreties én empiries nagevors. Die oënskynlik teenstrydige prosesse van kreatiwiteit as „n intuïtiewe, artisitieke, én logiese, kognitiewe proses is ondersoek, om die waarde daarvan vir die navorsingsdoel te bepaal. Die aard en waarde van kreatiewe aktiwiteite en die uitdagings wat gestel word aan die terapeute om kreatief te werk te gaan om die komplekse proses van seksueel-misbruikte kinders aan te spreek, is verder teoreties en empiries nagevors en beskryf. Die noodsaaklikheid van die ondersteunende sisteme vir die kind en terapeut, in belang van „n suksesvolle afloop van terapie, is ook ondersoek, beskryf en beklemtoon.In die empiriese navorsingsproses is veelvuldige gevallestudies, met behulp van vyf deelnemende veldnavorsers gedoen, waar elkeen „n terapeutiese proses gevolg het, volgens riglyne en onder leiding van die navorser, met „n seksueel-misbruikte kind. Die benutting en waarde van kreatiwiteit is ondersoek, beskryf en geëvalueer in die samelopende proses van die navorser met elke deelnemende navorser en kind binne die diverse kulturele konteks in Suid-Afrika. Die teoretiese raamwerk van die navorser en die riglyn vir kreatiewe spelterapie met seksueel-misbruikte kinders is sodoende getoets, verfyn en afgerond as hulpmiddel in die breër Suid-Afrikaanse konteks. Die navorsingsbevinding was dat kreatiwiteit onontbeerlik is in spelterapie met kinders wat seksueel misbruik is in „n multi-kulturele konteks soos Suid-Afrika. / Creativity is the central concept of this research. The goal of the research was to explore the value of creativity in play therapy with sexually abused children in the multi-cultural South-African context. The research was done from a constructivistic epistemological foundation and existential-phenomological paradigms. Extensive theoretical research was supported and substantiated by empirical research. The theoretical research process focused on the holistic impact of sexual abuse on children in and as part of their specific context (field). It became clear that sexual abuse implies severe trauma for the child, and affects all of their modalities, and their functioning in their field. The impact of severe and ongoing sexual abuse on children, as complex post-traumatic stress disorder, was described to clarify their therapeutic needs. A synthesis of gestalt-, person-centred- and logotherapy to address the traumatic after-effects of sexually abused children creatively in play therapy, was developed and described and motivated in the research paper. The concept of creativity was defined and extensively explored an applied in the context of therapy with sexually abused children. Creativity as a cognitive process, a problem solving process, and an artistic process is explored and applied in this context. The value of creative activities, the challenges of being a creative therapist, the supportive role of the supervisor and the systems in society, was explored and described. The empirical research process was done in a participatory way in the form of a multiple case study. Five therapists followed a therapeutic process, according to the guideline, guidance and supervision of the researcher, with a child who had been severely sexually abused. The results from the research confirmed the value and necessity of creativity in dealing with the severe trauma of sexually abused children and bridging gaps in a multi-cultural setting. The theoretical framework of the researcher and a guideline for creative therapy with sexually abused children was tested in the empirical research process, and could be refined and finalised. It was concluded that the use of creativity is crucial in play therapy with sexually abused children in a multi-cultural context, such as South Africa. / Social Work / D. Diac. (Spelterapie)

The purpose of the study was to locate the informal hiring sites for day labourers in Tshwane, to determine the approximate number of day labourers, to describe the nature of socio-economic activities taking place at the sites, and to make recommendations to address needs that have been identified. The research approach and methodology was exploratory, descriptive, quantitative and qualitative. In terms of the findings, 80 informal hiring sites were identified in Tshwane with approximately 3032 day labourers standing at the sites. Case studies were done on three sites and it was found that they were hazardous and lacked basic facilities such as shelter and toilets. Employer-employee interactions were also found to be haphazard and sometimes manipulative and exploitative. It is recommended that intervention programmes should be implemented which could include the provision of basic facilities, skills development, job search assistance and access to comprehensive social services. / Health Studies / M.A. (Social Science - Mental Health)

Community development and in particular participatory development is about people. This means that the person who studies or practices participatory development or any other of the participatory pratices should have a particular way of thinking about people. The main aim motivating this study was to investigate the paradigm/s about people on which participatory practices are based. This included a literature research on five participatory practices namely participatory development; participatory communication; participatory learning; participatory research; and participatory management. A guideline for paradigm analysis was developed by using Schriver's (1995) and Capra's (1996) descriptions of a paradigm as well as ideas of hermeneutics. From the paradigm analysis on the participatory practices two themes emerged: A shift from modernism to post modernism in the thinking processes and participatory practices. From the participatory practices the same concepts repeatedly emerged indicating a similar paradigm for all the participatory practices. Three post modern theories were therefore applied to enhance the description of the different concepts. The end result of this study is the development of an evolving paradigm for participatory practices in order to give enhanced meaning to concepts in the participatory vocabulary. Finally a critical reflection was done on the post modern research process. / Text in Afrikaans / Social Work / D.Phil. (Social Work)

The purpose of the study was to locate the informal hiring sites for day labourers in Tshwane, to determine the approximate number of day labourers, to describe the nature of socio-economic activities taking place at the sites, and to make recommendations to address needs that have been identified. The research approach and methodology was exploratory, descriptive, quantitative and qualitative. In terms of the findings, 80 informal hiring sites were identified in Tshwane with approximately 3032 day labourers standing at the sites. Case studies were done on three sites and it was found that they were hazardous and lacked basic facilities such as shelter and toilets. Employer-employee interactions were also found to be haphazard and sometimes manipulative and exploitative. It is recommended that intervention programmes should be implemented which could include the provision of basic facilities, skills development, job search assistance and access to comprehensive social services. / Health Studies / M.A. (Social Science - Mental Health)

Community development and in particular participatory development is about people. This means that the person who studies or practices participatory development or any other of the participatory pratices should have a particular way of thinking about people. The main aim motivating this study was to investigate the paradigm/s about people on which participatory practices are based. This included a literature research on five participatory practices namely participatory development; participatory communication; participatory learning; participatory research; and participatory management. A guideline for paradigm analysis was developed by using Schriver's (1995) and Capra's (1996) descriptions of a paradigm as well as ideas of hermeneutics. From the paradigm analysis on the participatory practices two themes emerged: A shift from modernism to post modernism in the thinking processes and participatory practices. From the participatory practices the same concepts repeatedly emerged indicating a similar paradigm for all the participatory practices. Three post modern theories were therefore applied to enhance the description of the different concepts. The end result of this study is the development of an evolving paradigm for participatory practices in order to give enhanced meaning to concepts in the participatory vocabulary. Finally a critical reflection was done on the post modern research process. / Text in Afrikaans / Social Work / D.Phil. (Social Work)