This research served to explore the client’s experiences of services in a clinic dealing with child sexual abuse and related issues. Addressing the issue of therapeutic interventions in clinics dealing with sexual abuse victims and their caregivers – looking at how the clients experience these treatments and services and how they have made ‘meaning’ of these on their journey to healing, is something that needs to be explored in greater depth. The aim therefore of this research is to gain insight into understanding the clients’ experiences of the therapeutic services. This study will be of specific importance due to the fact that to date no literature has been identified particularly from a South African perspective on how clients make meaning of these therapeutic services at such an agency, making it difficult to compare the findings. Much of the research identified has focused on the interventions in cases of sexual abuse and have thus typically been one-sided in approach, subsequently ignoring the voices of the child victims of sexual abuse and the non-offending caregivers. The client’s experience of the therapeutic interventions will be reviewed within the context of the Teddy Bear Clinic. An interpretive phenomenological approach was used to focus on the understanding of the participant’s subjective experiences and meanings of the therapeutic interventions. The research utilised a qualitative framework which privileged first-person descriptions as the primary sources of subjective meaning. Two case studies in an organisation in Johannesburg were investigated. The case studies comprised the child victim of abuse and the non-offending care-givers that participated with the child in the therapeutic process. Therefore two children and two caregivers were included in each case study. The recruitment of participants was, to a large extent, dependent on the assistance offered by the counsellors at the Teddy Bear Clinic. Therapeutic counsellors at the Teddy Bear Clinic identified a list of clients that had just terminated or were exiting the therapeutic process and not in need of further interventions, and fit the criteria as stipulated by the researcher. Data was gathered through semi-structured interviews of each participant. The analysis was carried out using thematic analysis which revealed the meaning of their experiences. The following themes emerged through the analysis and were used to explore the client’s experience and assignment of meaning to the therapeutic services: (1) background influences. Various sub-themes emerged from this theme: (1a) shame, guilt and fear of punishment (1b) developmental stages, (1c) relationship with stepmother, (1d) legal issues, (1e) marital and parenting difficulties, (1f) outside support structures and (1g) previous relationship with counsellor. The second main theme included; (2) the voices of children and caregivers on the therapeutic experience. The various sub-themes that emerged from this were; (2a) the therapeutic relationship, (2b) the role of the therapist, (2c) being kept in the loop – feedback and introductions, (2d) clarification and support for the caregiver (2e) giving back – peer support groups, and (2f) teddy bears and the therapeutic process. Thus the main findings that emerged from this study involves ‘background influences’, that clients present to the medico-legal clinic for rape or sexual abuse. However, background influences have a profound effect on the therapeutic relationship and the experience of the clinic’s services, as seen in the interrelationships that are interwoven with the presenting problem. A second finding emerging from the voices of the children and caregivers foresee that services could be improved in the following ways. Providing feedback and clarification of the therapeutic process; receiving an introductory brochure which highlights what services the clinic provides and resources available to the clients. Caregiver and peer support groups was another very important element that the clients expressed as a necessary and vital part of the services and interventions that the clinic could offer the clients. Finally, a positive element to the therapeutic interventions which helped the children cope and eased the caregivers anxiety were found to be the handing out of teddy bears which is symbolic of the Teddy Bear Clinic and should continue to be a cornerstone of the therapeutic intervention and introduction to the clinic. The study, while achieving its goal of providing some understanding of how the clients experience these interventions at this medico-legal clinic, highlights the need for further exploration of how clients experience these services and interventions at other clinics dealing with sexual abuse, particularly from a South African perspective. / Dissertation (MA)--University of Pretoria, 2012. / Psychology / unrestricted

This study was informed by a phenomenon observed by a variety of members from the multidisciplinary team at an acute psychiatric facility, where the researcher works daily. It appeared to clinicians as if the individual between the ages of 18 and 25 years was reluctant to engage in therapeutic intervention. The researcher considered current literature and discovered that this phenomenon seems to be globally relevant and an issue in the field of mental health. Emerging adulthood is the developmental phase that occupies the transitional period between adolescence and adulthood. The life phase is an essential developmental phase where an identity is established and skills are acquired to equip the individual through his/her life process. Emerging adulthood is predominantly defined by the individual’s progress to independence and autonomy and the establishment of a personal and societal identity. Developmental tasks include taking responsibility for him/herself, deciding on future career paths and re-evaluating introjected values to form an independent belief system. Literature indicates that emerging adults’ life phase can cause severe distress due to a variety of social and personal stressors. Emerging adults who are enrolled in university often face additional stressors with regards to adapting to campus life, academic pressure and a need to establish themselves within their new environments. A high prevalence and onset of mental health disorders is noted not only in the general emerging adult population, but also in the population of emerging adults who attend university. Despite the increase in stressful experiences the percentage of emerging adults who experience distress is not reflected in the percentage of emerging adults who actually seek and receive therapeutic intervention as a means to manage their distress. As therapeutic intervention is seen as an effective tool in managing distress, the fact that emerging adults negate the help is a clear area of concern. This urged the researcher to closely consider which factors might lead to negation of therapeutic services by the emerging adult. The study was performed at a South African university where students residing in campus residences where approached to volunteer their participation. In total fifteen participants participated in one of three focus groups with the focus on understanding which factors contribute to the negation of therapeutic services by emerging adults. The data crystallised into eleven main themes with different subthemes to support and describe the relevant main theme. The themes clearly emphasised the lack of awareness, pervasiveness of stigmatisation and the internalised beliefs emerging adults have about themselves and therapy that induce help negation. In addressing the issue of help negation in emerging adults this study suggests solutions and actions to the role players involved in the therapeutic intervention of emerging adults that would support the promotion of mental wellbeing and mental health awareness. / MA (Psychology), North-West University, Potchefstroom Campus, 2014

This study was informed by a phenomenon observed by a variety of members from the multidisciplinary team at an acute psychiatric facility, where the researcher works daily. It appeared to clinicians as if the individual between the ages of 18 and 25 years was reluctant to engage in therapeutic intervention. The researcher considered current literature and discovered that this phenomenon seems to be globally relevant and an issue in the field of mental health. Emerging adulthood is the developmental phase that occupies the transitional period between adolescence and adulthood. The life phase is an essential developmental phase where an identity is established and skills are acquired to equip the individual through his/her life process. Emerging adulthood is predominantly defined by the individual’s progress to independence and autonomy and the establishment of a personal and societal identity. Developmental tasks include taking responsibility for him/herself, deciding on future career paths and re-evaluating introjected values to form an independent belief system. Literature indicates that emerging adults’ life phase can cause severe distress due to a variety of social and personal stressors. Emerging adults who are enrolled in university often face additional stressors with regards to adapting to campus life, academic pressure and a need to establish themselves within their new environments. A high prevalence and onset of mental health disorders is noted not only in the general emerging adult population, but also in the population of emerging adults who attend university. Despite the increase in stressful experiences the percentage of emerging adults who experience distress is not reflected in the percentage of emerging adults who actually seek and receive therapeutic intervention as a means to manage their distress. As therapeutic intervention is seen as an effective tool in managing distress, the fact that emerging adults negate the help is a clear area of concern. This urged the researcher to closely consider which factors might lead to negation of therapeutic services by the emerging adult. The study was performed at a South African university where students residing in campus residences where approached to volunteer their participation. In total fifteen participants participated in one of three focus groups with the focus on understanding which factors contribute to the negation of therapeutic services by emerging adults. The data crystallised into eleven main themes with different subthemes to support and describe the relevant main theme. The themes clearly emphasised the lack of awareness, pervasiveness of stigmatisation and the internalised beliefs emerging adults have about themselves and therapy that induce help negation. In addressing the issue of help negation in emerging adults this study suggests solutions and actions to the role players involved in the therapeutic intervention of emerging adults that would support the promotion of mental wellbeing and mental health awareness. / MA (Psychology), North-West University, Potchefstroom Campus, 2014

Unsafe and unnecessary injections are administered in many developing and transitional countries. Injection device security is recommended in order to improve injection safety. Injection device stock depletions have been reported to contribute to unsafe injection practices. Poor distribution of health products has been reported in many parts of Uganda including Mpigi district. As a way of improving injection safety, this study explored the challenges encountered in maintaining an effective distribution system. A Cross-sectional, descriptive study of public and private-not-for-profit health care units in Mpigi district was conducted. 38 health care facilities were selected by stratified disproportionate sampling. Data on device security, the use of equipment and the distribution system were collected and analysed using descriptive statistics. / Health Studies / M.A. (Public Health)

Exploration of factors that lead to early termination of therapeutic services to sexually abused children at TygerBear Unit. Some children referred to TygerBear Unit because of sexual abuse did not complete their therapeutic intervention programmes and possibly did not receive sufficient time to work through the trauma of sexual abuse. The purpose of this qualitative study was to explore and describe the factors that result in the early termination of sexually abused children’s therapeutic services at TygerBear Unit. Applied research that is exploratory and descriptive in nature, with the case study method as strategy, was followed. Data were collected through telephonic and/or one-on-one semi-structured interviews, in addition to the use of notes in personal records. Respondents included parents and/or caregivers of children whose therapy was terminated early, as well as social workers involved with play therapeutic service delivery to these children. Information was analysed with reference to the Field Theory, Ecological Theory and the relevant literature. Several factors that influenced parents and/or caregivers to terminate therapeutic services early were identified. / Die verkenning van faktore wat lei tot voortydige terminering van terapeutiese dienslewering aan seksueel-mishandelde kinders by TygerBeer Eenheid. Sommige kinders wat na TygerBeer Eenheid verwys word weens seksuele mishandeling, voltooi nie hul terapeutiese intervensieprogramme nie. Die kinders is moontlik nie genoeg tyd gegun om deur die trauma van seksuele mishandeling te werk nie. Die doel van hierdie kwalitatiewe studie was om faktore te verken en te beskryf wat lei tot die voortydige terminering van terapeutiese dienslewering aan seksueel-mishandelde kinders by die TygerBeer Eenheid. Toegepaste navorsing van 'n verkennende en beskrywende aard is gebruik, met die gevallestudiemetode as strategie. Data is versamel deur middel van telefoniese en/of een-tot-een semi-gestruktureerde onderhoude en persoonlike rekords. Respondente het bestaan uit ouers en/of versorgers wat hul kinders of voogde se terapie voortydig termineer het, asook maatskaplike werkers betrokke by spelterapeutiese dienslewering aan kinders. lnligting is ontleed met verwysing na die Veldteorie en Ekologiese Teorie, asook die relevante literatuur. Verskeie faktore is geidentifiseer wat ouers en/of versorgers noodsaak om terapeutiese dienste voortydig te termineer. / Social Work / M. Diac. (Play Therapy)

Unsafe and unnecessary injections are administered in many developing and transitional countries. Injection device security is recommended in order to improve injection safety. Injection device stock depletions have been reported to contribute to unsafe injection practices. Poor distribution of health products has been reported in many parts of Uganda including Mpigi district. As a way of improving injection safety, this study explored the challenges encountered in maintaining an effective distribution system. A Cross-sectional, descriptive study of public and private-not-for-profit health care units in Mpigi district was conducted. 38 health care facilities were selected by stratified disproportionate sampling. Data on device security, the use of equipment and the distribution system were collected and analysed using descriptive statistics. / Health Studies / M.A. (Public Health)

Exploration of factors that lead to early termination of therapeutic services to sexually abused children at TygerBear Unit. Some children referred to TygerBear Unit because of sexual abuse did not complete their therapeutic intervention programmes and possibly did not receive sufficient time to work through the trauma of sexual abuse. The purpose of this qualitative study was to explore and describe the factors that result in the early termination of sexually abused children’s therapeutic services at TygerBear Unit. Applied research that is exploratory and descriptive in nature, with the case study method as strategy, was followed. Data were collected through telephonic and/or one-on-one semi-structured interviews, in addition to the use of notes in personal records. Respondents included parents and/or caregivers of children whose therapy was terminated early, as well as social workers involved with play therapeutic service delivery to these children. Information was analysed with reference to the Field Theory, Ecological Theory and the relevant literature. Several factors that influenced parents and/or caregivers to terminate therapeutic services early were identified. / Die verkenning van faktore wat lei tot voortydige terminering van terapeutiese dienslewering aan seksueel-mishandelde kinders by TygerBeer Eenheid. Sommige kinders wat na TygerBeer Eenheid verwys word weens seksuele mishandeling, voltooi nie hul terapeutiese intervensieprogramme nie. Die kinders is moontlik nie genoeg tyd gegun om deur die trauma van seksuele mishandeling te werk nie. Die doel van hierdie kwalitatiewe studie was om faktore te verken en te beskryf wat lei tot die voortydige terminering van terapeutiese dienslewering aan seksueel-mishandelde kinders by die TygerBeer Eenheid. Toegepaste navorsing van 'n verkennende en beskrywende aard is gebruik, met die gevallestudiemetode as strategie. Data is versamel deur middel van telefoniese en/of een-tot-een semi-gestruktureerde onderhoude en persoonlike rekords. Respondente het bestaan uit ouers en/of versorgers wat hul kinders of voogde se terapie voortydig termineer het, asook maatskaplike werkers betrokke by spelterapeutiese dienslewering aan kinders. lnligting is ontleed met verwysing na die Veldteorie en Ekologiese Teorie, asook die relevante literatuur. Verskeie faktore is geidentifiseer wat ouers en/of versorgers noodsaak om terapeutiese dienste voortydig te termineer. / Social Work / M. Diac. (Play Therapy)