Although the death of a child client is among the worst work-related events that a child welfare worker can experience, the phenomenon is tremendously understudied concerning how the event impacts the staff involved and how, or if, their employing agencies supported any mental health needs that may have arisen after the death. This study investigates what types of mental health/emotional support was made available to Northeastern Ontario child welfare workers following the death of a child client, and how effective that support was in helping the worker cope with any difficulties related to the death. This study was guided by principles of Constructivist Grounded Theory and semi-structured qualitative telephone interviews were conducted with five (5) participants. My analysis found that the death of a child client can negatively impact both the mental wellbeing of involved workers as well as the organizational climate of an agency. My analysis also found that workers may delay the emotions associated with the grieving process to effectively focus on the administrative requirements resulting from the child’s death, potentially to their detriment. The different ways child welfare organizations supported staff through these events included individual and group psychological debriefings, grief counselling, and providing information regarding additional support options. Only three of the five workers engaged in the strategies provided to them by their agency, and of those three, only one found the services to be helpful with managing emotional difficulties related to the child’s death. What remained true among all five participants was that they each had very personalized ideas as to what they felt would have best helped them through this difficult event. I conclude that based on related literature and the findings of this study, child welfare organizations are recommended to invest in a thorough and embedded agency framework of trauma-management that addresses policy and procedure development as well as support coordination at the pre-trauma, immediate trauma, and post-trauma levels. Additionally, trauma-management should not be a singular standardized response and should be tailored to the individualized needs of each worker. Agencies should be well-versed in delivering different strategies of trauma-management and letting the worker lead in determining what type of support they are looking for and when would be best to receive it. / Thesis / Master of Social Work (MSW)

Thesis (M.A.)--University of the Witwatersrand, Faculty of Humanities, 2013. / Domestic violence is rife in South Africa and the negative impact thereof is brought by survivors into their homes, communities and workplace settings. Trauma counsellors often take on the work responsibility of intervening in cases of domestic violence to meet the needs of the survivor. Adopting a qualitative research design, the researcher explored the perceptions of trauma counsellors in their workplace setting regarding intervention strategies used when providing services to survivors of domestic violence. Purposive sampling was used to identify 13 adult lay trauma counsellors, both male and female employed by a non-government institution operating as a 24-7 hour Crisis Hotline in the Johannesburg Metropolitan area. The researcher gathered data by conducting personal, semi-structured interviews with research participants. Data analysis took the form of Thematic Content Analysis. The researcher identified that the participants seemed not to be aware of workplace systems and procedural guidelines, and tended to adopt a personalized approach in dealing with survivors of domestic violence. Most participants managed cases utilising ‘early crisis intervention models’ as a once-off trauma intervention strategy although they did not perceive it as being effective. It is thus recommended that such stand-alone intervention strategies should not be implemented unless further follow-up or after-care support is offered to the survivors of domestic violence.

Die Behandlung polytraumatisierter Patienten stellt in ihrer Komplexität hohe Anforderungen an die aparativen und personellen Voraussetzungen einer Klinik. Dies bedingt einen erheblichen Kostenaufwand sowohl für die primäre Diagnostik und Therapie als auch für die Rehabilitation. Im Unfallkrankenhaus Berlin sieht der Algorithmus der Polytraumaversorgung nach klinischer Erstversorgung und sonographischer Untersuchung von Abdomen und Thorax die weitere primäre radiologische Diagnostik von Schädel, Halswirbelsäule, Thorax, Abdomen und Becken mittels Spiral-Computertomographie nach einem standardisiertem Untersuchungsprotokoll vor. Im Zeitraum von September 1997 bis Juli 1999 wurden 334 aufeinander folgende Patienten erfasst, bei denen unter dem Verdacht auf ein Polytrauma eine CT-Untersuchung im Rahmen des klinikinternen Algorithmus durchgeführt wurde. Unter Kenntnis aller Untersuchungsbefunde erfolgte die retrospektive Gruppenbildung mit Unterscheidung in polytraumatisierte (n=116) und nicht polytraumatisierte (n=220) Patienten. Der durchschnittliche ISS lag bei 32 (+/- 10) in der Gruppe der tatsächlich polytraumatisierten Patienten und bei 15 (+/- 9,4) in der Gruppe der nicht polytraumatisierten Patienten. In der weiteren Auswertung wurden die in der primären CT-Untersuchung erhobenen Diagnosen anhand des klinischen Verlaufs, operativer und anderer therapeutischer Maßnahmen sowie der weiteren Bildgebung überprüft. In der vorliegenden Untersuchung konnte gezeigt werden, dass die Spiral-Computertomographie in der Lage ist, das Verletzungsmuster eines polytraumatisierten Patienten, abgesehen von Extremitätenverletzungen, nahezu vollständig und mit großer Sicherheit zeiteffizient zu erfassen. Dabei konnte auf Grund der Verkürzung der Untersuchungszeit die Indikationsstellung auf Patienten mit kritischen Kreislaufsituationen ausgedehnt werden. Als strukturelle Voraussetzung muss jedoch die unmittelbare Nachbarschaft von Schockraum und CT-Untersuchungsraum sowie ein routiniertes Team gewährleistet sein. Insgesamt profitierten insbesondere die tatsächlich polytraumatisierten Patienten von der Durchführung des standardisierten Untersuchungsprotokolls bei der Aufdeckung von Verletzungen. Der große Anteil der nicht polytraumatisierten Patienten profitierte vorwiegend vom Verletzungsausschluss. Hier muss die Indikationsstellung überaus kritisch erfolgen. / The complex treatment of patients with multiple traumas requires a high standard of staff and equipment causing considerable expense at the point of primary diagnosis and treatment as well as at the rehabilitation stage. Conforming to a standardised examination routine, the algorithm of treating patients with multiple traumas at the Unfallkrankenhaus Berlin includes, after primary clinical treatment and ultrasound examination of abdomen and thorax , the further primary radiological diagnosis of the skull, the cervical spine, the thorax, the abdomen and the pelvis via spiral CT. Between September 1997 and July 1999 we registered 334 successive patients with suspected multiple traumas who underwent a CT examination according to our clinical algorithm. In the knowledge of all diagnoses the patients were subdevided into two groups: patients suffering from multiple traumas (n=116) and patients without multiple traumas (n=220). The average ISS was 32(+/- 10) for the group of patients actually suffering from multiple traumas and 15 (+/- 10) for the group of patients without multiple traumas. The diagnoses based on the primary CT examination were analysed in the light of the clinical course, surgical and other therapeutic measures as well as compared with other imaging methods (modalities). This study shows that, apart from injuries of the extremities, the spiral CT can reveal the injuries of a patient suffering from multiple traumas efficiently and quickly. Because of the shorter time needed for examination the diagnosis can be extended to patients with critical haemodynamical conditions. Yet it is important that the emergency romm and CT examination rooms are in close vicinity and that the team of examiners is well trained. Especially patients with multiple traumas benefit from this standardised routine of examinations. The majority of patients without multiple traumas benefit from the exclusion of injuries. Here the medical indication has to be carefully considered.

A study was conducted to describe and interpret the personal strategies that South African Police Service officers in the Vhembe District, Limpopo Province, use in their line of work. These are strategies to deal with the impact of the primary victims’ critical incidents of rape, domestic violence, murder and road accidents. The focus was on describing the impact of the critical incidents that the officers are exposed to, which manifest in a form of traumatic stress, namely, vicarious traumatisation, and management of this impact. Twenty participants were selected through purposive and theoretical sampling techniques from the family violence, child protection and sexual offences, domestic violence, field training, detective and social crime prevention units. Unstructured open-ended interviews, diaries and follow-up telephone interviews were used as data collection methods and data were collected in the participants’ home languages, Tshivenda and Xitsonga. Data gathered necessitated looking into both the aspects of the officers’ organisational and operational work. Data were thus analysed through the content thematic and constant comparative data analysis methods. The results first presented a profile of police vicarious traumatisation in the Vhembe District, which include the types of critical incidents exposed to, the organisational and operational stressors that lead to vicarious traumatisation, and the description of vicarious traumatisation symptoms. Second, a theoretical framework of the process of police critical incidents impact management (PCIIM) was developed. The framework shows that the management of the impact of the encountered incidents is inspired by various coping needs and subcultures of the officers, and the management takes place through the use of two styles of trauma management, namely, the linear and multilateral styles, which refer to application of coping strategies successively and the combination of horizontal and vertical application of coping strategies, respectively. The coping strategies used by the officers help them to have an objective understanding of the critical incidents encountered, have less severe symptoms of vicarious traumatisation, some symptoms last for shorter periods than before, and other symptoms are no longer experienced. Resilience to the encountered incidents is shown through the development of coping strategies to handle the incidents, facing them, and showing cognitive hardiness. The officers also manage to reflect on the experiences encountered, engage in narratives about them and mutual help thus still working towards attaining posttraumatic growth. / Psychology / D. Litt. et Phil. (Psychology)

A study was conducted to describe and interpret the personal strategies that South African Police Service officers in the Vhembe District, Limpopo Province, use in their line of work. These are strategies to deal with the impact of the primary victims’ critical incidents of rape, domestic violence, murder and road accidents. The focus was on describing the impact of the critical incidents that the officers are exposed to, which manifest in a form of traumatic stress, namely, vicarious traumatisation, and management of this impact. Twenty participants were selected through purposive and theoretical sampling techniques from the family violence, child protection and sexual offences, domestic violence, field training, detective and social crime prevention units. Unstructured open-ended interviews, diaries and follow-up telephone interviews were used as data collection methods and data were collected in the participants’ home languages, Tshivenda and Xitsonga. Data gathered necessitated looking into both the aspects of the officers’ organisational and operational work. Data were thus analysed through the content thematic and constant comparative data analysis methods. The results first presented a profile of police vicarious traumatisation in the Vhembe District, which include the types of critical incidents exposed to, the organisational and operational stressors that lead to vicarious traumatisation, and the description of vicarious traumatisation symptoms. Second, a theoretical framework of the process of police critical incidents impact management (PCIIM) was developed. The framework shows that the management of the impact of the encountered incidents is inspired by various coping needs and subcultures of the officers, and the management takes place through the use of two styles of trauma management, namely, the linear and multilateral styles, which refer to application of coping strategies successively and the combination of horizontal and vertical application of coping strategies, respectively. The coping strategies used by the officers help them to have an objective understanding of the critical incidents encountered, have less severe symptoms of vicarious traumatisation, some symptoms last for shorter periods than before, and other symptoms are no longer experienced. Resilience to the encountered incidents is shown through the development of coping strategies to handle the incidents, facing them, and showing cognitive hardiness. The officers also manage to reflect on the experiences encountered, engage in narratives about them and mutual help thus still working towards attaining posttraumatic growth. / Psychology / D. Litt. et Phil. (Psychology)