Some sections of the appendices are not available in the electronic copy of this thesis due to their format. The full version is available for consultation at the University of Leicester Library.

Background: Community interpreters are employed to work across multiple settings in the UK, including mental health services, to support individuals whose first language is not English. To date, little research attention has been paid to the emotional impact of mental health interpreting on community interpreters. Aims: The aim of this study is to develop an in-depth understanding of the emotional challenges of mental health interpreting and the coping strategies employed by community interpreters to overcome these challenges. It is hoped that this research will raise practitioners’ awareness and help guide health services to support interpreters better, to enable the highest standards of care for clients. Methodology: Semi-structured interviews were conducted with eight community interpreters working in mental health settings. The interview transcripts were analysed using Interpretative Phenomenological Analysis (IPA). Results: Four master themes emerged from analysis: ‘Feeling for the client’, ‘Relationships in Context’, ‘Balancing the personal self and the professional self’ and ‘You need to protect yourself’. These master themes, along with the subthemes contributing to them, are expanded in to a narrative account of interpreters’ experiences. Conclusions: This study has underscored the need for increased provision of support for interpreters, as well as training for practitioners in working with interpreters. Guidance for improved working relationships between interpreters, practitioners and employing agencies is given.

Vicarious traumatisation (VT) has been defined as an experience of change in several domains of personhood including worldview, identity, and beliefs related to major psychological needs. Self-care practice is widely considered essential in sustaining personal and professional well-being, and a lack of appropriate practice can enhance the risk of VT in trainee and newly qualified therapeutic practitioners. Both quantitative and qualitative research suggests that mindfulness practice can have a protective role in the risk of VT for trainees. This study examined the relationship between VT, self-care and mindfulness in a sample of 238 trainee therapists from the UK, Australia, Canada and Ireland. Structural equation modelling was used to test a mediation model with good fit with self-care as predictor variable, mindfulness as mediator, and VT as outcome variable. The hypothesis that when controlling for the effects of mindfulness on VT the effect of self-care on VT is no longer significant could not be confirmed as no mediational effect was present. The hypothesis that predicted a negative association between self-care practice and VT was confirmed with a significant total effect although the direct effect of self-care on VT was not significant. Findings are discussed in relation to previous research involving mindfulness in trainee cohorts. Links are made with neuroscience research to consider underlying mechanisms of mindfulness within the context of VT.

Paternal incest is the intimate sexual contact between biological, step or foster fathers and their children. These father-figures include the live-in partners of the non-offending mother. The actual incidence of paternal incest in South Africa is not known; however, the South African Police Services report the incidence of incest in the Western Cape for 2011/2012 to be the second highest in South Africa. When children reveal the incest to any person, this is called disclosure. After disclosure and with the removal of the paternal figure from the family unit, the mother or grandmother is responsible for the sole care of the child-victim and becomes the primary caregiver. However, in the South African context it is traditionally accepted that the grandmother assumes the role of primary caregiver of the child where the child’s mother and/or father are unable to fulfil their parental role adequately. Therefore in this study, “primary caregivers” refers to mothers and maternal grandmothers. In the South African context, limited studies have been done that explore the experiences of primary caregivers whose children or grandchildren were exposed to paternal incest. There is also a lack of information on how to support these primary caregivers in the abovementioned context. The aim of this study was firstly to explore the experiences of primary caregivers whose children or grandchildren were exposed to paternal incest and secondly to use these experiences to suggest guidelines that may be utilised by practitioners (such as social workers and registered counsellors) to develop support programmes for these caregivers. The research was conducted at a non-profit organisation in the Western Cape Province of South Africa, that provides psychosocial services and where cases of paternal incest are referred for intervention. A qualitative, phenomenological research design was applied in this study to obtain rich data. Six primary caregivers were chosen through purposive sampling, on the basis that their children or grandchildren were exposed to paternal incest within the last five years. Of these, four were mothers and two were maternal grandmothers who were responsible for the children. Data was collected through in-depth interviews and was analysed thematically. Two main themes emerged from the study. The first theme involved reactions to the disclosure and its aftermath, which encompassed emotional, cognitive and physiological reactions that are similar to secondary traumatisation. The second theme was coping strategies that emerged to deal with the disclosure and its aftermath, which encompassed effective coping strategies (behavioural coping strategies to actively solve problems and the presence of social support), unhealthy or negative coping strategies (behavioural coping strategies of avoidance) and threats to coping (a lack of social support). The contribution of this study lies in the suggestion of guidelines for the support of primary caregivers whose children or grandchildren were exposed to paternal incest. These guidelines include the provision of emotional support, multidisciplinary practitioner support and educational support programmes. / MA (Psychology), North-West University, Potchefstroom Campus, 2014

Paternal incest is the intimate sexual contact between biological, step or foster fathers and their children. These father-figures include the live-in partners of the non-offending mother. The actual incidence of paternal incest in South Africa is not known; however, the South African Police Services report the incidence of incest in the Western Cape for 2011/2012 to be the second highest in South Africa. When children reveal the incest to any person, this is called disclosure. After disclosure and with the removal of the paternal figure from the family unit, the mother or grandmother is responsible for the sole care of the child-victim and becomes the primary caregiver. However, in the South African context it is traditionally accepted that the grandmother assumes the role of primary caregiver of the child where the child’s mother and/or father are unable to fulfil their parental role adequately. Therefore in this study, “primary caregivers” refers to mothers and maternal grandmothers. In the South African context, limited studies have been done that explore the experiences of primary caregivers whose children or grandchildren were exposed to paternal incest. There is also a lack of information on how to support these primary caregivers in the abovementioned context. The aim of this study was firstly to explore the experiences of primary caregivers whose children or grandchildren were exposed to paternal incest and secondly to use these experiences to suggest guidelines that may be utilised by practitioners (such as social workers and registered counsellors) to develop support programmes for these caregivers. The research was conducted at a non-profit organisation in the Western Cape Province of South Africa, that provides psychosocial services and where cases of paternal incest are referred for intervention. A qualitative, phenomenological research design was applied in this study to obtain rich data. Six primary caregivers were chosen through purposive sampling, on the basis that their children or grandchildren were exposed to paternal incest within the last five years. Of these, four were mothers and two were maternal grandmothers who were responsible for the children. Data was collected through in-depth interviews and was analysed thematically. Two main themes emerged from the study. The first theme involved reactions to the disclosure and its aftermath, which encompassed emotional, cognitive and physiological reactions that are similar to secondary traumatisation. The second theme was coping strategies that emerged to deal with the disclosure and its aftermath, which encompassed effective coping strategies (behavioural coping strategies to actively solve problems and the presence of social support), unhealthy or negative coping strategies (behavioural coping strategies of avoidance) and threats to coping (a lack of social support). The contribution of this study lies in the suggestion of guidelines for the support of primary caregivers whose children or grandchildren were exposed to paternal incest. These guidelines include the provision of emotional support, multidisciplinary practitioner support and educational support programmes. / MA (Psychology), North-West University, Potchefstroom Campus, 2014

This study features an examination of the effects of working with traumatised individuals, namely vicarious traumatisation. Predictor variables such as age, career longevity, personal trauma history and workload were correlated with vicarious trauma. Support systems used by nurses were explored. The questionnaire consisted of items of the TSI Belief Scale, demographic characteristics of persons with a personal trauma history, work related aspects and support systems. Participants were 37 nurses (30 female and 7 male) who render a community mental health service in the Cape Metropole. Results of the study indicate that the variables age and career longevity were statistically significantly related to vicarious trauma. There was no relationship between personal trauma history, workload and vicarious trauma. The nurses identified the psychiatrist and psychologist as their main support systems in dealing with vicarious trauma. Recommendations were made to assist the organisation and nurses on how to deal with vicarious trauma. / Health Studies / M.A. (Health Studies)

Früh traumatisierte Kinder, die in den ersten Lebensjahren von ihren Bindungspersonen vernachlässigt, mißhandelt oder sexuell mißbraucht wurden, führen Sonderpädagogen und Kinderanalytiker schnell an ihre professionellen Grenzen. Besonders in der Kinderanalyse besteht im Bereich der Frühtrauma-Folgestörungen ein theoretisch-konzeptionelles wie behandlungstechnisches Defizit. Die vorliegende Dissertation, eine theoretische Literaturarbeit, leistet einen Beitrag zur interdisziplinären psychoanalytischen Konzeptforschung, indem sie den Begriff der „frühen Traumatisierung“ auf dem Hintergrund von Befunden aus Säuglingsforschung, Bindungstheorie und Neurobiologie neu konzipiert. Darüber hinaus entwickelt sie eine traumabezogene modifizierte tiefenpsychologisch fundierte Behandlungsmethode weiter, indem auf der Basis dieses interdisziplinär gewonnenen Konzepts „früher Traumatisierung“ entwicklungsorientierte mit traumazentrierten Interventionen verbunden werden: Während der therapeutische Hintergrund von entwicklungsorientierten Behandlungzielen geprägt ist (Bindungssicherheit, „Beantwortung“ nonverbaler Inszenierungen, Spiegelung und Regulation von Affekten sowie Förderung der Mentalisierungsfähigkeit), werden im traumazen-trierten Vordergrund, insbesondere im posttraumatischen Spiel, traumaassoziierte Phänomene (Übererregung, Intrusion, Dissoziation) erkannt und durch Einsatz distanzierender und stabilisierender Techniken (traumatherapeutische Imaginationsübungen, Dissoziationsstops) eingedämmt. Um den Behandlungserfolg zu gewährleisten, bedarf es ferner einer intensiven Kooperation mit medizinischen, pädagogischen und sozialpädagogischen Fachkräften einschließlich der Integration verfahrensfremder, z.B. übender Elemente in die psychodynamische Traumatherapie. / Traumatized children who have been neglected or physically or sexually abused by attachment figures in their first years of life quickly take special education teachers and child analysts to their professional limits. Particularly in child analysis, there is a theoretical/ conceptual as well as technique deficit in the field of secondary disorders of early trauma. The present dissertation, a theoretical literature review, contributes to interdisciplinary psychoanalytic concept research by redefining the term of “early traumatization” against the backdrop of findings from infant research, attachment theory and neurobiology. In addition, it further develops a trauma-related, modified psychodynamic treatment method by linking development-oriented interventions with trauma-centered interventions on the basis of this interdisciplinary concept of “early traumatization”: While the therapeutic background is characterized by development-oriented treatment goals (attachment security, “responding” to non-verbal enactments, mirroring and regulation of affects as well as the promotion of mentalization ability), in the trauma-centered foreground, especially in post-traumatic play, trauma-associated phenomena (hyperarousal, intrusion, dissociation) are recognized and curtailed through the use of distancing and stabilizing techniques (trauma therapy imagination exercises, dissociation stops). In order to ensure treatment success, this furthermore requires an intensive cooperation with medical, educational and special education experts that includes the integration of elements outside of the method, e.g. practicing elements, into psychodynamic trauma therapy.

The aim of this qualitative study was to explore and describe the experiences and needs of mothers of sexually abused children. A conceptual framework outlined the theoretical underpinnings of this study which focused on the core theoretical concepts of Gestalt therapy theory and the field of child sexual abuse with particular focus on the impact that the child’s trauma has on the mother. Semi–structured interviews were conducted with a sample of five mothers in order to gain rich data from their phenomenological experience. These interviews were transcribed into text and analysed. Several themes and categories emerged and were explored with the use of a literature control. These themes included the mother’s phenomenological experience of the sequence of disclosure, their awareness of the impact of their child’s sexual abuse on their holistic sense of self, their intra and interpersonal contact making styles, their need to facilitate a healthy sense of self and lastly their phenomenological knowledge gained through their field experience. The disclosure of their child’s sexual abuse signifies the start of the secondary trauma experienced by mothers, and the start of the cycle of a new experience that they struggle to bring to closure. This knowledge that their child has been sexually abused has an immediate negative impact on the mother’s field and their sense of self. Their process of healthy self–regulation is hindered due to the strong negative polarities in the self being formed and the self–blame that the mothers experience. This study therefore concluded and strongly recommended that mothers of sexually abused children receive support in the form of therapeutic intervention and education while their child receives therapy. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2012.

The aim of this qualitative study was to explore and describe the experiences and needs of mothers of sexually abused children. A conceptual framework outlined the theoretical underpinnings of this study which focused on the core theoretical concepts of Gestalt therapy theory and the field of child sexual abuse with particular focus on the impact that the child’s trauma has on the mother. Semi–structured interviews were conducted with a sample of five mothers in order to gain rich data from their phenomenological experience. These interviews were transcribed into text and analysed. Several themes and categories emerged and were explored with the use of a literature control. These themes included the mother’s phenomenological experience of the sequence of disclosure, their awareness of the impact of their child’s sexual abuse on their holistic sense of self, their intra and interpersonal contact making styles, their need to facilitate a healthy sense of self and lastly their phenomenological knowledge gained through their field experience. The disclosure of their child’s sexual abuse signifies the start of the secondary trauma experienced by mothers, and the start of the cycle of a new experience that they struggle to bring to closure. This knowledge that their child has been sexually abused has an immediate negative impact on the mother’s field and their sense of self. Their process of healthy self–regulation is hindered due to the strong negative polarities in the self being formed and the self–blame that the mothers experience. This study therefore concluded and strongly recommended that mothers of sexually abused children receive support in the form of therapeutic intervention and education while their child receives therapy. / Thesis (M.A. (MW))--North-West University, Potchefstroom Campus, 2012.

This study features an examination of the effects of working with traumatised individuals, namely vicarious traumatisation. Predictor variables such as age, career longevity, personal trauma history and workload were correlated with vicarious trauma. Support systems used by nurses were explored. The questionnaire consisted of items of the TSI Belief Scale, demographic characteristics of persons with a personal trauma history, work related aspects and support systems. Participants were 37 nurses (30 female and 7 male) who render a community mental health service in the Cape Metropole. Results of the study indicate that the variables age and career longevity were statistically significantly related to vicarious trauma. There was no relationship between personal trauma history, workload and vicarious trauma. The nurses identified the psychiatrist and psychologist as their main support systems in dealing with vicarious trauma. Recommendations were made to assist the organisation and nurses on how to deal with vicarious trauma. / Health Studies / M.A. (Health Studies)