What services and supports are needed to enable trauma survivors to rebuild their lives? Implications of a systematic case study of cognitive therapy with a township adolescent girl with PTSD following rape
- Authors: Payne, Charmaine , Edwards, David J A
- Date: 2009
- Language: English
- Type: Article
- Identifier: vital:6278 , http://hdl.handle.net/10962/d1008279
- Description: This systematic clinical case study describes the psychological assessment and treatment with cognitive therapy of Zanele, a Xhosa-speaking adolescent rape survivor with major depressive disorder and posttraumatic stress disorder (PTSD). A case narrative was developed to document the main features of the therapy process and progress was monitored using scales measuring symptoms of depression and PTSD. The narrative documents the operation in a local context of factors that maintain PTSD that have been identified in the international literature and, with the self-report scales, provides evidence for Zanele’s recovery from PTSD and the transportability to this context of an evidence-based psychological treatment. The narrative also documents the lack of safety for young women and girls in a South African township as well as significant limitations in the professional services available: in this case, Zanele was infected with HIV and other sexually transmitted diseases but medical management had not been followed through, and criminal charges against the rapist were dropped, and dropped again even after he had committed another rape on a six-year-old girl. This provides a basis for examining the complementary roles that can be played by psychologists and other professionals in empowering trauma survivors to regain a sense of dignity and control over their lives.
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Breaking the silence : Zanele's journey to recovery
- Authors: Payne, Charmaine
- Date: 2007
- Subjects: Rape victims -- Counseling of -- South Africa Rape victims -- Counseling of -- South Africa -- Case studies Post-traumatic stress disorder -- Patients -- Rehabilitation Post-traumatic stress disorder -- Patients -- Case studies
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3161 , http://hdl.handle.net/10962/d1007651
- Description: This study employed a case-based research design to document the psychological assessment and treatment of Zanele, a 15-year-old black Xhosa speaking female who was raped twice in 2006 by the same perpetrator. The aim of the study was to explore whether, the model for assessment and intervention for posttraumatic stress disorder (PTSD) developed by Ehlers and Clark (2000) was effective and transportable to the South African context. Zanele had a sufficient understanding of English for assessment to proceed without use of an interpreter. She reported a number of PTSD symptoms which were causing her significant distress and had impacted on her social and educational functioning. These included flashbacks of the perpetrator's face when she looked at the faces of black men, nightmares about the traumas she had endured and feeling isolated from others. A number of cognitive techniques were utilised in this study, however the central interventions included working with triggers, imagery rehearsal techniques with a focus on nightmares, and reliving with cognitive restructuring within and outside reliving. Psychoeducation and increasing her social support were also important components of the intervention. Her progress was monitored by means of several self-report measures which were displayed in graphic and tabular form. In addition, a thematically selective narrative of the assessment and first 23 sessions of the intervention was written which documents some of the central processes set in motion by the interventions. These results provide evidence that this model was both effective and transportable to the South African population. In addition, the study demonstrated that it is possible for a white English speaking clinician to work with a black Xhosa speaking individual and make substantial therapeutic gains.
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