An institutional analysis of community and home based care and support for HIV/AIDS sufferers in rural households in Malawi
- Authors: Munthali, Spy Mbiriyawaka
- Date: 2009
- Subjects: AIDS (Disease) -- Patients -- Care -- Malawi HIV-positive persons -- Care -- Malawi HIV infections -- Malawi Home-based family services -- Malawi Community health services -- Malawi Community development -- Malawi Economic development -- Malawi
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:985 , http://hdl.handle.net/10962/d1002719
- Description: Standard economic models often emphasize inputs, outputs and an examination of the structures in order to conduct an economic performance evaluation. This study applies the Institutional and Development Framework (IAD) in the broader context of New Institutional Economics (NIE) in order to examine the transaction costs of delivering Community and Home Based Care and Support (CHBC) to HIV/AIDS sufferers. For purposes of unveiling the empirical reality guiding decision making processes in the CHBC service delivery, comparative qualitative research techniques of normative variable and concept formation have been adopted to draw out the relative institutional influences from the HIV/AIDS national response partnerships. The study identifies the conflict between the predominantly standardized and more rigid formal management techniques adopted by key members of the national response and the informal cultural techniques familiar to the rural communities, and a lack of motivational incentives in the CHBC structures as the key factors against CHBC capacities to draw external funding for service delivery. CHBCs are also weakened by incoherent governance structures at the district level for facilitation of funding and information flow exacerbating the community vulnerability. Rationalization of the institutional arrangements and a clarification of roles from district to community levels, a shift of focus to facilitation of informal techniques and an integration of performance enhancing incentives are the critical policy insights envisaged to spur CHBCs to work better.
- Full Text:
- Date Issued: 2009
- Authors: Munthali, Spy Mbiriyawaka
- Date: 2009
- Subjects: AIDS (Disease) -- Patients -- Care -- Malawi HIV-positive persons -- Care -- Malawi HIV infections -- Malawi Home-based family services -- Malawi Community health services -- Malawi Community development -- Malawi Economic development -- Malawi
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:985 , http://hdl.handle.net/10962/d1002719
- Description: Standard economic models often emphasize inputs, outputs and an examination of the structures in order to conduct an economic performance evaluation. This study applies the Institutional and Development Framework (IAD) in the broader context of New Institutional Economics (NIE) in order to examine the transaction costs of delivering Community and Home Based Care and Support (CHBC) to HIV/AIDS sufferers. For purposes of unveiling the empirical reality guiding decision making processes in the CHBC service delivery, comparative qualitative research techniques of normative variable and concept formation have been adopted to draw out the relative institutional influences from the HIV/AIDS national response partnerships. The study identifies the conflict between the predominantly standardized and more rigid formal management techniques adopted by key members of the national response and the informal cultural techniques familiar to the rural communities, and a lack of motivational incentives in the CHBC structures as the key factors against CHBC capacities to draw external funding for service delivery. CHBCs are also weakened by incoherent governance structures at the district level for facilitation of funding and information flow exacerbating the community vulnerability. Rationalization of the institutional arrangements and a clarification of roles from district to community levels, a shift of focus to facilitation of informal techniques and an integration of performance enhancing incentives are the critical policy insights envisaged to spur CHBCs to work better.
- Full Text:
- Date Issued: 2009
A situation analysis of sex education and communication and the implications thereof for HIV/AIDS prevention work
- Authors: Mankayi, Andiswa
- Date: 2003
- Subjects: Sex instruction , Safe sex in AIDS prevention , AIDS (Disease) -- South Africa -- Eastern Cape , AIDS (Disease) -- South Africa -- Eastern Cape -- Prevention
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3147 , http://hdl.handle.net/10962/d1007447 , Sex instruction , Safe sex in AIDS prevention , AIDS (Disease) -- South Africa -- Eastern Cape , AIDS (Disease) -- South Africa -- Eastern Cape -- Prevention
- Description: This study explores the history of sex communication and education over a period of fifty years (1950 to the present), in a deep rural area of the Eastern Cape. It describes patterns of sex communication between peers, between siblings, between children and parents and between young people and other non-familial agencies within communities. Communication trends are traced from the period before contraception was introduced, through to the introduction of female birth control methods into the HIV/AIDS era where the focus has been on attempting to introduce condoms. Twelve semi-structured interviews and two four-person focus groups were conducted to gather information on how the participants acquired information about sexuality and their responses to the same. The findings of the present study suggest that the widespread use of injectable contraceptives has had a marked effect on the sexual culture of the community under investigation. It has led to the collapse of the regulatory practices which were previously in place. This in turn has significantly affected the sexual communication and negotiation context. Furthermore, it has had a determining influence on male involvement in sexual reproductive health matters and has created a poor context for the adoption of condoms as a prophylactic. There were no major changes in the sexual communication context within families and within communities in that education has always been limited to instructions to avoid pregnancy. Of note was a culture of collusion between adults and children surrounding sexuality, which absolved the parties involved in addressing sexuality. These factors are understood have mediated response to HIV/AIDS prevention efforts, and need to be taken into consideration in the development of sex communication and education programmes.
- Full Text:
- Date Issued: 2003
- Authors: Mankayi, Andiswa
- Date: 2003
- Subjects: Sex instruction , Safe sex in AIDS prevention , AIDS (Disease) -- South Africa -- Eastern Cape , AIDS (Disease) -- South Africa -- Eastern Cape -- Prevention
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3147 , http://hdl.handle.net/10962/d1007447 , Sex instruction , Safe sex in AIDS prevention , AIDS (Disease) -- South Africa -- Eastern Cape , AIDS (Disease) -- South Africa -- Eastern Cape -- Prevention
- Description: This study explores the history of sex communication and education over a period of fifty years (1950 to the present), in a deep rural area of the Eastern Cape. It describes patterns of sex communication between peers, between siblings, between children and parents and between young people and other non-familial agencies within communities. Communication trends are traced from the period before contraception was introduced, through to the introduction of female birth control methods into the HIV/AIDS era where the focus has been on attempting to introduce condoms. Twelve semi-structured interviews and two four-person focus groups were conducted to gather information on how the participants acquired information about sexuality and their responses to the same. The findings of the present study suggest that the widespread use of injectable contraceptives has had a marked effect on the sexual culture of the community under investigation. It has led to the collapse of the regulatory practices which were previously in place. This in turn has significantly affected the sexual communication and negotiation context. Furthermore, it has had a determining influence on male involvement in sexual reproductive health matters and has created a poor context for the adoption of condoms as a prophylactic. There were no major changes in the sexual communication context within families and within communities in that education has always been limited to instructions to avoid pregnancy. Of note was a culture of collusion between adults and children surrounding sexuality, which absolved the parties involved in addressing sexuality. These factors are understood have mediated response to HIV/AIDS prevention efforts, and need to be taken into consideration in the development of sex communication and education programmes.
- Full Text:
- Date Issued: 2003
The process of coping and self-management in the experience of recovering from chronic fatigue syndrome (CFS)
- Authors: Andrews, Karen Joyce
- Date: 2003 , 2013-05-20
- Subjects: Chronic fatigue syndrome , Chronic fatigue syndrome -- Psychological aspects
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:3094 , http://hdl.handle.net/10962/d1003132 , Chronic fatigue syndrome , Chronic fatigue syndrome -- Psychological aspects
- Description: A hermeneutical model of doing research is adopted to investigate the process of coping and self-management in the experience of recovering from Chronic Fatigue Syndrome (CFS). Three research participants who consider themselves as recovering or recovered from CFS were interviewed to obtain data for analysis. The findings are that once the participants cope with the uncertainty about the meaning of the onset of symptoms by defining themselves as ill in somatic terms, the participants use external social and treatment resources to cope with the onset of symptoms and being chronically ill with CFS. As a consequence of feeling stigmatised in relation to social and professional scepticism about initially being ill and subsequently, being chronically ill with CFS, the participants become uncertain about the meaning of having CFS. Coping shifts to using internal resources by adopting self-management practises. In this process, firstly, existing self-management shifts in such a way that the participants view themselves as recovering or recovered from CFS, and secondly, the participants come to the understanding that difficulties with self-management cause and maintain CFS. The findings are discussed to conclude that CFS may be a misdiagnosis of difficulties with self-management. CFS itself may not be an 'objective' disorder, but a constituent of social processes. Becoming diagnosed with CFS arises as a consequence of the search for meaning in relation to the lay and professional assumption that psychological illness does not constitute 'real' illness, operating at both the levels of popular society and the doctor-patient relationship. Difficulties with self-management rather than the diagnosis of CFS provide a more adequate understariding of the participants' illnesses. , KMBT_363 , Adobe Acrobat 9.54 Paper Capture Plug-in
- Full Text:
- Date Issued: 2003
- Authors: Andrews, Karen Joyce
- Date: 2003 , 2013-05-20
- Subjects: Chronic fatigue syndrome , Chronic fatigue syndrome -- Psychological aspects
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:3094 , http://hdl.handle.net/10962/d1003132 , Chronic fatigue syndrome , Chronic fatigue syndrome -- Psychological aspects
- Description: A hermeneutical model of doing research is adopted to investigate the process of coping and self-management in the experience of recovering from Chronic Fatigue Syndrome (CFS). Three research participants who consider themselves as recovering or recovered from CFS were interviewed to obtain data for analysis. The findings are that once the participants cope with the uncertainty about the meaning of the onset of symptoms by defining themselves as ill in somatic terms, the participants use external social and treatment resources to cope with the onset of symptoms and being chronically ill with CFS. As a consequence of feeling stigmatised in relation to social and professional scepticism about initially being ill and subsequently, being chronically ill with CFS, the participants become uncertain about the meaning of having CFS. Coping shifts to using internal resources by adopting self-management practises. In this process, firstly, existing self-management shifts in such a way that the participants view themselves as recovering or recovered from CFS, and secondly, the participants come to the understanding that difficulties with self-management cause and maintain CFS. The findings are discussed to conclude that CFS may be a misdiagnosis of difficulties with self-management. CFS itself may not be an 'objective' disorder, but a constituent of social processes. Becoming diagnosed with CFS arises as a consequence of the search for meaning in relation to the lay and professional assumption that psychological illness does not constitute 'real' illness, operating at both the levels of popular society and the doctor-patient relationship. Difficulties with self-management rather than the diagnosis of CFS provide a more adequate understariding of the participants' illnesses. , KMBT_363 , Adobe Acrobat 9.54 Paper Capture Plug-in
- Full Text:
- Date Issued: 2003
Peer group supervision as an adjunct to individual supervision: an investigation of models of learning
- Akhurst, Jacqueline Elizabeth
- Authors: Akhurst, Jacqueline Elizabeth
- Date: 2000
- Subjects: Peer-group tutoring of students Psychotherapy -- Study and teaching -- Supervision Psychology -- Supervision of
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2922 , http://hdl.handle.net/10962/d1002431
- Description: Supervision of practice makes an important contribution to the development of psychotherapeutic skills in the training of psychologists (Bernard and Goodyear, 1998). Much research has, until recently, focussed on dyadic, hierarchical models of supervision, even though other forms of supervision have been developed. Peer group supervision has had little attention in the literature, although it is a common form of supervision utilised by psychologists in practice (Lewis, Greenburg and Hatch, 1988). A review of the literature considers the purposes of supervision; elements of dyadic supervision; various forms of group, peer and peer group supervision; and the leaming process in supervision. The development and implementation of a peer supervision group (pSG) of intern psychologists within the training setting of a University is described in this study. The PSG model was developed from the model proposed by Wilbur, Roberts-Wilbur, Morris, Betz and Hart (1991). Transcripts from nine audio-taped PSG sessions were analysed, and a comparison with four audio-taped dyadic supervision sessions was then undertaken. Grounded Theory methodology was employed in the design of the study and analysis of the data. The form and content of the two models of supervision were examined, with particular attention to the perspective of the trainees' learning experiences. The relative merits of both forms of supervision were assessed, and this analysis clearly demonstrates that peer group supervision has the potential to complement dyadic supervision by contributing differing learning experiences. A model of key influences upon, and effects of, participation in the two forms of supervision has been developed. Suggestions are made of ways in which dyadic supervision may be optimised, and recommendations for further development of the PSG emerge. The results were then considered from a neo-Vygotskian perspective. This enabled the findings to be linked to a comprehensive theory of learning, pointing to the key role of speech in thinking, and the contributions of the various forms of dialogue to deepened understandings. The discussion includes: consideration of techniques which enable trainees to obtain assistance from both more experienced practitioners as well as from their peers; an exploration of aspects of subjectivity and intersubjectivity; and contextual influences which have bearing on the study. This study identifies the need for further consideration of the supervision process in South Africa, and makes recommendations for the training of supervisors. The neo-Vygotskian model offers great promise both as a framework for understanding the leaming process in. supervision, and for developing guidelines for enhancing supervisory practice.
- Full Text:
- Date Issued: 2000
- Authors: Akhurst, Jacqueline Elizabeth
- Date: 2000
- Subjects: Peer-group tutoring of students Psychotherapy -- Study and teaching -- Supervision Psychology -- Supervision of
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2922 , http://hdl.handle.net/10962/d1002431
- Description: Supervision of practice makes an important contribution to the development of psychotherapeutic skills in the training of psychologists (Bernard and Goodyear, 1998). Much research has, until recently, focussed on dyadic, hierarchical models of supervision, even though other forms of supervision have been developed. Peer group supervision has had little attention in the literature, although it is a common form of supervision utilised by psychologists in practice (Lewis, Greenburg and Hatch, 1988). A review of the literature considers the purposes of supervision; elements of dyadic supervision; various forms of group, peer and peer group supervision; and the leaming process in supervision. The development and implementation of a peer supervision group (pSG) of intern psychologists within the training setting of a University is described in this study. The PSG model was developed from the model proposed by Wilbur, Roberts-Wilbur, Morris, Betz and Hart (1991). Transcripts from nine audio-taped PSG sessions were analysed, and a comparison with four audio-taped dyadic supervision sessions was then undertaken. Grounded Theory methodology was employed in the design of the study and analysis of the data. The form and content of the two models of supervision were examined, with particular attention to the perspective of the trainees' learning experiences. The relative merits of both forms of supervision were assessed, and this analysis clearly demonstrates that peer group supervision has the potential to complement dyadic supervision by contributing differing learning experiences. A model of key influences upon, and effects of, participation in the two forms of supervision has been developed. Suggestions are made of ways in which dyadic supervision may be optimised, and recommendations for further development of the PSG emerge. The results were then considered from a neo-Vygotskian perspective. This enabled the findings to be linked to a comprehensive theory of learning, pointing to the key role of speech in thinking, and the contributions of the various forms of dialogue to deepened understandings. The discussion includes: consideration of techniques which enable trainees to obtain assistance from both more experienced practitioners as well as from their peers; an exploration of aspects of subjectivity and intersubjectivity; and contextual influences which have bearing on the study. This study identifies the need for further consideration of the supervision process in South Africa, and makes recommendations for the training of supervisors. The neo-Vygotskian model offers great promise both as a framework for understanding the leaming process in. supervision, and for developing guidelines for enhancing supervisory practice.
- Full Text:
- Date Issued: 2000
The phenomenology of the anorexic body
- Authors: Shapiro, Joel
- Date: 2000
- Subjects: Anorexia nervosa Eating disorders Anorexia nervosa -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3053 , http://hdl.handle.net/10962/d1002562
- Description: The purpose of the study is to articulate the phenomenology of the anorexic body. In order to describe the complex meaning of the anorexic body, the present research adopts the qualitative and exploratory approach of Seidman's (1991) in-depth phenomenologically based interviewing method. This involves a series of three separate interviews, with three research participants who have had personal experience of anorexia. The method of data analysis used is essentially on editing style of analysis (Miller and Crabtree, 1992) and is based on a hybrid of the grounded theory approach of Glaser and Strauss (1967) and Heidegger's (1927) ontological hermeneutics to form what Addison (1992) calls grounded interpretive research. Anorexic embodiment is conceptualised as precipitating a fundamental disturbance between the interactions of embodied consciousness and the world. The body is no longer taken-for-granted, and becomes an object for scrutiny. As an object, the body is experienced as a thing exterior to the self, and this awareness contributes to the sense of qisorder which permeates anorexic embodiment. Bodily intentionality is frustrated when the sphere of bodily actions and habitual acts become circumscribed. The character of lived temporality and lived spatiality are also effected with the anorexic's focus on the now, ushering in a spatiality of the here. These findings indicate that anorexic embodiment is experienced primarily as a disruption of the 'lived body' rather than that of the biological body. The prevailing discourses of anorexic embodiment are shown to be split between the naturalized discourses that provide a model of the body that is biologically determined and ahistorical, and the denaturalized discourses that provide a model of the body that is culturally constructed and lacks embodied givenness. It is argued that Merleau-Ponty's phenomenology of the body offers a renaturalization of the body that overcomes the nature/culture dichotomy of the naturalized and denaturalized discourses, thereby providing a solid foundation that more directly addresses the phenomenology of the anorexic body. The theoretical and treatment implications of Merleau-Ponty's renaturalization of the anorexic body are highlighted, and suggestions for further research are presented.
- Full Text:
- Date Issued: 2000
- Authors: Shapiro, Joel
- Date: 2000
- Subjects: Anorexia nervosa Eating disorders Anorexia nervosa -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3053 , http://hdl.handle.net/10962/d1002562
- Description: The purpose of the study is to articulate the phenomenology of the anorexic body. In order to describe the complex meaning of the anorexic body, the present research adopts the qualitative and exploratory approach of Seidman's (1991) in-depth phenomenologically based interviewing method. This involves a series of three separate interviews, with three research participants who have had personal experience of anorexia. The method of data analysis used is essentially on editing style of analysis (Miller and Crabtree, 1992) and is based on a hybrid of the grounded theory approach of Glaser and Strauss (1967) and Heidegger's (1927) ontological hermeneutics to form what Addison (1992) calls grounded interpretive research. Anorexic embodiment is conceptualised as precipitating a fundamental disturbance between the interactions of embodied consciousness and the world. The body is no longer taken-for-granted, and becomes an object for scrutiny. As an object, the body is experienced as a thing exterior to the self, and this awareness contributes to the sense of qisorder which permeates anorexic embodiment. Bodily intentionality is frustrated when the sphere of bodily actions and habitual acts become circumscribed. The character of lived temporality and lived spatiality are also effected with the anorexic's focus on the now, ushering in a spatiality of the here. These findings indicate that anorexic embodiment is experienced primarily as a disruption of the 'lived body' rather than that of the biological body. The prevailing discourses of anorexic embodiment are shown to be split between the naturalized discourses that provide a model of the body that is biologically determined and ahistorical, and the denaturalized discourses that provide a model of the body that is culturally constructed and lacks embodied givenness. It is argued that Merleau-Ponty's phenomenology of the body offers a renaturalization of the body that overcomes the nature/culture dichotomy of the naturalized and denaturalized discourses, thereby providing a solid foundation that more directly addresses the phenomenology of the anorexic body. The theoretical and treatment implications of Merleau-Ponty's renaturalization of the anorexic body are highlighted, and suggestions for further research are presented.
- Full Text:
- Date Issued: 2000
The relative influence of value priorities ethnicity and worries in the determination of political party affiliation amongst Ugandan university students
- Authors: Kibanja, Grace M
- Date: 1999
- Subjects: Political psychology , Uganda -- Politics and government -- 1979- , Students -- Uganda -- Political activity , College students -- Uganda -- Psychology
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:3003 , http://hdl.handle.net/10962/d1002512 , Political psychology , Uganda -- Politics and government -- 1979- , Students -- Uganda -- Political activity , College students -- Uganda -- Psychology
- Description: This study examines the relative influence of value priorities, ethnicity and 'worries' in the determination of political party affiliation amongst Ugandan university students. Schwartz's values questionnaire was administered to 309 male and 176 female first year students from the faculties of engineering, medicine, law, commerce, social sciences, sciences, education and mass communication at Makerere University Uganda. The sample included respondents from all of the six sub-ethnic groups in Uganda. Respondents also covered the major religious groups in the country and were also representative of the major political parties. Results from the statistical analysis on the data show that ethnicity and certain values playa role in the determination of these students' affiliation to a political party. Chi-square results show that achievement, benevolence, universalism, security, tradition and conformity values are given differing importance across political parties. And, Anova results show that the tradition value has a significant mean difference across parties. Other factors such as religion and course of study are also found to have significant influence on these student's affiliation to political parties. Although 'worries' are found not to have a significant influence on student's political party affiliation, findings show that students from different political parties differ in their ratings of the different types of ' worries'. Therefore results show that ethnicity and value priorities do infl4ence these students' affiliation to a political party but ' worries' do not. The discussion section explores these findings in the context of contemporary Ugandan politics.
- Full Text:
- Date Issued: 1999
- Authors: Kibanja, Grace M
- Date: 1999
- Subjects: Political psychology , Uganda -- Politics and government -- 1979- , Students -- Uganda -- Political activity , College students -- Uganda -- Psychology
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:3003 , http://hdl.handle.net/10962/d1002512 , Political psychology , Uganda -- Politics and government -- 1979- , Students -- Uganda -- Political activity , College students -- Uganda -- Psychology
- Description: This study examines the relative influence of value priorities, ethnicity and 'worries' in the determination of political party affiliation amongst Ugandan university students. Schwartz's values questionnaire was administered to 309 male and 176 female first year students from the faculties of engineering, medicine, law, commerce, social sciences, sciences, education and mass communication at Makerere University Uganda. The sample included respondents from all of the six sub-ethnic groups in Uganda. Respondents also covered the major religious groups in the country and were also representative of the major political parties. Results from the statistical analysis on the data show that ethnicity and certain values playa role in the determination of these students' affiliation to a political party. Chi-square results show that achievement, benevolence, universalism, security, tradition and conformity values are given differing importance across political parties. And, Anova results show that the tradition value has a significant mean difference across parties. Other factors such as religion and course of study are also found to have significant influence on these student's affiliation to political parties. Although 'worries' are found not to have a significant influence on student's political party affiliation, findings show that students from different political parties differ in their ratings of the different types of ' worries'. Therefore results show that ethnicity and value priorities do infl4ence these students' affiliation to a political party but ' worries' do not. The discussion section explores these findings in the context of contemporary Ugandan politics.
- Full Text:
- Date Issued: 1999
The social construction of 'capacity building': a grounded theory study of organisation development consultants' accounts
- Authors: Eagar, Ryan
- Date: 1999
- Subjects: Organizational change -- South Africa , Business consultants -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:2969 , http://hdl.handle.net/10962/d1002478 , Organizational change -- South Africa , Business consultants -- South Africa
- Description: The primary aim of this thesis is to explore, through organisation development (OD) consultants' accounts, the meaning of 'capacity building' in the South African development context. The need for theory development in this area is apparent from two interrelated vantage points. Firstly, while 'capacity building' is an increasingly espoused development approach, it is seen to be a confusing and ill-defined concept, for which there exists no adequate theory. Secondly, there is an growing call within the OD field to perfonn 'recOIlllaissance' (Weick,1990) on OD as it is being practised in different socio-historical and organisational contexts, so as to discern future trends for this discipline. Due to the lack of documented debate which grounds OD issues in the South African development sector, OD practitioners' 'capacity building' interventions were seen to provide suitably unchartered terrain for this study. Given that theory generation was intended, the general epistemological principles provided by Glaser and Strauss's (1967) 'grounded theory' methodology were adopted. As a way of avoiding some of the criticisms and limitations of this approach, this thesis followed later conceptualisations of this method, in particular its reframing within the social constructionist idiom. In accordance with this perspective, this study directed attention to the ways in which OD consultants, in a non-governmental organisational (NGO) sector known as 'intermediary' NGOs, accounted for their 'capacity building' role in this development context. The results, based on in-depth interviews with ten OD consultants, indicate that 'capacity building' is an elusive and inchoate concept with more than one meaning for the participants. Their narrative account variously constructs 'capacity building' as value-driven OD process facilitation; funder and market regulated service provision; and people-driven product delivery. As a result of this multi-vocal construction, the participants' accounts reveal that OD consultancy in this sector is primarily concerned with 'managing the tensions' of the consultants' ambiguous and contradictory roles. By examining how the tensions articulated by the consultants inhere in their relationship to the environment in which they operate, this thesis firstly explores how the contradiction and anlbiguity attached to this concept can be traced to different stakeholder expectations of 'capacity building'. Secondly, it exanlines how these different stakeholder discourses conflict with each other and with an OD perspective. Thirdly, through an explication of the core category of 'managing tensions', it explores the image of OD consulting as a 'shifting and inconstant balancing act'. Fourthly, it shows how there exist wider contextual forces operating in the development sector which serve to throw these consultants 'off balance' and into delimited and 'received' service provision roles which run counter to their raison d'etre. Finally, the research examines new ways of approaching the 'capacity building' question and of understanding the nature of OD consultancy. It concludes with an attempt to respond to a conceptual aporia in OD literature by examining possible alternative images and metaphors for the role of the OD consultant.
- Full Text:
- Date Issued: 1999
- Authors: Eagar, Ryan
- Date: 1999
- Subjects: Organizational change -- South Africa , Business consultants -- South Africa
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:2969 , http://hdl.handle.net/10962/d1002478 , Organizational change -- South Africa , Business consultants -- South Africa
- Description: The primary aim of this thesis is to explore, through organisation development (OD) consultants' accounts, the meaning of 'capacity building' in the South African development context. The need for theory development in this area is apparent from two interrelated vantage points. Firstly, while 'capacity building' is an increasingly espoused development approach, it is seen to be a confusing and ill-defined concept, for which there exists no adequate theory. Secondly, there is an growing call within the OD field to perfonn 'recOIlllaissance' (Weick,1990) on OD as it is being practised in different socio-historical and organisational contexts, so as to discern future trends for this discipline. Due to the lack of documented debate which grounds OD issues in the South African development sector, OD practitioners' 'capacity building' interventions were seen to provide suitably unchartered terrain for this study. Given that theory generation was intended, the general epistemological principles provided by Glaser and Strauss's (1967) 'grounded theory' methodology were adopted. As a way of avoiding some of the criticisms and limitations of this approach, this thesis followed later conceptualisations of this method, in particular its reframing within the social constructionist idiom. In accordance with this perspective, this study directed attention to the ways in which OD consultants, in a non-governmental organisational (NGO) sector known as 'intermediary' NGOs, accounted for their 'capacity building' role in this development context. The results, based on in-depth interviews with ten OD consultants, indicate that 'capacity building' is an elusive and inchoate concept with more than one meaning for the participants. Their narrative account variously constructs 'capacity building' as value-driven OD process facilitation; funder and market regulated service provision; and people-driven product delivery. As a result of this multi-vocal construction, the participants' accounts reveal that OD consultancy in this sector is primarily concerned with 'managing the tensions' of the consultants' ambiguous and contradictory roles. By examining how the tensions articulated by the consultants inhere in their relationship to the environment in which they operate, this thesis firstly explores how the contradiction and anlbiguity attached to this concept can be traced to different stakeholder expectations of 'capacity building'. Secondly, it exanlines how these different stakeholder discourses conflict with each other and with an OD perspective. Thirdly, through an explication of the core category of 'managing tensions', it explores the image of OD consulting as a 'shifting and inconstant balancing act'. Fourthly, it shows how there exist wider contextual forces operating in the development sector which serve to throw these consultants 'off balance' and into delimited and 'received' service provision roles which run counter to their raison d'etre. Finally, the research examines new ways of approaching the 'capacity building' question and of understanding the nature of OD consultancy. It concludes with an attempt to respond to a conceptual aporia in OD literature by examining possible alternative images and metaphors for the role of the OD consultant.
- Full Text:
- Date Issued: 1999
Understanding the image in art therapy: a phenomenological-hermeneutic investigation
- Authors: Douglas, Blanche Daw
- Date: 1999
- Subjects: Art therapy Art -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2966 , http://hdl.handle.net/10962/d1002475
- Description: Part One of the research seeks to establish a context wherein certain assumptions pertaining to the interpretative dimensions of understanding the image in art therapy can be considered and reviewed. Notions about the image, meaning and reality are discussed both in terms of how they relate to current art therapy practice, and how they may be alternatively thought about, both from the perspective of ancient Hellenic Greek thought, and more contemporary thought, particularly that of phenomenological and philosophical-hermeneutics. Part Two of the research investigates the phenomenon of understanding the image in an art therapy situation, with a view to reconsidering certain of the assumptions raised in the first part of the thesis (phrased in the form of research questions). It did this utilizing a qualitative method, by exposing four respondents (patients), and two therapists to an art therapy situation in which images were created out of clay. The respondents (patients) and therapists articulated their understanding of the image production procedure, and the meaning of the images created. The way understanding occurred in the empirical part of the research was explained and illustrated by means of the hermeneutic circle, which was operational on a number of different levels. The results of the research suggest that the meaning of the image in art therapy is a creative synthesis, which emerges from within a dialectics of exchange. This exchange involves a number of meaning-generating contexts, of which the patient’s experience, and the therapist’s knowledge, form only a part. The outcome of this exchange is the derived meaning of the image, which represents a ‘fictional’ world that gives the patient and therapist a way of understanding the patient’s situation. The process of the research, which investigates the way understanding of the image in art therapy occurs, is at the same time, an application of the principles of understanding
- Full Text:
- Date Issued: 1999
- Authors: Douglas, Blanche Daw
- Date: 1999
- Subjects: Art therapy Art -- Psychological aspects
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2966 , http://hdl.handle.net/10962/d1002475
- Description: Part One of the research seeks to establish a context wherein certain assumptions pertaining to the interpretative dimensions of understanding the image in art therapy can be considered and reviewed. Notions about the image, meaning and reality are discussed both in terms of how they relate to current art therapy practice, and how they may be alternatively thought about, both from the perspective of ancient Hellenic Greek thought, and more contemporary thought, particularly that of phenomenological and philosophical-hermeneutics. Part Two of the research investigates the phenomenon of understanding the image in an art therapy situation, with a view to reconsidering certain of the assumptions raised in the first part of the thesis (phrased in the form of research questions). It did this utilizing a qualitative method, by exposing four respondents (patients), and two therapists to an art therapy situation in which images were created out of clay. The respondents (patients) and therapists articulated their understanding of the image production procedure, and the meaning of the images created. The way understanding occurred in the empirical part of the research was explained and illustrated by means of the hermeneutic circle, which was operational on a number of different levels. The results of the research suggest that the meaning of the image in art therapy is a creative synthesis, which emerges from within a dialectics of exchange. This exchange involves a number of meaning-generating contexts, of which the patient’s experience, and the therapist’s knowledge, form only a part. The outcome of this exchange is the derived meaning of the image, which represents a ‘fictional’ world that gives the patient and therapist a way of understanding the patient’s situation. The process of the research, which investigates the way understanding of the image in art therapy occurs, is at the same time, an application of the principles of understanding
- Full Text:
- Date Issued: 1999
Testing Guidano's model of psychopathology in eating-disordered individuals : a multiple case study
- Authors: Hajayiannis, Helen
- Date: 1998
- Subjects: Psychology, Pathological Eating disorders -- Case studies Guidano, V F Eating disorders -- Etiology
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:3192 , http://hdl.handle.net/10962/d1008557
- Description: This thesis sets out to critically examine Guidano's model of psychopathology in eating-disordered individuals . The literature review highlights the diverse etiological approaches that have been taken in understanding eating disorders. Guidano's model is presented as an alternative to traditional approaches . It is a developmental, unitary model of psychopathology, conceptualised within a systems/process-oriented approach to organised complexity. Within a qualitative framework, case study methodology is utilised to test the viability and limitations of Guidano's model. Four in-depth case histories are presented which offer appropriate material for the testing of the model. The data is analysed using the reading guide method and presented in terms of the four features of Guidano's model: (1) dysfunctional patterns of attachment; (2) sense of self; (3) major themes on systemic coherence; (4) common coping strategies. The findings of the research support Guidano's model of psychopathology in eating-disordered individuals. The findings are: (1) attachment styles are ambiguous, "intrusive, and enmeshed; participants experience a disappointment in the preferential attachment relationship; (2) that participants' sense of self is blurred and wavering; (3) the major theme on systemic coherence is the oscillation between seeking and avoiding intimacy; (4) common coping strategies are: the seeking of supportive intimacy with minimal self-exposure; withdrawal into the self; perfectionism; the development of an eating disorder; continuous thoughts about food, eating, and weight which prevents participants from becoming aware of the real issues confronting them. An evaluation of Guidano's model in terms of its specific contribution to knowledge and research on the role of father in child and adolescent psychopathology, as well as how father effects evidence in eating disorders, demonstrates the model's value as an explanatory tool and raises implications for future treatment, theory, and research practices of eating-disordered individuals.
- Full Text:
- Date Issued: 1998
- Authors: Hajayiannis, Helen
- Date: 1998
- Subjects: Psychology, Pathological Eating disorders -- Case studies Guidano, V F Eating disorders -- Etiology
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:3192 , http://hdl.handle.net/10962/d1008557
- Description: This thesis sets out to critically examine Guidano's model of psychopathology in eating-disordered individuals . The literature review highlights the diverse etiological approaches that have been taken in understanding eating disorders. Guidano's model is presented as an alternative to traditional approaches . It is a developmental, unitary model of psychopathology, conceptualised within a systems/process-oriented approach to organised complexity. Within a qualitative framework, case study methodology is utilised to test the viability and limitations of Guidano's model. Four in-depth case histories are presented which offer appropriate material for the testing of the model. The data is analysed using the reading guide method and presented in terms of the four features of Guidano's model: (1) dysfunctional patterns of attachment; (2) sense of self; (3) major themes on systemic coherence; (4) common coping strategies. The findings of the research support Guidano's model of psychopathology in eating-disordered individuals. The findings are: (1) attachment styles are ambiguous, "intrusive, and enmeshed; participants experience a disappointment in the preferential attachment relationship; (2) that participants' sense of self is blurred and wavering; (3) the major theme on systemic coherence is the oscillation between seeking and avoiding intimacy; (4) common coping strategies are: the seeking of supportive intimacy with minimal self-exposure; withdrawal into the self; perfectionism; the development of an eating disorder; continuous thoughts about food, eating, and weight which prevents participants from becoming aware of the real issues confronting them. An evaluation of Guidano's model in terms of its specific contribution to knowledge and research on the role of father in child and adolescent psychopathology, as well as how father effects evidence in eating disorders, demonstrates the model's value as an explanatory tool and raises implications for future treatment, theory, and research practices of eating-disordered individuals.
- Full Text:
- Date Issued: 1998
Punishment in schools: perspectives of parents, teachers and pupils
- Authors: Sedumedi, Susan Dimakatso
- Date: 1997
- Subjects: Punishment -- South Africa , Discipline of children -- Psychological aspects , Discipline of children -- South Africa , High school teachers -- South Africa -- Attitudes , High school students -- South Africa -- Attitudes , Parents -- South Africa -- Attitudes , Corporal punishment , Corporal punishment -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3051 , http://hdl.handle.net/10962/d1002560 , Punishment -- South Africa , Discipline of children -- Psychological aspects , Discipline of children -- South Africa , High school teachers -- South Africa -- Attitudes , High school students -- South Africa -- Attitudes , Parents -- South Africa -- Attitudes , Corporal punishment , Corporal punishment -- South Africa
- Description: While some research has been done on the use of corporal punishment in South African schools, there is a dearth of research on other forms of punishment and little has been done to research the meaning of punishment. This study explores the meaning of punishment in a high school context and focuses on the different attitudes of parents, teachers and pupils, with a view to identifying, in particular, how they justify the use of punishment. A sample of 50 pupils, 30 teachers and 30 parents were selected for the study. Focus groups and a questionnaire with closed and open-ended questions were used to collect the data. The questionnaire was constructed to explore themes which emerged in the focus group discussions . Results were grouped into themes and arranged by tables , and the Chi-square test of statistical significance was used to analyze some of the data. The results show that the meaning and the approach to punishment is differently construed by participants. Parents construe punishment as an educative instrument and a disciplinary measure used for the good of pupils and the society. Teachers see it as a discip1inary measure, a strategy used for effective learning, and a negative stimulus used to inflict pain towards the goal of an orderly school environment. To pupils the punishment scene provides an opportunity for what they perceive as sadistic enjoyment and as something negative which is used by teachers to vent their own frustrations. Participants agree that clear, consensually agreed upon rules should be set to regulate school behaviour and that there should be clear and consensually agreed upon ways of ensuring that these rules are adhered to; and constructive ways of dealing with violation of these rules. The central concern seems to be to move away from a retributive, punitive mode of thinking about punishment, towards a purposeful one. The implications of the research findings are discussed in the context of existing literature in the area and in relation to policy development.
- Full Text:
- Date Issued: 1997
- Authors: Sedumedi, Susan Dimakatso
- Date: 1997
- Subjects: Punishment -- South Africa , Discipline of children -- Psychological aspects , Discipline of children -- South Africa , High school teachers -- South Africa -- Attitudes , High school students -- South Africa -- Attitudes , Parents -- South Africa -- Attitudes , Corporal punishment , Corporal punishment -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3051 , http://hdl.handle.net/10962/d1002560 , Punishment -- South Africa , Discipline of children -- Psychological aspects , Discipline of children -- South Africa , High school teachers -- South Africa -- Attitudes , High school students -- South Africa -- Attitudes , Parents -- South Africa -- Attitudes , Corporal punishment , Corporal punishment -- South Africa
- Description: While some research has been done on the use of corporal punishment in South African schools, there is a dearth of research on other forms of punishment and little has been done to research the meaning of punishment. This study explores the meaning of punishment in a high school context and focuses on the different attitudes of parents, teachers and pupils, with a view to identifying, in particular, how they justify the use of punishment. A sample of 50 pupils, 30 teachers and 30 parents were selected for the study. Focus groups and a questionnaire with closed and open-ended questions were used to collect the data. The questionnaire was constructed to explore themes which emerged in the focus group discussions . Results were grouped into themes and arranged by tables , and the Chi-square test of statistical significance was used to analyze some of the data. The results show that the meaning and the approach to punishment is differently construed by participants. Parents construe punishment as an educative instrument and a disciplinary measure used for the good of pupils and the society. Teachers see it as a discip1inary measure, a strategy used for effective learning, and a negative stimulus used to inflict pain towards the goal of an orderly school environment. To pupils the punishment scene provides an opportunity for what they perceive as sadistic enjoyment and as something negative which is used by teachers to vent their own frustrations. Participants agree that clear, consensually agreed upon rules should be set to regulate school behaviour and that there should be clear and consensually agreed upon ways of ensuring that these rules are adhered to; and constructive ways of dealing with violation of these rules. The central concern seems to be to move away from a retributive, punitive mode of thinking about punishment, towards a purposeful one. The implications of the research findings are discussed in the context of existing literature in the area and in relation to policy development.
- Full Text:
- Date Issued: 1997
An analysis of the experience of the acute phase of traumatic spinal cord injury in a South African spinal unit
- Authors: Gaitelband, Philip Joseph
- Date: 1996
- Subjects: Spinal cord -- Wounds and injuries -- Psychological aspects , Spinal cord -- Wounds and injuries -- Patients -- Rehabilitation
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2978 , http://hdl.handle.net/10962/d1002487 , Spinal cord -- Wounds and injuries -- Psychological aspects , Spinal cord -- Wounds and injuries -- Patients -- Rehabilitation
- Description: This study aims to explore, and to a certain extent to clarify, what it means psychologically to experience Traumatic spinal cord injury (TSCI) in a South African spinal unit. The target time chosen for analysis is the acute medical period. The study presents a review of the literature on psychological adjustment to TSCI and then proceeds to introduce and extensively articulate the hermeneutic approach and methodology. Subsequently, an interpretive research strategy is presented for the purpose of studying the acute phase of TSCI. The data for the study was obtained by means of three dialogical interviews which were tape recorded, transcribed and analyzed with~n a cyclical framework consisting of three interdependent levels. The interpretive procedure is modeled upon the 'reading guide' developed by Brown, Tappan, Gilligan, Miller and Argyris (1989). The analysis follows a course from the individual psychological descriptions of the experience to the generation of a general, nomothetic narrative account of the acute phase. The findings are then discussed in relation to the existing literature and evaluated on the basis of the goals of the study. The study highlights the value of some of the 'stage' ways of thinking about SCI adjustment, while simultaneously stressing the need for placing adjustment within a more personalized, and individually meaningful context. Significant differences between the psycho-physical experiences of patients in the categories of complete and -incomplete SCI were found, which suggests that a sharper distinction be made in the literature between these two groups, in order to account for the marked variations in their experiences.-- The study also contains a number of shortcomings, such as a lack of understanding about certain historical and contextual factors which may have mediated the experiences of the trauma for the individuals concerned. These shortcomings and some suggestions fro their resolution are then discussed. The study concludes with an evaluation of the research strategy and methodology and also offers some suggestions for future research.
- Full Text:
- Date Issued: 1996
- Authors: Gaitelband, Philip Joseph
- Date: 1996
- Subjects: Spinal cord -- Wounds and injuries -- Psychological aspects , Spinal cord -- Wounds and injuries -- Patients -- Rehabilitation
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2978 , http://hdl.handle.net/10962/d1002487 , Spinal cord -- Wounds and injuries -- Psychological aspects , Spinal cord -- Wounds and injuries -- Patients -- Rehabilitation
- Description: This study aims to explore, and to a certain extent to clarify, what it means psychologically to experience Traumatic spinal cord injury (TSCI) in a South African spinal unit. The target time chosen for analysis is the acute medical period. The study presents a review of the literature on psychological adjustment to TSCI and then proceeds to introduce and extensively articulate the hermeneutic approach and methodology. Subsequently, an interpretive research strategy is presented for the purpose of studying the acute phase of TSCI. The data for the study was obtained by means of three dialogical interviews which were tape recorded, transcribed and analyzed with~n a cyclical framework consisting of three interdependent levels. The interpretive procedure is modeled upon the 'reading guide' developed by Brown, Tappan, Gilligan, Miller and Argyris (1989). The analysis follows a course from the individual psychological descriptions of the experience to the generation of a general, nomothetic narrative account of the acute phase. The findings are then discussed in relation to the existing literature and evaluated on the basis of the goals of the study. The study highlights the value of some of the 'stage' ways of thinking about SCI adjustment, while simultaneously stressing the need for placing adjustment within a more personalized, and individually meaningful context. Significant differences between the psycho-physical experiences of patients in the categories of complete and -incomplete SCI were found, which suggests that a sharper distinction be made in the literature between these two groups, in order to account for the marked variations in their experiences.-- The study also contains a number of shortcomings, such as a lack of understanding about certain historical and contextual factors which may have mediated the experiences of the trauma for the individuals concerned. These shortcomings and some suggestions fro their resolution are then discussed. The study concludes with an evaluation of the research strategy and methodology and also offers some suggestions for future research.
- Full Text:
- Date Issued: 1996
The Bender Gestalt Test: an investigation into problems concerning administration and scoring and its application to low-educated adults
- Authors: Dyall, Kate
- Date: 1996
- Subjects: Bender-Gestalt Test , Psychological tests , Brain-damaged children -- Psychological testing
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2968 , http://hdl.handle.net/10962/d1002477 , Bender-Gestalt Test , Psychological tests , Brain-damaged children -- Psychological testing
- Description: The study investigates .the use of the Bender Gestalt Test (BGT) amongst low-educated adults. Three versions of the BGT are used in this study; the original 'copy' version as well as the 'immediate' and 'delayed'recall versions. This is done so as to expand the ability of the BGT to identify neurological impairment and to differentiate between this and functional impairment. A literature review explores the problems of standardization in the administration, scoring and application of all three versions of the test Suggestions are made to correct the problems identified and a novel system of scoring the recall versions are proposed, which allows for the comparison of results of the three versions of the test and which is based on Lacks's (1984) and Weiss's (1970) systems. Administration procedures were also developed to suit the context of the study. The copy, immediate and delayed versions of the BGT were administered to a group of 184 low-educated adults. Statistical analyses revealed significant education effects for the sample tested with regards to both test scores and performance time. The finding of an education effect for performance time is discussed at length, as some literature regards excessive time as a neurological indicator. An anomaly for the group with no education was found to exist, with the scores of these subjects not Significantly different from those with 4-6 years of education. Possible reasons for this were explored. In addition, the findings of this research revealed a plateau effect with those having less than 6 years of education scoring substantially lower than those with 7 years and more. The scores of adults with 7 and more years of education level out with no significant differences between educational levels. This appears to suggest that education effects rather than the developmental maturity level proposed by Koppitz, are involved. In addition, the scores of low-educated adults on the expanded Bender Gestalt Test were significantly lower than those of children with similar educational levels, in other studies. These findings and possible explanations are discussed. The study concludes by suggesting new research areas and emphasizing the urgent need for separate normative data on the expanded BGT for low-educated adults, and the establishment of appropriate 'cut-off' points.
- Full Text:
- Date Issued: 1996
- Authors: Dyall, Kate
- Date: 1996
- Subjects: Bender-Gestalt Test , Psychological tests , Brain-damaged children -- Psychological testing
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2968 , http://hdl.handle.net/10962/d1002477 , Bender-Gestalt Test , Psychological tests , Brain-damaged children -- Psychological testing
- Description: The study investigates .the use of the Bender Gestalt Test (BGT) amongst low-educated adults. Three versions of the BGT are used in this study; the original 'copy' version as well as the 'immediate' and 'delayed'recall versions. This is done so as to expand the ability of the BGT to identify neurological impairment and to differentiate between this and functional impairment. A literature review explores the problems of standardization in the administration, scoring and application of all three versions of the test Suggestions are made to correct the problems identified and a novel system of scoring the recall versions are proposed, which allows for the comparison of results of the three versions of the test and which is based on Lacks's (1984) and Weiss's (1970) systems. Administration procedures were also developed to suit the context of the study. The copy, immediate and delayed versions of the BGT were administered to a group of 184 low-educated adults. Statistical analyses revealed significant education effects for the sample tested with regards to both test scores and performance time. The finding of an education effect for performance time is discussed at length, as some literature regards excessive time as a neurological indicator. An anomaly for the group with no education was found to exist, with the scores of these subjects not Significantly different from those with 4-6 years of education. Possible reasons for this were explored. In addition, the findings of this research revealed a plateau effect with those having less than 6 years of education scoring substantially lower than those with 7 years and more. The scores of adults with 7 and more years of education level out with no significant differences between educational levels. This appears to suggest that education effects rather than the developmental maturity level proposed by Koppitz, are involved. In addition, the scores of low-educated adults on the expanded Bender Gestalt Test were significantly lower than those of children with similar educational levels, in other studies. These findings and possible explanations are discussed. The study concludes by suggesting new research areas and emphasizing the urgent need for separate normative data on the expanded BGT for low-educated adults, and the establishment of appropriate 'cut-off' points.
- Full Text:
- Date Issued: 1996
The interface between Western mental health care and indigenous healing in South Africa: Xhosa psychiatric nurses' views on traditional healers
- Authors: Kahn, Marc Simon
- Date: 1996
- Subjects: Mental health services -- Research -- South Africa , Traditional medicine -- South Africa , Black people -- Mental health -- South Africa , Mental health -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2999 , http://hdl.handle.net/10962/d1002508 , Mental health services -- Research -- South Africa , Traditional medicine -- South Africa , Black people -- Mental health -- South Africa , Mental health -- South Africa
- Description: Xhosa psychiatric nurses stand unique at the interface between Western mental health care and indigenous healing in South Africa. They stem from a cultural history that is embedded within traditional health care discourses and yet are trained and work within a Western psychiatric model. In embodying the intersection between these two paradigms, they are faced with the challenge of making sense of such an amalgamation. These nurses' views are thus valuable in reflecting this intersection and illustrating many of the central concerns that surround it. This study explicates the views of these nurses toward traditional healers and their potential role in mental health care in South Africa. In addition, it illuminates some of the cultural dynamics at work amongst these subjects as they struggle to make sense of their unique cultural position. Using a questionnaire-based methodology, the views of Xhosa psychiatric nurses in a psychiatric hospital in the Eastern Cape, toward traditional healers and their role in mental-health care, were examined. The findings reveal that the vast majority of these nurses believe in traditional cosmology, involve themselves in traditional ritual practices and regularly visit traditional healers as patients. In suggesting ways in which indigenous healing and Western mental health care can work together, 75% of the nurses were in favour of a general referral system between the hospital and traditional healers, most (77%) agreed that certain patients would be better off being treated by both the hospital and traditional healers than they would if they were only being treated by the hospital alone, and 85% of the subjects agreed that patients who are already seeing traditional healers should check if psychiatric medication might help them. These findings indicate that these nurses operate across two healing systems which are at this point not conceptually compatible. This results in deep cultural tension for the nurses. In being entangled in the dialectical tension created in this context, the nurses manage the incongruencies in three general ways: a) Most, in one form or another, incorporate beliefs from both systems into an integrative model, b) some assimilate their cultural belief system into the Western mental health paradigm, throwing off their beliefs in traditional healing, and c) others remain ambivalent in the dialectic between traditional and Western health care discourses. Although this may suggest that these nurses reside within a cultural milieu that is somewhat unhealthy, at another level, in managing and containing the incompatibility between the two systems, these nurses ensure a space for on-going and healthy critique of the underlying assumptions involved in this health care malaise.
- Full Text:
- Date Issued: 1996
- Authors: Kahn, Marc Simon
- Date: 1996
- Subjects: Mental health services -- Research -- South Africa , Traditional medicine -- South Africa , Black people -- Mental health -- South Africa , Mental health -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:2999 , http://hdl.handle.net/10962/d1002508 , Mental health services -- Research -- South Africa , Traditional medicine -- South Africa , Black people -- Mental health -- South Africa , Mental health -- South Africa
- Description: Xhosa psychiatric nurses stand unique at the interface between Western mental health care and indigenous healing in South Africa. They stem from a cultural history that is embedded within traditional health care discourses and yet are trained and work within a Western psychiatric model. In embodying the intersection between these two paradigms, they are faced with the challenge of making sense of such an amalgamation. These nurses' views are thus valuable in reflecting this intersection and illustrating many of the central concerns that surround it. This study explicates the views of these nurses toward traditional healers and their potential role in mental health care in South Africa. In addition, it illuminates some of the cultural dynamics at work amongst these subjects as they struggle to make sense of their unique cultural position. Using a questionnaire-based methodology, the views of Xhosa psychiatric nurses in a psychiatric hospital in the Eastern Cape, toward traditional healers and their role in mental-health care, were examined. The findings reveal that the vast majority of these nurses believe in traditional cosmology, involve themselves in traditional ritual practices and regularly visit traditional healers as patients. In suggesting ways in which indigenous healing and Western mental health care can work together, 75% of the nurses were in favour of a general referral system between the hospital and traditional healers, most (77%) agreed that certain patients would be better off being treated by both the hospital and traditional healers than they would if they were only being treated by the hospital alone, and 85% of the subjects agreed that patients who are already seeing traditional healers should check if psychiatric medication might help them. These findings indicate that these nurses operate across two healing systems which are at this point not conceptually compatible. This results in deep cultural tension for the nurses. In being entangled in the dialectical tension created in this context, the nurses manage the incongruencies in three general ways: a) Most, in one form or another, incorporate beliefs from both systems into an integrative model, b) some assimilate their cultural belief system into the Western mental health paradigm, throwing off their beliefs in traditional healing, and c) others remain ambivalent in the dialectic between traditional and Western health care discourses. Although this may suggest that these nurses reside within a cultural milieu that is somewhat unhealthy, at another level, in managing and containing the incompatibility between the two systems, these nurses ensure a space for on-going and healthy critique of the underlying assumptions involved in this health care malaise.
- Full Text:
- Date Issued: 1996
The phenomenology of the events of client inhibition and self-disclosure in the therapeutic dialogue
- Authors: Lockhart, Ian
- Date: 1994
- Subjects: Self-disclosure , Client-centered psychotherapy , Inhibition
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3009 , http://hdl.handle.net/10962/d1002518 , Self-disclosure , Client-centered psychotherapy , Inhibition
- Description: The aim of this study was to provide an account of the power relations that are implicit in the experience of clients who initially withhold but eventually disclose a sensitive issue in the psychotherapeutic dialogue. Mainstream psychotherapeutic literature has maintained that clients who withhold sensitive material implicitly express a psychological powerlessness. The literature review also turned attention to an alternative view, not arising from within the psychotherapeutic literature. Specific reference was made to the work of Foucault who suggests that although clients may appear to be empowered through self-disclosure, they are in fact constrained, since disclosing themselves constitutes. an appropriation of selfunderstanding which forecloses openness to other forms of self-understanding. The tension between these conflicting accounts about the relation of self-disclosure to empowerment was discussed as an issue requiring further exploration through clinical research. A phenomenologically orientated research method was used to describe the experiences of five clients who withheld and subsequently disclosed sensitive issues in psychotherapy. These descriptions yielded a thematically differentiated process of psychological change. The structure of client inhibition and self-disclosure was seen to correspond to the concepts of powerlessness and empowerment outlined in the psychotherapeutic literature. The apparent empowerment of clients during self-disclosure casts doubt on Foucault's perspective. However, on further reflection and through a review of the research method, it became apparent that the lack of support for Foucault's perspective was a consequence of the particular research method used rather than an indication of the non-existence of constraint. Ricoeur's hermeneutic phenomenology was used to develop the above methodological critique. Using this alternative approach the researcher critically evaluated the findings of the phenomenological study. This facilitated a reinterpretation of the clinical material. It emerged that the experience of empowerment represents a particular form of selfunderstanding, and it was shown, in relation to the clinical material, how this can indeed as Foucault suggests (because of its very specificity) constrain the client from understanding him/herself in alternative ways. It was revealed that the experience of empowerment is a necessary but limited component of successful client disclosure. This does not, however, go far enough. It was suggested that ideally, critical reflection on the constraints of self-understanding, rather than self-disclosure per se, should be regarded as the destination of the urge to self-disclosure.
- Full Text:
- Date Issued: 1994
The phenomenology of the events of client inhibition and self-disclosure in the therapeutic dialogue
- Authors: Lockhart, Ian
- Date: 1994
- Subjects: Self-disclosure , Client-centered psychotherapy , Inhibition
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3009 , http://hdl.handle.net/10962/d1002518 , Self-disclosure , Client-centered psychotherapy , Inhibition
- Description: The aim of this study was to provide an account of the power relations that are implicit in the experience of clients who initially withhold but eventually disclose a sensitive issue in the psychotherapeutic dialogue. Mainstream psychotherapeutic literature has maintained that clients who withhold sensitive material implicitly express a psychological powerlessness. The literature review also turned attention to an alternative view, not arising from within the psychotherapeutic literature. Specific reference was made to the work of Foucault who suggests that although clients may appear to be empowered through self-disclosure, they are in fact constrained, since disclosing themselves constitutes. an appropriation of selfunderstanding which forecloses openness to other forms of self-understanding. The tension between these conflicting accounts about the relation of self-disclosure to empowerment was discussed as an issue requiring further exploration through clinical research. A phenomenologically orientated research method was used to describe the experiences of five clients who withheld and subsequently disclosed sensitive issues in psychotherapy. These descriptions yielded a thematically differentiated process of psychological change. The structure of client inhibition and self-disclosure was seen to correspond to the concepts of powerlessness and empowerment outlined in the psychotherapeutic literature. The apparent empowerment of clients during self-disclosure casts doubt on Foucault's perspective. However, on further reflection and through a review of the research method, it became apparent that the lack of support for Foucault's perspective was a consequence of the particular research method used rather than an indication of the non-existence of constraint. Ricoeur's hermeneutic phenomenology was used to develop the above methodological critique. Using this alternative approach the researcher critically evaluated the findings of the phenomenological study. This facilitated a reinterpretation of the clinical material. It emerged that the experience of empowerment represents a particular form of selfunderstanding, and it was shown, in relation to the clinical material, how this can indeed as Foucault suggests (because of its very specificity) constrain the client from understanding him/herself in alternative ways. It was revealed that the experience of empowerment is a necessary but limited component of successful client disclosure. This does not, however, go far enough. It was suggested that ideally, critical reflection on the constraints of self-understanding, rather than self-disclosure per se, should be regarded as the destination of the urge to self-disclosure.
- Full Text:
- Date Issued: 1994
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