The double burden of treating traumatic stress in low-resource communities: experiences and perspectives of non-specialist health workers in South Africa
- Booysen, Duane D, Kagee, Ashraf
- Authors: Booysen, Duane D , Kagee, Ashraf
- Date: 2022
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/454132 , vital:75312 , xlink:href="https://doi.org/10.1177/0081246320984051 "
- Description: Considering the global trend towards the dissemination and implementation of trauma-focused treatments in the majority of the world, it is imperative to ascertain the contextual factors which affect the treatment of traumatic stress, especially in low- and middle-income countries characterised by ongoing adversity such as poverty and increased levels of trauma exposure. We explored the experiences of non-specialist health workers whose work involved providing trauma-focused services in low-resource communities in South Africa. Participants (n = 18) worked at four non-governmental organisations in the Eastern Cape and Western Cape of South Africa. Semi-structured individual interviews were conducted and analysed using a phenomenologically informed thematic analysis. Two superordinate themes were identified, namely, adjusting to trauma-focused work and trauma in the social context. Five themes that made up the superordinate themes were Encountering Trauma Narratives, Support and Resilience, Going the Extra Mile, Helplessness, and Social Factors. The findings are not only in keeping with the psychological risks of trauma-focused work (e.g., vicarious traumatisation) but also highlighting the impact of the social context on the provision of trauma-focused work. Participants reported experiencing an added burden of helplessness due to social factors, such as poverty and high levels of trauma exposure, which affect the process of treating traumatic stress in low-resource settings. We discuss how these findings can contribute to efforts to implement trauma-focused services in low- and middle-income countries.
- Full Text:
- Date Issued: 2022
- Authors: Booysen, Duane D , Kagee, Ashraf
- Date: 2022
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/454132 , vital:75312 , xlink:href="https://doi.org/10.1177/0081246320984051 "
- Description: Considering the global trend towards the dissemination and implementation of trauma-focused treatments in the majority of the world, it is imperative to ascertain the contextual factors which affect the treatment of traumatic stress, especially in low- and middle-income countries characterised by ongoing adversity such as poverty and increased levels of trauma exposure. We explored the experiences of non-specialist health workers whose work involved providing trauma-focused services in low-resource communities in South Africa. Participants (n = 18) worked at four non-governmental organisations in the Eastern Cape and Western Cape of South Africa. Semi-structured individual interviews were conducted and analysed using a phenomenologically informed thematic analysis. Two superordinate themes were identified, namely, adjusting to trauma-focused work and trauma in the social context. Five themes that made up the superordinate themes were Encountering Trauma Narratives, Support and Resilience, Going the Extra Mile, Helplessness, and Social Factors. The findings are not only in keeping with the psychological risks of trauma-focused work (e.g., vicarious traumatisation) but also highlighting the impact of the social context on the provision of trauma-focused work. Participants reported experiencing an added burden of helplessness due to social factors, such as poverty and high levels of trauma exposure, which affect the process of treating traumatic stress in low-resource settings. We discuss how these findings can contribute to efforts to implement trauma-focused services in low- and middle-income countries.
- Full Text:
- Date Issued: 2022
Preliminary effectiveness of brief prolonged exposure therapy for ptsd: expanding access to effective therapies
- Booysen, Duane D, Kagee, Ashraf
- Authors: Booysen, Duane D , Kagee, Ashraf
- Date: 2021
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/454121 , vital:75311 , xlink:href="https://doi.org/10.1177/15346501211017989"
- Description: Over the last three decades, several empirically supported trauma therapies have been developed to treat post-traumatic stress disorder (PTSD). Yet issues such as access to treatments and dropout are ongoing barriers to adequate dissemination and implementation, especially in low resource settings. To this end, we present results on the preliminary effectiveness of a brief prolonged exposure therapy (PE) for PTSD in South Africa, a low resource setting. Based on a case-series design, seven participants (n = 7) from diverse socio-cultural backgrounds were recruited and started a six-session brief PE for PTSD and co-morbid depression and anxiety. To examine the treatment outcomes, participants were assessed at baseline, during treatment, post-intervention, and at 3-month follow-up. Overall, brief PE reduced symptoms of PTSD, depression, and anxiety from baseline to post-intervention, and at 3-month follow-up. A downward trend in symptoms was evident during treatment, with slight symptom variations during exposure sessions. In conclusion, a six-session brief PE intervention produced positive outcomes for PTSD, depression, and anxiety at two community counseling centers in South Africa. We reflect on the implementation of brief PE in a South African context.
- Full Text:
- Date Issued: 2021
- Authors: Booysen, Duane D , Kagee, Ashraf
- Date: 2021
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/454121 , vital:75311 , xlink:href="https://doi.org/10.1177/15346501211017989"
- Description: Over the last three decades, several empirically supported trauma therapies have been developed to treat post-traumatic stress disorder (PTSD). Yet issues such as access to treatments and dropout are ongoing barriers to adequate dissemination and implementation, especially in low resource settings. To this end, we present results on the preliminary effectiveness of a brief prolonged exposure therapy (PE) for PTSD in South Africa, a low resource setting. Based on a case-series design, seven participants (n = 7) from diverse socio-cultural backgrounds were recruited and started a six-session brief PE for PTSD and co-morbid depression and anxiety. To examine the treatment outcomes, participants were assessed at baseline, during treatment, post-intervention, and at 3-month follow-up. Overall, brief PE reduced symptoms of PTSD, depression, and anxiety from baseline to post-intervention, and at 3-month follow-up. A downward trend in symptoms was evident during treatment, with slight symptom variations during exposure sessions. In conclusion, a six-session brief PE intervention produced positive outcomes for PTSD, depression, and anxiety at two community counseling centers in South Africa. We reflect on the implementation of brief PE in a South African context.
- Full Text:
- Date Issued: 2021
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