Massed prolonged exposure therapy for PTSD and alcohol use: a single case experimental study of a university student
- Authors: Abrahams, Sherwin Owen
- Date: 2025-04-25
- Subjects: Prolonged exposure therapy , Post-traumatic stress disorder , Alcoholism , Flooding , College students Alcohol use South Africa , College students Psychology
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478284 , vital:78173
- Description: Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are common among university students in South Africa. Bantjies et al. (2023) found a PTSD prevalence of 21.0% (n=28,268), and McGowan and Kagee (2013) reported that 90% (n=1337) had experienced at least one traumatic event. There is a high comorbidity between PTSD and AUD, especially in hazardous drinkers (Peltzer & Pengpid, 2015). Despite the prevalence, research on effective trauma-focused therapies (TFTs) in low-resource settings is limited (Booysen & Kagee, 2021). This study evaluates the effectiveness of massed-prolonged exposure (MPE) therapy for comorbid PTSD and AUD among South African university students, using a Single-Case Experimental Design (SCED). The participant (n=1) underwent comprehensive assessments using CAPS-5, AUDIT, PDS-5, and PCL-5, confirming PTSD and AUD diagnoses. Regular PCL-5 assessments during the intervention showed significant symptom improvement, and post-intervention assessments indicated the participant no longer met PTSD criteria. AUDIT scores also improved from 11 (harmful/hazardous drinking) to 6. The participant found MPE therapy to be feasible, acceptable, and appropriate. This study supports the effectiveness, feasibility and acceptability of MPE therapy and highlights the importance of evidence-based interventions to improve PTSD outcomes within university settings and in low-to-middle-income countries. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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The feasibility and acceptability of Prolonged Exposure Therapy for PTSD at a community trauma centre in Cape Town: a qualitative analysis
- Authors: Markham, Kate Emily
- Date: 2025-04-25
- Subjects: Prolonged exposure therapy , Post-traumatic stress disorder , Psychic trauma Treatment , Community-based corrections South Africa Cape Town , Social workers South Africa Cape Town
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478339 , vital:78178
- Description: South Africa deals with pervasive trauma stemming from its history of political violence, high crime rates, and social challenges, ultimately contributing to a significant burden of trauma exposure and post-traumatic stress disorder (PTSD) among its population. Despite the prevalence of PTSD, evidence-based psychological treatments (EBTs) such as Prolonged Exposure Therapy (PE) remain underutilised, particularly in low-resourced areas. This study aimed to assess the feasibility and acceptability of PE among social workers at The Trauma Centre for Survivors of Violence and Torture in Cape Town. This study used a qualitative research design, with special emphasis on Implementation Science. The study used the concepts of feasibility and acceptability to guide the research. The results revealed several key themes. Social workers’ pre-implementation themes included the perceptions around PE and implementation in South Africa, with three subthemes emerging. First, the impact of South African socioeconomic and political factors on The Trauma Centre. Second, perceptions surrounding the implementation of PE. And finally, the improvements and feasibility of PE; the social worker’s post-intervention findings focused on the feasibility and improvement of PE, post-treatment views, and the hurdles and limitations to implementation. The client's post-intervention findings explored refugee struggles, associated psychological distress, with two sub-themes of self-worth and suicidal ideation, and second, a lack of support and helplessness, loneliness, and isolation. The final theme looked at the experiences of PE, more specifically the positive client experiences with PE, and the challenges of PE. The implementation of PE at The Trauma Centre revealed both successes and challenges. Findings from this study suggest that PE can be effectively administered through task-shifting in low-resource settings. However, this study also highlighted significant challenges in the feasibility of implementing PE long-term in this context. Clients revealed ambivalent feelings regarding PE. Those who experienced positive outcomes demonstrated the potential for PE to be utilised in resource-limited settings. Those who did not find PE beneficial, highlight the need for future research to adapt PE to be culturally specific and feasible for a resource-constrained setting. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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Post migration factors associated with elevated symptoms of posttraumatic stress disorder, depression, and anxiety, among refugees in Cape Town
- Authors: Mujuru, Agnes
- Date: 2024-10-11
- Subjects: Post-traumatic stress disorder , Refugees South Africa Cape Town , Social work with refugees , Anxiety , Depression, Mental , Refugees Counseling of
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/465810 , vital:76655
- Description: There has been a heavy influx of refugees in South Africa due to wars, conflicts, political persecution, and economic recessions around the world. As a result, South Africa hosts the highest number of African refugees, who are susceptible to mental health problems because of their exposure to war, violence, and post migration stressors. The current study assessed post migration predictors of post-traumatic stress disorder (PTSD), depression and anxiety symptoms among refugees in Cape Town South Africa. A cross-sectional survey of refugees from war- and conflict-torn countries settled in Cape Town was conducted between February and May 2023. Study participants (N = 147) were selected using respondent driven sampling technique. Data were collected using a questionnaire made up of the Post-traumatic Stress Disorder Checklist (PCL-5), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), and the Post- Migration Difficulties Checklist (PMLDs), to assess PTSD, depression, anxiety and PMLDs, respectively. Descriptive and inferential statistics were used to analyse the questionnaire data. The prevalence of PTSD, anxiety and depression symptoms was 26.5%, 33.3% and 33.3%, respectively. Regression analyses identified discrimination, poor access to health services, and poor access to food as the major predictors of common mental disorders among refugees. The document-seeking process, unemployment stress, language difficulties, not getting help with welfare, fears of being sent home and isolation, were also associated with symptoms of mental health conditions. These results suggest that psychological distress symptoms are highly elevated among refugees and are associated with post-migration stressors. Mental health interventions for refugees should not only address psychological difficulties but also consider the socio-economic needs of refugees. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
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The acceptability of Prolonged Exposure Therapy for Primary Care (PE-PC) for the treatment of PTSD in a low resourced community in the Eastern Cape
- Authors: Leboho, Lerato
- Date: 2024-10-11
- Subjects: Post-traumatic stress disorder , Prolonged exposure therapy , Primary care (Medicine) South Africa Eastern Cape , Trauma therapy , Poor Medical care South Africa Eastern Cape
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/466191 , vital:76706
- Description: Post-traumatic stress disorder (PTSD) is a global mental health concern, especially in low- resourced communities that are characterised by limited access to health professionals, limited healthcare infrastructure, and limited access to evidence-based mental healthcare at primary care level. Over the last decade, several psychological trauma-focused therapies (TFTs), such as prolonged exposure therapy (PE) have been developed to treat PTSD. In the context of the existing literature, studies done in HICs have explored the implementation and acceptability of prolonged exposure therapy at primary care level (PE-PC) as a first-line treatment for PTSD. Contrary to this, there is little to no implementation studies done to date that have examined the acceptability of empirically supported treatments (ESTs), such as PE in low-resourced countries, such as South Africa. Using the Implementation Science framework, ten participants were recruited to be interviewed, using semi-structured interviews, about their experiences and perceptions of PE-PC as a treatment for PTSD, and to also share their experiences of living with PTSD. The interview data was analysed using the reflexive thematic analysis (RTA) method to determine whether PE-PC is an acceptable treatment for PTSD that can be administered at community level and highlights the importance of integrating mental health within primary healthcare practice. Based on the analysis four superordinate themes were identified, namely, lack and absence of social support; factors preventing trauma survivors from accessing EBTs; lack of knowledge regarding mental health literacy, and adaptation of a brief trauma-focused therapy in a low-resource community. The evidence this study shows that some of the factors that hinder the acceptability of trauma-focused therapies (TFTs) at community level, include stigma and discrimination, the absence of social support, limited resources, and inadequate knowledge on mental health and illness. Therefore, it makes sense of the urgency to implement evidence-based treatments (EBTs) in LMICs. Findings of this thesis suggest that (a) PE-PC should be adopted at community level, and that (b) PE-PC is an acceptable treatment for PTSD in low-resourced communities. , Thesis (MSocSci) -- Faculty of Humanities, Psychology, 2024
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The feasibility of task-shifting prolonged exposure for Primary Care (PE-PC) for PTSD within a low resource community in the Eastern Cape
- Authors: Shabangu, Princess Noxolo Nonhlanhla
- Date: 2024-04-04
- Subjects: Task shifting , Prolonged exposure therapy , Post-traumatic stress disorder , Primary health care , Community psychiatry South Africa Eastern Cape
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/435479 , vital:73161
- Description: Although high levels of trauma exposure potentiate an alarming prevalence of PTSD, increasing the need for trauma-focused treatment, the South African health system is unable to care for the population. The South African healthcare system contains a range of systemic and structural inefficiencies, including suboptimal care and shortages of healthcare professionals. PE-PC offers a resource-constrained mental healthcare system solution by integrating an evidence-based intervention (EBI) in primary care settings. Likewise, the present study acknowledges the ratio of mental healthcare professionals to patients in low- and middle-income countries (LMIC). It explores task shifting to expand mental healthcare to primary care settings. The study follows qualitative healthcare design research to explore the experiences and perceptions of the two cohorts of trauma support workers (TSW) from Rhode University and the Joza community in Makhanda. The feasibility of the PE-PC intervention in Makhanda was illustrated through the data obtained from the TSWs' experiences and perceptions of the intervention's utility. The present study presents an essential contribution to the sparse research conducted on treating PTSD in LMIC with shortages in healthcare professionals. The thematic findings look at the trauma support workers (TSWs) role, including some of its challenges, to explore the feasibility of interventions. Some of the themes highlighted unpack the perceived utility of task-shifting in low-resource contexts, the limitations thereof and considerations for future research. Notwithstanding the challenges, the data from the present study indicates that PE-PC can be feasibly task-shifted in low-resource contexts such as Makhanda. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
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The effectiveness and feasibility of online prolonged exposure therapy for post-traumatic stress among university students
- Authors: Slabbert, Maryna
- Date: 2023-03-30
- Subjects: Exposure therapy , Post-traumatic stress disorder , College students South Africa , Prolonged exposure therapy , Online therapy
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/408885 , vital:70534
- Description: Research has found that 70.6% of university students reported exposure to several traumatic events (Hoffman, 2002). Considering the high prevalence of trauma exposure among South African university students, many are at risk of developing post-traumatic stress disorder (PTSD) (Iribarren, Prolo, Naegos & Chiappelli, 2005). Prolonged Exposure Therapy (PE) is regarded as a first-line trauma therapy for PTSD (Foa, Hembree, Rothbaum, & Rauch, 2019). During the Covid-19 pandemic, public health guidelines for physical distancing reduced access to face-to-face mental health care. In response to this, many health care providers adapted to pandemic constraints by meeting their clients online, through Zoom, for example (Wells et al., 2020). Considering the prevalence of trauma exposure among university students, as well as the increased necessity of teletherapy, the study aimed to investigate the effectiveness and feasibility of online PE for PTSD among university students in a South African setting. The study employed Single-Case Experimental Design (SCED) as basis for its research design. Participants included a sample of Rhodes University students (n = 3) who were recruited through purposive sampling. Prior to the intervention, all three participants met the criteria for PTSD, and comorbid depression. Based on the measures used, two of the three participants did not meet the criteria for PTSD post-intervention. In terms of depression symptoms, one participant did not meet the criteria for depression post-intervention, and another participant showed a decrease in depression symptoms. Regarding the feasibility of online PE, all three participants reported the intervention to be feasible, acceptable, and appropriate. Overall, the study provides preliminary results to support the effectiveness and feasibility of online PE. It also gives insight into the value of intervention research and how it can ameliorate PTSD in a South African setting, as well as other low- and middle-income countries (LMICs). , Thesis (MA) -- Faculty of Humanities, Psychology, 2023
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Compensating employees who suffer work-related psychiatric harm in the course and scope of their employment
- Authors: Du Plessis, Meryl Candice
- Date: 2008
- Subjects: Workers' compensation -- Law and legislation , Liability for emotional distress , Post-traumatic stress disorder , Occupational diseases
- Language: English
- Type: Thesis , Masters , LLM
- Identifier: vital:3671 , http://hdl.handle.net/10962/d1003186 , Workers' compensation -- Law and legislation , Liability for emotional distress , Post-traumatic stress disorder , Occupational diseases
- Description: This study aims to ascertain the legal redress available to employees who suffer psychological harm as a result of workplace stress. On a general level, it identifies and assesses some of the available policy options, particularly as they relate to the interaction of statutory workers’ compensation schemes and the common law. On a more specific level, it examines and analyses various issues: the nature and extent of compensable psychiatric harm; the legal duty on employers to protect employees’ health and well being; the role of negligence; requirements specific to the Compensation for Occupational Injuries and Diseases Act 130 of 1993 (COIDA); and the causal nexus necessary to sustain a claim. The conclusion is reached that employees should utilise the workers’ compensation system as the primary vehicle to obtain redress if they suffer from occupational psychiatric harm. However, due to the law’s generally conservative approach to psychiatric harm and intimations that the Department of Labour intends setting strict requirements for claims for psychiatric harm in terms of COIDA, the common law of delict might continue to play an important role in claims for occupational psychiatric harm. The writer recommends that a hybrid system for compensation for stress-related psychiatric harm suffered in the course and scope of employment be adopted, with the statutory compensation scheme providing relatively limited benefits and the common law providing general damages if the claimant can prove negligence on the part of the employer; that the requirement of a recognised psychiatric illness be maintained for both statutory compensation and compensation in terms of the common law; that all parties’ interests are carefully balanced in delineating the employer’s legal duty to employers and that undue weight not be accorded to the terms of the contract of employment; that more attention be paid to factual causation and the development of lternatives/complements to the traditional conditio sine qua non test; that the validity of the circular instruction on post-traumatic stress disorder (PTSD) be tested on administrative-law grounds; and that the stringent prescription requirements set by the circular instruction on PTSD be reviewed.
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The psychological sequelae of involvement in combat: a preliminary investigation
- Authors: Hodgson, Shane Ralph Colin
- Date: 1992
- Subjects: War -- Psychological aspects , War victims -- Mental health , Post-traumatic stress disorder
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:2993 , http://hdl.handle.net/10962/d1002502 , War -- Psychological aspects , War victims -- Mental health , Post-traumatic stress disorder
- Description: The psychological sequelae of being involved in combat are only recently coming to be understood. Most of the available data are from research conducted on help-seeking Vietnam veterans in the United States, and very little work has been done in South Africa. There does not as yet appear to be any instrument designed specifically to detect combat-related psychopathologies amongst soldiers who are still in active service, either in the USA or in South Africa. Combat involvement has been shown to lead to a high incidence of combat stress reaction. This in turn has shown that it can predispose sufferers to the development of a Post-traumatic Stress Disorder. It is thus expected that there would be significantly higher incidences of reported symptoms of stress disorders amongst soldiers exposed to high levels of combat as compared with a similar group of soldiers who had no combat involvement. This study used a self-reporting questionnaire, developed in the USA but adapted for use in South Africa, to allow the soldiers in the study to rate the severity of various symptoms derived from the DSM-III criteria for Post-traumatic Stress Disorder. A Beck Depression Inventory was also administered to eliminate any persons who nay have been exhibiting symptoms of depression, as this would have confounded the results. Both questionnaires were administered to serving members of the Permanent Force of the South African Defence Force, with one group being members of various high-combat units based in what was then South West Africa, and the other group being non-combat or Headquarters elements. As a precondition of the study, absolute confidentiality of the respondents and their units was maintained. The study found the expected higher scores in the high-combat group, and also showed that the Keane questionnaire has a good coefficient alpha in South Africa. The study closes with several recommendations for further research, especially in the light of the new PTSD criteria in the DSM-IIIR.
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Towards an essential description of the experience of psychotherapy
- Authors: Letlaka, Kedibone Tembisa
- Date: 1988
- Subjects: Psychotherapy , Post-traumatic stress disorder , Prison psychology , Stress (Psychology)
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10962/193183 , vital:45307
- Description: The aim of this thesis is to explore and clarify what the experience of psychotherapy with ex-detainees entails. This investigation and analysis is conducted within the framework of a phenomenological method. The researcher elicits both the ex-detainees' and the therapist's experiences of psychotherapy. Initially the problematic nature of research in psychotherapy is layed out. This is followed by an overview of literature and theory on trauma and its conceptualizations from various psychotherapeutic perspectives. The treatment implications in each case are mentioned. Trauma occurs in the detention experience so detention is then briefly looked at in terms of torture basically and the detention syndrome, post traumatic stress disorder. Core personality processes in relation to this diagnosis are given and the stress recovery process is summarized. , Thesis (MA) -- Faculty of Humanities, Psychology, 1988
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