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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- Date Issued: 2023-03-30
The effectiveness of prolonged exposure therapy for the treatment of PTSD and suicide ideation: a case study
- Authors: Mhlane, Zuziwe Gloria
- Date: 2023-10-13
- Subjects: Post-traumatic stress disorder South Africa , Suicidal ideation , Prolonged exposure therapy , Post-traumatic stress disorder in adolescence South Africa , Emotional process , Beck Scale for Suicide Ideation , Beck Depression Inventory , Beck Anxiety Inventory , CORE-OM
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/424997 , vital:72200
- Description: Post-Traumatic Stress Disorder (PTSD) is regarded as a public health burden in South Africa (SA) (Atwoli et al., 2013; Kagee, Bantjies & Saal 2017; Koenen et al.; 2017; Williams et al., 2007). According to McGowan & Kagee (2013), young adults in SA are a high-risk group of trauma. Exposure to trauma is also associated to comorbid conditions such as depression, anxiety suicidal ideation (SI) experienced by a large population (Bantjes, McGowan, Kagee & Steel, 2016). Prolonged Exposure (PE) is empirically supported and evaluated trauma therapy for PTSD (Foa, Hembree, & Rothbaum, 2007). However, there has been limited to no studies conducted to evaluate the effectiveness of PE in SA. Therefore, this study investigated whether PE is effective treatment for PTSD symptom reduction and suicide ideation in South Africa. Three participants were recruited from Focus on the Family SA (FOTF SA SA) through purposive sampling, and single-case experimental design (SCED) was utilised. PE was implemented online through zoom for 6 sessions on each client. At baseline, all the participants met the criteria for PTSD as per the Post-traumatic stress disorder symptom scale interview for DSM-5 (PSSI-5): Participant 1 (PSSI-5 - 63), Participant 2 (PSSI-5 - 53), Participant 3 (PSSI-5 - 63) and the clinical cut off score is 23. Furthermore, all participants were screened for suicide ideation (SI) using the Beck Suicide Inventory (BSI). All participants’ BSI score ranges were mild to moderate. Participants were also screened for depression using the Beck Depression Inventory second edition (BDI-II) and anxiety using the Beck Anxiety Inventory (BAI). The score ranges for both BDI-II and BAI were moderate to severe. The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) was also used to assess general psychological distress. The CORE-OM scores for all the participants for trauma, depression and anxiety were severe. However, the risk to self/SI for all the participants was minimal. During the intervention phase, all the participants scores showed a downtrend of PTSD symptomology, as per the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5). The PCL-5 scores went down from PCL-5 score of 58 to final session PCL-5 score of 3. The clinical cut off score is 31-33. They were also screened using the BSI, BDI and BAI and the score ranges were mild. The CORE-OM scores for trauma, anxiety, depression, and risk to self/SI were also minimal. Overall, the preliminary result of this study supports the notion that adults with symptoms of PTSD and SI had improved at the end of a brief 6-session PE intervention. The comorbid depression also showed a downtrend. , Thesis (MA) -- Faculty of Humanities, Psychology, 2023
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- Date Issued: 2023-10-13
The professional experiences of early career counselling psychologists in South Africa: a mixed method study
- Authors: Haine, Phillipa Claire
- Date: 2023-10-13
- Subjects: Counseling psychology South Africa , Career development , Counseling psychologists Training of South Africa , Mixed methods research , Interpretative phenomenological analysis
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/432321 , vital:72861 , DOI 10.21504/10962/432322
- Description: Counselling psychologists represent a considerable proportion of psychologists in South Africa (SA), yet knowledge on the discipline’s workforce is limited. In addition, professional lifespan issues have received inadequate attention, inclusive of the early career stage, identified as an exceptionally vulnerable segment of the professional lifespan. Undergirded by an interpretative phenomenology research paradigm, this mixed method sequential explanatory study, consisting of two distinct phases, aimed to explore the professional experiences of early career counselling psychologists (counselling ECPs) in SA, inclusive of employment trends, challenges and support needs. The quantitative phase (‘First Phase’) comprised of an online survey questionnaire (n = 512) to investigate the employment trends of counselling ECPs in SA. A qualitative phase (‘Second Phase’) followed, comprising of online semi-structured interviews with ten counselling ECPs. The rationale for this was that the preliminary quantitative data provided a broad understanding of the research problem, whereas the qualitative data sought to expand on the quantitative data by exploring the participants’ experiences in depth. Moreover, the collection of quantitative data provided a strong justification and phenomenological orientation for the second, qualitative, phase. The data from the two research phases were combined within a joint discussion to ensure a level of methodological complementarity and a more holistic understanding of the data captured. Trends from the first, quantitative, phase demonstrated that counselling ECPs differed across various domains from more senior generations. In the second, qualitative, phase, Interpretative Phenomenological Analysis of the data revealed three Group Experiential Themes: i) Complexity of finding and securing work, ii) Navigating an array of personal, professional and systemic challenges, and iii) Support as self-acquired. Overall, the findings suggest that counselling ECPs in SA face a variety of challenges upon entering the workforce, enhanced support is thus needed for this new, more diverse cohort of practitioners. Actionable recommendations are offered at various levels. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2023
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- Date Issued: 2023-10-13
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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- Date Issued: 2024-04-04
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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- Date Issued: 2024-10-11
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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- Date Issued: 2024-10-11
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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- Date Issued: 2025-04-25
Mental healthcare users’ perceptions of mental health services at a primary healthcare level
- Authors: Zwane, Siphelele
- Date: 2025-04-25
- Subjects: Mental health services South Africa Makhanda , Primary care (Medicine) , Mental health consumer , Mental health education South Africa , Help-seeking
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478372 , vital:78181
- Description: This study interrogates the complexities of mental healthcare in primary healthcare settings, focusing on the experiences and perceptions of participants within the Makana municipality in the Eastern Cape Province, which is characterised by a low socio-economic status. The matter of mental healthcare is of great significance within the context of South Africa, a country grappling with multifaceted challenges. Over the years, mental health has progressed from being marginalised to being more widely acknowledged. While the integration into tertiary and urban healthcare settings has become smoother, primary healthcare has encountered numerous obstacles. This presents a concern, due to the socioeconomic difficulties faced by individuals accessing primary care, which predispose them to mental health issues. Consequently, it is imperative to conduct research focusing on the experiences and perspectives of mental healthcare users within primary healthcare, a relatively underexplored area. The primary objective of the current research study was to contribute to the existing knowledge base, providing valuable insights for relevant stakeholders and policymakers, such as the National Mental Health Policy Framework 2023-2030, to reference when formulating strategies to enhance the integration of mental healthcare into primary healthcare. The study used purposive sampling to interview mental healthcare users within the Makana municipality. Employing a qualitative design facilitated in-depth dialogue between the participants and the researcher, generating valuable data. Thematic Analysis was employed to analyse and present meaningful data, providing an overview of the participants' shared experiences. The study identified four significant themes: the utility of primary health clinic; the urgent need for mental health education; socioeconomics, and mental health, and the complex dynamics of help-seeking behaviours. The findings underscore the pressing need to integrate quality mental health into PHC, emphasising the importance of mental health education, increased resources, task-sharing, and the prioritisation of both physical and mental illnesses. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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- Date Issued: 2025-04-25
Perceptions and reflections of primary healthcare professionals on mental health services in Makhanda
- Authors: Piliso, Zandisiwe
- Date: 2025-04-25
- Subjects: Primary care (Medicine) , Mental health services South Africa Makhanda , Medical personnel , Ecological Systems Theory , Mental health personnel South Africa Makhanda
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478344 , vital:78179
- Description: Primary mental healthcare in South Africa is still in its early stages, despite policies that have been developed, such as the National Mental Health Framework Policy. Provinces such as the Eastern Cape are far behind development, which can be attributed to limited resources. The scarcity has been noted in the literature, but not extensively. Literature concentrated on healthcare professionals’ perspectives towards primary health greatly narrow, particularly in the Makhanda area. With the integration of primary mental health services, healthcare workers’ viewpoints have impacted on service delivery. This study aims to add knowledge and explore the perspectives of healthcare professionals on primary mental healthcare in Makhanda. The ecological systems theory was used as a theoretical framework for the study. Thematic analysis was used to examine the healthcare professionals’ insights and to extract meaning for the participants involved in the study. Thirteen participants were used, using purposive sampling in four primary healthcare settings. Data were collected using semi-structured and one-on-one interviews. The study revealed three themes including, (i) Scarcity of Mental Health Services, (ii) Mental Health Literacy, (iii) Barriers to the Provision and Use of Physical and Mental Health Services. The findings suggest that there are limited mental health care services in primary care and that there is a gap between service provision and physical and mental healthcare. The data also revealed that mental health literacy is limited, which links to the stigma around mental illness. Furthermore, evidence points out that more mental health education, human resources and training of healthcare professionals would further improve the mental health services in the Makhanda area. In addition, there are barriers to the provision of not only primary mental health care but healthcare, as well as a lack of medical equipment, human resources, and structural space that make it difficult for healthcare professionals to perform their jobs and affect clinic functioning, at times. Another barrier is that the perception of mental health service provision is simultaneously viewed in a positive and negative light and mainly received negatively by service users. In conclusion, healthcare professionals experience a deficiency of resources and a limited provision of mental healthcare, which highlights the lack of implementation of policies that have developed nationally and globally. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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- Date Issued: 2025-04-25
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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- Date Issued: 2025-04-25