Clinical Psychology

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The adjustment experiences of the aged when entering a retirement home in South Africa.
(2021) Bussy, Danielle Vivian.; Cartwright, Duncan James.
In our modern society, many elderly people inevitably reach a stage where they have to make the decision to move into a retirement home; which can be a majorly stressful event. Although several overseas studies have explored the adjustment process of the elderly from their previous living situations (either independent or inter-generational living) to a retirement home, literature related to this process for the elderly in South Africa is limited. Therefore, the present study aimed to explore the adjustment experiences of the elderly (persons aged 65 and above) into a retirement home in South Africa. The study adopted a qualitative descriptive approach; with a group of ten elderly people (four men and six women) participating in an hour long, semi-structured interview with the researcher at BBGE (name protected for confidentiality) retirement home, Durban, South Africa, to make sense of their adjustment experiences. Research questions aimed to understand; how the elderly made sense of their experiences moving into the home, how they described challenges faced in the process, as well as how the adjustment experience impacted their sense of self-definition and interpersonal relatedness. Interpretative Phenomenological Analysis (IPA) was used to analyse the data gathered in interviews. The findings were filtered into eight super-ordinate themes namely; moving into the home, dealing with different types of loss, dealing with traumatic ruptures in attachment, changes in understandings of self-identity, relationships within the home, institutional living, mindsets and adjustments, and the South African context. It was found that the adjustment process did not necessarily have a significant impact on the elderly’s self-definition or relatedness from a personality perspective, however, lifelong developments of the elderly’s personality styles had an effect on the adjustment process; by either enabling them to adjust with relative ease, or causing distress and ultimately a failure to adjust into the home adequately.
The application of African psychology to the South African clinical context: a scoping review.
(2021) Kayat, Brandon George.; Cartwright, Duncan James.
This scoping review identifies research on the existing applications of African Psychology to the clinical context in South Africa. This scoping review endorsed the methodology of Arksey and O’Malley (2005) in terms of their six stages of conducting a scoping review. These were identified as the identification of the research question, the identification of literature relevant to this question, the selection of studies through a thorough inclusion and exclusion of sources, the charting of the data, the collection, summarising and reporting of the data and the conducting of a consultation exercise; these were applied accordingly, resulting in 76 sources that were analysed to identify the existing applications, relevant concepts and significant challenges facing African Psychology. Pre-existing applications were observed to include implicit or explicit applications or extensions from African Psychology, adaptations to mainstream models, and the development of unique models endorsing concepts specific to African Psychology (such as uBuntu therapy and Swa Moya), and the collaboration of psychologists with traditional healers, participatory action research, community psychology as well as initiatives in the training of psychologists were also evident. Concepts such as uBuntu, Badimo, uMvelinqanqi, traditional healers and rituals had the highest prevalence in sources embracing African Psychology. In terms of the challenges, multiple definitions and conceptualisations of African Psychology present problems for the standardisation of any particular African Psychology model or framework. Secondly, there exists several epistemological and ontological differences between African and mainstream psychology. This creates a concern for the empirical testing of proposed African Psychology applications in terms of their effectiveness as well as their standardisation. The study found that there remain large gaps in the application of African Psychology to the clinical context, despite the growing interest in African Psychology in South Africa.
The experience of burnout among psychologists in South Africa.
(2019) Anderson, Kerry-Leigh Tara.; Cartwright, Duncan James.
Psychologists are at risk for burnout due to the emotional challenges and structural difficulties encountered in their daily work. Given the high prevalence of burnout amongst psychologists, a considerable amount of research has been conducted on the effects, risks and management of burnout. However, despite the proliferation of burnout literature, the majority of research has been restricted to quantitative analysis, with a paucity of studies exploring the phenomenon from a qualitative standpoint. More so, even fewer studies have explored the lived experience of burnout amongst psychologists. Thus, this study explored the experience of burnout among psychologists using interpretative phenomenological analysis. Six psychologists working in South Africa were purposively sampled and interviewed in order to collect rich, detailed accounts of their experience and perceptions of burnout. Five super-ordinate themes emerged from the data: (1) description of burnout reflects inner experience; (2) idealised expectations of self; (3) effects are multi-faceted; (4) risky business (5) the self-protection: a lofty goal. Findings from the study highlighted the uniqueness of individual experience even within commonalities. Findings demonstrated that the impact of burnout is far reaching and affects the psychologist in multiple areas of functioning. Findings also suggested that burnout can be self-sustaining and various processes such as self-stigma and stigma from colleagues intersect to create barriers to protection and effective resolution of burnout. Most notably, research findings suggested that psychologists’ self-concept may be impacted negatively by burnout which, in turn, may cause psychologists to work harder and invest more emotionally, possibly giving rise to a self-perpetuating cycle of burnout. These findings have implications for the training, supervision and support of psychologists in practice in addition to the prevention and management of burnout.
An exploration of the psychosocial risk factors that lead to antisocial behaviour and delinquent group (gang) membership amongst a cohort of youth living in Wentworth, Durban, South Africa.
(2019) Clayton, Neil Warren.; Cartwright, Duncan James.
Researchers have identified a number of risk factors that increase vulnerability amongst young people, and coerce them towards engaging in antisocial behaviour, substance use, and gang membership. Drawing from an Ecological Systems Model, these risk factors are considered across five influential domains, including (1) the individual’s personal characteristics, (2) the family, (3) the peer group, (4) the school, and (5) the community. Inherent risks within these domains include a history of family instability, poverty, living within a marginalized community, neighbourhood criminality, and the pressures experienced from delinquent peers. This thesis utilizes Interactional Theory as a lens through which to explore the bidirectional interaction of these risk factors across the five influential domains, as experienced by adolescents living in Wentworth, Durban. Q Methodology was employed as a quali-quantitative research tool to explore the perceptions of adolescents from two schools in Wentworth. This process involved holding one-hour classroom-based sessions with four different groups of adolescents who made up the sample of 117 people. In these sessions respondents engaged in a ‘Q-Sorting’ exercise, which involved comparing and arranging a series of 44 statements onto a ‘Q-Sort Matrix Board’ to reflect individual perceptions about each of the domains mentioned above. Factor Analysis was used to evaluate these Q-Sorts, which yielded five unique factors, each of which represented a cluster (or group) of similar-minded adolescents. Narrative explanations were developed to make sense of these factors. The findings revealed central themes of risk that are considered indicative and predictive of antisocial behaviour and delinquent group and/or gang affiliation amongst youth living in Wentworth. These include (1) the dominant influence of the family; (2) low socio-economic status and associated financial stress; (3) living within a marginalized community; and (4) peer influences relating to the use of illicit substances, especially cannabis and LenazineÓ (Codeine-containing cough syrup). The bidirectional interaction between these central themes indicates that when an adolescent experiences an accumulation of the effects of disadvantage from across a range of risk factors, so the likelihood of stress and insecurity increases. This increases vulnerability, and coerces adolescents towards antisocial behaviour, substance use, delinquent peer group association, and gangsterism.
Exploring ‘cultural countertransference’: a qualitative study of therapists’ understanding of the interface between culture and countertransference.
(2021) Chichevo, Lilian Nyasha.; Cartwright, Duncan James.
There has been limited research on the relationship between culture and countertransference. Although extant literature indicates that culture-induced countertransference has a profound effect on therapeutic alliances with clients from culturally diverse population groups, this association between the two concepts remains relatively unexplored. In the South African multicultural context, there is no published research exploring the understanding that therapists have of the interface between these two concepts. The qualitative research design enabled the therapists to provide comprehensive descriptions of their culture-induced countertransference experiences. These culture-induced countertransference experiences were explored and analysed utilising Interpretative Phenomenological Analysis perspective. The therapists’ experiences and perceptions were obtained through semi-structured interviews conducted with nine registered and practising therapists from KwaZulu-Natal. Four superordinate themes were obtained from the data, namely: (1) Awareness of Countertransference and Culture; (2) Cultural Aspects Inducing Countertransference; (3) Affective, Behavioural and Cognitive Reactions; and (4) Managing the Countertransference Experiences. The main findings indicated that therapists acknowledged an interface between culture and countertransference. Additionally, the therapists made a distinction between cultural countertransference and general counter-transference. Cultural countertransference was perceived to originate from the beliefs, assumptions, biases and unresolved conflicts within the therapist, triggered by various cultural aspects, including language, racial and ethnic diversity, cultural practices and age. The interplay of these triggers and origins resulted in the countertransference being manifested through affective, behavioural and cognitive reactions. Furthermore, the study revealed that there were slight differences in the management of cultural countertransference in comparison with general countertransference. The discussion of the findings drew on the Structural Theory of Countertransference and the Theory of Multicultural Counselling and Therapy in understanding the therapists’ perceptions of cultural countertransference.
Rape survivors’ experiences of helpful and unhelpful counselling aspects.
(2018) Van Rooyen, Melissa Victoria.; Cartwright, Duncan James.
The purpose of this study was to explore the counselling aspects perceived to be helpful and unhelpful by rape survivors in South Africa. While there is some existing South African literature on rape and the efficacy of rape treatments, very few studies exist which focus on rape counselling from the survivor’s perspective. Exploring the subjective experiences of counselling from a rape survivor’s point of view allowed us to further our theoretical understanding of mediational processes in counselling, test our understanding of existing theories and to also contribute to improving counselling techniques. This study was conducted using a qualitative research approach. Semi-structured interviews with 5 adult participants who had survived a rape experience and who had sought and concluded counselling at a local rape crisis centre were conducted. Interview transcripts were analysed using an interpretative phenomenological approach (IPA) and relevant themes and sub-themes that emerged from these transcripts were interpreted and discussed. The majority of helpful counselling aspects centred on the quality of the therapeutic relationship between the counsellor and the rape survivor. Specific aspects relating to the counsellor’s personality as well as the way in which certain techniques were implemented in counselling were described as facilitating the restoration of survivors’ sense of dignity as well as contributing to an increased sense of connection and trust following the trauma. Important considerations for a South African context included the provision of practical and social support, follow up counselling and interventions that increase survivors sense of safety. This is likely to benefit South African survivors who may not have adequate access to resources, and therefore health services needed for recovery, as well as those who are at risk for coming into contact with the perpetrator. The inclusion of these aspects into future rape counselling programmes will likely contribute to a more holistic and meaningful counselling experience for rape survivors in South Africa.
The secondary consequences of the helping profession : an exploration of trainee psychologist's attitudes and perceptions towards vicarious trauma.
(2017) Loeve, Jenna-Lee.; Cartwright, Duncan James.
The primary objective of this research was to initiate exploratory research in to the attitudes, perceptions, and experiences of trainee psychologists with regard to vicarious trauma. This research focused on exploring student psychologists’ understanding of vicarious trauma, which included an exploration of its symptoms, consequences, risk factors, and coping methods. A central focus of this study was also to gain an understanding of the challenges that student psychologists experience during their M1 year, as well as their knowledge/awareness of vicarious trauma. An underlying aim was to generate suggestions for education and training programmes in order to increase such knowledge so that trainee psychologists are better prepared to cope with the secondary consequences of the helping profession. The understanding of vicarious trauma was situated within Constructivist Self-Development Theory described by Trippany, Kress and Wilcoxon (2004). Semi-structured, open-ended interviews were conducted with six respondents. Braun and Clarke’s (2006) method of qualitative thematic analysis was used to analyse and interpret the data. A prominent finding of this research was that the participants had a basic understanding of vicarious trauma in terms of its symptoms and consequences, but struggled to conceptualize the phenomenon. It was evident that the student psychologists believed vicarious trauma to be a severe consequence of the helping profession but felt that more could be done during their education and training to increase knowledge and awareness of the concept and ultimately their ability to cope with it should they experience it. Suggestions offered by the participants included seminars on vicarious trauma, group mentoring and debriefing sessions, and more exposure to trauma cases in order to gain practical knowledge rather than theoretical knowledge without the know-how. It was concluded that there is a need within masters training programmes to incorporate a focus on vicarious trauma, which will act as a buffer to decrease risk.
"Vicarious traumatization in therapists working with trauma : do defences make a difference?"
(2017) Dubock, Urishka Sharee.; Cartwright, Duncan James.
Vicarious traumatization presents a significant concern for therapists around the globe. In South Africa, research around therapist wellbeing appears lacking. Despite various international studies on vicarious trauma, there remains a lack of conceptual clarity and comprehensive theory on vicarious trauma in therapists. Several studies have attempted to find factors associated with the development of vicarious trauma, with varying outcomes. Factors such as history of personal trauma, trauma caseload and supervision have been found to be associated with vicarious trauma. However, few studies have focused on the possibility that defence style could play a significant role. Recent research by Adams and Riggs (2008) found trauma symptoms in trainee therapists to be significantly associated with defence style. The current study explored the relationship between vicarious trauma and defence style (image-distorting, affect-regulating and adaptive defence styles). In addition, demographic factors were analyzed to discover whether they may be better determinants of vicarious trauma. The study used 127 participants (independent practitioners) from across South Africa. Participants were requested to complete three questionnaires: a demographic questionnaire, the DSQ 60 and the ProQol 5. Data were analyzed using a quantitative, positivist method. Correlations were used to identify significant relationships among the variables and a series of multiple regressions were conducted to explore predictive factors of the defence styles. Multiple regressions were also used to explore the predictive ability of the demographic variables and professional quality of life. The findings indicated a strong positive relationship between image distorting defence style and vicarious trauma. Of the demographic factors analyzed, therapeutic modality was found to be a significant predictor of vicarious trauma. A significant negative correlation was also found between help seeking for personal trauma and compassion satisfaction. This study provides evidence for the relationship between defence style and vicarious trauma. Further, it is indicative that most demographic factors had no effect on professional quality of life and ultimately, vicarious trauma. The current study suggests that further research needs to be done to further investigate the impact of defence style on vicarious traumatization. Implications, limitations and future directions of these findings are discussed further.

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Browsing Clinical Psychology by Author "Cartwright, Duncan James."