Verliesverwerking na ontvalling : 'n psigo-ontwikkelingsprogram vir adolessente

De Villiers, Reniette Hofmeyr (2000-03)

Thesis (PhD)--Universiteit van Stellenbosch, 2000.

Thesis

ENGLISH ABSTRACT: Most researchers agree that for a child the death of a parent constitutes a psychological risk. Some of these children might experience the first onset of psychiatric disorder (depression, anxiety or substance use disorder) prior to age 20, with a peak age of occurrence at 18. Within the South African context children are more and more confronted with parental death due to the upsurge of violence, the increase in HIV, aids and tuberculoses, as well as many fatal traffic accidents. The need for psychological support of these children within the school system was brought to the attention of the researcher by concerned surviving parents. Society tends to expect an early (often premature) return of survivors to the activities of everyday life. The adult or child thus often finds him-/herself isolated in grief. In family context on the other hand, the single parent has to deal with the personal loss of a spouse, the children's loss of a parent and often also the grandparents' loss of a child. Furthermore, roles within the family have to be reallocated so as to accommodate the lost person's functions. The surviving parent is therefore often not adequately available for the child who, having had his/her personal world and belief system shattered, does not always understand the consequences of death, primarily due to cognitive immaturity. They may react with anxiety, irrational beliefs and suppression, thus blocking a healthier course of grief. The aim of this study was to design and implement a psycho-educational grief resolution program and to investigate the effect thereof on the mood states, coping skills and self-concepts of 17 urban adolescents who had experienced parental death. Using the General Systems Theory as metatheory and the Intervention Designand- Development research methodology (Thomas & Rothman, 1994), a model of adolescent grief resolution was devised which served as basis for the design of the program. The participants were requested to reappraise personal resolution of grief tasks and were introduced to cognitive restructuring (for example the relinquishment of suppression and the disputing of irrational beliefs). With a clearer understanding and the skills to control emotions and behaviour, they were encouraged to attribute (now with hindsight) meaning to the experience of having lost a loved one, and to incorporate the event into a personal narrative. Statistical analyses of test-retest results indicated, amongst others, that adolescents tend to prematurely avow acceptance of the loss; that the experimental group demonstrated less fatigue-inertia after attending the program than the control group; and that a high risk group, comprised of members of both the experimental and control groups, showed more depression during the re-test situation. The last finding indicates that a high risk group should rather receive psychotherapy than participate in a psychoeducational program which is not primarily of a psychotherapeutic nature. On the other hand taking part in the program caused those adolescents to become aware of their need for psychotherapy.

AFRIKAANSE OPSOMMING: Die meeste navorsers is dit eens dat die dood van 'n ouer vir die kind sielkundige risiko's inhou. Sommige van dié kinders mag voor die ouderdom van 20 jaar (met die grootste aantal teen 18 jaar) psigiatriese probleme soos depressie, angs of middelmisbruik vertoon. Suid-Afrikaanse kinders word tans toenemend aan ouersterfte blootgestel weens die toename in geweld, die Hl-virus, vigs, tuberkulose en verkeersongelukke. Agtergeblewe ouers het die behoefte aan sielkundige ondersteuning van dié kinders binne skoolverband onder die aandag van die navorser gebring. Dit blyk dat die gemeenskap 'n vroeë (dikwels voortydige) terugkeer van die treurende na die gewone daaglikse aktiwiteite verlang. Die treurende beleef hom-/haarself dus dikwels as alleen in smart. In gesinsverband word daar verder hoë eise aan die enkelouer gestel, soos om die verlies van 'n huweliksmaat te verwerk, om kinders wat 'n ouer verloor het, en moontlik ook grootouers wat 'n kind verloor het, te ondersteun. Verder moet die rolle binne die gesin herverdeel word om ook die oorledene se funksies te vervul. Die beskikbaarheid van die agtergeblewe ouer is dus ingekort, en die kind wie se leefwêreld en oortuigings aan flarde is, het weens veral kognitiewe onrypheid, selde begrip vir die nagevolge van sterwensverlies. Hulle mag reageer met angs, irrasionele denke en onttrekking wat die rouproses kan inhibeer. Die doel van die studie was die ontwerp en toepassing van 'n verliesverwerkingsprogram Cn psigo-ontwikkelingsprogram) en die bepaling van die programeffek op die gemoedstoestand, streshanteringsvaardighede en selfkonsep van 17 stedelike adolessente met ouerverlies. Met die Algemene Sisteemteorie as metateorie en die Intervensie-Ontwerp-en-Ontwikkelingsnavorsingsparadigma (Thomas & Rothman, 1994) kon 'n adolessente verliesverwerkingsmodel saamgestel word wat gedien het as basis vir die ontwerp van die program. Die deelnemers kon die eie verwerking van routake herbeoordeel en kognitiewe herstrukturering waar nodig toepas (onder meer deur die opheffing van onderdrukte gedagtes en die betwisting van irrasionele aannames). Met beter begrip vir die eie situasie en beheer oor emosie en gedrag kon ook betekenisgewing (terugskouend oor die verliesgebeure) volg en kon die ervaring geïnkorporeer word in 'n persoonlike lewensverhaal. Statistiese ontleding van die toets-hertoetsresultate het onder meer daarop gedui dat adolessente neig om voortydig aanvaarding van die verlies aan te dui; dat die eksperimentele groep, vergeleke met die kontrolegroep, minder vermoeid-lusteloos was na programdeelname; en dat hoë risikodeelnemers uit beide die eksperimentele en kontrolegroepe met die na-toetsing meer depressief voorgekom het. Laasgenoemde bevinding dui daarop dat die hoë risikogroep eerder op psigoterapie aangewese was. Diegene uit die hoë risikogroep wat wel aan die program deelgeneem het, het nogtans bewus geword van die behoefte aan sodanige terapie en dit daadwerklik opgevolg.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/52049
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