Doctoral Degrees (Psychology)

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Browsing Doctoral Degrees (Psychology) by browse.metadata.advisor "Ashraf, Kagee"

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    The feasibility of disseminating and implementing prolonged exposure therapy for survivors of trauma in South Africa: a mixed method pilot and feasibility study
    (Stellenbosch : Stellenbosch University, 2021-03) Booysen, Duane Danny-Coe; Ashraf, Kagee; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH ABSTRACT: The study investigated the feasibility of disseminating and implementing brief prolonged exposure therapy (PE) for post-traumatic stress disorder (PTSD) in South Africa. I used a mixed method design to investigate and explore the broad aim, which was to implement PE in a South African context, and to explore whether PE is feasible and acceptable in a South African context. The study had three aims. The first aim was to explore the experiences and perspectives of trauma counsellors treating PTSD in low resource communities and to explore their attitudes toward the use of PE in South Africa. Using Thematic Analysis (TA), eighteen counsellors (n = 18) participated in semi-structured individual interviews across four community counselling centres located in the Western Cape (WC) and Eastern Cape (EC) of South Africa. The first aim produced eight themes that were grouped under three superordinate themes. The superordinate themes were working as a counsellor, which consisted of the following themes: encountering trauma narratives, social support and resilience, treatments for trauma, and a collective approach. The second superordinate theme was trauma in the social context, which consisted of: helplessness and social factors. The final superordinate theme was experiences of growth, which included: helping others heal and empowerment. The second aim of the study investigated the effectiveness of brief PE therapy for treatment of PTSD at two community counselling centres in the WC and EC of South Africa. Using a single case experimental design (SCED), a total sample of 12 participants started a 6-session intervention and only nine completed the intervention. The phase had four data time points, namely, baseline, intervention, post-intervention, and three-month follow-up. The clinical assessments used were the Post-traumatic Symptom Scale Interview for DSM-5 (PSSI-5), the Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5), the Beck Depression Inventory second edition (BDI-II), and the Beck Anxiety Inventory (BAI). Considering the results of the brief PE intervention, I reject the null hypothesis, and the research hypothesis has not been falsified, which is that trauma survivors who complete six sessions of brief PE had statistically significant reduced PTSD symptoms (p < 0.001) and maintained their symptom reductions at three-month follow-up. The third aim of the study was to explore the acceptability of PE in a South African context, which was to explore how trauma clients (n = 7) who present with symptoms of traumatic stress experience a brief prolonged exposure treatment for PTSD. Using TA, phase 3 produced a total of six themes grouped under two superordinate themes that highlighted the experiences of persons receiving PE as a trauma therapy at a community counselling centre. The superordinate theme implementation of PE consisted of the following: room for improvement: “it’s nice to hear that it’s not your fault”, obstacles: “cure my problem”, and gender: “talking about my experiences with a man”. The second superordinate theme, adapting to PE, consisted of the following themes: PE structure: “all my issues”; exposure: “are we really going to deal with my issues here”, and noticing change: “I’m actually dealing with things”. Overall, the study found that brief PE is a feasible treatment to disseminate and implement in a South African context for the treatment of PTSD among adults at a primary care level but need to consider the social context factors.