Conceptualising a proposed support strategy for sexually abused boys in middle childhood

Male child sexual abuse in middle childhood has serious effects with the increased risk of development of various mental illnesses and disorders, as well as extreme forms of emotional and behavioural problems. This study conceptualises a proposed support strategy for sexually abused boys in their middle childhood placed in a clinic school. The proposed support strategy involves three main facets, namely the strengthening of the sexually abused boy as an individual; sustaining a deep, trusting relationship; and the facilitation of a sustainable supportive context for these boys

Conceptualising a proposed support strategy for sexually abused boys in middle childhood

Male child sexual abuse in middle childhood has serious effects with the increased risk of development of various mental illnesses and disorders, as well as extreme forms of emotional and behavioural problems. This study conceptualises a proposed support strategy for sexually abused boys in their middle childhood placed in a clinic school. The proposed support strategy involves three main facets, namely the strengthening of the sexually abused boy as an individual; sustaining a deep, trusting relationship; and the facilitation of a sustainable supportive context for these boys

INTERVENTION STRATEGIES USED BY SOCIAL WORKERS IN EMERGENCY CHILD PROTECTION

This research provides insight into the current intervention strategies used by social workers in emergency child protection, whereby children are removed from their caregivers as a result of abuse and are placed at child and youth care centres. The research findings suggested that because of the lack of a practice model to guide professionals, as well as the significant challenges experienced by such professionals (high caseloads, staff turnover, lack of resources), the current intervention strategies in child protection are rushed, bureaucratic (paperwork focused) and emotionally disconnected from the child and family

Beroepstres en streshantering by maatskaplike werkers wat betrokke is by intervensie met seksueel misbruikte kinders

Thesis (PhD (Social Work))--University of Stellenbosch, 2011.AFRIKAANSE OPSOMMING: Maatskaplike werkers kry daagliks te doen met seksueel misbruikte kinders en daar word spesifiek deur wetgewing en beleidsdokumente voorsiening gemaak vir hierdie intervensie. Sommige maatskaplike werkers is in diens van 'n spesifieke organisasie wat van hulle verwag om aan 'n spesifieke groep kliënte dienste te lewer. Die fokus van hierdie studie is gerig op maatskaplike werkers wat betrokke is by intervensie met seksueel misbruikte kinders. Dienslewering geskied in 'n emosioneel hooggelaaide omgewing waar die moontlikheid van beroepstres groot is. Beroepstres kan veroorsaak word deur faktore in die interne omgewing (individu), die eksterne omgewing (werk/omgewing) of in die aard van die werk. Die doel van hierdie studie was om begrip te ontwikkel vir beroepstres en streshantering by maatskaplike werkers wat betrokke is by intervensie met seksueel misbruikte kinders. Die navorsingsvraag vir die studie lui soos volg: “Hoe word beroepstres ondervind en hanteer deur maatskaplike werkers wat betrokke is by intervensie met seksueel misbruikte kinders?” Hierdie navorsingsvraag is aangespreek deur kwalitatiewe navorsing te onderneem. Die studie kan geklassifiseer word as verkennende en beskrywende navorsing. Twee- en-twintig maatskaplike werkers, werksaam by vyf organisasies wat spesifiek fokus op intervensie met seksueel misbruikte kinders in die Kaapse Metropolitaanse Gebied, is deur middel van 'n doelgerigte, nie-waarskynlike steekproef geselekteer. 'n Profiel van deelnemers is saamgestel en semi-gestruktureerde een-tot-een onderhoude is benut om 'n gedetailleerde beeld te verkry van beroepstres en streshantering by maatskaplike werkers wat betrokke is by intervensie met seksueel misbruikte kinders. Hierdie onderhoude is aan die hand van 'n onderhoudskedule gevoer wat na aanleiding van die literatuurstudie saamgestel is. Die onderhoude is getranskribeer vir die doeleindes van data-analisering en aan die hand van Creswell (2009) se stappe geanaliseer. Sewe temas is geïdentifiseer, naamlik (1) perspektiewe op keuse van beroep, (2) dienslewering binne die konteks van 'n organisasie-struktuur, (3) oorsake van beroepstres, (4) manifestering van beroepstres, (5) implikasies van beroepstres, (6) voorkoming en hantering van beroepstres, en (7) ontwikkeling en groei van maatskaplike werkers. Hierdie temas is in subtemas en kategorieë verdeel en aan die hand van toepaslike narratiewe uit die onderhoude bespreek en met literatuur gekontroleer. Ten opsigte van elke tema is daar bepaalde gevolgtrekkings en aanbevelings gemaak. Daar is bevind dat maatskaplike werkers om verskeie redes in die veld van seksuele misbruik begin werk het, waarvan die meerderheid toevallig in hierdie veld begin werk het. Aangesien die intervensie in die konteks van 'n organisasie-struktuur plaasvind, is dit belangrik dat hierdie organisasies die verantwoordelikheid aanvaar vir werknemers se welstand, die nodige ondersteuning bied en hulpbronne/infrastruktuur voorsien. Daar is verder insig ontwikkel in watter faktore 'n oorsaak van beroepstres is, op watter wyses dit manifesteer en wat die implikasies daarvan vir die maatskaplike werker, gesin/huis/vriende en werkopset is. Daar is verskeie primêre, sekondêre en tersiêre strategieë wat benut kan word om beroepstres te voorkom of te hanteer. Dit blyk dat ondersteuning wat op verskeie vlakke aan die maatskaplike werkers gebied moet word, een van die belangrikste bevindinge in hierdie verband is. Laastens is die belang van ontwikkeling en groei van maatskaplike werkers in die veld van seksuele misbruik beklemtoon en verskeie wyses waarop dit kan geskied is geïdentifiseer. Aanbevelings is gemaak na aanleiding van die gevolgtrekkings van die studie. Die belangrikste aanbeveling is dat maatskaplike werkers wat betrokke is by intervensie met seksueel misbruikte kinders op verskeie wyses na hul eie welstand moet omsien. Daar moet verder ook ondersteuning ontvang word van die organisasie in wie se diens hulle is ten einde effektiewe betrokkenheid te verseker by intervensie met seksueel misbruikte kinders.ENGLISH ABSTRACT: Social workers work with sexually abused children on a daily basis and legislation and policy documents contain specific provisions for this intervention. Some social workers are employed by a specific organisation that expects them to render services to a specific group of clients. The focus of this study is on those social workers who are involved in intervention with sexually abused children. Service delivery takes place in an emotionally charged environment where occupational stress is a very real threat. Occupational stress can be caused by factors in the internal environment (individual), the external environment (work/environment) or in the nature of the work. The aim of this study was to create awareness of occupational stress and the handling thereof by social workers involved in intervention with sexually abused children. The research question for this study is as follows: “How do social workers that are involved in intervention with sexually abused children experience and handle occupational stress?” This research question was addressed through the use of qualitative research. The study can be classified as explorative and descriptive research. Twenty-two social workers, working at five organisations that are specifically focussing on intervention with sexually abused children in the Cape Metropolitan Area, were selected by means of a purposive, non-probability sample. A Profile of participants was compiled and semi-structured one-on-one interviews were used to obtain a detailed reflection of occupational stress and the handling thereof by social workers involved in intervention with sexually abused children. These interviews were conducted following an interview schedule that was compiled in accordance with the literature study. The interviews were transcribed for the purpose of data analysis and were analyzed according to the steps of Creswell (2009). Seven themes were identified, namely (1) perspectives on the choice of occupation, (2) service delivery within the context of an organisation structure, (3) causes of occupational stress, (4) manifestation of occupational stress, (5) implications of occupational stress, (6) prevention and handling of occupational stress, and (7) development and growth of social workers. These themes were divided into sub-themes and categories and discussed according to relevant narratives from the interviews and controlled with literature. Conclusions and recommendations were made according to each theme. It was concluded that social workers started working in the field of sexual abuse for a number of different reasons, with the most workers starting in this field by chance. Because this intervention takes place within the context of an organisation structure, it is important that the organisations take responsibility for the wellbeing of employees, give the necessary support, and supply resources/infrastructure. Insight was further gained into the factors causing occupational stress, the ways in which it manifests, and what the implications are for the social worker, family/home/friends and the work setup. There are different primary, secondary and tertiary strategies which can be used to prevent and handle occupational stress. It seems that one of the most important findings in this regard is that support must be given to social workers on various levels. The importance of development and growth of social workers in the field of sexual abuse was lastly emphasized and various ways in which this can be done were identified. Recommendations were made in accordance with the conclusions of the study. The most important recommendation is that social workers who are involved in intervention with sexually abused children must look after their own wellbeing in various ways. Support must also be received from the organisation by which they are employed in order to be effectively involved in intervention with sexually abused children

FACILITATING CHILDREN’S PARTICIPATION WITHIN MULTIDISCIPLINARY MEETINGS: GUIDING PRINCIPLES FOR CHILD AND YOUTH CARE CENTRES

Legislation on both an international and national level advocates that all children have a right to participate in all matters affecting them.  This article reflects an interest in children’s participation in the broad field of child protection, and specifically within the context of South African child and youth care centres. Against this contextual background, the article aims to introduce guiding principles that may stimulate ongoing conversation on the facilitation of children’s participation in a specific space of decision-making within child and youth care centres, namely multidisciplinary meetings. Guiding principles were derived from a comprehensive qualitative study in which individual semi-structured interviews and focus group groups were conducted to collect data from residential social workers, child and youth care workers, and children from child and youth care centres in the greater metropolitan area of Cape Town in South Afric

The experiences of primary caregivers whose children/grandchildren were exposed to paternal incest

Paternal incest is traumatic for the child-victim and has the potential to be harmful to the rest of the family members, particularly the primary caregivers (mothers and grandmothers), who therefore need to be supported. The aim of this study was firstly to explore the experiences of primary caregivers whose children or grandchildren were exposed to paternal incest and secondly to use these experiences to suggest guidelines for practitioners on how to support these caregivers. A qualitative, phenomenological design was used in the study. In-depth interviews were conducted with six primary caregivers (four mothers and two maternal grandmothers) from the coloured population group, aged between 25 and 60, from the Western Cape Province of South Africa. Data was analysed thematically. Two main themes emerged from the study. The first theme entailed reactions to the disclosure and its aftermath, which encompassed emotional, cognitive and physiological reactions that were similar to secondary traumatisation. The second theme was coping strategies that emerged to deal with the disclosure and its aftermath, which encompassed effective coping strategies (behavioural coping strategies to actively solve problems and the presence of social support), unhealthy or negative coping strategies (behavioural coping strategies of avoidance) and threats to coping (a lack of social support). Guidelines are suggested for emotional support, multidisciplinary practitioner support and educational support programmes

Delayed retinal vein recovery responses indicate both non-adaptation to stress as well as increased risk for stroke : the SABPA study

OBJECTIVES: Low or high sympatho-adrenal-medullary axis (SAM) and hypothalamic-pituitary-adrenal axis (HPA) dysregulation reflect chronic stress. Retinal vessel dynamics may relate to SAM, HPA activity and stroke risk. Our objectives were therefore to assess the relationships between retinal vessel, SAM and HPA responses, and to determine stroke risk.METHODS: A prospective bi-ethnic gender cohort (n = 275, 45 ± 9 years) was included. Urine/serum/saliva samples for SAM [norepinephrine:creatinine ratio (u-NE)] and HPA [adrenocorticotrophic hormone (ACTH), cortisol] were obtained at baseline, three-year follow up and upon flicker light-induced provocation. Diastolic ocular perfusion pressure was measured as a marker of hypo-perfusion. Retinal arterial narrowing and venous widening calibres were quantified from digital images in the mydriatic eye. A validated stress and stroke risk score was applied.RESULTS: An interaction term was fitted for venous dilation in u-NE tertiles (p ≤ 0.05) and not in u-NE median/quartiles/quintiles. Independent of race or gender, tertile 1 (low u-NE) had a 112% increase in u-NE, decreases in cortisol, and no changes in ACTH over three years (positive feedback). Tertile 3 (high u-NE) contradictorily had decreases in u-NE and cortisol, and increases in ACTH (negative feedback). In tertile 1, reduced arterial dilation, and faster arterial vasoconstriction and narrowing were related to higher SAM activity and hypo-perfusion (p ≤ 0.05), whereas delayed venous dilation, recovery and widening were related to cortisol hypo-secretion (p ≤ 0.05). In tertile 1, delayed venous recovery responses predicted stress and stroke risk [odds ratio 4.8 (1.2-19.6); p = 0.03]. These associations were not found in u-NE tertiles 2 and 3.CONCLUSIONS: In response to low norepinephrine, a reflex increase in SAM activity occurred, enhancing arterial vasoconstriction and hypo-perfusion. Concomitant HPA dysregulation attenuated retinal vein vasoactivity and tone, reflecting delayed vein recovery responses and non-adaptation to stress. These constrained vein recovery responses are indicative of increased chronic stress and stroke risk