Diane Elkonin

The Use of Religion and Spirituality in Psychotherapy: Enablers and Barriers

The use of religion and spirituality in psychotherapy has been a contentious issue for decades. This paper explores and describes whether psychologists would use religion and spirituality in psychotherapy as well as enablers and barriers in this regard. A qualitative exploratory descriptive method was followed using purposive sampling to obtain a sample of clinical and counselling psychologists. The focus group strategy was used to collect the data, and Tesch’s model of content analysis was used to analyse the qualitative findings. Most participants expressed a willingness to discuss religion and spirituality with their clients. Participants also highlighted specific enablers and barriers to incorporating religion and spirituality in psychotherapy. This article has the potential to influence professional training in psychology and psychotherapy.

Mind the Gap: Have the Registered Counsellors Fallen Through?

The professional category of Bachelor of Psychology (B.Psych.) Registered Counsellor was created in order to deliver psychological services at a primary health care level to previously disadvantaged communities. Between 2002 and 2004 the Nelson Mandela Metropolitan University, in the Eastern Cape, produced 84 graduates in this category. In an attempt to follow the career paths of these graduates, a survey was undertaken to determine how many graduates had progressed to the stage of professional registration and were working as Registered Counsellors, and to explore their present status and employment experiences. It was found that very few had registered with the Professional Board for Psychology and that most were continuing postgraduate studies or had moved into alternate career fields. Themes that emerged from the survey concern difficulty with registration, difficulty with employment, and lack of public and professional knowledge of the scope of practice of the Registered Counsellor. There were also some positive perceptions regarding the value of the Registered Counsellor category and the quality of training.

Religion, Spirituality and Therapy: Implications for Training

Religion and spirituality are recognized coping resources but are neglected in psychological training and practice. However, religion and spirituality can be successfully used to cope with psychological disorders, prevent unhealthy behaviors and promote resilience. This study explored and described two questions regarding the concepts of the terminology religion and spirituality, and the perceptions of the use of religion and spirituality in therapy. Purposive sampling was utilized in a qualitative study of 15 registered psychologists, and data were analyzed using Tesch’s model of qualitative content analysis. The concepts religion and spirituality appear difficult to define but the importance of their use as coping mechanisms in their own and their clients’ lives was recognized. These findings have implications for professional training.

Childhood sexual abuse and HIV sexual-risk behaviour among men who have sex with men in South Africa

Previous research has indicated an association between childhood sexual abuse and an increased risk of engaging in unsafe behaviours during adulthood, including risky sexual practices. This study examines the relationship between self-reported childhood sexual abuse and adult HIV sexual-risk behaviour in a sample of South African men who have sex with men. Potential long-term childhood sexual abuse–related outcomes, including dissociation, recreational and sex-related drug use, depression, impaired interpersonal communication, and adult re-victimisation were treated as variables mediating the relationship between childhood sexual abuse and sexual-risk behaviour. Men using a gay Internet dating site were randomly selected to complete the anonymous electronic survey. Results indicate that one-fourth of participants reported a history of childhood sexual abuse. Men with a history of unwanted sexual activity during childhood were more likely to report recreational and sex-related drug use, and adult re-victimisation experiences. Furthermore, mediation analyses revealed that men who have sex with men who are survivors of childhood sexual abuse are more likely to report drug use and sex-related drug use, and these outcomes in turn are associated with increased HIV risk as measured by number of male sexual partners. These results highlight the importance of mental health services and new approaches in HIV prevention for men who have sex with men who have been sexually abused as children.

Perceptions of Registered Counsellor Efficacy

The registration category of the Registered Counsellor has resulted in on ongoing debate regarding the training and efficacy of these practitioners in the delivery of psychological services. Although the category has been in existence for some years there is little evidence that the category is fulfilling the purpose for which it was developed, namely, to supply psychological services at a primary health-care level. Our aim in this article is to explore the roles that registered counsellors play in their practicum placements, in order to better understand and to provide evidence of the practical value of the skills and expertise that they can offer in a variety of settings. Through the use of semi-structured questionnaires, in face to face and telephone surveys, 15 supervisors were interviewed to obtain their perceptions and experiences of the efficacy of the registered counsellors and the role that registered counsellor trainees play in their different placement settings. Findings were extremely positive in terms of the perceived value of the registered counsellor across a variety of settings.

An evaluation of health information and wellness priorities among socioeconomically disadvantaged students

Objective: A critical evaluation of a salutogenic, wellness education programme was conducted with a group of first-year socioeconomically disadvantaged higher education students, in order to assess the value they placed on health information and wellness priorities. Methods: This study took a mixed-methods approach utilising a quantitative–qualitative design. Quantitative analysis regarding the values placed by the students on 22 aspects of health-related information and qualitative analysis of their health priorities drew on findings from a semi-structured researcher-generated questionnaire, administered pre-, post- and 15-week post-post-intervention. Setting: The setting was a higher education institution in the Eastern Cape Province of South Africa. Participants were 34 first-year consumer science students, who engaged in a year-long, salutogenic wellness programme. Results: Findings revealed an increase in the participants’ value of health information for a number of wellness variables. Future planning, positive thinking and nutrition ranked high among wellness priorities, the reasons for which were disease prevention, as well as the impact of various aspects of health on participants’ future success. Conclusion: A holistic, salutogenic, wellness education programme increased student values for information with regard to a number of health variables.

The quality of life of HIV-infected South African university students: Experiences with the WHOQOL-HIV-Bref

ABSTRACT HIV and AIDS has serious repercussions on psychological, social and physical well-being, and the assessment of Quality of Life (QoL) of people living with HIV and AIDS is essential to gauge how these challenges are met. The WHOQoL-HIV Bref forms part of a suite of instruments developed by the World Health Organisation. The purpose of this paper is to describe the quality of life of a sample of HIV-infected students at a South African university, as well as explain the internal consistency between questions within each of the QoL domains. A descriptive, cross-sectional study design using a quantitative approach was applied. A non-probability, purposive sampling approach was utilized and students enrolled in the antiretroviral therapy or wellness programme were invited to voluntarily participate in this study. The WHOQOL-HIV Bref was self-administered after explanation of the questions by a registered, trained health care professional. A total of 63 students returned completed questionnaires that were included in the analysis. Acceptable to good reliability scores were established for the following domains: Level of Independence; Social Relations; Environment and Spiritual or Personal Beliefs. Assessing QoL in the sample, the lowest score was for “Spirituality” and the highest “Social Relations”. The “Physical” and “Psychological” domain scores for females were significantly lower than the score for males. There was no significant difference between any of the domain scores among participants with CD4 cell counts above or below 350 cells/mm3. In general the performance of this sample is encouraging and it is recommended that the measure be utilized for QoL screening, and further research. The WHOQOL-HIV Bref for students does not contain an academic wellness component which should be added considering the significant effects of HIV on neuropsychological functioning. Also further investigation into the reasons for poor scores obtained in physical and psychological well-being in females should be encouraged.

Manualised health support interventions: Their efficacy in a South African primary healthcare setting

The study examined the implementation efficacy of a stress-reduction intervention for people living with HIV/AIDS by health care workers in the Eastern Cape Province, South Africa. Informants were 20 health care workers drawn from two health facilities. There were 17 females (85%) and 3 males (15%). Participants engaged in a focus group discussion on their experiences using a theory-based manualised stress-reduction support intervention in primary care settings. Thematic content analysis of the data yielded the following themes characterising costs to faithful implementation: departure from manualised instructions and ad hoc improvisation of theoretical concepts; disruptive power dynamics; lack of grounding in community values; and implementation resource limitations. Manualised intervention implementation efficacy by health workers needs customisation to local culture and health service support services.

Wellness and Academic Outcomes among Disadvantaged Students in South Africa: An Exploratory Study.

Objective: The aim of this study was to measure possible impacts of a salutogenic lifestyle education programme on wellness and academic outcomes in a group of socioeconomically disadvantaged students in the first year of higher education. Setting: University in the Eastern Cape Province, South Africa. Methods: A mixed-methods approach was utilised to assess the relationship between wellness and academic outcomes. Data were gathered using the Wellness Questionnaire for Higher Education, a semi-structured researcher-generated questionnaire and transcripts of academic results. Data were analysed using SPSSv20 and NVIVOv8. Results: Findings revealed that all students showed modest improvements in overall wellness scores. A correlation was found between student wellness and academic success (r = .362, p = .049), which was stronger for students who gained the highest marks (r = .610, p = .004) and who made two to three lifestyle changes. Conclusion: A holistic, salutogenic, wellness education programme shows potential to increase student wellness, which may then translate into student academic success.

Sense of Coherence and Quality of Life in Elderly Persons Living with Diabetes Mellitus: An Exploratory Study

This study sought to explore and describe the sense of coherence (SOC) and quality of life (QoL) in elderly people living with diabetes mellitus (DM). Participants were 72 elderly persons with DM (men = 19, women = 53, M (age) = 74.33, SD = 7.78). Data were collected using the Sense of Coherence Inventory (SOC-29) and WHOQOL-100. Cramers V was used to assess the relationship between the SOC-29 and the WHOQOL-100. Results suggest that the elderly persons had a strong SOC and perceived themselves as having a satisfactory QoL. The correlational analysis revealed a significant positive relationship between these two measures for the current sample. Elderly persons with DM seemed to have personal resources and capacities for living well with their health condition.