Liesel Ebersöhn

A randomized clinical trial of an intervention to promote resilience in young children of HIV-positive mothers in South Africa

Objective:The objective of this study is to assess the efficacy of an intervention designed to promote resilience in young children living with their HIV-positive mothers. Design/methods:HIV-positive women attending clinics in Tshwane, South Africa, and their children, aged 6–10 years, were randomized to the intervention (I) or standard care (S). The intervention consisted of 24 weekly group sessions led by community care workers. Mothers and children were in separate groups for 14 sessions, followed by 10 interactive sessions. The primary focus was on parent–child communication and parenting. Assessments were completed by mothers and children at baseline and 6, 12 and 18 months. Repeated mixed linear analyses were used to assess change over time. Results:Of 390 mother–child pairs, 84.6% (I: 161 and S: 169) completed at least two interviews and were included in the analyses. Childrens mean age was 8.4 years and 42% of mothers had been ill in the prior 3 months. Attendance in groups was variable: only 45.7% attended more than 16 sessions. Intervention mothers reported significant improvements in childrens externalizing behaviours (ß = –2.8, P = 0.002), communication (ß = 4.3, P = 0.025) and daily living skills (ß = 5.9, P = 0.024), although improvement in internalizing behaviours and socialization was not significant (P = 0.061 and 0.052, respectively). Intervention children reported a temporary increase in anxiety but did not report differences in depression or emotional intelligence. Conclusion:This is the first study demonstrating benefits of an intervention designed to promote resilience among young children of HIV-positive mothers. The intervention was specifically designed for an African context and has the potential to benefit large numbers of children, if it can be widely implemented.

Formative evaluation of the STAR intervention: improving teachers’ ability to provide psychosocial support for vulnerable individuals in the school community

The article describes the pilot phase of a participatory reflection and action (PRA) study. The longitudinal investigation explores teachers’ ability to provide psychosocial support within the context of HIV/AIDS following an asset-based intervention. The study ensued from our desire to understand and contribute to knowledge about the changed roles of teachers due to adversity in the community, specifically in relation to HIV/AIDS and education. The supportive teachers, assets and resilience (STAR) intervention was facilitated from November 2003 to October 2005 and consisted of the research team undertaking nine field visits and facilitating 20 intervention sessions (2–3 hours each), and 12 post-intervention research visits have been conducted to date. Ten female teachers were selected for participation through random purposeful sampling at a primary school in an informal settlement outside Port Elizabeth, South Africa. Data-generation included PRA activities, observation, informal interactive interviews, and focus group discussions. The data were analysed by means of inductive thematic analysis. We found that the teachers did not view vulnerability as being related to children or HIV/AIDS in isolation, but rather that their psychosocial support to children and the school community was inclusive across a spectrum of vulnerabilities and services. We argue that teachers who are inclined to provide such support will fulfil this role irrespective of understanding policy or receiving training. We contend that teachers are well-positioned to manage school-based psychosocial support in order to create relevant and caring spaces for vulnerable individuals in the school community.

Adding ‘Flock’ to ‘Fight and Flight’: A Honeycomb of Resilience Where Supply of Relationships Meets Demand for Support

In this article I explain how solidarity can support positive adjustment, collective in nature, where people face chronic, cumulative stress and largely lack resources. I propose that when individuals use relationships as a way to access and mobilise resources, an enabling ecology is configured to foster positive adjustment. Applying a collectivist, transactional-ecological view of resilience I propose Relationship-Resourced Resilience (RRR) as a generative theory to explain how resilience occurs as collective, rather than individual and subjective processes. To do this, I draw on eight years of longitudinal case study data that were generated using a Participatory Reflection and Action (PRA) approach with partnership schools (N = 12, primary = 9, secondary = 3; urban = 9, rural = 3) and teachers (N = 74, female = 63, male = 11). The RRR model posits that, when under threat of chronic stress in a poverty setting, a collective response is to flock (rather than fight or flight). Flock entails a process of alone-standing individuals, experiencing shared and persistent burdens, connecting to access, share, mobilise and sustain use of resources for positive adaptation. RRR extends current resilience views of subjective, individual adjustment to individually reported stress in the direction of resilience as collective experiences of continual stress with subsequent collective positive adaptation.

Teacher resilience: theorizing resilience and poverty

In this article, I hope to provide some novel insights into teacher resilience and poverty on the basis of ten-year long-term ethnographic participatory reflection and action data obtained from teachers (n = 87) in rural (n = 6) and urban (n = 8) schools (n = 14, high schools = 4, primary schools = 10) in three South African provinces. In resilience debates, resilience in poverty-saturated schools is generally indicated as both process and outcome. Evidence from this study posits resilience processes in poverty as a lifeline chain, linking uninterrupted incidences of adaptation one after the other. Thus, rather than once-off incidental processes depicting a clear adversity beginning and positive adaptation end, adapting to poverty calls for resilience qualities characterized as a cable of nonstop vigilance. To mediate risk during resilience processes, the teachers in the study made use of traits such as compassion, creativity, optimism and especially flocking to access and use scarce protective resources. In the lifeline chain of resilience, the teachers demonstrated mostly positive outcomes as well as instances of maladaptation and thriving. Teacher resilience in poverty contexts means that teachers ceaselessly adapt in a sequence of linked incidents to a procession of risks. They use particular traits to unite and direct their adaptive series of behaviors in order to transform high-risk schools into supportive spaces where they sometimes thrive, and sometimes feel distressed but mostly function effectively as teachers.

Children's Resilience as Assets for Safe Schools

In this article I argue that employing positive psychology conceptions in research allows for a continuum of findings for educational psychology. I illustrate my contention by means of a participatory action research (PAR) survey-based case study in which methodological decisions were informed by an asset-focused resilience conceptual framework. First I provide a rationale, as well as contextual information for the article. Then I explicate asset-focused resilience as a conceptual framework. Subsequently, I present the methodological background of the PAR survey-based case study, after which I align the scope of the findings to the contention of my article. I conclude that the choice of a positive psychology theoretical stance enriched the scope of the findings.

Emotional Intelligence and Achievement: Redefining Giftedness?

Many researchers still consider measured intelligence as the most significant predictor for academic and life success, despite the fact that research time and again confirms that proven academic achievement is a far better predictor of academic achievement than a mere IQ score. This article examines the possible meaning of the construct “emotional intelligence”. The term is used to explain individual differences associated with life success; differences that are not sufficiently measured with traditional intelligence measuring instruments. Emotional intelligence includes social deftness, emotional stability, compassion and integrity. It is defined by Goleman, Salovey and Mayer, Bar-On and others as the ability to motivate oneself, to persist in the face of frustrations; to control impulse and delay gratification; to regulate ones moods, to keep distress from interfering with the ability to think; to empathize, to hope, to perform, to be creative. Two case studies are discussed in an attempt to facilitate a contribution to the understanding of some of the reasons for the often-found gap between a persons potential and his or her actual achievement.

Voicing Perceptions of Risk and Protective Factors In Coping In A Hiv&Aids Landscapes Reflecting on Capacity for Adaptiveness

The purpose of this article is to locate childrens own voices within the discourse of ‘disadvantaged children’. I commence by proposing that foregrounding vulnerable childrens knowledge of protective factors may enable resiliency in similar scenarios. After that, from a positive psychology framework, I explicate the conceptual framework integrating constructs from resilience theory, featuring protective factors in a systemic model. Next I describe the action research design of a partnership study1 1 A South African Department of Education and UNICEF partnership study to enable child-friendly environments in schools. in 78 schools in an impoverished rural province -focusing on the computer-based random sampling of 10 percent of the participants (n=2391), the development, piloting and translation of a mixed method questionnaire and the framework analysis of collected data. Then I introduce the emerged themes in terms of protective factors, locating most protection in the (disadvantaged) community, with the child as the central system negotiating adaptation. Subsequently I interpret the themes from my conceptual framework. I submit that the presence of cumulative protection will most probably enhance personal capacity. I also surmise that health-promoting schools may function as replacement safe spaces when safe family systems are lacking, whereas at-risk schools may aggravate the experience and consequences of unsafe family systems. I suggest that perceived capacity in the community system be built on to further support vulnerable children to be resilient. I conclude by suggesting some strategies for future research and intervention endeavours.

Demonstrating Resilience in a HIV & AIDS Context: An Emotional Intelligence Perspective

In this article we contemplate resilience in vulnerable children as a form of emotional giftedness. By foregrounding relevant segments of six ongoing studies and focusing on ways in which vulnerable children in communities in South Africa cope with the impact of HIV&AIDS. The concepts of protective factors, processes and cumulative protection shape our understanding of vulnerable childrens coping in terms of resilience as a signature form of (emotional) giftedness. In our studies we use a qualitative case study research design with groups of children in the six participating communities. We rely on dimensions of resilience to extract evidence of vulnerable childrens resilient coping. The results of the study indicate that traces of resilient coping amongst the participating group of children do exist, and that these traces are closely related to the manifestation of emotional intelligence. Themes indicative of childrens resilient coping include a sense of self-worth (based on added responsibility and related to education), the presence of hope and optimism, a sense of security, comfort and belonging (based on knowledge of future caregivers and remaining in a familiar community), as well as self- regulation capacity. We conclude by debating these resilient coping strategies as a form of emotional giftedness.

Behavior and psychological functioning of young children of HIV-positive mothers in South Africa

Adults with HIV are living longer due to earlier diagnosis and increased access to antiretroviral medications. Therefore, fewer young children are being orphaned and instead, are being cared for by parents who know they are HIV positive, although they may be asymptomatic. Presently, it is unclear whether the psychological functioning of these young children is likely to be affected or, alternatively, whether it is only when a mother is ill, that children suffer adverse effects. We, thus, aimed to compare the behavior and psychological functioning of young children (aged 6–10 years) of HIV-positive and HIV-negative mothers. We also aimed to examine the association between HIV status disclosure and child outcomes. This study uses cross-sectional data from the baseline assessment of a randomized controlled trial conducted in Tshwane, South Africa. Participants (n=509) and their children were recruited from area health clinics. Among the 395 mothers with HIV, 42% reported symptoms of HIV disease. Multivariate linear regression models suggested that after adjusting for socio-demographic characteristics, children of HIV-positive mothers had significantly greater externalizing behaviors than children of HIV-negative mothers. Importantly, children whose mothers were symptomatic had greater internalizing and externalizing behaviors compared with children of HIV-negative mothers, but this was not true for children of asymptomatic mothers. Additionally, among children of HIV-positive mothers, those who had been told their mothers were sick compared with children who had been told nothing had less internalizing and externalizing behaviors and improved daily living skills. This study, therefore, provides evidence that maternal HIV disease can affect the behaviors of young children in South Africa but, importantly, only when the mothers are symptomatic from their disease. Furthermore, results suggest that disclosure of maternal illness but not HIV status was associated with improved behavior and psychological functioning among young children.

Some thoughts on the perceptions of the role of educational psychologists in early childhood intervention

The importance of early childhood intervention in a developing country is indisputable. Even though we have a relatively clear idea of what effective early childhood intervention (ECI) means, there are still uncertainties about the roles of professionals in this ever‐changing field. In South Africa we face particular challenges because of huge disparities in the system. Within this context educational psychologists need to find ways in which to make constructive contributions. To explore this question a study was undertaken to find out what educational psychologists can and are doing in early childhood intervention. Three focus groups were conducted, involving educational psychologists and transdisciplinary representatives who work in the field of ECI. Results indicate a number of trends, for example the perception that educational psychologists are making increasing use of an asset‐based approach, focusing on learning and teaching, and an increased emphasis on their role in ECI within a context of group work, prevention and a focus on the community.