South African Journal of Psychology

Given high rates of trauma exposure in South Africa, mental health practitioners often need to deliver interventions to trauma survivors. While there have been few local trauma intervention studies, there is an extensive international evidence base that provides a rich resource on which to draw. This article reviews evidence-based treatments for posttraumatic stress disorder and complex posttraumatic stress disorder. The current weight of evidence supports the use of trauma-focused cognitive behavioural therapy approaches in the treatment of posttraumatic stress disorder and the use of multimodal, phase-based interventions to treat complex posttraumatic stress disorder. There is also a long-standing, though less extensive, evidence base for psychodynamic therapy in the treatment of these conditions, as well as a number of emerging treatment approaches that require further study. While there are some limitations to transferring these approaches to the South African context, the current evidence base provides valuable guidelines for local practitioners seeking to develop their competencies in treating posttraumatic stress disorder and more complex trauma-based presentations.

Information is needed regarding the antecedents and outcomes of flourishing, particularly in sports contexts, where the study of this optimal well-being state has remained largely unexplored. This study examined the role of strength use to facilitate flourishing, enhance team embeddedness, and counter withdrawal behaviour of athletes. It further investigated the role of flourishing to retain athletes to their sport and teams and examined the role of team embeddedness in this relationship. A cross-sectional research design was utilised with structural equation modelling to assess model fit and examine postulated relationships. The sample comprised 235 student athletes. The results suggested that team strength use predicts flourishing. It further revealed positive paths to team embeddedness from both individual and team strength use. Flourishing was also positively related to team embeddedness. Lastly, a negative association was found between team embeddedness and withdrawal behaviour among the athletes.

The wider availability of highly active antiretroviral therapy has resulted in a concomitant increase in adults aging with HIV and the persistence of milder forms of neuropsychological impairment in this cohort. This study investigated the differences in neuropsychological functioning between a group of HIV+ adults and older adults and an HIV− matched control group. Participants from a semi-urban community clinic volunteered to participate in the study. The performance of 50 participants (33 HIV+ and 17 HIV−) who met the inclusion criteria were compared on the following measures: Dementia Rating Scale-2, the Stroop Color and Word Test, the Symbol Digits Modalities Test, and the Delis–Kaplan Executive Function System Trail Making Test. The results indicated that the HIV+ in comparison with the HIV− negative group had poorer performance profiles in global cognitive functioning, memory, executive functioning, visuoconstruction ability, psychomotor functioning, and processing speed. The findings suggest that further research in South Africa will contribute to a better understanding of the neuropsychological profiles of adults aging with HIV and inform intervention strategies specific to addressing the mental healthcare needs of this subgroup.

Burnout is considered an occupational health concern. The burnout–depression overlap is an important area of research as the foundations of burnout and its diagnostic value have come under increasing scrutiny, calling for burnout to not be classified as an independent disorder but rather as a subtype of depression. Furthermore, as burnout is defined as a work-specific syndrome, workplace factors have been argued to be the major indicators of burnout. Recent research however, calls this into question. This study seeks to establish the overlap between burnout and depressive symptoms and to determine if burnout is in fact a multi-domain phenomenon. A cross-sectional research design was used, a convenience sample of educators from the Gauteng province of South Africa was collected (N = 399). Confirmatory factor analysis was applied in a structural equation modelling framework. Discriminant validity analysis was conducted by investigating the average variance extracted and the shared variance between constructs. Finally, relative weight analysis was conducted to ascertain the unique contribution explained by the work-specific and general life domain factors. Results showed that burnout could be distinguished from depressive symptoms. Job demands, depressive symptoms, and satisfaction with life all explained significant amounts of variance in the burnout construct. Relative weight analysis revealed that emotional load and depressive symptoms explained equal amounts of variance in burnout, but that the aggregated work-specific factors explained the most variance in burnout. This study indicates that burnout is a multi-domain phenomenon and not isolated to the domain of work. Further research is needed in this regard.

Clinical supervision is fundamental to the training and development of professional psychologists; however, no clear supervision methods have been developed, and the ideal competencies for psychologists and supervisors are yet to be defined. This lack of consensus is aggravated in the field of clinical neuropsychology supervision due to the dearth of literature available, which has an impact not only in the supervisory activities and the training of new professionals, but also ultimately in the quality of service provided to people that in many cases could be considered to be a vulnerable population. The theoretical background provided in this review covers conceptual developments and debates in relation to clinical supervision. Specifically, it reflects on the definition of supervision in the context of neuropsychology, as well as competencies and practices required in order to render supervision. A brief review of supervision in the field of clinical neuropsychology is included. Additionally, some insights are offered into the dearth of research and theoretical developments in this area. Finally, some comments are included in relation to the professional progress of clinical neuropsychology in developing countries, with particular reference to South Africa.

Individual realities and perceptions are embedded in a web of dominant social and cultural views which shape the individual. Mothers of deaf children therefore cannot be understood in isolation, and neither can their experiences, perceptions, and well-being. The present research investigated the construction of deafness through the experiences of mothers raising a deaf child and considered the manner in which these constructions impacted their well-being and relationship with the child. The study explored the experiences of six Black South African hearing mothers of a deaf child between the ages of 3 and 8 years. Individual semi-structured interviews were conducted. Through an interpretive theoretical framework, this qualitative study noted seven main themes, namely, deafness is foreign and unknown, increased awareness and normalising of deafness, religious and Traditional African beliefs about disability/deafness, external pity and the mother’s rejection of it, the discourse of the ‘superiority’ of speech and encouragement of speech and hearing, barriers to communicating with her child, and ‘Why me?’ attribution of cause and the emergence of blame. Extrapolation of the data suggests that there is a lack of awareness regarding the deaf individual, and this creates misinformed perceptions about deafness which impact negatively both mother and child.

Two of the most popular psychotherapeutic approaches to treat depression are cognitive-behavioural therapy and psychodynamic psychotherapy, yet little consensus has been reached concerning which therapy is most beneficial for the treatment of depression. A review of the literature revealed that, while cognitive-behavioural therapy and psychodynamic psychotherapy are the most effective psychotherapeutic modalities for the treatment of depression, evidence suggests that neither of these modalities is superior to the other. Furthermore, multiple issues plague the studies investigating these treatments. Efficacy and effectiveness are often confounded, while rates of remission and response are often far less than might be expected from such highly regarded and widely used treatments. Severity of depression appears to moderate treatment outcomes, yet many studies overlook this, while the impact that the aetiology of a patient’s depression has on treatment outcomes is largely ignored in the literature. Additionally, a majority of studies have focused on therapies of short duration, which often have poor follow-up results. Finally, mechanisms of change in the treatment of depression have been ignored to a large extent, but there is some evidence that non-specific therapeutic factors may be more important than specific therapeutic techniques in producing positive treatment outcomes. These issues need to be closely examined and resolved if researchers and clinicians are serious about optimising treatments, improving outcomes, and adequately addressing the serious problem of depression.

We examine the extent to which psychotherapy can be successfully conducted with the aid of an interpreter. We propose that, even if we assume idealistic levels of training on the part of the interpreter and the therapist, and openness on the part of the client, there are still many challenges inherent in interpreter-assisted therapy. We focus on some of the characteristics common to client experiences of effective psychotherapy, as well as the characteristics and habits of effective therapists, and show how the insertion of an interpreter into the therapeutic relationship could affect both. Where the literature provides, we also note steps which could be taken to minimise the harmful impacts and maximise the positive contributions which the therapist–interpreter–client dynamic could yield. In South Africa, where informal interpreters play the invaluable role of facilitating essential communication between psychotherapists and their clients, it is imperative that informal interpreters, and clinicians working with interpreters, are aware of some of the complex issues at play in interpreted interactions. The issue of interpreting in mental health care is commonly addressed only in regard to the question of the competence of interpreters; we suggest that attitudinal and skill issues are equally important for clinicians. We conclude that successful therapy with an interpreter necessitates a consideration of the dynamic interaction between all parties involved.

Competitive state anxiety is a common response to stressful competitive sports situations that could affect athletic performance. The effects of state anxiety on swimming performance need further inquiry. The aim of the study was to determine the component of state anxiety that best predicts swimming performance. A quantitative, cross-sectional study design that made use of the Competitive State Anxiety Inventory-2 to measure precompetitive state anxiety was used. A total of 61 male high school swimmers whose age ranged between 14 and 19 years (M = 16.16, standard deviation = 1.66 years) completed the Competitive State Anxiety Inventory-2 1 hr before competing in a 50-m individual swimming event. Performance was evaluated using finishing position. Due to the relatively short duration of the 50-m event, the available literature would suggest that Somatic Anxiety would have a greater effect on Performance—there is not enough time to allow cognitive anxiety to have a detrimental impact on performance. Thus, it was hypothesized that somatic rather than cognitive anxiety will best predict swimming performance. It emerged that both cognitive (b = .787; p < .001) and somatic anxieties (b = .840; p < .001) can independently predict swimming performance. However, when both cognitive and somatic anxieties were regressed onto swimming performance, somatic anxiety partially dominated cognitive anxiety (b = .626; p < .001) and became the significant predictor of swimming performance. It is recommended that swimmers and swimming coaches make use of specific intervention strategies that eradicate the detrimental effects of somatic anxiety immediately before competition.

According to self-determination theory, an individual’s goal content and the processes involved in goal setting often represent the status of the individual’s mental health and well-being. When examining the importance placed on goal setting, an individual’s goals and aspirations are often synonymous with mental health and well-being. Aspiring to achieve intrinsic life goals has been associated with greater psychological well-being in literature. This study therefore aimed to establish the relationships between goals and aspirations, mental health behaviour (interpersonal relations, stress management, and spiritual growth), and psychological well-being (measured by positive affect). A sample of 457 secondary school learners in the Overberg Educational District, Western Cape, South Africa, participated in the study. The results suggest a significant positive relationship between placing importance on intrinsic goals and aspirations, and psychological well-being (as indicated by positive affect). However, psychological well-being was not correlated with mental health behaviour. The results of the hierarchical regression analysis suggest that importance placed on intrinsic goals and aspirations predicts psychological well-being and accounts for 8% of the variance. The results highlight the role of intrinsic goals and aspirations in predicting the psychological well-being of adolescents. The findings are supported by the theoretical assumptions of self-determination theory.