A case of effective single-session treatment for attention deficit and learning problems in a routine clinical practice : the value of a transdiagnostic approach to case formulation
- Whitefield-Alexander, V, Edwards, David J A
- Authors: Whitefield-Alexander, V , Edwards, David J A
- Date: 2009
- Language: English
- Type: Article
- Identifier: vital:6274 , http://hdl.handle.net/10962/d1008274
- Description: This article reports a systematic clinical case study of the psychological assessment and treatment of Daniel (9), a coloured South African boy with a diagnosis of attention deficit hyperactivity disorder (ADHD) (inattentive type). The case is of scientific interest because: (1) there was only a single treatment session, in which contingency management training was delivered to Daniel’s parents and teacher; (2) there was evidence for the effectiveness of the intervention immediately and at two-year follow-up; (3) it documents the transportability to a South African context of an intervention developed by overseas research; (4) it documents the central role of case formulation in the delivery of effective psychological interventions; and (5) although Daniel met the criteria for ADHD, he also displayed symptoms of depression and social anxiety and the case supports the use of a transdiagnostic approach to case formulation. The conscientiousness with which his parents and teachers applied the programme was a major factor in the effectiveness of the intervention, and such rapid impact would not be possible where parents and teachers are unavailable or not co-operative. The publication of systematic case studies such as this one is important for the development of a local evidence-based practice in South Africa.
- Full Text:
- Date Issued: 2009
- Authors: Whitefield-Alexander, V , Edwards, David J A
- Date: 2009
- Language: English
- Type: Article
- Identifier: vital:6274 , http://hdl.handle.net/10962/d1008274
- Description: This article reports a systematic clinical case study of the psychological assessment and treatment of Daniel (9), a coloured South African boy with a diagnosis of attention deficit hyperactivity disorder (ADHD) (inattentive type). The case is of scientific interest because: (1) there was only a single treatment session, in which contingency management training was delivered to Daniel’s parents and teacher; (2) there was evidence for the effectiveness of the intervention immediately and at two-year follow-up; (3) it documents the transportability to a South African context of an intervention developed by overseas research; (4) it documents the central role of case formulation in the delivery of effective psychological interventions; and (5) although Daniel met the criteria for ADHD, he also displayed symptoms of depression and social anxiety and the case supports the use of a transdiagnostic approach to case formulation. The conscientiousness with which his parents and teachers applied the programme was a major factor in the effectiveness of the intervention, and such rapid impact would not be possible where parents and teachers are unavailable or not co-operative. The publication of systematic case studies such as this one is important for the development of a local evidence-based practice in South Africa.
- Full Text:
- Date Issued: 2009
A cross-cultural study of interpersonal distance and orientation schemata
- Authors: Edwards, David J A
- Date: 1977
- Subjects: Personal space -- Testing Orientation (Psychology) Cross-cultural studies
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3206 , http://hdl.handle.net/10962/d1011743
- Description: Expectations about interpersonal distance during social encounters (distance schemata) and body orientation (orientation schemata) were investigated among White English-speakers and Xhosa groups which included illiterate traditionalists (Reds), poorly educated urban dwellers, and highly literate students and nurses. In a series of six experiments a doll placement task was used in which subjects represented dyadic encounters by placing pairs of standing dolls. For each situation represented the responses of each group of subjects were summarised in the form of a profile which showed the mean of the distance and three angle measures (IPOS profile). Independent variables included culture of subject, type of situation represented (friendly encounter, quarrel, accusation and denial, request) and the sex, age or relationship of the persons represented. In the culminating experiment (Experiment 6), females from three Xhosa groups (Reds or XR, poorly educated urban or XU, and urban nurses or XN) made twenty-three placements. In some respects the schemata of the four groups were very similar, while in others both distance and orientation schemata were a function of cultural group. The experiments allowed an assessment of the validity of the doll placement method to be made, and results were discussed in terms of the effects on interpersonal distance and body orientation of cultural norms concerning the showing of respect and the nature and strength of the emotions present in the various types of situation. It was concluded that with cultural movement away from the traditionalist pattern the schemata of the urban Xhosa showed a transition towards those found among the Whites in some respects. However, while the schemata of the XN group showed features of both those of the XR and White groups, those of the XU group showed features found in neither which seemed to reflect the insecurity of the cultural milieu of the urban poor.
- Full Text:
- Date Issued: 1977
- Authors: Edwards, David J A
- Date: 1977
- Subjects: Personal space -- Testing Orientation (Psychology) Cross-cultural studies
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3206 , http://hdl.handle.net/10962/d1011743
- Description: Expectations about interpersonal distance during social encounters (distance schemata) and body orientation (orientation schemata) were investigated among White English-speakers and Xhosa groups which included illiterate traditionalists (Reds), poorly educated urban dwellers, and highly literate students and nurses. In a series of six experiments a doll placement task was used in which subjects represented dyadic encounters by placing pairs of standing dolls. For each situation represented the responses of each group of subjects were summarised in the form of a profile which showed the mean of the distance and three angle measures (IPOS profile). Independent variables included culture of subject, type of situation represented (friendly encounter, quarrel, accusation and denial, request) and the sex, age or relationship of the persons represented. In the culminating experiment (Experiment 6), females from three Xhosa groups (Reds or XR, poorly educated urban or XU, and urban nurses or XN) made twenty-three placements. In some respects the schemata of the four groups were very similar, while in others both distance and orientation schemata were a function of cultural group. The experiments allowed an assessment of the validity of the doll placement method to be made, and results were discussed in terms of the effects on interpersonal distance and body orientation of cultural norms concerning the showing of respect and the nature and strength of the emotions present in the various types of situation. It was concluded that with cultural movement away from the traditionalist pattern the schemata of the urban Xhosa showed a transition towards those found among the Whites in some respects. However, while the schemata of the XN group showed features of both those of the XR and White groups, those of the XU group showed features found in neither which seemed to reflect the insecurity of the cultural milieu of the urban poor.
- Full Text:
- Date Issued: 1977
A successful cognitive-behavioural intervention that failed : a case study of adolescent conduct disorder at a school for the disadvantaged
- Mashalaba, Eugenia D, Edwards, David J A
- Authors: Mashalaba, Eugenia D , Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6273 , http://hdl.handle.net/10962/d1008273
- Description: Conduct Disorder (CD) is a widespread problem in southern Africa. The aim of the study was to design, implement and evaluate a multi-modal cognitive-behavioural intervention based on treatments developed overseas, in order to investigate whether this approach can be transported to a South African school for deprived children. The target adolescent had a history of severely disruptive behaviour and was facing expulsion from a shelter for homeless children and his school. A thorough assessment served as the basis for a case formulation and treatment plan. Intervention included 23 individual sessions focussing on bereavement and the learning of self-control skills and prosocial behaviours, as well as contingency management training for school and shelter staff. Progress was tracked with a behaviour checklist completed daily by the teacher and regular interviews with school and shelter staff. After four months, the disruptive behaviour was eliminated. However, he was involved in stealing with some other learners and expelled anyway. Nevertheless the case study provides evidence for the transportability of the cognitive-behavioural approach to this kind of setting and documents the way in which a comprehensive intervention can be tailored to the needs of a child with a severely deprived background and little social support.
- Full Text:
- Date Issued: 2005
- Authors: Mashalaba, Eugenia D , Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6273 , http://hdl.handle.net/10962/d1008273
- Description: Conduct Disorder (CD) is a widespread problem in southern Africa. The aim of the study was to design, implement and evaluate a multi-modal cognitive-behavioural intervention based on treatments developed overseas, in order to investigate whether this approach can be transported to a South African school for deprived children. The target adolescent had a history of severely disruptive behaviour and was facing expulsion from a shelter for homeless children and his school. A thorough assessment served as the basis for a case formulation and treatment plan. Intervention included 23 individual sessions focussing on bereavement and the learning of self-control skills and prosocial behaviours, as well as contingency management training for school and shelter staff. Progress was tracked with a behaviour checklist completed daily by the teacher and regular interviews with school and shelter staff. After four months, the disruptive behaviour was eliminated. However, he was involved in stealing with some other learners and expelled anyway. Nevertheless the case study provides evidence for the transportability of the cognitive-behavioural approach to this kind of setting and documents the way in which a comprehensive intervention can be tailored to the needs of a child with a severely deprived background and little social support.
- Full Text:
- Date Issued: 2005
An investigation of the determinants of the spatial characteristics of figure placements
- Authors: Edwards, David J A
- Date: 1973
- Subjects: Characters and characteristics , Psychology, Applied , Cross-cultural studies
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3205 , http://hdl.handle.net/10962/d1011739 , Characters and characteristics , Psychology, Applied , Cross-cultural studies
- Description: The doll placement technique is a projective instrument which yields objective measures from which inferences may be drawn. Subjects place pairs of dolls to represent social encounters described to them by the experimenter. When the dolls have been placed, the distance between them and the angles at which they stand can serve as a source of information either about the personality of the placer or about the way in which he perceives the relationship between the interactors represented. Most experimental work employing figure placements has used flat felt figures which subjects have mounted on a flannel graph. This method limits an investigator to one dependent variable, the inter-figure distance. However if three dimensional dolls are placed three dependent measures can be derived from a placement, one of distance and two of orientation. It has been demonstrated that a reliable correlation exists between the spatial relations between figures placed by a person and the spatial relationships between real interactors. The theoretical analysis of the determinants of interpersonal distance and orientation in social encounters which has been worked out by students of non-verbal behaviour is therefore able to serve as a basis for the interpretation of the spatial characteristics of doll placements. Previous work with the doll placement technique has concentrated on the distance between dolls. The present study explored the determinants of figure orientations. Firstly an analysis was made of the types of orientation pattern that can occur when two persons are involved in a social encounter. Secondly, an experiment was performed which was designed to explore whether asymmetry in an orientation pattern might act as a cue to determine how individual figures in a pair were perceived. Thirdly, two doll placement studies were performed which were designed to investigate the conditions giving rise to asymmetrical orientation patterns and the determinants of direct and indirect orientations. The confidence or anxiety attributed to an interactor represented by a figure proved to be a major determinant of its spatial position. The results of the study indicate that the use of the angle measures in the analysis of doll placements considerably enhances the value of the technique. It is argued that the doll placement method could be profitably employed both as a clinical instrument and as a research tool for cross-cultural psychology.
- Full Text:
- Date Issued: 1973
- Authors: Edwards, David J A
- Date: 1973
- Subjects: Characters and characteristics , Psychology, Applied , Cross-cultural studies
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3205 , http://hdl.handle.net/10962/d1011739 , Characters and characteristics , Psychology, Applied , Cross-cultural studies
- Description: The doll placement technique is a projective instrument which yields objective measures from which inferences may be drawn. Subjects place pairs of dolls to represent social encounters described to them by the experimenter. When the dolls have been placed, the distance between them and the angles at which they stand can serve as a source of information either about the personality of the placer or about the way in which he perceives the relationship between the interactors represented. Most experimental work employing figure placements has used flat felt figures which subjects have mounted on a flannel graph. This method limits an investigator to one dependent variable, the inter-figure distance. However if three dimensional dolls are placed three dependent measures can be derived from a placement, one of distance and two of orientation. It has been demonstrated that a reliable correlation exists between the spatial relations between figures placed by a person and the spatial relationships between real interactors. The theoretical analysis of the determinants of interpersonal distance and orientation in social encounters which has been worked out by students of non-verbal behaviour is therefore able to serve as a basis for the interpretation of the spatial characteristics of doll placements. Previous work with the doll placement technique has concentrated on the distance between dolls. The present study explored the determinants of figure orientations. Firstly an analysis was made of the types of orientation pattern that can occur when two persons are involved in a social encounter. Secondly, an experiment was performed which was designed to explore whether asymmetry in an orientation pattern might act as a cue to determine how individual figures in a pair were perceived. Thirdly, two doll placement studies were performed which were designed to investigate the conditions giving rise to asymmetrical orientation patterns and the determinants of direct and indirect orientations. The confidence or anxiety attributed to an interactor represented by a figure proved to be a major determinant of its spatial position. The results of the study indicate that the use of the angle measures in the analysis of doll placements considerably enhances the value of the technique. It is argued that the doll placement method could be profitably employed both as a clinical instrument and as a research tool for cross-cultural psychology.
- Full Text:
- Date Issued: 1973
Cognitive restructuring through guided imagery : lessons from Gestalt therapy
- Authors: Edwards, David J A
- Date: 1989
- Language: English
- Type: Text
- Identifier: vital:6281 , http://hdl.handle.net/10962/d1013181
- Description: [Summary] In this chapter, a guided imagery method used in gestalt therapy was described in detail and analyzed into its specific components. The basic principles underlying the imagery work were shown to be analogous to those upon which standard cognitive therapy is founded, and this was illustrated by means of case examples, first from one of Perls' dreamwork seminars and then from the author's case files. It was shown how the method could be used to elicit the idiosyncratic meanings of the client in relation to a specific theme and to identify core dysfunctional assumptions. Illustrations were given of specific techniques that could be employed to challenge and restructure these cognitions. The benefits of the imagery modality are that it provides: (1) access to cognitions underlying emotional responses that may be difficult to identify through questioning, (2) a holistic presentation of networks of beliefs, and (3) a means of keeping the client in contact with avoided painful affect. Once a good conceptualization of the client's problem has been achieved, guided imagery provides a modality within which specific strategies for cognitive restructuring can be facilitated through guided discovery. Therapists who are willing to explore this modality and find an aptitude for it will be gaining access to something that will greatly enrich their potential for helping and can provide exciting avenues for developing their own creativity in the challenging work of enabling clients to identify and free themselves from dysfunctional personal meaning systems.
- Full Text:
- Date Issued: 1989
- Authors: Edwards, David J A
- Date: 1989
- Language: English
- Type: Text
- Identifier: vital:6281 , http://hdl.handle.net/10962/d1013181
- Description: [Summary] In this chapter, a guided imagery method used in gestalt therapy was described in detail and analyzed into its specific components. The basic principles underlying the imagery work were shown to be analogous to those upon which standard cognitive therapy is founded, and this was illustrated by means of case examples, first from one of Perls' dreamwork seminars and then from the author's case files. It was shown how the method could be used to elicit the idiosyncratic meanings of the client in relation to a specific theme and to identify core dysfunctional assumptions. Illustrations were given of specific techniques that could be employed to challenge and restructure these cognitions. The benefits of the imagery modality are that it provides: (1) access to cognitions underlying emotional responses that may be difficult to identify through questioning, (2) a holistic presentation of networks of beliefs, and (3) a means of keeping the client in contact with avoided painful affect. Once a good conceptualization of the client's problem has been achieved, guided imagery provides a modality within which specific strategies for cognitive restructuring can be facilitated through guided discovery. Therapists who are willing to explore this modality and find an aptitude for it will be gaining access to something that will greatly enrich their potential for helping and can provide exciting avenues for developing their own creativity in the challenging work of enabling clients to identify and free themselves from dysfunctional personal meaning systems.
- Full Text:
- Date Issued: 1989
Cognitive therapy and the restructuring of early memories through guided imagery
- Authors: Edwards, David J A
- Date: 1990
- Language: English
- Type: Article
- Identifier: vital:6241 , http://hdl.handle.net/10962/d1007853
- Description: This article describes the application of a guided imagery psychodrama technique to emotionally charged early memories. Such memories provide access to core schemata about the self and social relationships. Two case studies illustrate how the imagery technique enables the therapist to identify and restructure key cognitions out of which the schemata are constructed. The need for techniques to modify developmentally primitive schemata is discussed. Examples are given of ways to assist the patient in confronting the strong affect that may be aroused and in dealing with cognitions that block the process. Effectiveness is discussed in terms of the contribution of a guided imagery session to the overall process of ''learning to learn'' that takes place in cognitive psychotherapy.
- Full Text: false
- Date Issued: 1990
- Authors: Edwards, David J A
- Date: 1990
- Language: English
- Type: Article
- Identifier: vital:6241 , http://hdl.handle.net/10962/d1007853
- Description: This article describes the application of a guided imagery psychodrama technique to emotionally charged early memories. Such memories provide access to core schemata about the self and social relationships. Two case studies illustrate how the imagery technique enables the therapist to identify and restructure key cognitions out of which the schemata are constructed. The need for techniques to modify developmentally primitive schemata is discussed. Examples are given of ways to assist the patient in confronting the strong affect that may be aroused and in dealing with cognitions that block the process. Effectiveness is discussed in terms of the contribution of a guided imagery session to the overall process of ''learning to learn'' that takes place in cognitive psychotherapy.
- Full Text: false
- Date Issued: 1990
Cognitive therapy for social phobia : the human face of cognitive science
- Edwards, David J A, Henwood, Jennifer, Kannan, Swetha
- Authors: Edwards, David J A , Henwood, Jennifer , Kannan, Swetha
- Date: 2003
- Language: English
- Type: Article
- Identifier: vital:6280 , http://hdl.handle.net/10962/d1008281
- Description: [abstract from Index to SA Periodicals]Points to the male/masculine ideology pervading science. Gives a history of cognitive science. Shows that current clinical models on which cognitive therapy treatments are based are complex and detailed, but also situated and human. Warns about the contemporary enthusiasm for cognitive science. Presents a case study which illustrates how the cognitive model of social phobia works inpractice when applied to one person's life situation.
- Full Text:
- Date Issued: 2003
- Authors: Edwards, David J A , Henwood, Jennifer , Kannan, Swetha
- Date: 2003
- Language: English
- Type: Article
- Identifier: vital:6280 , http://hdl.handle.net/10962/d1008281
- Description: [abstract from Index to SA Periodicals]Points to the male/masculine ideology pervading science. Gives a history of cognitive science. Shows that current clinical models on which cognitive therapy treatments are based are complex and detailed, but also situated and human. Warns about the contemporary enthusiasm for cognitive science. Presents a case study which illustrates how the cognitive model of social phobia works inpractice when applied to one person's life situation.
- Full Text:
- Date Issued: 2003
Cognitive-behavioral and existential-phenomenological approaches to therapy : complementary or conflicting paradigms?
- Authors: Edwards, David J A
- Date: 1990
- Language: English
- Type: Article
- Identifier: vital:6242 , http://hdl.handle.net/10962/d1007854
- Description: The relationship between the cognitive-behavioral and existential-phenomenological traditions in therapy is examined. While Beck cites phenomenological writers such as Heidegger, Husserl, and Binswanger, he does not initiate any dialogue with this tradition in depth. Parallels are drawn between the goals of psychotherapy as outlined by Rogers and goals identified in the contemporary cognitive-behavioral literature, between cognitive therapy's approach to clients' underlying assumptions and the phenomenological reduction as described by Husserl, and between a shared acceptance of the therapeutic use of the client-therapist interaction. While, in both approaches, therapists take on an educative role, in each approach a different aspect of the learning process is focused on. Phenomenological therapy's attitude to reality testing, the dangers of a directive stance by the therapist, the conflict between empathy and rational dialogue, and cognitive therapy's view of emotion are also discussed. The complementarity between the two approaches is emphasized and a continuing dialogue recommended.
- Full Text:
- Date Issued: 1990
- Authors: Edwards, David J A
- Date: 1990
- Language: English
- Type: Article
- Identifier: vital:6242 , http://hdl.handle.net/10962/d1007854
- Description: The relationship between the cognitive-behavioral and existential-phenomenological traditions in therapy is examined. While Beck cites phenomenological writers such as Heidegger, Husserl, and Binswanger, he does not initiate any dialogue with this tradition in depth. Parallels are drawn between the goals of psychotherapy as outlined by Rogers and goals identified in the contemporary cognitive-behavioral literature, between cognitive therapy's approach to clients' underlying assumptions and the phenomenological reduction as described by Husserl, and between a shared acceptance of the therapeutic use of the client-therapist interaction. While, in both approaches, therapists take on an educative role, in each approach a different aspect of the learning process is focused on. Phenomenological therapy's attitude to reality testing, the dangers of a directive stance by the therapist, the conflict between empathy and rational dialogue, and cognitive therapy's view of emotion are also discussed. The complementarity between the two approaches is emphasized and a continuing dialogue recommended.
- Full Text:
- Date Issued: 1990
Collaborative versus adversarial stances in scientific discourse : implications for the role of systematic case studies in the development of evidence-based practice in psychotherapy
- Authors: Edwards, David J A
- Date: 2007
- Language: English
- Type: Article
- Identifier: vital:6245 , http://hdl.handle.net/10962/d1007861
- Description: There is still a need for advocacy in the promotion of case study research because there has been insufficient appreciation of its role as a source of evidence relevant to the development and evaluation of practice in psychotherapy. Distorted use of terms like "gold standard", "anecdotal",and "empirical" in the discourse in which research methodology is typically presented has disempowered the practitioner's perspective and discredited the role of case-based knowledge building. The framework of evidence-based practice (EBP) recognizes the complementarity of different research methods and acknowledges the significance of casebased research. To spell out some of these complementary links, a typology of seven research methods - including both experimental group comparison designs and individual case studies - is proposed and the contribution of each to the development of EBP is set out. Finally some suggestions are made for strategies to promote the publication of high quality case studies.
- Full Text:
- Date Issued: 2007
- Authors: Edwards, David J A
- Date: 2007
- Language: English
- Type: Article
- Identifier: vital:6245 , http://hdl.handle.net/10962/d1007861
- Description: There is still a need for advocacy in the promotion of case study research because there has been insufficient appreciation of its role as a source of evidence relevant to the development and evaluation of practice in psychotherapy. Distorted use of terms like "gold standard", "anecdotal",and "empirical" in the discourse in which research methodology is typically presented has disempowered the practitioner's perspective and discredited the role of case-based knowledge building. The framework of evidence-based practice (EBP) recognizes the complementarity of different research methods and acknowledges the significance of casebased research. To spell out some of these complementary links, a typology of seven research methods - including both experimental group comparison designs and individual case studies - is proposed and the contribution of each to the development of EBP is set out. Finally some suggestions are made for strategies to promote the publication of high quality case studies.
- Full Text:
- Date Issued: 2007
Critical perspectives on research on post-traumatic stress disorder and implications for the South African context
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6228 , http://hdl.handle.net/10962/d1007778
- Description: This article introduces a special issue of the Journal of Psychology in Africa on post-traumatic stress disorder (PTSD) in Africa and particularly in South Africa and examines the critical debate that has surrounded PTSD research. It begins with an examination of the meaning of the term trauma, and of its specialised use within the clinical context and with respect to the concept of PTSD. The diagnostic approach to the detection of PTSD is presented, criteria in the DSM-IV-TR and the ICD-10 are summarised and differences between the two manuals are discussed. Arguments presented by critics of the concept of PTSD are presented and discussed. These concern the historical evolution of the concept, concerns about the universality of PTSD cross-culturally, and problems arising from understanding human suffering from a narrow medical perspective. It is concluded that while there are dangers in thinking of the sequelae of trauma as a medical/psychiatric problem, and while the alarming rate of traumatic events needs to be addressed at the political, economic and societal level, there is an important place for the provision of assessment and treatment of PTSD within a psychiatric/psychological clinical setting.
- Full Text:
- Date Issued: 2005
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6228 , http://hdl.handle.net/10962/d1007778
- Description: This article introduces a special issue of the Journal of Psychology in Africa on post-traumatic stress disorder (PTSD) in Africa and particularly in South Africa and examines the critical debate that has surrounded PTSD research. It begins with an examination of the meaning of the term trauma, and of its specialised use within the clinical context and with respect to the concept of PTSD. The diagnostic approach to the detection of PTSD is presented, criteria in the DSM-IV-TR and the ICD-10 are summarised and differences between the two manuals are discussed. Arguments presented by critics of the concept of PTSD are presented and discussed. These concern the historical evolution of the concept, concerns about the universality of PTSD cross-culturally, and problems arising from understanding human suffering from a narrow medical perspective. It is concluded that while there are dangers in thinking of the sequelae of trauma as a medical/psychiatric problem, and while the alarming rate of traumatic events needs to be addressed at the political, economic and societal level, there is an important place for the provision of assessment and treatment of PTSD within a psychiatric/psychological clinical setting.
- Full Text:
- Date Issued: 2005
Developing evidence-based practice: the role of case-based research
- Edwards, David J A, Dattilio, F M, Bromley, D B
- Authors: Edwards, David J A , Dattilio, F M , Bromley, D B
- Date: 2004
- Language: English
- Type: Article
- Identifier: vital:6243 , http://hdl.handle.net/10962/d1007856
- Description: How can practitioners engage in evidence-based practice when the evidence for effectiveness of psychological treatments comes from randomized controlled trials using patient populations different from those encountered in everyday settings and treatment manuals that seem oversimplified and inflexible? The authors argue that important evidence about best practice comes from case-based research, which builds knowledge in a clinically useful manner and complements what is achieved by multivariate research methods. A multidimensional model of the research process is provided that includes clinical practice and case-based research as significant contributors. The authors summarize the principles of case-based research and provide examples of recent technical advances. Finally, the authors suggest ways in which practitioners can apply the case-based approach in researching and publishing their own cases, perhaps in collaboration with university-based researchers.
- Full Text:
- Date Issued: 2004
- Authors: Edwards, David J A , Dattilio, F M , Bromley, D B
- Date: 2004
- Language: English
- Type: Article
- Identifier: vital:6243 , http://hdl.handle.net/10962/d1007856
- Description: How can practitioners engage in evidence-based practice when the evidence for effectiveness of psychological treatments comes from randomized controlled trials using patient populations different from those encountered in everyday settings and treatment manuals that seem oversimplified and inflexible? The authors argue that important evidence about best practice comes from case-based research, which builds knowledge in a clinically useful manner and complements what is achieved by multivariate research methods. A multidimensional model of the research process is provided that includes clinical practice and case-based research as significant contributors. The authors summarize the principles of case-based research and provide examples of recent technical advances. Finally, the authors suggest ways in which practitioners can apply the case-based approach in researching and publishing their own cases, perhaps in collaboration with university-based researchers.
- Full Text:
- Date Issued: 2004
Development and validation of the Xhosa translations of the Beck Inventories: 1. Challenges of the translation process
- Steele, Gary I, Edwards, David J A
- Authors: Steele, Gary I , Edwards, David J A
- Date: 2008
- Language: English
- Type: Article
- Identifier: vital:6248 , http://hdl.handle.net/10962/d1007866
- Description: This article describes the translation of the Beck Depression Inventory-II, the Beck Hopeless Scale, and the Beck Anxiety Inventory, into Xhosa the language spoken in the Eastern Cape of South Africa. The processes of translation, back-translation and committee discussion failed to yield trustworthy translations because of practical difficulties in working with translators. Critical words and phrases were identified which gave rise to lack of agreement. For each, a range of options was generated and the advantages and disadvantages evaluated in terms of criteria such as conceptual and idiomatic equivalence, and extensiveness of usage. Examples are given of the problems encountered and the way in which final decisions were made. A pilot clinical trial demonstrated the acceptability of the translated Instruments. Two further articles report the psychometric evaluation of the translated scales.
- Full Text:
- Date Issued: 2008
- Authors: Steele, Gary I , Edwards, David J A
- Date: 2008
- Language: English
- Type: Article
- Identifier: vital:6248 , http://hdl.handle.net/10962/d1007866
- Description: This article describes the translation of the Beck Depression Inventory-II, the Beck Hopeless Scale, and the Beck Anxiety Inventory, into Xhosa the language spoken in the Eastern Cape of South Africa. The processes of translation, back-translation and committee discussion failed to yield trustworthy translations because of practical difficulties in working with translators. Critical words and phrases were identified which gave rise to lack of agreement. For each, a range of options was generated and the advantages and disadvantages evaluated in terms of criteria such as conceptual and idiomatic equivalence, and extensiveness of usage. Examples are given of the problems encountered and the way in which final decisions were made. A pilot clinical trial demonstrated the acceptability of the translated Instruments. Two further articles report the psychometric evaluation of the translated scales.
- Full Text:
- Date Issued: 2008
Disturbances of attitudes and behaviours related to eating in black and white females at high school and university in South Africa
- Edwards, David J A, d'Agrela, A, Geach, M, Welman, Mark
- Authors: Edwards, David J A , d'Agrela, A , Geach, M , Welman, Mark
- Date: 2003
- Language: English
- Type: Article
- Identifier: vital:6246 , http://hdl.handle.net/10962/d1007864
- Description: This paper reports two studies, which contribute to the increasing evidence that the attitudes and behaviours associated with eating disorders, are encountered among both black and white females in South Africa. In Study One, the Eating Disorders Inventory EDI was administered to black (n=39) and white (n=41) female students in Natal. There were no significant differences between black and white on the sub-scales which measure disturbed eating behaviour directly (Drive for Thinness, Bulimia, Body Dissatisfaction). However black respondents scrored higher on Perfectionism, Interpersonal Distrust and Maturity Fears, variables believed to predispose individuals to eating disorders. In Study Two, the Bulimia Test (BULIT) was administered to black and white females at three educational levels. There was no significant effect of Ethnicity, but there was a significant effect of Age: Standard 6 respondents had significantly higher scores than University students. In both studies, Body mass index (BMI) was significantly higher among blacks than whites. In Study One there was no significant correlation between BMI and Drive for Thinness in either blacks or whites. However in Study Two, the correlation between BMI and BULIT full scale was significant in the case of both blacks (r = 0,39; p <,01) and whites (r = 0,38; p<,05). These findings are consistent with those of other recent studies, which find disturbances in eating-related attitudes and behaviour in all ethnic groups in South Africa.
- Full Text:
- Date Issued: 2003
- Authors: Edwards, David J A , d'Agrela, A , Geach, M , Welman, Mark
- Date: 2003
- Language: English
- Type: Article
- Identifier: vital:6246 , http://hdl.handle.net/10962/d1007864
- Description: This paper reports two studies, which contribute to the increasing evidence that the attitudes and behaviours associated with eating disorders, are encountered among both black and white females in South Africa. In Study One, the Eating Disorders Inventory EDI was administered to black (n=39) and white (n=41) female students in Natal. There were no significant differences between black and white on the sub-scales which measure disturbed eating behaviour directly (Drive for Thinness, Bulimia, Body Dissatisfaction). However black respondents scrored higher on Perfectionism, Interpersonal Distrust and Maturity Fears, variables believed to predispose individuals to eating disorders. In Study Two, the Bulimia Test (BULIT) was administered to black and white females at three educational levels. There was no significant effect of Ethnicity, but there was a significant effect of Age: Standard 6 respondents had significantly higher scores than University students. In both studies, Body mass index (BMI) was significantly higher among blacks than whites. In Study One there was no significant correlation between BMI and Drive for Thinness in either blacks or whites. However in Study Two, the correlation between BMI and BULIT full scale was significant in the case of both blacks (r = 0,39; p <,01) and whites (r = 0,38; p<,05). These findings are consistent with those of other recent studies, which find disturbances in eating-related attitudes and behaviour in all ethnic groups in South Africa.
- Full Text:
- Date Issued: 2003
From panic disorder to complex traumatic stress disorder : retrospective reflections on the case of Tariq
- Authors: Edwards, David J A
- Date: 2013
- Language: English
- Type: Article
- Identifier: vital:6234 , http://hdl.handle.net/10962/d1007784
- Description: This is a phenomenological-hermeneutic case study of Tariq who initially presented with panic disorder. It documents how, as therapy proceeded, the underlying meaning of his initial panic deepened as its roots in traumatic memories of childhood emerged. There were four spaced phases of treatment over four years. The first focused on anxiety management; the second was conceptualized within schema-focused therapy, and evoked and worked with childhood memories using inner child guided imagery; in the third and fourth phases insights gained led to an authentic re-engagement with family members in relationships that had been problematic. The panic attacks resolved and there were two dreams representing a reconfiguring of his relationship with his deceased father. The first two phases were the focus of an unpublished case study presented at a conference in 1995. This article incorporates material from that study and looks back at the case both in light of developments in phases two and three and also in light of theoretical developments in our understanding of complex trauma since the initial presentation.
- Full Text:
- Date Issued: 2013
- Authors: Edwards, David J A
- Date: 2013
- Language: English
- Type: Article
- Identifier: vital:6234 , http://hdl.handle.net/10962/d1007784
- Description: This is a phenomenological-hermeneutic case study of Tariq who initially presented with panic disorder. It documents how, as therapy proceeded, the underlying meaning of his initial panic deepened as its roots in traumatic memories of childhood emerged. There were four spaced phases of treatment over four years. The first focused on anxiety management; the second was conceptualized within schema-focused therapy, and evoked and worked with childhood memories using inner child guided imagery; in the third and fourth phases insights gained led to an authentic re-engagement with family members in relationships that had been problematic. The panic attacks resolved and there were two dreams representing a reconfiguring of his relationship with his deceased father. The first two phases were the focus of an unpublished case study presented at a conference in 1995. This article incorporates material from that study and looks back at the case both in light of developments in phases two and three and also in light of theoretical developments in our understanding of complex trauma since the initial presentation.
- Full Text:
- Date Issued: 2013
From trauma debriefing to trauma support: a South African experience of responding to individuals and communities in the aftermath of traumatising events
- Van Wyk, G, Edwards, David J A
- Authors: Van Wyk, G , Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6267 , http://hdl.handle.net/10962/d1008266
- Description: This paper documents the approach and experience of Traumaclinic, a Cape Town based organisation offering a trauma support service. The controversy over single session debriefing interventions is examined and it is concluded that interventions that invite intense emotional expression should not be offered indiscriminately or forced on those who do not want them. When they do occur, they need to be carefully managed and take place over several sessions. A review of contemporary approaches to intervention following trauma highlights their comprehensive and flexible nature and the inclusion of multiple components that are introduced in a manner responsive to the needs of the situation. This is the basis of the current model used by Traumaclinic. The principles of that model are summarised and examples given of the application of the approach to specific cases.
- Full Text:
- Date Issued: 2005
- Authors: Van Wyk, G , Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6267 , http://hdl.handle.net/10962/d1008266
- Description: This paper documents the approach and experience of Traumaclinic, a Cape Town based organisation offering a trauma support service. The controversy over single session debriefing interventions is examined and it is concluded that interventions that invite intense emotional expression should not be offered indiscriminately or forced on those who do not want them. When they do occur, they need to be carefully managed and take place over several sessions. A review of contemporary approaches to intervention following trauma highlights their comprehensive and flexible nature and the inclusion of multiple components that are introduced in a manner responsive to the needs of the situation. This is the basis of the current model used by Traumaclinic. The principles of that model are summarised and examples given of the application of the approach to specific cases.
- Full Text:
- Date Issued: 2005
Handling multiple levels of data and multiple research questions in an embedded case study : methodological challenges
- Authors: Edwards, David J A
- Date: 2008
- Language: English
- Type: Article
- Identifier: vital:6247 , http://hdl.handle.net/10962/d1007865
- Description: Hougaard et al. report an embedded case study in which nine socially phobic clients were treated as part of a therapy program, which incorporated individual and group therapy and which was largely delivered by trainee clinicians. An important focus of the report is on the effectiveness of their treatment model. This commentary draws attention to the size and complexity of the available data, and it suggests ways in which the use of a more explicitly interpretative methodology can draw out additional dimensions of the data and allow a more systematic contribution to be made to the development of clinical theory.
- Full Text:
- Date Issued: 2008
- Authors: Edwards, David J A
- Date: 2008
- Language: English
- Type: Article
- Identifier: vital:6247 , http://hdl.handle.net/10962/d1007865
- Description: Hougaard et al. report an embedded case study in which nine socially phobic clients were treated as part of a therapy program, which incorporated individual and group therapy and which was largely delivered by trainee clinicians. An important focus of the report is on the effectiveness of their treatment model. This commentary draws attention to the size and complexity of the available data, and it suggests ways in which the use of a more explicitly interpretative methodology can draw out additional dimensions of the data and allow a more systematic contribution to be made to the development of clinical theory.
- Full Text:
- Date Issued: 2008
Identifying and targeting idiosyncratic cognitive processes in group therapy for social phobia : the case of Vumile
- Edwards, David J A, Kannan, Swetha
- Authors: Edwards, David J A , Kannan, Swetha
- Date: 2006
- Language: English
- Type: Article
- Identifier: vital:6244 , http://hdl.handle.net/10962/d1007859
- Description: “Vumile” was a patient in a cognitive therapy group that was designed for socially phobic African students and based on a therapy model developed by Clark and Wells. The case narrative shows how Vumile constructed a personal model of the factors maintaining his social phobia, and within the group and through homework challenged negative beliefs, reduced selfconsciousness and engaged in a range of previously avoided behaviors. A significant maintaining factor, spontaneous images of women looking at him with pity or mockery, was only identified in the last session. However, Vumile was able to use the skills he had learned to investigate this further and to correct these processes, which were distorting his experience of social interactions with women. Significant gains were made after the end of the formal treatment program and these are reflected in scores at follow-up on several self-report scales measuring anxiety, depression and various aspects of social phobic behavior and cognition.
- Full Text:
- Date Issued: 2006
- Authors: Edwards, David J A , Kannan, Swetha
- Date: 2006
- Language: English
- Type: Article
- Identifier: vital:6244 , http://hdl.handle.net/10962/d1007859
- Description: “Vumile” was a patient in a cognitive therapy group that was designed for socially phobic African students and based on a therapy model developed by Clark and Wells. The case narrative shows how Vumile constructed a personal model of the factors maintaining his social phobia, and within the group and through homework challenged negative beliefs, reduced selfconsciousness and engaged in a range of previously avoided behaviors. A significant maintaining factor, spontaneous images of women looking at him with pity or mockery, was only identified in the last session. However, Vumile was able to use the skills he had learned to investigate this further and to correct these processes, which were distorting his experience of social interactions with women. Significant gains were made after the end of the formal treatment program and these are reflected in scores at follow-up on several self-report scales measuring anxiety, depression and various aspects of social phobic behavior and cognition.
- Full Text:
- Date Issued: 2006
Mythic and theoretic aspects of the concept of 'the unconscious' in popular and psychological discourse
- Authors: Edwards, David J A
- Date: 2003
- Language: English
- Type: Article
- Identifier: vital:6227 , http://hdl.handle.net/10962/d1007777
- Description: From the introduction: In Greek mythology, Typhon was the youngest son of Gaea (the Earth) and Tartarus (the underworld). Typhon was not a beautiful baby. He was a grisly monster with a hundred dragons' heads. He was one of the Titans, a group of powerful and dangerous creatures who rebelled against Zeus, the King of the Gods. The rebellion was crushed and Typhon was imprisoned under Mount Etna, the volcano in Sicily which was active in classical times and remains active today. It was said that when Typhon raged, the earth shook and Etna erupted. Many such tales from mythology from all over world seem to dramatize aspects of our relationship with potent forces of which we have little understanding and over which we have little control. Many of these forces are less concrete than the forces of nature. They arise from our apprehension of our existential predicaments, our interpersonal vulnerability and the intensity of our own psychological pain. In many contemporary discourses this territory is referred to more neutrally as ‘the unconscious;’ but the unconscious will always elude our attempts to capture it in words.
- Full Text:
- Date Issued: 2003
- Authors: Edwards, David J A
- Date: 2003
- Language: English
- Type: Article
- Identifier: vital:6227 , http://hdl.handle.net/10962/d1007777
- Description: From the introduction: In Greek mythology, Typhon was the youngest son of Gaea (the Earth) and Tartarus (the underworld). Typhon was not a beautiful baby. He was a grisly monster with a hundred dragons' heads. He was one of the Titans, a group of powerful and dangerous creatures who rebelled against Zeus, the King of the Gods. The rebellion was crushed and Typhon was imprisoned under Mount Etna, the volcano in Sicily which was active in classical times and remains active today. It was said that when Typhon raged, the earth shook and Etna erupted. Many such tales from mythology from all over world seem to dramatize aspects of our relationship with potent forces of which we have little understanding and over which we have little control. Many of these forces are less concrete than the forces of nature. They arise from our apprehension of our existential predicaments, our interpersonal vulnerability and the intensity of our own psychological pain. In many contemporary discourses this territory is referred to more neutrally as ‘the unconscious;’ but the unconscious will always elude our attempts to capture it in words.
- Full Text:
- Date Issued: 2003
Post-traumatic stress disorder as a public health concern in South Africa
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6229 , http://hdl.handle.net/10962/d1007779
- Description: This article briefly surveys the extent to which traumatic events are a feature of life all over Africa and provides a comprehensive review of research that documents the pervasiveness of traumatic events in South Africa and the prevalence of PTSD symptoms. The material reviewed includes statistics on crime, violence and accidents, research from clinical settings, and surveys. Several provide evidence for the causal link between traumatic events and the development of PTSD. These studies show that PTSD has been and continues to be a significant problem for public health in South Africa, affecting individuals in all sectors of society and as much a concern with respect to children as to adults.
- Full Text:
- Date Issued: 2005
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6229 , http://hdl.handle.net/10962/d1007779
- Description: This article briefly surveys the extent to which traumatic events are a feature of life all over Africa and provides a comprehensive review of research that documents the pervasiveness of traumatic events in South Africa and the prevalence of PTSD symptoms. The material reviewed includes statistics on crime, violence and accidents, research from clinical settings, and surveys. Several provide evidence for the causal link between traumatic events and the development of PTSD. These studies show that PTSD has been and continues to be a significant problem for public health in South Africa, affecting individuals in all sectors of society and as much a concern with respect to children as to adults.
- Full Text:
- Date Issued: 2005
Responsive integrative treatment of PTSD and trauma related disorders : an expanded evidence-based model
- Authors: Edwards, David J A
- Date: 2013
- Language: English
- Type: Article
- Identifier: vital:6223 , http://hdl.handle.net/10962/d1007679
- Description: In this article a practitioner oriented review of the literature on the treatment of post-traumatic stress disorder is used to construct a phase-based model that can serve as a basis for case formulation and treatment planning. Treatments shown to be efficacious in randomized controlled trials are listed and two discourses about them are contrasted. One calls for therapists to implement treatments scrupulously according to the manual, the other calls for flexibility and responsiveness to contextual understanding of the situation and personality of individual clients. Evidence for the centrality of the principles of this latter discourse for professional practice is summarized from work on case formulation, standards for therapist competence, and the concept of evidence-based practice. This provides the foundation for a model for treatment of PTSD, both simple and complex, that has five levels which represent increasing degrees of depth of clinical work. In accordance with the phased approach, conditions at one level need to be satisfied before proceeding to work on a deeper level. At each level specific areas of clinical focus are highlighted including risk management (at level 1), building the therapeutic alliance (at level 2) and trauma-focused work (at level 3). The model serves as a broad structured summary of accumulated clinical knowledge about PTSD and its treatment that provides an evidence-based foundation for assessment and treatment planning.
- Full Text:
- Date Issued: 2013
- Authors: Edwards, David J A
- Date: 2013
- Language: English
- Type: Article
- Identifier: vital:6223 , http://hdl.handle.net/10962/d1007679
- Description: In this article a practitioner oriented review of the literature on the treatment of post-traumatic stress disorder is used to construct a phase-based model that can serve as a basis for case formulation and treatment planning. Treatments shown to be efficacious in randomized controlled trials are listed and two discourses about them are contrasted. One calls for therapists to implement treatments scrupulously according to the manual, the other calls for flexibility and responsiveness to contextual understanding of the situation and personality of individual clients. Evidence for the centrality of the principles of this latter discourse for professional practice is summarized from work on case formulation, standards for therapist competence, and the concept of evidence-based practice. This provides the foundation for a model for treatment of PTSD, both simple and complex, that has five levels which represent increasing degrees of depth of clinical work. In accordance with the phased approach, conditions at one level need to be satisfied before proceeding to work on a deeper level. At each level specific areas of clinical focus are highlighted including risk management (at level 1), building the therapeutic alliance (at level 2) and trauma-focused work (at level 3). The model serves as a broad structured summary of accumulated clinical knowledge about PTSD and its treatment that provides an evidence-based foundation for assessment and treatment planning.
- Full Text:
- Date Issued: 2013