Massed prolonged exposure therapy for PTSD and alcohol use: a single case experimental study of a university student
- Authors: Abrahams, Sherwin Owen
- Date: 2025-04-25
- Subjects: Prolonged exposure therapy , Post-traumatic stress disorder , Alcoholism , Flooding , College students Alcohol use South Africa , College students Psychology
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478284 , vital:78173
- Description: Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are common among university students in South Africa. Bantjies et al. (2023) found a PTSD prevalence of 21.0% (n=28,268), and McGowan and Kagee (2013) reported that 90% (n=1337) had experienced at least one traumatic event. There is a high comorbidity between PTSD and AUD, especially in hazardous drinkers (Peltzer & Pengpid, 2015). Despite the prevalence, research on effective trauma-focused therapies (TFTs) in low-resource settings is limited (Booysen & Kagee, 2021). This study evaluates the effectiveness of massed-prolonged exposure (MPE) therapy for comorbid PTSD and AUD among South African university students, using a Single-Case Experimental Design (SCED). The participant (n=1) underwent comprehensive assessments using CAPS-5, AUDIT, PDS-5, and PCL-5, confirming PTSD and AUD diagnoses. Regular PCL-5 assessments during the intervention showed significant symptom improvement, and post-intervention assessments indicated the participant no longer met PTSD criteria. AUDIT scores also improved from 11 (harmful/hazardous drinking) to 6. The participant found MPE therapy to be feasible, acceptable, and appropriate. This study supports the effectiveness, feasibility and acceptability of MPE therapy and highlights the importance of evidence-based interventions to improve PTSD outcomes within university settings and in low-to-middle-income countries. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
- Full Text:
- Date Issued: 2025-04-25
- Authors: Abrahams, Sherwin Owen
- Date: 2025-04-25
- Subjects: Prolonged exposure therapy , Post-traumatic stress disorder , Alcoholism , Flooding , College students Alcohol use South Africa , College students Psychology
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478284 , vital:78173
- Description: Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are common among university students in South Africa. Bantjies et al. (2023) found a PTSD prevalence of 21.0% (n=28,268), and McGowan and Kagee (2013) reported that 90% (n=1337) had experienced at least one traumatic event. There is a high comorbidity between PTSD and AUD, especially in hazardous drinkers (Peltzer & Pengpid, 2015). Despite the prevalence, research on effective trauma-focused therapies (TFTs) in low-resource settings is limited (Booysen & Kagee, 2021). This study evaluates the effectiveness of massed-prolonged exposure (MPE) therapy for comorbid PTSD and AUD among South African university students, using a Single-Case Experimental Design (SCED). The participant (n=1) underwent comprehensive assessments using CAPS-5, AUDIT, PDS-5, and PCL-5, confirming PTSD and AUD diagnoses. Regular PCL-5 assessments during the intervention showed significant symptom improvement, and post-intervention assessments indicated the participant no longer met PTSD criteria. AUDIT scores also improved from 11 (harmful/hazardous drinking) to 6. The participant found MPE therapy to be feasible, acceptable, and appropriate. This study supports the effectiveness, feasibility and acceptability of MPE therapy and highlights the importance of evidence-based interventions to improve PTSD outcomes within university settings and in low-to-middle-income countries. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
- Full Text:
- Date Issued: 2025-04-25
The feasibility and acceptability of Prolonged Exposure Therapy for PTSD at a community trauma centre in Cape Town: a qualitative analysis
- Authors: Markham, Kate Emily
- Date: 2025-04-25
- Subjects: Prolonged exposure therapy , Post-traumatic stress disorder , Psychic trauma Treatment , Community-based corrections South Africa Cape Town , Social workers South Africa Cape Town
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478339 , vital:78178
- Description: South Africa deals with pervasive trauma stemming from its history of political violence, high crime rates, and social challenges, ultimately contributing to a significant burden of trauma exposure and post-traumatic stress disorder (PTSD) among its population. Despite the prevalence of PTSD, evidence-based psychological treatments (EBTs) such as Prolonged Exposure Therapy (PE) remain underutilised, particularly in low-resourced areas. This study aimed to assess the feasibility and acceptability of PE among social workers at The Trauma Centre for Survivors of Violence and Torture in Cape Town. This study used a qualitative research design, with special emphasis on Implementation Science. The study used the concepts of feasibility and acceptability to guide the research. The results revealed several key themes. Social workers’ pre-implementation themes included the perceptions around PE and implementation in South Africa, with three subthemes emerging. First, the impact of South African socioeconomic and political factors on The Trauma Centre. Second, perceptions surrounding the implementation of PE. And finally, the improvements and feasibility of PE; the social worker’s post-intervention findings focused on the feasibility and improvement of PE, post-treatment views, and the hurdles and limitations to implementation. The client's post-intervention findings explored refugee struggles, associated psychological distress, with two sub-themes of self-worth and suicidal ideation, and second, a lack of support and helplessness, loneliness, and isolation. The final theme looked at the experiences of PE, more specifically the positive client experiences with PE, and the challenges of PE. The implementation of PE at The Trauma Centre revealed both successes and challenges. Findings from this study suggest that PE can be effectively administered through task-shifting in low-resource settings. However, this study also highlighted significant challenges in the feasibility of implementing PE long-term in this context. Clients revealed ambivalent feelings regarding PE. Those who experienced positive outcomes demonstrated the potential for PE to be utilised in resource-limited settings. Those who did not find PE beneficial, highlight the need for future research to adapt PE to be culturally specific and feasible for a resource-constrained setting. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
- Full Text:
- Date Issued: 2025-04-25
- Authors: Markham, Kate Emily
- Date: 2025-04-25
- Subjects: Prolonged exposure therapy , Post-traumatic stress disorder , Psychic trauma Treatment , Community-based corrections South Africa Cape Town , Social workers South Africa Cape Town
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/478339 , vital:78178
- Description: South Africa deals with pervasive trauma stemming from its history of political violence, high crime rates, and social challenges, ultimately contributing to a significant burden of trauma exposure and post-traumatic stress disorder (PTSD) among its population. Despite the prevalence of PTSD, evidence-based psychological treatments (EBTs) such as Prolonged Exposure Therapy (PE) remain underutilised, particularly in low-resourced areas. This study aimed to assess the feasibility and acceptability of PE among social workers at The Trauma Centre for Survivors of Violence and Torture in Cape Town. This study used a qualitative research design, with special emphasis on Implementation Science. The study used the concepts of feasibility and acceptability to guide the research. The results revealed several key themes. Social workers’ pre-implementation themes included the perceptions around PE and implementation in South Africa, with three subthemes emerging. First, the impact of South African socioeconomic and political factors on The Trauma Centre. Second, perceptions surrounding the implementation of PE. And finally, the improvements and feasibility of PE; the social worker’s post-intervention findings focused on the feasibility and improvement of PE, post-treatment views, and the hurdles and limitations to implementation. The client's post-intervention findings explored refugee struggles, associated psychological distress, with two sub-themes of self-worth and suicidal ideation, and second, a lack of support and helplessness, loneliness, and isolation. The final theme looked at the experiences of PE, more specifically the positive client experiences with PE, and the challenges of PE. The implementation of PE at The Trauma Centre revealed both successes and challenges. Findings from this study suggest that PE can be effectively administered through task-shifting in low-resource settings. However, this study also highlighted significant challenges in the feasibility of implementing PE long-term in this context. Clients revealed ambivalent feelings regarding PE. Those who experienced positive outcomes demonstrated the potential for PE to be utilised in resource-limited settings. Those who did not find PE beneficial, highlight the need for future research to adapt PE to be culturally specific and feasible for a resource-constrained setting. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
- Full Text:
- Date Issued: 2025-04-25
The acceptability of Prolonged Exposure Therapy for Primary Care (PE-PC) for the treatment of PTSD in a low resourced community in the Eastern Cape
- Authors: Leboho, Lerato
- Date: 2024-10-11
- Subjects: Post-traumatic stress disorder , Prolonged exposure therapy , Primary care (Medicine) South Africa Eastern Cape , Trauma therapy , Poor Medical care South Africa Eastern Cape
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/466191 , vital:76706
- Description: Post-traumatic stress disorder (PTSD) is a global mental health concern, especially in low- resourced communities that are characterised by limited access to health professionals, limited healthcare infrastructure, and limited access to evidence-based mental healthcare at primary care level. Over the last decade, several psychological trauma-focused therapies (TFTs), such as prolonged exposure therapy (PE) have been developed to treat PTSD. In the context of the existing literature, studies done in HICs have explored the implementation and acceptability of prolonged exposure therapy at primary care level (PE-PC) as a first-line treatment for PTSD. Contrary to this, there is little to no implementation studies done to date that have examined the acceptability of empirically supported treatments (ESTs), such as PE in low-resourced countries, such as South Africa. Using the Implementation Science framework, ten participants were recruited to be interviewed, using semi-structured interviews, about their experiences and perceptions of PE-PC as a treatment for PTSD, and to also share their experiences of living with PTSD. The interview data was analysed using the reflexive thematic analysis (RTA) method to determine whether PE-PC is an acceptable treatment for PTSD that can be administered at community level and highlights the importance of integrating mental health within primary healthcare practice. Based on the analysis four superordinate themes were identified, namely, lack and absence of social support; factors preventing trauma survivors from accessing EBTs; lack of knowledge regarding mental health literacy, and adaptation of a brief trauma-focused therapy in a low-resource community. The evidence this study shows that some of the factors that hinder the acceptability of trauma-focused therapies (TFTs) at community level, include stigma and discrimination, the absence of social support, limited resources, and inadequate knowledge on mental health and illness. Therefore, it makes sense of the urgency to implement evidence-based treatments (EBTs) in LMICs. Findings of this thesis suggest that (a) PE-PC should be adopted at community level, and that (b) PE-PC is an acceptable treatment for PTSD in low-resourced communities. , Thesis (MSocSci) -- Faculty of Humanities, Psychology, 2024
- Full Text:
- Date Issued: 2024-10-11
- Authors: Leboho, Lerato
- Date: 2024-10-11
- Subjects: Post-traumatic stress disorder , Prolonged exposure therapy , Primary care (Medicine) South Africa Eastern Cape , Trauma therapy , Poor Medical care South Africa Eastern Cape
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/466191 , vital:76706
- Description: Post-traumatic stress disorder (PTSD) is a global mental health concern, especially in low- resourced communities that are characterised by limited access to health professionals, limited healthcare infrastructure, and limited access to evidence-based mental healthcare at primary care level. Over the last decade, several psychological trauma-focused therapies (TFTs), such as prolonged exposure therapy (PE) have been developed to treat PTSD. In the context of the existing literature, studies done in HICs have explored the implementation and acceptability of prolonged exposure therapy at primary care level (PE-PC) as a first-line treatment for PTSD. Contrary to this, there is little to no implementation studies done to date that have examined the acceptability of empirically supported treatments (ESTs), such as PE in low-resourced countries, such as South Africa. Using the Implementation Science framework, ten participants were recruited to be interviewed, using semi-structured interviews, about their experiences and perceptions of PE-PC as a treatment for PTSD, and to also share their experiences of living with PTSD. The interview data was analysed using the reflexive thematic analysis (RTA) method to determine whether PE-PC is an acceptable treatment for PTSD that can be administered at community level and highlights the importance of integrating mental health within primary healthcare practice. Based on the analysis four superordinate themes were identified, namely, lack and absence of social support; factors preventing trauma survivors from accessing EBTs; lack of knowledge regarding mental health literacy, and adaptation of a brief trauma-focused therapy in a low-resource community. The evidence this study shows that some of the factors that hinder the acceptability of trauma-focused therapies (TFTs) at community level, include stigma and discrimination, the absence of social support, limited resources, and inadequate knowledge on mental health and illness. Therefore, it makes sense of the urgency to implement evidence-based treatments (EBTs) in LMICs. Findings of this thesis suggest that (a) PE-PC should be adopted at community level, and that (b) PE-PC is an acceptable treatment for PTSD in low-resourced communities. , Thesis (MSocSci) -- Faculty of Humanities, Psychology, 2024
- Full Text:
- Date Issued: 2024-10-11
The feasibility of task-shifting prolonged exposure for Primary Care (PE-PC) for PTSD within a low resource community in the Eastern Cape
- Shabangu, Princess Noxolo Nonhlanhla
- Authors: Shabangu, Princess Noxolo Nonhlanhla
- Date: 2024-04-04
- Subjects: Task shifting , Prolonged exposure therapy , Post-traumatic stress disorder , Primary health care , Community psychiatry South Africa Eastern Cape
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/435479 , vital:73161
- Description: Although high levels of trauma exposure potentiate an alarming prevalence of PTSD, increasing the need for trauma-focused treatment, the South African health system is unable to care for the population. The South African healthcare system contains a range of systemic and structural inefficiencies, including suboptimal care and shortages of healthcare professionals. PE-PC offers a resource-constrained mental healthcare system solution by integrating an evidence-based intervention (EBI) in primary care settings. Likewise, the present study acknowledges the ratio of mental healthcare professionals to patients in low- and middle-income countries (LMIC). It explores task shifting to expand mental healthcare to primary care settings. The study follows qualitative healthcare design research to explore the experiences and perceptions of the two cohorts of trauma support workers (TSW) from Rhode University and the Joza community in Makhanda. The feasibility of the PE-PC intervention in Makhanda was illustrated through the data obtained from the TSWs' experiences and perceptions of the intervention's utility. The present study presents an essential contribution to the sparse research conducted on treating PTSD in LMIC with shortages in healthcare professionals. The thematic findings look at the trauma support workers (TSWs) role, including some of its challenges, to explore the feasibility of interventions. Some of the themes highlighted unpack the perceived utility of task-shifting in low-resource contexts, the limitations thereof and considerations for future research. Notwithstanding the challenges, the data from the present study indicates that PE-PC can be feasibly task-shifted in low-resource contexts such as Makhanda. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
- Full Text:
- Date Issued: 2024-04-04
- Authors: Shabangu, Princess Noxolo Nonhlanhla
- Date: 2024-04-04
- Subjects: Task shifting , Prolonged exposure therapy , Post-traumatic stress disorder , Primary health care , Community psychiatry South Africa Eastern Cape
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/435479 , vital:73161
- Description: Although high levels of trauma exposure potentiate an alarming prevalence of PTSD, increasing the need for trauma-focused treatment, the South African health system is unable to care for the population. The South African healthcare system contains a range of systemic and structural inefficiencies, including suboptimal care and shortages of healthcare professionals. PE-PC offers a resource-constrained mental healthcare system solution by integrating an evidence-based intervention (EBI) in primary care settings. Likewise, the present study acknowledges the ratio of mental healthcare professionals to patients in low- and middle-income countries (LMIC). It explores task shifting to expand mental healthcare to primary care settings. The study follows qualitative healthcare design research to explore the experiences and perceptions of the two cohorts of trauma support workers (TSW) from Rhode University and the Joza community in Makhanda. The feasibility of the PE-PC intervention in Makhanda was illustrated through the data obtained from the TSWs' experiences and perceptions of the intervention's utility. The present study presents an essential contribution to the sparse research conducted on treating PTSD in LMIC with shortages in healthcare professionals. The thematic findings look at the trauma support workers (TSWs) role, including some of its challenges, to explore the feasibility of interventions. Some of the themes highlighted unpack the perceived utility of task-shifting in low-resource contexts, the limitations thereof and considerations for future research. Notwithstanding the challenges, the data from the present study indicates that PE-PC can be feasibly task-shifted in low-resource contexts such as Makhanda. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
- Full Text:
- Date Issued: 2024-04-04
The effectiveness and feasibility of online prolonged exposure therapy for post-traumatic stress among university students
- Authors: Slabbert, Maryna
- Date: 2023-03-30
- Subjects: Exposure therapy , Post-traumatic stress disorder , College students South Africa , Prolonged exposure therapy , Online therapy
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/408885 , vital:70534
- Description: Research has found that 70.6% of university students reported exposure to several traumatic events (Hoffman, 2002). Considering the high prevalence of trauma exposure among South African university students, many are at risk of developing post-traumatic stress disorder (PTSD) (Iribarren, Prolo, Naegos & Chiappelli, 2005). Prolonged Exposure Therapy (PE) is regarded as a first-line trauma therapy for PTSD (Foa, Hembree, Rothbaum, & Rauch, 2019). During the Covid-19 pandemic, public health guidelines for physical distancing reduced access to face-to-face mental health care. In response to this, many health care providers adapted to pandemic constraints by meeting their clients online, through Zoom, for example (Wells et al., 2020). Considering the prevalence of trauma exposure among university students, as well as the increased necessity of teletherapy, the study aimed to investigate the effectiveness and feasibility of online PE for PTSD among university students in a South African setting. The study employed Single-Case Experimental Design (SCED) as basis for its research design. Participants included a sample of Rhodes University students (n = 3) who were recruited through purposive sampling. Prior to the intervention, all three participants met the criteria for PTSD, and comorbid depression. Based on the measures used, two of the three participants did not meet the criteria for PTSD post-intervention. In terms of depression symptoms, one participant did not meet the criteria for depression post-intervention, and another participant showed a decrease in depression symptoms. Regarding the feasibility of online PE, all three participants reported the intervention to be feasible, acceptable, and appropriate. Overall, the study provides preliminary results to support the effectiveness and feasibility of online PE. It also gives insight into the value of intervention research and how it can ameliorate PTSD in a South African setting, as well as other low- and middle-income countries (LMICs). , Thesis (MA) -- Faculty of Humanities, Psychology, 2023
- Full Text:
- Date Issued: 2023-03-30
- Authors: Slabbert, Maryna
- Date: 2023-03-30
- Subjects: Exposure therapy , Post-traumatic stress disorder , College students South Africa , Prolonged exposure therapy , Online therapy
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/408885 , vital:70534
- Description: Research has found that 70.6% of university students reported exposure to several traumatic events (Hoffman, 2002). Considering the high prevalence of trauma exposure among South African university students, many are at risk of developing post-traumatic stress disorder (PTSD) (Iribarren, Prolo, Naegos & Chiappelli, 2005). Prolonged Exposure Therapy (PE) is regarded as a first-line trauma therapy for PTSD (Foa, Hembree, Rothbaum, & Rauch, 2019). During the Covid-19 pandemic, public health guidelines for physical distancing reduced access to face-to-face mental health care. In response to this, many health care providers adapted to pandemic constraints by meeting their clients online, through Zoom, for example (Wells et al., 2020). Considering the prevalence of trauma exposure among university students, as well as the increased necessity of teletherapy, the study aimed to investigate the effectiveness and feasibility of online PE for PTSD among university students in a South African setting. The study employed Single-Case Experimental Design (SCED) as basis for its research design. Participants included a sample of Rhodes University students (n = 3) who were recruited through purposive sampling. Prior to the intervention, all three participants met the criteria for PTSD, and comorbid depression. Based on the measures used, two of the three participants did not meet the criteria for PTSD post-intervention. In terms of depression symptoms, one participant did not meet the criteria for depression post-intervention, and another participant showed a decrease in depression symptoms. Regarding the feasibility of online PE, all three participants reported the intervention to be feasible, acceptable, and appropriate. Overall, the study provides preliminary results to support the effectiveness and feasibility of online PE. It also gives insight into the value of intervention research and how it can ameliorate PTSD in a South African setting, as well as other low- and middle-income countries (LMICs). , Thesis (MA) -- Faculty of Humanities, Psychology, 2023
- Full Text:
- Date Issued: 2023-03-30
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