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 The first two phases were the focus of an unpublished case study presented at a conference in 1995.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 The first two phases were the focus of an unpublished case study presented at a conference in 1995.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
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
Treating posttraumatic stress disorder in South Africa : an integrative model grounded in case-based research
- Authors: Edwards, David J A
- Date: 2009
- Language: English
- Type: Article
- Identifier: vital:6232 , http://hdl.handle.net/10962/d1007782
- Description: The article presents a model for formulating and planning treatment for post-traumatic stress disorder (PTSD) in South Africa derived from the existing literature and in conjunction with a review of a series of studies of cases treated using the guidelines of Ehlers and Clark's cognitive therapy. It is argued that the construction of psychotherapies (or even components of psychotherapy) for PTSD in terms of traditional categories ("psychodynamic", "cognitive-behavioural", "narrative" etc.) is misleading and unhelpful. Instead, superordinate concepts derived from thinking about evidence-based practice provide a more grounded focus on the practical issues faced by therapists treating PTSD. These concepts, which include competences and metcacompetences, therapist responsiveness, stages of therapy and case formulation, provide a basis for a genuinely integrative approach. The proposed model suggests seven broad areas of clinical focus for work with PTSD which can be arranged at three levels of priority: level 1 crisis intervention and stabilization; level 2 promoting engagement with treatment, and level 3 selection, sequencing and timing of active treatment interventions. Material from the case series is used to illustrate the application of the model.
- Full Text:
- Date Issued: 2009
- Authors: Edwards, David J A
- Date: 2009
- Language: English
- Type: Article
- Identifier: vital:6232 , http://hdl.handle.net/10962/d1007782
- Description: The article presents a model for formulating and planning treatment for post-traumatic stress disorder (PTSD) in South Africa derived from the existing literature and in conjunction with a review of a series of studies of cases treated using the guidelines of Ehlers and Clark's cognitive therapy. It is argued that the construction of psychotherapies (or even components of psychotherapy) for PTSD in terms of traditional categories ("psychodynamic", "cognitive-behavioural", "narrative" etc.) is misleading and unhelpful. Instead, superordinate concepts derived from thinking about evidence-based practice provide a more grounded focus on the practical issues faced by therapists treating PTSD. These concepts, which include competences and metcacompetences, therapist responsiveness, stages of therapy and case formulation, provide a basis for a genuinely integrative approach. The proposed model suggests seven broad areas of clinical focus for work with PTSD which can be arranged at three levels of priority: level 1 crisis intervention and stabilization; level 2 promoting engagement with treatment, and level 3 selection, sequencing and timing of active treatment interventions. Material from the case series is used to illustrate the application of the model.
- Full Text:
- Date Issued: 2009
Using systematic case studies to investigate therapist responsiveness : examples from a case series of PTSD treatments
- Authors: Edwards, David J A
- Date: 2010
- Language: English
- Type: Article
- Identifier: vital:6224 , http://hdl.handle.net/10962/d1007774
- Description: This article highlights the emerging literature on therapist responsiveness in psychotherapy and examines several concepts used to identify dimensions of responsiveness. Some methodological obstacles are identified to studying responsiveness in a systematic manner, and several examples of existing responsiveness research are reviewed. It is argued that meaningful theory on responsiveness has emerged from research methods that are qualitative and interpretive and that the writing of systematic case studies can be of particular importance since only the presentation of a case unfolding over time can disclose some of the more complex aspects of therapist responsiveness. Examination of a series of systematic case studies of the treatment of post traumatic case disorder in South Africa was used to derive a model for guiding therapist responsiveness with respect with what to focus on at a particular phase of the therapy within a particular session. Material from the cases is used to illustrate aspects of the model related to building social support for the client and promoting emotional processing of trauma memories. , Acknowledgements: This research was supported by grants from the National Research Foundation and the Joint Research Committee of Rhodes University. An earlier version of this paper was presented at the Conference of the Society for Psychotherapy Research in Barcelona in 2008 (Edwards, 2008).
- Full Text:
- Date Issued: 2010
- Authors: Edwards, David J A
- Date: 2010
- Language: English
- Type: Article
- Identifier: vital:6224 , http://hdl.handle.net/10962/d1007774
- Description: This article highlights the emerging literature on therapist responsiveness in psychotherapy and examines several concepts used to identify dimensions of responsiveness. Some methodological obstacles are identified to studying responsiveness in a systematic manner, and several examples of existing responsiveness research are reviewed. It is argued that meaningful theory on responsiveness has emerged from research methods that are qualitative and interpretive and that the writing of systematic case studies can be of particular importance since only the presentation of a case unfolding over time can disclose some of the more complex aspects of therapist responsiveness. Examination of a series of systematic case studies of the treatment of post traumatic case disorder in South Africa was used to derive a model for guiding therapist responsiveness with respect with what to focus on at a particular phase of the therapy within a particular session. Material from the cases is used to illustrate aspects of the model related to building social support for the client and promoting emotional processing of trauma memories. , Acknowledgements: This research was supported by grants from the National Research Foundation and the Joint Research Committee of Rhodes University. An earlier version of this paper was presented at the Conference of the Society for Psychotherapy Research in Barcelona in 2008 (Edwards, 2008).
- Full Text:
- Date Issued: 2010
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
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
Types of case study work : a conceptual framework for case-based research
- Authors: Edwards, David J A
- Date: 1998
- Language: English
- Type: Article
- Identifier: vital:6240 , http://hdl.handle.net/10962/d1007852
- Description: This paper describes a conceptual framework for understanding the phases of casebased research. Case-based strategies in research are widely used in case study methodology as well as in a number of qualitative methodologies including grounded theory development, phenomenological research method and psychotherapy process research. The epistemological principles upon which casebased research is based are fundamentally different those which inform groupbased research using quantitative multivariate statistics. The case-based research process is divided into three general phases: descriptive, theoretical-heuristic, and theory-testing. Each of these phases is subdivided into two categories. The aims and epistemological principles related to each phase are discussed and illustrated with examples from contemporary research. The principles for establishing validity in case-base research are also reviewed and, in order to assist research students and supervisors, some common pitfalls are noted. The paper shows that rigorous work with single cases or series of cases using case-based principles and methodology is indeed, as Bromley (1986) claimed, "the bedrock of scientific investigation".
- Full Text:
- Date Issued: 1998
- Authors: Edwards, David J A
- Date: 1998
- Language: English
- Type: Article
- Identifier: vital:6240 , http://hdl.handle.net/10962/d1007852
- Description: This paper describes a conceptual framework for understanding the phases of casebased research. Case-based strategies in research are widely used in case study methodology as well as in a number of qualitative methodologies including grounded theory development, phenomenological research method and psychotherapy process research. The epistemological principles upon which casebased research is based are fundamentally different those which inform groupbased research using quantitative multivariate statistics. The case-based research process is divided into three general phases: descriptive, theoretical-heuristic, and theory-testing. Each of these phases is subdivided into two categories. The aims and epistemological principles related to each phase are discussed and illustrated with examples from contemporary research. The principles for establishing validity in case-base research are also reviewed and, in order to assist research students and supervisors, some common pitfalls are noted. The paper shows that rigorous work with single cases or series of cases using case-based principles and methodology is indeed, as Bromley (1986) claimed, "the bedrock of scientific investigation".
- Full Text:
- Date Issued: 1998
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
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
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
Trauma, resilience and vulnerability to PTSD : a review and clinical case analysis
- Edwards, David J A, Sakasa, P, Van Wyk, G
- Authors: Edwards, David J A , Sakasa, P , Van Wyk, G
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6230 , http://hdl.handle.net/10962/d1007780
- Description: This article begins with two case examples of a girl and an adolescent who were raped and developed chronic PTSD. These are used as a basis for understanding the role of a range of factors that are associated with resilience and vulnerability in the face of traumatic events. A literature review examines the proportion of individuals who develop PTSD following trauma and the factors associated with vulnerability and resilience. These include gender, developmental factors, social support and personality factors. Psychological factors associated with maintenance of chronic PTSD are also briefly reviewed. This material is used as a basis for reconsidering the case examples. Each case is formulated within a framework based on sources of vulnerability and qualities of resilience. Approaches to intervention are suggested that could address the range of factors making the individuals vulnerable to chronic psychological problems and support resiliency and recovery.
- Full Text:
- Date Issued: 2005
- Authors: Edwards, David J A , Sakasa, P , Van Wyk, G
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6230 , http://hdl.handle.net/10962/d1007780
- Description: This article begins with two case examples of a girl and an adolescent who were raped and developed chronic PTSD. These are used as a basis for understanding the role of a range of factors that are associated with resilience and vulnerability in the face of traumatic events. A literature review examines the proportion of individuals who develop PTSD following trauma and the factors associated with vulnerability and resilience. These include gender, developmental factors, social support and personality factors. Psychological factors associated with maintenance of chronic PTSD are also briefly reviewed. This material is used as a basis for reconsidering the case examples. Each case is formulated within a framework based on sources of vulnerability and qualities of resilience. Approaches to intervention are suggested that could address the range of factors making the individuals vulnerable to chronic psychological problems and support resiliency and recovery.
- Full Text:
- Date Issued: 2005
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
The play of surface and depth in the art of psychotherapy for anxiety and depression : inaugural lecture delivered at Rhodes University
- Authors: Edwards, David J A
- Date: 1987
- Subjects: Psychotherapy , Anxiety , Depression, Mental
- Language: English
- Type: Text
- Identifier: vital:620 , http://hdl.handle.net/10962/d1020689 , ISBN 0868101672
- Description: Inaugural lecture delivered at Rhodes University. , Rhodes University Libraries (Digitisation)
- Full Text:
- Date Issued: 1987
- Authors: Edwards, David J A
- Date: 1987
- Subjects: Psychotherapy , Anxiety , Depression, Mental
- Language: English
- Type: Text
- Identifier: vital:620 , http://hdl.handle.net/10962/d1020689 , ISBN 0868101672
- Description: Inaugural lecture delivered at Rhodes University. , Rhodes University Libraries (Digitisation)
- Full Text:
- Date Issued: 1987
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
Treating PTSD in South African contexts : a theoretical framework and a model for developing evidence-based practice
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6231 , http://hdl.handle.net/10962/d1007781
- Description: Several psychological factors contribute to the development and maintenance of post-traumatic stress disorder (PTSD) because they interfere with the emotional processing of the traumatic event. These include problematic and painful emotions such as anxiety, shame, guilt and grief, distorted or dysfunctional cognitions, and cognitive, emotional, and behavioural avoidance mechanisms. Analysis of these maintaining factors provides the basis for current approaches to treatment which support traumatised individuals in facing emotional pain, working to resolve shame, grief and guilt, and expanding existing schemas to accommodate the traumatic event(s). Randomised controlled trials (RCTs) are reviewed in which the efficacy of some of these treatments have been evaluated. While many South African practitioners are familiar with current evidence-based approaches and are skilled at adapting them to local cultural and contextual conditions, a great deal still needs to be done to build a sound research base for local practice in the treatment of PTSD and disseminating that research to practitioners in the field. It is recommended that a case-based evaluation strategy be used to complement the findings of international RCT studies in order to build a foundation of locally contextualised and applicable scientific knowledge.
- Full Text:
- Date Issued: 2005
- Authors: Edwards, David J A
- Date: 2005
- Language: English
- Type: Article
- Identifier: vital:6231 , http://hdl.handle.net/10962/d1007781
- Description: Several psychological factors contribute to the development and maintenance of post-traumatic stress disorder (PTSD) because they interfere with the emotional processing of the traumatic event. These include problematic and painful emotions such as anxiety, shame, guilt and grief, distorted or dysfunctional cognitions, and cognitive, emotional, and behavioural avoidance mechanisms. Analysis of these maintaining factors provides the basis for current approaches to treatment which support traumatised individuals in facing emotional pain, working to resolve shame, grief and guilt, and expanding existing schemas to accommodate the traumatic event(s). Randomised controlled trials (RCTs) are reviewed in which the efficacy of some of these treatments have been evaluated. While many South African practitioners are familiar with current evidence-based approaches and are skilled at adapting them to local cultural and contextual conditions, a great deal still needs to be done to build a sound research base for local practice in the treatment of PTSD and disseminating that research to practitioners in the field. It is recommended that a case-based evaluation strategy be used to complement the findings of international RCT studies in order to build a foundation of locally contextualised and applicable scientific knowledge.
- Full Text:
- Date Issued: 2005
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
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
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