Abstract
BackgroundThis qualitative study was nested within a randomized controlled trial (RCT) where two psychotherapeutic interventions (supportive counselling and prolonged exposure for adolescents) were provided by supervised nurses (who served as ‘nurse counsellors’) to adolescents with PTSD in school settings. This paper describes the perspectives of nurse counsellors (NCs) and school liaisons (SLs). SLs were teachers or administrative personnel at the schools who coordinated the study visits of participants with the NCs. We focus on the impediments and catalysts to and recommendations for treatment implementation.MethodsNCs (n = 3) and SLs (n = 3) who participated in the RCT during 2014 were purposively recruited by telephone and participated in face-to-face semi-structured in-depth interviews that were recorded and doubly transcribed. Thematic content analysis was applied using Atlas.ti software to identify emerging themes. This paper describes the impediments and catalysts to provide psychotherapy by task-shifting in a community setting across three sub-themes: personal, community, and collaborative care.ResultsAlthough nurses were initially resistant to supervision it was central to personally coping with complex interventions, managing traumatic content, and working apart from a multi-disciplinary team. Delivering the interventions in the community presented multiple logistical impediments (e.g. transport, communication, venue suitability) which required creative solutions. In light of resource shortages, networking is central to effective delivery and uptake of the interventions. Collaboration between government departments of health and education may have a major impact on providing school-based psychotherapy through task-shifting.ConclusionsImpediments to implementation are not insurmountable. This article provides recommendations to maximize the success of task-shifting interventions should they be rolled out.
Highlights
This qualitative study was nested within a randomized controlled trial (RCT) where two psychotherapeutic interventions were provided by supervised nurses to adolescents with posttraumatic stress disorder (PTSD) in school settings
The results are presented in three clusters: Personal Care, Community Care, and Collaborative Care
‘Natalia’ felt like she was “hyperventilating” the first time she recorded a session for supervision
Summary
This qualitative study was nested within a randomized controlled trial (RCT) where two psychotherapeutic interventions (supportive counselling and prolonged exposure for adolescents) were provided by supervised nurses (who served as ‘nurse counsellors’) to adolescents with PTSD in school settings. White Afrikaans nurse from out of town with 6 years psychiatry experience White Afrikaans nurse with 30 years nursing experience Black Xhosa nurse, working in psychiatric hospital since 2006 Afrikaans coloured administrator, basic counselling training at local NGO (Lifeline) Coloured Afrikaans teacher, youth work experience, desires to study psychology Black Xhosa teacher, no known counselling background. This challenge was amplified by not being prepared “for what the children would tell you” (‘Natasha’), knowing that the child would be returning to a “dysfunctional system” (‘Noleen’), being “acutely aware of their circumstances” (‘Natalia’), and feeling guilt about “leaving them again” (‘Noleen’). It’s like, who is going to do this? (‘Noleen’)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
