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Creating a Sustainable Future: Task-shifting for Adolescent Mental Health Care

South African adolescents face many historical, political, social, cultural, and economic influences in their lives that are perpetuated based on race and class. Unfortunately, the availability of mental health treatment for at-risk adolescents is inadequate in the current mental healthcare system i...

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Main Author: Faku, Nqabisa
Other Authors: Ward, Catherine
Format: Thesis
Language:English
Published: Department of Psychology 2023
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access_status_str Open Access
author Faku, Nqabisa
author2 Ward, Catherine
author_browse Faku, Nqabisa
Ward, Catherine
author_facet Ward, Catherine
Faku, Nqabisa
author_sort Faku, Nqabisa
collection Thesis
description South African adolescents face many historical, political, social, cultural, and economic influences in their lives that are perpetuated based on race and class. Unfortunately, the availability of mental health treatment for at-risk adolescents is inadequate in the current mental healthcare system in South Africa. Project ASPIRE is a counselling mental health programme designed for registered counsellors to deliver age-appropriate mental health services to meet the mental health needs of adolescents in community-based settings. This study aimed to explore the facilitators and barriers to task-shifting in Project ASPIRE through the views and experiences of the registered counsellors, the supervisor, and the adolescents. The researcher conducted semi-structured interviews and used the framework analysis method and thematic narrative analysis to analyze the data. The facilitating factors associated with making the intervention successful were intervention-related factors such as the value of the counselling techniques, flexibility and adaptability of the structure of the sessions and content relevance; supervision and supervisor-related factors such as ongoing supervision and monitoring and evaluation assessments; counsellor-related factors such as patient-tracking duties and upholding diversity, equity and inclusion; and adolescent-related factors such as intrinsic motivation and accessible and appropriate counselling services and sites. The barriers associated with posing challenges to the conditions, design, and structure of the ASPIRE counselling programme were intervention-related factors such as weak referral pathways and the amount of reading required by the patient handbook; contextual factors such as the multiple deprivations that severely disadvantaged Black adolescents and the impact of the COVID-19 pandemic; supervisor-related factors such as experiencing imposter syndrome, lacking cultural sensitivity training for the Xhosa population and high case volumes; and counsellor-related factors such as the constant disruption of work and supervision schedules caused by fulfilling patient-tracking duties and appointment availability issues. Moving forward, the ASPIRE principal investigators must strategically address the unique challenges that the adolescents, counsellors, and the counsellor supervisor experienced because of the conditions, design, structure, and the limited workforce of the ASPIRE counselling programme to improve the intervention for future trials.
format Thesis
id oai:open.uct.ac.za:11427/37402
institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:32:05.102Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2023
publishDateRange 2023
publishDateSort 2023
publisher Department of Psychology
publisherStr Department of Psychology
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/37402 Creating a Sustainable Future: Task-shifting for Adolescent Mental Health Care Faku, Nqabisa Ward, Catherine Lund, Crick adolescence mental health treatment gap adolescent mental health services task-shifting lay counsellors sustainable future South African adolescents face many historical, political, social, cultural, and economic influences in their lives that are perpetuated based on race and class. Unfortunately, the availability of mental health treatment for at-risk adolescents is inadequate in the current mental healthcare system in South Africa. Project ASPIRE is a counselling mental health programme designed for registered counsellors to deliver age-appropriate mental health services to meet the mental health needs of adolescents in community-based settings. This study aimed to explore the facilitators and barriers to task-shifting in Project ASPIRE through the views and experiences of the registered counsellors, the supervisor, and the adolescents. The researcher conducted semi-structured interviews and used the framework analysis method and thematic narrative analysis to analyze the data. The facilitating factors associated with making the intervention successful were intervention-related factors such as the value of the counselling techniques, flexibility and adaptability of the structure of the sessions and content relevance; supervision and supervisor-related factors such as ongoing supervision and monitoring and evaluation assessments; counsellor-related factors such as patient-tracking duties and upholding diversity, equity and inclusion; and adolescent-related factors such as intrinsic motivation and accessible and appropriate counselling services and sites. The barriers associated with posing challenges to the conditions, design, and structure of the ASPIRE counselling programme were intervention-related factors such as weak referral pathways and the amount of reading required by the patient handbook; contextual factors such as the multiple deprivations that severely disadvantaged Black adolescents and the impact of the COVID-19 pandemic; supervisor-related factors such as experiencing imposter syndrome, lacking cultural sensitivity training for the Xhosa population and high case volumes; and counsellor-related factors such as the constant disruption of work and supervision schedules caused by fulfilling patient-tracking duties and appointment availability issues. Moving forward, the ASPIRE principal investigators must strategically address the unique challenges that the adolescents, counsellors, and the counsellor supervisor experienced because of the conditions, design, structure, and the limited workforce of the ASPIRE counselling programme to improve the intervention for future trials. 2023-03-13T12:29:22Z 2023-03-13T12:29:22Z 2022 2023-02-20T12:44:20Z Master Thesis Masters MA http://hdl.handle.net/11427/37402 eng application/pdf Department of Psychology Faculty of Humanities
spellingShingle adolescence
mental health treatment gap
adolescent mental health services
task-shifting
lay counsellors
sustainable future
Faku, Nqabisa
Creating a Sustainable Future: Task-shifting for Adolescent Mental Health Care
thesis_degree_str Master's
title Creating a Sustainable Future: Task-shifting for Adolescent Mental Health Care
title_full Creating a Sustainable Future: Task-shifting for Adolescent Mental Health Care
title_fullStr Creating a Sustainable Future: Task-shifting for Adolescent Mental Health Care
title_full_unstemmed Creating a Sustainable Future: Task-shifting for Adolescent Mental Health Care
title_short Creating a Sustainable Future: Task-shifting for Adolescent Mental Health Care
title_sort creating a sustainable future task shifting for adolescent mental health care
topic adolescence
mental health treatment gap
adolescent mental health services
task-shifting
lay counsellors
sustainable future
url http://hdl.handle.net/11427/37402
work_keys_str_mv AT fakunqabisa creatingasustainablefuturetaskshiftingforadolescentmentalhealthcare