A multiple case study exploration of the implementation of the Wits Integrative Trauma Counselling Model.

Abstract

The purpose of this research is to document and describe an exploration and appraisal of the implementation of a brief-term integrative intervention model, known as the Wits Trauma Model, used widely in the Gauteng region of South Africa by both volunteer and professional counsellors for the treatment of acute and post-traumatic stress in counselling victims of violence. Literature is reviewed pertaining to psychotherapeutic treatment techniques for acute and post-traumatic stress, efficacy research and the premise that an integrative psychotherapy approach is ideally suited to the treatment of psychological trauma. The study adopted a qualitative approach, making use of a multiple, case-based design in which archival case-based data served as the basis for extracting thematically selective case narratives that demonstrated the application of the model and illustrated the operationalisation of its principles. In interaction with the literature reviewed, six sets of case notes provided the basis for highlighting and discussing both the strengths and perceived lacunae within the model as well as how it appeared to work in practice. In all six cases, significant relief from traumatic stress symptoms was found to be achieved in a relatively limited time frame and sufficient qualitative evidence suggested a causal relationship between the different clients’ initial symptom presentation, reported improvements and the activities and changes in their lives that they undertook in response to the treatment model. The model was also found to hold a degree of clinical flexibility in terms of timing, emphasis and technique regarding its implementation by the different therapists. In addition, by investigating how the different therapists appeared to have implemented and understood the Wits Trauma Model, as well as the dilemmas and challenges they faced in working with traumatised individuals, the study aimed to provide valuable insights into the clinical utility and implementation of the model, thereby informing best practice for practitioners who might be utilising the model in the future.