THE ASSOCIATION BETWEEN

SELF-CONCEPT AWARENESS AND

EMOTION- FOCUSED COPING OF
CHILDREN WITH ATTENTION
DEFICIT- HYPERACTIVITY
DISORDER

Jacqueline Caseiro Gomes Da Silva

2008
University of Pretoria

THE ASSOCIATION BETWEEN SELF-CONCEPT

AWARENESS AND EMOTION- FOCUSED COPING
OF CHILDREN WITH ATTENTION DEFICITHYPERACTIVITY DISORDER
by

Jacqueline Caseiro Gomes Da Silva

Submitted in partial fulfilment of the requirements for the degree

Magister Educationis
(Educational Psychology)
in the
Department of Educational Psychology
Faculty of Education
University of Pretoria

Supervisor:
Prof. Liesel Ebershn

PRETORIA
2008

ACKNOWLEDGMENTS
My sincerest appreciation and thanks go to:

Prof. Liesel Ebershn who accompanied me through the highs and lows of my
research journey. Her expertise, guidance and wisdom were inspirational.
Thank you for developing and nurturing the researcher and writer in me.

My special thanks go to:

My parents, Ana and Carlos Gomes Da Silva and my brother Ricardo for their
unconditional love and support throughout my studies. Their infinite support of
and belief in me has been my pillar of strength throughout this journey.

My boyfriend, Dario Meneguzzi, for never allowing me to give up when it all

seemed too much and for the countless hours of emotional (and technical)
support. Your love, support, motivation and encouragement saw me through.

My friends, those still with me and those who have passed, for your sense of
humour and calm approach in stressful situations.

Thanks also to:

The children, mothers, educators and therapists who participated in my study.
Adrie van Dyk who went above and beyond the call of duty (and always with a
smile) in assisting me to schedule appointments as well as the submission of
needed documentation.
Lili Rees for her exemplary technical editing and proof reading.

In loving memory of my grandfather, Adelino Caseiro.

DECLARATION
I, Jacqueline Caseiro Gomes Da Silva (26220963) hereby
declare that all the resources that were consulted are included
in the reference list and that this study is my original work.

___________________________

J. Caseiro Gomes Da Silva

August 2008

SUMMARY
THE ASSOCIATION BETWEEN SELF-CONCEPT AWARENESS AND EMOTIONFOCUSED COPING OF CHILDREN WITH ATTENTION DEFICITHYPERACTIVITY DISORDER
by
Jacqueline Gomes Da Silva
Supervisor: Prof. Liesel Ebershn
Department: Educational Psychology
Degree: M Ed (Educational Psychology)
The purpose of this exploratory and descriptive study was to determine the association (if any)
between the self-concept awareness and emotion- focused coping of children with ADHD.
Theories informing this study were Barkleys conceptualisation of ADHD, Banduras social
cognitive theory as a means of understanding self-concept awareness and Gonzales and
Sellers theory of emotion- focused coping. The study was conducted by means of an
intervention research design. I purposively selected two children with ADHD and their respective
parents, educators and therapists to participate in the study. Ebershns intrapersonal regulation
intervention was implemented with the child participants at different intervals. Both child
participants self-concept awareness and emotion- focused coping strategies were assessed
pre- and post intervention, through the use of formal interviews and observations. The data was
analysed and interpreted through thematic analysis. The following themes emerged; selfconcept awareness, adaptive emotion-focused- coping strategies and maladaptive emotionfocused coping strategies. Findings of the study confirmed that prior to the intervention, the two
child participants were predisposed towards emotion- focused coping, especially maladaptive
emotion- focused coping strategies. Post- intervention findings suggested that increased selfconcept awareness resulted in the use of two adaptive emotion- focused coping strategies
(namely relaxation methods and re-appraisal) with maladaptive emotion- focused coping
(namely direct- active physical aggression and direct-passive aggression) remaining. Thus, an
association exists between self-concept awareness and emotion- focused coping in children with
ADHD.
Die doel van hierdie ondersoekende en beskrywende studie was om die assosiasie (indien
enige) vas te stel tussen self-konsepbewustheid en emosie-gefokusde hantering van kinders
met AAHV. Teorie wat hierdie studie ondersteun was Barkley se konseptualisering van AAHV,
Bandura se sosiale kognitiewe teorie as n middel om self-konsep bewustheid te verstaan en
Gonzales en Sellers se teorie van emosie-gefokusde hantering. Die studie was gerig deur
middel van n intervensie-navorsingsontwerp. Ek het doelbewus twee seuns met AAHV en hulle
onderskeie ouers, opvoeders en terapeute eeselekteer om deel te neem in die studie. Ebershn
se intra-persoonlike regulasie intervensie was gemplementeer met die kinder-deelnemers op

verskeie tye. Beide kinder-deelnemers se self-konsepbewustheid en emosie-gefokusde

hanteringstrategie was voor- en na intervensie ge-assesseer, deur middel van formele
onderhoude en observasies. Die data was toe ge-analiseer en genterpreteer deur tematiese
analise. Die volgende temas het te voorskyn gekom; self-konsepbewustheid, funksionele
emosie-gefokusde
hanteringstrategie
en
nie-funksionele
emosie-gefokusde
hanteringstrategie. Bevindinge van die studie het bevestig dat voor die intervensie, die twee
kinder- deelnemers geneig was tot emosie-gefokusde strategie, veral nie-funksionele emosiegefokusde hanteringstrategie. Na-intervensie bevindinge stel voor dat verhoogde selfkonsepbewustheid gelei het tot die gebruik van twee funksionele emosie-gefokusde
hanteringstrategie (naamlik ontspanningsmetodes en her-evalueering) terwyl nie-funksionele
emosie-gefokusde hantering (naamlik direkte-aktiewe fisieke aggressie en direkte-passiewe
aggressie) nog teenwoordig was. Dus, n assosiasie bestaan tussen self-konsepbewustheid en
emosie-gefokusde hantering in kinders met AAHV.
Key Words:
Attention Deficit- Hyperactivity Disorder
Self-Concept Awareness
Emotion- Focused Coping
Intervention
Interpretivism
Interventionist Research Design

TABLE OF CONTENTS

Page
Chapter 1: Contextualising my Research Study
1.1
1.1.1
1.1.2

Introduction and Rationale

Why ADHD?
Why Emotion- Focused Coping?

1
3
4

1.2

Purpose of the study

1.3

Research Question

1.4
1.4.1
1.4.2
1.4.3
1.4.4
1.4.5

Clarification of Key Concepts

Introduction
Children diagnosed with Attention-Deficit Hyperactivity Disorder
Self-Concept Awareness
Emotion-focused coping strategies
Intervention

6
6
6
7
7
8

1.5
1.5.1
1.5.2

Paradigmatic Assumptions
Metatheoretical Paradigm
Methodological Paradigm

9
9
10

1.6
1.6.1
1.6.2
1.6.3
1.6.4

Research Methodology and Data Collection Strategies

Research Design: Intervention Research
Selection of Participants
Data Collection Strategies
Data Analysis and Interpretation

10
10
10
11
11

1.7

Ethical Considerations

11

1.8

Quality Criteria

12

1.9

Role of Researcher

12

1.10

Outline of Chapters

12

1.11

Conclusion

12

Page
CHAPTER 2: Conceptual Parameters
2.1

Introduction

2.2

Fundamental underpinnings of Attention Deficit Hyperactivity

Disorder
An Introduction to Attention Deficit Hyperactivity Disorder
What are the challenges experienced by children with ADHD
Challenges associated with ADHD and their impact on the
self-concept awareness of the child with ADHD

2.2.1
2.2.2
2.2.3

2.3
2.3.1
2.3.1.1
2.3.1.2
2.3.1.3
2.3.2
2.3.3

Fundamental Underpinnings of Coping

Introduction to Coping
Problem-Solving Coping Strategies
Emotion- Focused Coping Strategies
Conceptualization of Coping in this study
Coping strategies and the child with ADHD (hyperactiveimpulsive type)
How do these challenges associated with ADHD impacts on
the child with ADHDs chosen coping strategies?

14

14
14
15
18
22
22
23
23
24
27
28

2.4

What interventions exist to impact on self-concept awareness

and emotion-focused coping
30

2.5

Conclusion

34

Page
Chapter 3: Paradigmatic Assumptions
3.1

Introduction

35

3.2

Purpose of the study and research questions

35

3.3
3.3.1
3.3.2
3.3.3

Paradigmatic Assumptions
Introduction
Metatheoretical Paradigm
Methodological Paradigm

36
36
37
38

3.4
3.4.1
3.4.2

Research Design
Introduction
Intervention Research Design

40
40
40

3.5
3.5.1
3.5.2
3.5.2.1
3.5.2.2
3.5.2.3

Selection of Participants
Introduction
Define the population
Children with ADHD
Parents of Children with ADHD
Educators and therapists

42
42
43
43
44
44

3.6

Research Process

45

3.7
3.7.1
3.7.2
3.7.2.1
3.7.2.2
3.7.2.3
3.7.3

Data Collection
Introduction
Observation
Introduction
Documentation of Observations
Strengths and limitations of Observations
Guided interviews to determine the self-concept awareness
and emotion-focused coping as outlined by the indicators
in Chapter 2
Introduction
Guided Interviews
Documentation of Guided Interviews
Strengths and limitations of Guided Interviews
Visual Data
Introduction
Documentation of Visual Data

46
46
46
46
46
47

3.7.3.1
3.7.3.2
3.7.3.3
3.7.3.4
3.7.4
3.7.4.1
3.7.4.2

47
47
48
48
49
49
49
50

3.7.4.3
3.7.5
3.7.5.1
3.7.5.2
3.7.5.3

Strengths and Limitations of Visual Data

Reflective Journal: Reflexivity
Introduction
Documentation of Reflections
Strengths and Limitations of Reflective Journal

50
51
51
52
52

3.8
3.8.1
3.8.2
3.8.3

Data Analysis
Introduction
Analysis and Interpretation of Text
Analysis and interpretation of Visual Data

53
53
54
54

3.9
3.9.1
3.9.2
3.9.2.1
3.9.2.2
3.9.2.3
3.9.2.4

Intervention
Introduction
Pre- and Post intervention
Draw-A-Person Technique (D-A-P)
Kinetic Family Drawing (K-F-D)
Brinks Incomplete Sentences
How is your self-concept inventory

54
54
55
55
56
56
56

3.10
3.10.1
3.10.2
3.10.3

Ethical Issues
Informed consent and voluntary participation
Protection from harm and de-briefing
Confidentiality and anonymity

57
57
58
58

3.11
3.11.1
3.11.2
3.11.3
3.11.4
3.11.5

Quality Criteria
Introduction
Credibility
Transferability
Dependability
Confirmability

58
58
59
60
60
60

3.12

Challenges of the study

60

3.13

Conclusion

61

Page
Chapter 4: Data Analysis, Discussion of Results and
Literature Control
4.1

Introduction

62

4.2

Conducting the Interventionist Research

62

4.3

Results of the thematic analysis

66

4.3.1
4.3.1.1

Results of the thematic analysis: Pre-intervention

Discussion of the Baseline results

66
102

4.3.2
4.3.2.2

Results of the thematic analysis: Post-intervention

A Comparative Discussion of the results that emerged:
Post- intervention

102

Conclusion

119

4.4.

118

Page
Chapter 5: Conclusions and Recommendations
5.1

Introduction

120

5.2

Discussion of findings

120

5.3
5.3.1

Addressing the research questions

120
What is the association between self-concept awareness
and emotion- focused coping of children diagnosed with ADHD 120

5.3.2

Sub-questions

121

5.4

Conclusions of the study

122

5.5.

Limitations of the study

124

5.6

Contributions of this study

125

5.7
5.7.1
5.7.2
5.7.3

Recommendations
Recommendations for practice
Recommendations for training
Recommendations for future research

126
126
126
127

5.8

Concluding remarks

127

6.

Reference List

129

LIST OF TABLES

Page
Table 1.1 Data Collection Strategies

12

Table 3.1 Outline of Participants in this study

42

Table 4.1 Goals of the intervention

65

Table 4.2 Results of the thematic analysis indicating emotionfocused coping and self-concept awareness themes as
well as subthemes and categories: Pre-intervention

67

Table 4.3 Definition, subthemes, indicators, exclusions and

exceptions related to the theme of self-concept
awareness (pre-intervention)

68

Table 4.4 Definition, indicators, exclusions and exceptions

related to the category self-confidence (pre-intervention)

69

Table 4.5 Definition, indicators and exclusions related to the

category self-awareness (pre-intervention)

70

Table 4.6 Definition, indicators, exclusions and exceptions

related to the category positive interactions with others
(pre-intervention)

73

Table 4.7 Definition, indicators, exclusions and exceptions related

to the category negative interactions with others (preintervention)

75

Table 4.8 Definition, indicators and exclusions related to the

category identification and expression of feelings
(pre-intervention)

78

Table 4.9 Definition, subthemes, indicators, exclusions and

exceptions related to the theme adaptive emotionfocused coping strategies (pre-intervention)

79

Table 4.10 Definition, indicators and exclusions related to the

subtheme seeks social support from significant
others (pre-intervention)

81

Table 4.11 Definition, indicators and exclusions related to the

category seeks social support from significant others
to communicate and work through stressful situations
(pre-intervention)

82

Table 4.12 Definition, indicators and exclusions related to the

category reliance on social support to deal with
stressful situations (pre-intervention)

83

Table 4.13 Definition, indicators and exclusions related to the

category use of relaxation methods in order to examine
the situation from another perspective (pre-intervention)

84

Table 4.14 Definition, subthemes, indicators, exclusions and

exceptions related to the theme maladaptive emotionfocused coping strategies (pre-intervention)

87

Table 4.15 Definition, indicators and exclusions related to the

category indirect, active physical aggression (preintervention)

88

Table 4.16 Definition, indicators and exclusions related to the

category heightened physiological arousal in response
to stressful situations (pre-intervention)

88

Table 4.17 Definition, indicators and exclusions related to the

category physical aggression as well as exceptional
responses to this category (pre-intervention)

90

Table 4.18 Definition, indicators and exclusions related to the

subtheme direct- passive aggression (pre-intervention)

92

Table 4.19 Definition, indicators and exclusions related to the

category helplessness (pre-intervention)

94

Table 4.20 Definition, indicators and exclusions related to the

category internalizing (pre-intervention)

96

Table 4.21 Definition, indicators and exclusions related to the

category avoidance (pre-intervention)

98

Table 4.22 Definition, indicators and exclusions related to the

category projecting blame (pre-intervention)

100

Table 4.23 Definition, indicators and exclusions related to the

category withdrawal (pre-intervention)

101

Table 4.24 Results of the thematic analysis indicating emotionfocused coping and self-concept awareness themes,
subthemes and categories: Post-intervention

103

Table 4.25 Definition, subthemes, indicators, exclusions and

exceptions to the theme maladaptive emotion- focused
coping strategies which remained maladaptive (postintervention)

114

LIST OF FIGURES

Page
Figure 2.1 Conceptualising the Research Study

21

Figure 2.2 Self-concept awareness cycle addressed in the

intervention

22

Figure 2.3 When may emotion- focused coping be relevant?

25

Figure 2.4 Conceptualization of ADHD (Based on Barkleys (1996)

Definition)

30

Figure 2.5 Working assumptions of changes in coping postintervention

33

Figure 3.1 Research Process

45

Figure 4.1 Child 1s interpretation of the D-A-P activity

72

Figure 4.2 Child 2s interpretation of the D-A-P activity

72

Figure 4.3 Child 1s drawing of a positive interpersonal interaction

75

Figure 4.4 Drawing depicting the use of direct- active physical

aggression in response to being perceived as weak,
fallible and out of control

77

Figure 4.5 Child 1s depiction of the use of direct- active physical

aggression in response to being teased. I denote the use
of the shapes i.e. stars and triangles with heightened
physiological arousal

92

Figure 4.6 Child 1 exploring his positive and negative

characteristics
Figure 4.7 Child 1 using a feelings chart to identify and express the
happy, sad and angry feelings in response to
Significant experiences

105

110

LIST OF APPENDICES

APPENDIX A: INFORMED CONSENT FORMS

APPENDIX B: ETHICAL CLEAREANCE FORM
APPENDIX C: PRE-DEFINED TARGET BEHAVIOURS
APPENDIX D: SELF-CONCEPT AWARENESS INDICATORS
APPENDIX E: EMOTION- FOCUSED COPING INDICATORS
APPENDIX F: BEHAVIOUR CHECKLIST TO PREVENT OBSERVER BIAS
APPENDIX G: PRE- AND POST- INTERVENTION CHECKLISTS
APPENDIX H: PRE- AND POST- INTERVENTION FORMAL INTERVIEW
SCHEDULES
APPENDIX I: EXAMPLE OF FIELD NOTES
APPENDIX J: EXAMPLE OF TRANSCRIPTION
APPENDIX K: INTERVENTION
APPENDIX L: EXAMPLES OF INTERVENTION ACTIVITY- BASED DATA
DOCUMENTED VISUALLY
APPENDIX M: EXAMPLES OF DATA ANALYSIS AS PART OF THEMATIC
ANALYSIS
APPENDIX N: EXTRACTS FROM MY REFLECTIVE JOURNAL
APPENDIX O: RESEARCH SCHEDULE
APPENDIX P: D-A-P, K-F-D, BRINKS INCOMPLETE SENTENCES AND THE

HOW IS YOUR SELF-CONCEPT INVENTORY

Chapter 1: Contextualising My Research Study

1.1

Introduction and Rationale

A vast array of literature and statistics explore the persisting and negative symptoms of
Attention- Deficit Hyperactivity Disorder related to impaired executive functioning, with
particular emphasis on children with ADHD1, as well as those who are indirectly affected,
such as those with whom these children reside and learn alongside. The inclusive education
policy encourages learning environments to promote full personal, academic and
professional development of all learners regardless of race, age, gender, learning style or
disability (NCSNET, 1998). Thus, it seems important to explore how interventionists are
responding to the coping needs of children with ADHD. However, with approximately 60% of
children diagnosed with ADHD progressing into adulthood with persisting, and even
worsening, symptoms associated with ADHD (Jeeva, 2007), I believe that despite using
interventions based on their existing resources, skills, and knowledge in attempt to meet the
needs of children with ADHD, it appears that the interventions currently being employed are
inadequate. Thus, with a large percentage of children continuing to experience escalating
symptoms of ADHD in adulthood, the need to identify and implement effective coping
strategies in childhood becomes of fundamental importance if they are able to effectively
confront and deal with life stressors, and it is for this reason that the study strives to explore
an intervention which could promote more effective coping in children with ADHD.

Biederman (1993) and Shekim (1990 as cited in Barkley & Murphy, 1996)

state that

approximately 50% of adults diagnosed with ADHD are also diagnosed with substance
abuse disorders, 40% with anxiety disorders and 35% with major depressive disorders.
Statistics like these illuminate the lasting impact of ADHD on the individual, and
consequently, on his functioning with/ within various systems. With a large percentage of
children continuing to experience escalating symptoms of ADHD in adulthood any many of
them developing co-morbid disturbances, the need to identify and implement effective coping

For the purpose of this study, I will be using the abbreviation of the term Attention Deficit Hyper- Activity Disorder- ADHD

strategies in childhood becomes of fundamental importance if they are able to effectively

confront and deal with life stressors.

Gonzales and Sellers (2002) suggest that there is a heightened level of awareness in
literature with regards to the difficulties that children with ADHD experience. This has
resulted in the creation of interventions concerned with cognitive aspects, behavioural
manifestations and treatment modalities. However little research has focused on their social
and emotional functioning, which play a fundamental role in motivation. Studies conducted by
Yamatsaki, Akiko, Kanako (2006) briefly explore emotion-focused coping and stress
management in children. However, in my literature survey I could not find literature which
applies these findings to children with ADHD. Gonzales and Sellers (2002) outline pertinent
literature which supports the need for programmes to increase the ability of children to cope
with stress (learning to successfully cope with stress is a pivotal determinant in the long term
psychosocial, emotional and physiological effects of stress). This necessitates the need for a
study to be conducted which explores the levels of psychological distress experienced by
children with ADHD in an attempt to develop interventions aimed at the acquisition and
development of effective coping strategies.

Thus, the primary purpose of this study is to explore and describe the association between
children with ADHDs self-concept awareness and their emotion-focused coping. I focus first
on the systemic exploration of the experiences of children with ADHD, and how these
experiences are impacted on by the symptoms of ADHD. I then go on to explore the role of
coping with ADHD related challenges, focusing primarily on resources and assets within this
system whilst acknowledging barriers. My study aims to explore and describe the impact of
an intervention on self-concept awareness and emotion-focused coping of children with
ADHD. I have drawn on existing literature of ADHD and interventions designed to facilitate
coping in children with ADHD, and have identified no literature anchored in an asset-based
approach. Therefore, my research could contribute to existing literature on therapeutic
interventions designed to develop and enhance the coping strategies of children with ADHD.
The purpose of my study is thus descriptive and intervention- related.

Besides the clear need for research to be conducted in the field, for reasons detailed above,
personal reasons have compelled me to complete this study. As an Intern Educational
Psychologist working in a school for learners with special education needs last year, the
severity of ineffective coping strategies that children with ADHD presented with was brought
to my attention on a daily basis. Children with ADHD were often referred for therapy within
social skills groups as well as for individual therapy. Thus, I developed an interest in the

emotion-focused coping strategies used by children with ADHD- particularly the role that selfconcept awareness plays in the choice of coping strategies- and how this process could be
facilitated by parents and interventionists alike through the use of an intervention to expand
the emotion-focused repertoire of children with ADHD . Other than theoretical meaning, this
study could prove valuable to professionals, educators and parents in both remedial
mainstream schooling environments, for the focus would ultimately be on equipping learners
with adaptive emotion-focused skills within the classroom and school setting.

I will now discuss the significance and underlying theoretical principles of my study.

1.1.1. Why ADHD?

Widespread research exists on the impact of ADHD on children and their families which has
ignited my interest in ADHD. Of particular interest to me is the research exploring the reconceptualisations of ADHD, such as that offered by Barkley, Hutchins, Green, Chee and
Nash (2007) and Goldstein (2002). Goldstein (2002) re-conceptualizes ADHD as a problem
rooted in motivational rather than attentional deficits resulting in difficulties within the
intellectual, academic and emotional realms- with social and conduct problems often being
associated with ADHD (Lerner, 2003). Barkley, Hutchins, Green, Chee and Nash (2007)
conceptualise ADHD as a disorder that results from response disinhibition which creates
impairments in executive functioning which lead to deficient self-regulation as well as
disorganised behaviour which over time results in deficits in adaptive behaviour. This
definition supports the assertion that interventions for ADHD should be rooted within a
system and not targeted only at the individual. Both conceptualisations frame ADHD as a
behavioural disorder characterised by deficits in the purposeful associations between the
childs behaviour and environmental events as opposed to cognitive constructs or capacities
which result in lessened awareness of behavioural consequences and poor rule-governed
behaviour- both of which are far cries from traditional definitions of ADHD (Barkley, 1999).

My experiences as an Intern psychologist suggested that learners with ADHD (hyperactiveimpulsive type) were often referred to therapy for emotional and social support as a result of
stress incurred by the above symptoms. Due to impaired executive functioning, children with
ADHD are confronted with scholastic, personal and social failure and confrontation on a daily
basis in a number of forms. As infants, children with ADHD experience difficulty in attaching
to their primary care givers (Jeeva, 2007). As infants, they present with sleeping and
feeding problems, sensory integration difficulties, allergies, become easily frustrated by
changes in routine and are often in conflict with their siblings. Children with ADHD present
with a number of learning difficulties such as deficient working memory, co-ordination

difficulties, speech and language difficulties, visual and auditory processing difficulties to
name a few. Such impairments impact significantly on their ability to perform and achieve
scholastically, which results in experiences of failure and negative feedback (Lerner, 1999).
Impaired executive functioning seems to result in difficulty forming accurate self-appraisals
resulting in inaccurate reflections and understanding of their strengths, limitations and
available resources (Goldstein, 2002). Thus, self-appraisals influence not only the childs
self-efficacy (which influences a childs effort and perseverance) but also the childs
appraisals of events and whether they are deemed stressful or not (Bandura, 2007). A study
conducted by Contugno (1995) supports that children with ADHD have limited coping
capacity resulting in an avoidance of affect-laden stimuli, difficulties with self and
interpersonal perceptions and difficulties with social reality perception. Socially, children with
ADHD have difficulty reading social cues and lack essential pragmatic skills which result in
them appearing inadequate in social situations making it difficult for them to establish and
maintain friendships (Barkley, 2007). Enduring and intense experiences of negative affect as
a result of exposure to significant life stressors result in deep seated feelings of
inadequacy which may result in anxiety and depression (Barkley, 2007). The working
assumption of this study then is that if the child with ADHD is able to come to a greater level
of personal competence (accurate self-assessment and self-regulation) through increased
self-concept awareness, then he/ she is able to catch themselves making inaccurate selfappraisals which may influence their choice of coping strategies.

1.1.2. Why Emotion- Focused Coping?

As research has indicated, ADHD has a lasting and evasive influence on children, their
families, schools and communities. Thus, individuals, their parents and their educators and
therapists (if applicable) are required to cope with the symptoms and the impact thereof in
order to promote the well-being of the child with ADHD. Hudiberg (2007) defines emotionfocused coping as the utilization of behavioural and cognitive strategies to deal with
conditions which are viewed as fixed and beyond ones control. It has been my experience
as an interventionist working with children with ADHD that emotion-focused coping strategies
are being utilised, and utilised ineffectively, by children with ADHD. For example, a child who
is involved in conflict with a fellow classmate may lack adequate self-control to modulate their
feelings regarding the source of conflict to distance him/ herself long enough to diffuse the
situation and deal with it at a later stage. This may result in him/ her becoming physically
aggressive towards his/ her peer. When being reprimanded for this action, the child with
ADHD has difficulty in acknowledging his/ her role in the conflict. This lack of accountability
makes it difficult for a positive reappraisal of the situation to take place which may result in
the child with ADHD experiencing the situation negatively, thus re-enforcing a negative self-

concept and influencing future appraisals of self and situations. Accordingly, if the basic
features of a child coping effectively are the possession of a healthy self-esteem and
sense of self competence, which promotes feelings of control, ownership and optimism, then
ineffective coping strategies manifest behaviourally in underachievement, a lack of
perseverance, acting out behaviour, substance abuse and heightened physiological arousal
and frustration (Gonzales & Sellers, 2006).

Based on coping and ADHD theory, I have formulated a number of working assumptions to
guide me through my study. My first working assumption is that social support networks act
as stress buffers as they provide individuals with affirmation and a sense of belonging. As
children with ADHD (hyperactive- impulsive type) struggle to meaningfully bond with friends
and maintain friendships, they form part of a limited social support network. Thus, they are
exposed to reduced emotional support and ineffective coping strategies. My second working
assumption is that problematic interpersonal outcomes result in children with ADHD
presenting with a low self-esteem and limited efficacy. This results in children with ADHD
believing that they do not have the inner resources to cope with presented situations, thus
evaluating situations as stressful. My third working assumption is that in order to expand a
childs emotion-focused repertoire, one would need to change the cognitive and emotional
appraisal of events through greater self-concept awareness. My fourth working assumption
is that children with ADHD tend to perceive the situation to be out of their control, which
results in them employing avoidant, emotion-focused coping strategies. This may result in
learned helplessness, which serves as a reinforcement for ones negative self-concept and
sense of self-efficacy. My premis is that the role of the intervention, then, would be to break
this cycle through insight gained by self-concept awareness. My fifth working assumption
stems from this premise namely that if the self-concept motivates behaviour as proposed by
Ebershn (2006), should the self-concept change through greater cognitive awareness and
regulation, so too will the manner in which one conducts oneself in various situations due to
a change in appraisals (for further conceptual elucidation, refer to Figure 1 in Chapter 2).

1.2.

Purpose of the Study

This study is descriptive, exploratory and intervention- related, making the purpose of my
study three fold: my study is descriptive as I aim to describe the impact of the intervention
(or not) on the self-concept awareness and emotion-focused coping strategies of children
with ADHD through the use of observation, analysis and rich descriptions pre- and postintervention (Koh & Owen, 2000). It is through these thick descriptions that I may be able to
assess the impact of this intervention which I wouldnt be able to investigate otherwise. My
study is also exploratory as I aspire to gain new insights into the association between self-

concept awareness and emotion-focused coping (Wolfinbarger, 2007). I aim to explore and
clarify how children with ADHD, their families and schools cope with the symptoms of ADHD
and ADHD- related challenges with existing resources and assets whilst acknowledging
barriers.

1.3.

Research Question

My study aims to answer the following primary research question:

What is the association between self-concept awareness and emotion-focused coping of

children diagnosed with ADHD?
In order to address the above-mentioned primary question, the following sub-questions were
explored:

To what extent were the children with ADHDs self-concept awareness impacted on
(or not) by the intervention?

How were the children with ADHDs emotion-focused coping strategies impacted on
(or not) after the intervention?

To what extent did self-concept awareness influence (or not) the child with ADHDs
emotion-focused coping strategies?

To what extent were children diagnosed with ADHD able to transfer the selfawareness skills and knowledge acquired from the intervention into their everyday
interactions within the school and home?

1.4.

Clarification of Key Concepts

1.4.1. Introduction
For the purpose of elucidation, I briefly discuss key concepts that feature in my research
report. I discuss these concepts in more detail in Chapter 2.

1.4.2. Children diagnosed with Attention- Deficit- Hyperactivity Disorder

The American Psychiatric Association (2000) defines Attention-Deficit/ Hyperactivity disorder
as a condition characterized by severe problems of inattention, hyperactivity and/ or
impulsivity that are not age and developmentally appropriate. To diagnose ADHD, symptoms
need to be apparent for at least six months, with these symptoms having been present
before the age of seven within two settings, namely the home and the school (American
Psychiatric Association, 2000; Wenar & Kerig, 2000; Rinehart, Bradshaw, Brereton & Tonge,

2002; DeClerq, 2003; Yapko, 2003; Williams & Wright, 2004). Inattention, hyperactivity and/
or impulsivity cause clinically significant impairment in social, occupational or academic
functioning. In the study, however, I choose to define ADHD as a behavioural disorder
characterised by deficits in the purposeful associations between the childs behaviour and
environmental events as opposed to cognitive constructs or capacities which result in
lessened awareness of behavioural consequences and poor rule-governed behaviour as I
align myself with the notion that the core deficit of ADHD is not attentional but rather
motivational (Steer, 2007). Barkley, Hutchins, Green, Chee and Nash (2007) conceptualise
ADHD as a disorder that results from response disinhibition which creates impairments in
executive functioning which lead to deficient self-regulation as well as disorganised
behaviour which over time results in deficits in adaptive behaviour. This re-conceptualization
defines ADHD as being a problem rooted in motivational rather than attentional deficits which
result in difficulties within the intellectual, academic and emotional realms, with social and
conduct problems often being associated with ADHD.

1.4.3. Self-concept awareness

According to Ebershn (2006), the self-concept is defined as a set of perceptions which are
situation-specific and include appraisals of ones identity as well as self-efficacy beliefs. A
persons self-concept is multi-faceted, complex and inter related. It consists primarily of the
physical, personal, family, social, moral and academic selves. Of particular relevance to the
study is that a change in one of the self-concepts, namely the personal self, will influence all
other aspects of the self-concept (Kruger, 1994).
Ebershn (2006) and Kruger (1998) assert that ones self-concept motivates behaviour as a
child will act in accordance with the way he/ she has learnt to see him/ herself. It is through
cognitive appraisals that we attribute meaning to the situations with which we are faced, that
our behaviour is motivated by deductions made from thought and affect. Ebershn (2006)
further indicates that the self-concept could be viewed as a life skill, and that should the selfconcept change, so too will the manner in which one cognitively and affectively appraises
and behaves in chosen situations. Thus, despite a learner with ADHDs best efforts to act
empathetically towards others, his/ her behaviour is characterised by a lack of self-regulation
which results in his/ her behaviour being construed as abrasive, intolerable and ill-mannered
which result in relationships being characterised by rejection and dislike, anxiety and tension.
Constant and enduring negative feedback negatively impacts on his/ her self-concept which
has a profound impact on the manner in which he/ she responds to people and situations,
which has negative connotations for holistic performance and achievement therein (WicksNelson & Israel, 2000).

1.4.4. Emotion-focused coping strategies:

Diener, Lucas and Oishi, as cited in Ebershn (2006), state that subjective well-being is
related to a persons cognitive and affective evaluations of their lives as well as the amount
of control that one feels one has over ones life. In accordance with the above definition of
well-being, stress can be defined as the negative emotional state which occurs as a
response to events which are perceived (through cognitive appraisals) as taxing or
exceeding ones ability to cope (Weir, 2003). For the purpose of the proposed study, coping
is defined as behavioural and psychological efforts to master, endure, diminish, or decrease
stressful events (Mischara, 2007).

Literature makes the distinction between two types of coping strategies, namely problemsolving strategies and emotion-focused coping strategies, of which emotion- focused coping
strategies are the focus of this study. Emotion- focused coping strategies do not change the
actual stressful situation, but allow for the regulation of emotional consequences of stressful
events (Taylor, 1998). Emotion-focused coping strategies include activities, such as drug
abuse, or mental states, such as withdrawal and denial, which prevent the individual from
actively addressing the stress provoking situation (Taylor, 1998).

1.4.5. Intervention
On a daily basis and throughout ones development, people are required to adapt to change
and cope with stressors. Bender (2007) states that through life skills facilitation and
acquisition, the individual is better equipped to function adaptively and autonomously within a
community. According to Ebershn (2006):

A possible way in which cumulative protection could be developed is by means of an assetfocused life-skills facilitation approach: facilitating adaptation processes of awareness,
identification, access and mobilisation of human, social and material capital. Life skills could
thus improve the capacity of individuals to respond to threats so as to modify the impact of
perils on their lives. However, many children do not have the necessary life skills to cope
effectively.

Mischara (2007) states that children have the capacity to become aware of the manner in
which coping strategies are chosen through understanding of the situation as well as
personal resources and habits. Children who feel overwhelmed by a situation have evaluated
that the personal resources they have at their disposal are insufficient to meet the demands
of the situations, which result in a stressed response characterised by a lack of belief that
they possess the ability to change the situation or their responses to the situation. Ebershn

(2006) clearly articulates the role that life skills facilitation plays in the facilitation of coping. I
align myself with Ebershns (2006) assertion that the identification of inaccurate thoughts is
not sufficient in the acquisition of adaptive life skills. She emphasises that children should be
supported to behave in an independent manner in order for them to innovatively cope with
the stressors that they face for as is evident in the literature, children with ADHD may lack
intrapersonal, and subsequently, interpersonal knowledge resulting in an external locus of
control, no assumption of personal responsibility as well as negative appraisals which
manifest in ineffective coping strategies. The need exists for the implementation of an
intervention program which will empower the child with ADHD to meet the demands of a
dynamic and ever-changing world. For the purpose of this study, I selected to apply the
asset- focused life skills facilitation model developed by Ebershn (2006) in conjunction with
Krugers (1998) programme.

Ebershns (2006) intervention encourages cognitive regulation intervention strategies as a

means of altering thoughts, ideas, assumptions, self- communication, basic philosophies
(and therefore cognitive structures and appraisals) that people use for themselves, others
and situations (Ebershn, 2006). By applying this intervention with children with ADHD, I
hope to explore if childrens self-communication at an intrapersonal level will be altered
(which may motivate the acquisition of more established external interpersonal skills). Whilst
acknowledging the role and existence of deficiencies, the intervention focuses on the
strengths, abilities and resources available to children with ADHD which may assist them in
best coping within their respective environments. Applying the asset- focused life-skills
facilitation model may facilitate the process of empowerment for it implies a shift from
working from a deficit approach to an asset- based approach which calls for the mobilisation
of already existing assets and resources (Ebershn, 2006). This requires of interventionists
to design interventions which focus on the developing of resilience as well as focusing on
remediation.

Through the use of both programmes participants

will be involved in the

process of assessment and evaluation (refer to table 3.1. in chapter 3).

1.5.

Paradigmatic Assumptions

Here I provide a brief discussion of my selected paradigm, methodological choices and

processes. More detailed discussions of these aspects are included in Chapter 3.

1.5.1. Metatheoretical Paradigm

My study is based in the interpretivist paradigm which asserts the existence of multiple
realities over time and space, acknowledging that research is a process characterised by
interaction and is shaped by personal histories, gender, race and experiences of the

participants, including myself and those that share their setting (Denzin & Lincoln, 2000).
Interpretivism is characterised by the description, understanding and interpretation of the
research participants perceptions (Myers, 2000). Conducting my study from the interpretivist
paradigm permits me to gain insight into the childrens ways of coping with the symptoms of
ADHD through the exploration of detailed and rich descriptions of children with ADHDs
attempts to cope with challenging situations in which they find themselves. Pertinent to
working from this paradigm is the ontological acknowledgement that all interactions and
communications take place within a context, and it is within this context that subjective
meaning is ascribed to experience. Thus, each persons context is unique as is their
perception of reality.

1.5.2. Methodological Paradigm

I employed the Qualitative paradigm as my methodological paradigm. Denzin and Lincoln
(1994) define qualitative research as research that is conducted within the natural settings of
the participants in order to gain insight into the meanings that the participants attach to their
life worlds. The qualitative paradigm is an inductive process requiring of me to not make
attempts to understand the situation or phenomenon being studied by introducing preexisting expectations into the setting (Mouton & Marais, 1991). Instead, my role as
researcher is to gather data on as many facets of the situation as possible in order to
construct a complete understanding of the participants unique and dynamic situation, thus
adhering to the primary aim of qualitative research which is to capture the unique
experiences and interpretations of the participants, mine included (Mouton et. al. 1991).

1.6.

Research Methodology and Data Collection Strategies

1.6.1. Research Design: Intervention Research

My study was conducted using by means of an intervention research design as
conceptualised by Rothman and Thomas (1994). Rothman and Thomas (1994) define
intervention research as the development of knowledge about interventions, how to apply
this knowledge into social practice and the effectiveness of the intervention within a particular
setting.

They offer an integrate model of intervention research in an attempt to design and

develop interventions to enhance the well-being of the individual and school community.
Having said this, a strong emphasis is placed on the participation and of all participants in the
research process. I selected intervention research as I argue for a need to research
interventions which are aimed at developing and enhancing the coping strategies of children
with ADHD.

1.6.2. Selection of Participants

Qualitative research is exemplified by comprehensive inquisition of a phenomenon within its
natural context. The interpretivist paradigm is characterised by the emphasis it places on
multiple and unique perspectives of the participants within situation-specific contexts, which
prioritises description and exploration over generalisation (Jacobs, 2007). Qualitative
samples are generally small due to the time and resources required to conduct and to
partake in such a study. Thus, purposive sampling was required and selected.

Purposive sampling (Babbie & Mouton, 2004) can be defined as a process in which the
researcher selects a sample based on experience and knowledge of the group being
selected. I selected various groupings of participants, namely 2 children with ADHD and their
respective parents, educators and therapists. I provide a comprehensive discussion on
participant selection in Chapter 3.

1.6.3. Data Collection Strategies:

Table 1.1 outlines the various types of data collection strategies employed during the study. I
discuss these data collection strategies in more detail in Chapter 3.

1.6.4. Data Analysis and Interpretation

Data analysis involved the identification of themes that emerged during data collection. I
used thematic analysis in data analysis in order to conduct this more detailed data analysis
(Braun & Clarke, 2006). This required of me to familiarise myself with the various sources of
data, reading through the data and documenting primary thoughts and ideas. I then
generated initial codes in order to identify and document repeated patterns of meaning as
they emerged. At this stage, I linked identified themes back to the research question and
existing literature. I engaged in the process of data analysis and interpretation on my own.

1.7.

Ethical Considerations

In compliance with the University of Pretorias Ethics Committee (refer to certificate in

Appendix B), I obtained the informed consent of the participants (Appendix A) before
commencing with my study, addressing the issues of confidentiality and anonymity (Babbie &
Mouton, 2004). Throughout the research process, I adhered to the ethical principles of
confidentiality, anonymity and privacy, allowing for me to protect the participants from harm
as far as possible (Babbie & Mouton, 2004). For example, I ensured that my reflective
journal, which contained my field notes and reflections, were stored in a safe place at all
times and that all indentifying details were omitted from transcriptions of interviews as well as
from photographs taken. I honoured the participants right to withdraw from the study at any

time. With the permission of the child participant, I took photographs and made audio footage
during the intervention activities. These visual images were used during discussions, as well
as reports I wrote about the study. I did not share the participants name with those who saw
the images. At the request of Child 2, I did not take photos of his intervention activities or
make audio recordings of his intervention sessions. All of the information that I collected from
the project were stored in locked files in research offices at the University of Pretoria.

Table 1.1. Data Collection Strategies

Source

Type

Documented

Explored

Participants
Involved

Observation

*Participant
*Nonparticipant

* Field Notes
* Reflective
diary

*Participants during
intervention
*Participants within the
classroom setting

* Child
Child 2

and

Interviews (in
and outside of
intervention)

*Guided

*Field Notes
*Audio recorded
*Verbatim
transcription

*Accounts of the childs

emotion-focused coping
strategies and self-concept
awareness

*Children
ADHD
* Parent/s
*Educator/s
*Therapists

with

Visual Data

*Photographs

*Participants
engaging in
and with the
interventions

*Child with ADHD

Reflexivity
Reflexivity

*Reflective Journal

*My thoughts,
feelings and working
assumptions as they
evolve through the
research process

*Researcher

1.8.

Quality Criteria

Throughout my study, I strove to make my research study trustworthy by delineating the

impartiality of my research findings and conclusions (Babbie & Mouton, 2004). This required
of me to strive for credibility, transferability, dependability and confirmability (Babbie &
Mouton, 2004). In Chapter 3 I discuss the strategies I used to ensure rigour in my study.

1.9.

Role of Researcher

During the study, I assumed the role of researcher and interventionist- both of which
informed the choices made throughout the study. In order to differentiate between these
roles, I liaised closely with my supervisor as well as reflected on this process within my

reflective journal. This process became especially important in that I was the sole tool for
data collection, analysis and interpretation (Babbie & mouton, 2004).

1.10.

Outline of Chapters

Chapter 1: Overview and Rationale

Chapter 1 will be an introductory chapter to the study. The purpose and rationale of the
study, conceptual parameters, epistemology, and the research design and methodology of
the study will be outlined.
Chapter 2: Conceptual Framework
Chapter 2 outlines the conceptual framework of the study, exploring the concepts of assetbased life skills facilitation, self-concept awareness, emotion-focused coping and AttentionDeficit/ Hyperactivity Disorder.

Chapter 3: Research Design and Methodology

Chapter 3 discusses the study in terms of the research design, selection of participants, data
collection and data analysis and interpretation. This chapter will also explore the
trustworthiness of the study as well as the manner in which ethical issues were addressed.

Chapter 4: Findings of the Study

Chapter 4 presents and discusses the findings based on data collection, analysis and
interpretation. The findings will be discussed against the existing literature, as outlined in
Chapter 2.

Chapter 5: Final Conclusions and Recommendations

Chapter 5 includes the final conclusions of the study as well as linking these findings to the
research question, as stipulated in Chapter 1. The potential value and challenges of the
study will be discussed, and recommendations for further research will be made.

1.11.

Conclusion

I provided a general introduction and rationale to my study in this chapter. I formulated and
expressed my central research question: What is the association between self-concept
awareness and emotion-focused coping of children diagnosed with ADHD? Thereafter, I
explored and described the key concepts within my study as well as briefly discussed my
paradigmatic assumptions, methodological choices and research design. I then discussed
my ethical and quality considerations, which will be explored in more detail in chapter three.

In the next chapter, I will contextualise my study within a conceptual framework by exploring
existing literature on ADHD, self-concept awareness and emotion-focused coping.

CHAPTER 2: Conceptual Parameters

2.1. Introduction
In Chapter 1, I discussed the aim of my study, which was to investigate the association
between self-concept awareness and emotion-focused coping in children with ADHD.
Chapter 2 is a detailed discussion of the conceptual parameters of my study. In order to
elucidate and situate my study within conceptual parameters, I reviewed a number of
literature sources on Attention Deficit Hyperactivity Disorder (ADHD), emotion-focused
coping, self-concept awareness and intervention. During my literature survey, I was unable to
source studies explicitly exploring the association between these constructs. I therefore
attempted to explore these concepts in association with one another. I discuss existing
literature, limitations in this knowledge and the gaps that exist within this knowledge base. I
conclude Chapter 2 with a presentation of the framework that forms the theoretical backdrop
to the intervention in my study.

2.2. Fundamental underpinnings of Attention Deficit Hyperactivity Disorder

2.2.1 An Introduction to Attention- Deficit Hyperactivity Disorder

I explored ADHD as the construct under investigation in this study. In order to contextualise
my study, I provided the necessary background by exploring existing literature on ADHD. I
then investigated the challenges that children with ADHD experience because of the
symptoms of ADHD, as well as the extent to which these symptoms impact on the childs
self-concept awareness. I engaged in a discussion around the behavioural manifestations of
ADHD (hyperactive-impulsive type) and the extent to which the childs self-concept
awareness informs these behaviours. This provided the backdrop for the later exploration of
the extent to which the childs self-concept awareness affects his /her chosen emotionfocused coping strategies.

Attention-Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed

behavioural disorders, with approximately three to six per cent of school-going children

currently diagnosed with ADHD (Gonsalez, 2002). Traditionally, ADHD was defined as a
condition characterised by severe problems of inattention, hyperactivity and/or impulsivity
that are not age and developmentally appropriate. Children diagnosed with ADHD
(predominantly hyperactive-impulsive type) display hyperactive, disinhibited and impulsive
behaviour. Hyperactive behaviour tends to cause conflict between the learner, his peers and
his siblings whereas disinhibited and impulsive behaviour sees children with ADHD giving
impulsive, irrelevant answers to questions and they struggle to focus their attention (Bley &
Thorton, 2001 as cited in Landsberg et al. 2005). Such children tend to lack insight into the
consequences of their behaviour, which results in them reacting to all stimuli, relevant or
otherwise. Children diagnosed with ADHD (combined type) display an amalgamation of
inattentiveness, hyperactivity and impulsiveness.

For the purpose of this study, I chose to use the definition of ADHD as offered by Steer
(2007), who asserts that the core characteristic of ADHD deficit is not attentional but rather
motivational in nature. Barkley, Hutchins, Green, Chee and Nash (2007) support Steers
(2007) conceptualisation regarding ADHD as a disorder resulting from response disinhibition.
Therefore, response disinhibition creates impairments in executive functioning - leading to
deficient self-regulation as well as disorganised behaviour. Over time, this results in deficits
in adaptive behaviour. This definition conceptualises ADHD as a behavioural disorder
characterised by deficits in the purposeful associations between the childs behaviour and
environmental events, which result in the use of less effective emotion-focused coping
strategies. As opposed to cognitive constructs or capacities which result in lessened
awareness of behavioural consequences and poor rule-governed behaviour resulting in
difficulties within the intellectual, academic, emotional and social realms (Steer, 2007).

The definition offered by the American Psychiatric Association (2000) sees attentional
deficits as intrinsic to the individual, whereas Steers (2007) definition regards motivational
deficits as being a product of purposeful and reciprocal interactions between internal (childs
behaviour) and external (environmental) factors. This definition challenges the traditional
conceptualisation of ADHD as a disorder that is characterised by impaired cognitive
structures or capacities resulting in lessened awareness of behavioural consequences and
poor rule-governed behaviour. This distinction allowed me to move away from working from a
traditional needs-based approach to an asset-based approach, exploring cognitive constructs
as well as the childs social and emotional functioning, which encouraged the child with
ADHD to arrive at a greater awareness of what motivates behaviour through greater selfconcept awareness (Ebershn, 2006).

2.2.2. What are the challenges experienced by children with ADHD?

Children with ADHD experience a number of difficulties within the intellectual, academic,
social and emotional realms. Emotional difficulties as a result of the latter are the focus of my
enquiry (Lerner, 2003). According to Bos, Schumm and Vaughn (2003), children with ADHD
display high levels of activity, behaviour problems and a short attention span. The
behavioural manifestations of inattentive and hyperactive-impulsive types of ADHD differ
significantly, and will now be explored.

Children with ADHD (inattentive type) tend to approach decision-making in a sluggish

manner. They tend to honour boundaries and are obedient and polite, which may result in
them acting passively in social situations. They tend to be socially withdrawn, making it
difficult for them to attract friends. However, once they attract a friend, they are able to bond
with them. Children with this type of ADHD are described as introverts, and a percentage of
them become depressed in their later years (Bos, Schumm & Vaughn, 2003). Children with
ADHD (hyperactive-impulsive type) tend to make impulsive decisions, are rebellious and
intrusive of boundaries. They tend to be more aggressive, have an antagonistic demeanour
and are often labelled as egotistical or show offs. Although they are able to attract friends,
they often find it difficult to make meaningful attachments with others (Bos, Schumm &
Vaughn, 2003). Children diagnosed with this type of ADHD tend to have greater co-morbidity
of conduct disorders. Adopted boys demonstrate greater rates of disruptive disorders,
subsequently being less socially integrated and accepted (Goldstein, 1999). A number of
sources reviewed identify boys that have been diagnosed with ADHD (hyperactive-impulsive
type), particularly pre-adolescent boys, as forming part of a high-risk group that may be in
need of support and intervention to develop optimally.

As explored above, impairments in executive functioning result in cognitive deficits that

manifest behaviourally. Impairments in executive functioning manifest in children with ADHD
in the following ways: difficulty in inhibiting responses and regulating behaviour through the
use of inner speech; working memory and control of emotions; problem-solving; effective
communication and compromising on accuracy for the sake of speed (Wicks- Nelson et al.
2000). This has a direct link on the childs ability to exercise self-control. Thus, children with
ADHD (hyperactive-impulsive type) may struggle to engage in turn taking when having a
conversation, have difficulty withholding a response or reaction, delaying gratification and
preventing distractions which interfere with ongoing activities (Bos, Schumm & Vaughn,
2003). The behavioural manifestations of impaired executive functioning influence the way
others perceive the child with ADHD, and ultimately influences their relationships (Bos,
Schumm & Vaughn, 2003).

Impaired executive functioning and cognition result in children with ADHD experiencing a
number of intellectual challenges and learning disabilities. Wicks-Nelson et al. (2000) assert
that children with ADHD tend to perform slightly lower on intelligence tests than those
children not diagnosed with ADHD. They attribute this to the negative impact of hyperactivity
on intellectual performance. However, literature in this regard in contentious, with a lack of
clarity with regards to whether factors such as hyperactivity and impulsivity directly interfere
with intellectual functioning or whether children with ADHD generally have lower intelligence
than other children. What is undisputed in most of the literature is that children with ADHD
are generally more prone to developing learning disabilities than children not diagnosed with
ADHD. This is particularly apparent in tasks requiring mathematics, spelling and reading
skills (Wicks-Nelson, 2000).

It is believed that, in addition to ADHD impacting negatively on scholastic performance, it

also diminishes the probability of success within the schooling environment. Jeeva (2007)
and Wicks-Nelson (2000) state that academic problems, particularly academic failure, are a
core associated characteristic of learners with ADHD. In their opinion, most educators report
that children with ADHD tend not to reach their full potential, with many of these children
continuously exposed to low test scores, failure, and eventual placement into special classes
within mainstream education or placement within remedial school environments. According
to Wicks-Nelson (2000), approximately thirty per cent of children with ADHD repeat a grade
at school, with forty per cent of these learners experiencing at least one special education
placement. As a result, many children with ADHD experience school as a place of little
achievement and success, directly impacting on the process of identity formation and selfconcept.

Furthermore, because of a general lack of understanding of ADHD, children with ADHD are
misunderstood and rejected by significant others in their lives (Jeeva, 2007). Rutherford
(2007) postulates that significant others do not have an accurate understanding of the cause
and consequences of the behaviour exhibited by children with ADHD, resulting in judgement
and subsequent punishment through exclusion. The thoughts and feelings related to
exclusion are internalised by the child with ADHD, leaving him believing that despite his
greatest efforts, he can do little right (Rutherford, 2007). Through exclusion from formal and
informal social situations, the child does not have the opportunity to gain esteem or social
support thus perpetuating feelings of isolation. Such negative interpersonal outcomes result
in a negative self-concept, limited efficacy and a limited coping repertoire. As the
relationships of children with ADHD are increasingly characterised by perceived rejection and

dislike, anxiety and tension are exacerbated and school becomes a place of little pleasure;
negatively influencing performance and achievement therein (Wicks-Nelson et al. 2000).

The result of such unsatisfactory relationships appears to persist beyond childhood and
adolescence. Approximately sixty per cent of children diagnosed with ADHD progress into
adulthood with persisting, and even worsening, symptoms associated with ADHD. These are
in more detail in proceeding discussions (Jeeva, 2007).

2.2.3. Challenges associated with ADHD and their impact on the self-concept
awareness of the child with ADHD.
According to Ebershn (2006), the self-concept is defined as a set of perceptions which are
situation-specific and which include appraisals of ones identity as well as self-efficacy
beliefs. A persons self-concept is multi-faceted, complex and interrelated. The self-concept
consists primarily of the physical, personal, family, social, moral and academic selves. Of
particular relevance to my study was that a change in one of the self-concepts, namely the
personal self, influences other aspects of the self-concept (Kruger, 1994). Accordingly, it
seemed vital to explore the childs awareness of his self-concept. Through increased selfconcept awareness, children confronted with a potentially stressful situation may be better
able to identify - and confidently rely on - their inner resources to effectively problem-solve
and confront the situation.

According to the Illinois State Board of Education (2008), the following are possible indicators
of self-concept awareness and provide a useful point of reference from which to work when
assessing the participants self-concept awareness before and after the intervention. In
chapter 3 I indicate how I used these characteristics to guide my meaning- making of the
analysed data. Self-concept awareness may manifest in:

Self-knowledge:

Knowledge of the influence of the self-concept.

The ability to describe personal likes and dislikes.

Describe individual skills required to fulfil different life roles.

Describe how ones behaviour influences the feelings and actions of

others.

Identify environmental factors influencing attitude and behaviour.

Skills to interact positively with others.

Demonstrate respect for the feelings and beliefs of others.

Demonstrate an appreciation for peoples similarities and differences.

Demonstrate tolerance and flexibility in interpersonal and group situations.

Demonstrate skills in responding to criticism.

Demonstrate effective group membership skills.

Demonstrate effective social skills.

Knowledge of the importance of growth and change.

Identify feelings associated with significant experiences.

Identify internal and external sources of stress.

Demonstrate ways of responding to others when under stress.

Describe changes that occur in the physical, psychological, social and

emotional development of the individual.

Describe physiological and psychological factors as they relate to emotionfocused coping.

Describe the importance of academic, family and leisure activities to

mental, emotional and physical well-being.

The self-concept is the vehicle through which we manoeuvre around our intra-personal and
interpersonal realms. It is informed by ones identity and self-efficacy beliefs. The selfefficacy beliefs of children with ADHD seem to have a direct bearing on their choice of
emotion-focused coping strategies. According to Banduras social cognitive theory, the
individuals self-efficacy beliefs heavily influence the choices that they make and their
behaviour as a consequence thereof (Schunk, 1981; Schunk & Hanson, 1985; Schunk,
Hanson, & Cox, 1987 in Pajares & Schunk; 2001). He further states that people can engage
with situations only when they feel competent enough to do so, and avoid situations when
feeling incompetent in dealing with them. Self-efficacy beliefs play a large role in
perseverance and the resilience of an individual when confronting adverse situations. Thus,
the higher the childs self-efficacy, the more likely they may be to persevere in the face of
obstacles and the less likely they may be to experience extreme amounts of anxiety and
stress when confronted with stressful situations. Thus, it appears that the self-efficacy beliefs
of a child with ADHD result in the employment of ineffective emotion-focused coping
strategies.
It is evident that meaning is attributed to the situations with which we are faced through
cognitive appraisals; and these cognitive appraisals inform the self-concept. The self-concept
has classically been defined in terms of the cognitive appraisals one makes of the hopes,
depictions and prescriptions that one holds of oneself (Pajares & Schunk, 2001) Thus, the
self-concept may provide the individual with structure, a sense of coherence and personal
meaning. Ebershn (2006) and Kruger (1998) assert that ones self-concept is one variable

which motivates behaviour, as children act in accordance with the way they have learnt to
see themselves. Ebershn (2006) further indicates that self-concept formation could be
viewed as a life skill, and that, should the self-concept change, so to could the manner in
which one cognitively and affectively appraises and behaves in chosen situations (Ebershn,
2006). Thus, greater self-concept awareness seems to be one way in which people may
come to a greater understanding of the manner in which their cognitive appraisals inform
their self-concept and the extent to which the self- concept influences their behaviour both
positively and negatively (Ginorio, Yee, Banks and Todd-Bazemore, 2007). I
In order to more completely understand the interactions which influence the self-concept, I
refer to Cooleys looking glass self theory (Cooley, 1902 as cited in Pajares & Schunk,
2001). Cooleys (1902) theory asserts that the self-concept is formed primarily as a result of
how individuals believe others perceive them. If the self-concept is a by-product of social
interactions, he believes it vital for children to learn social interactions as a life skill at school
(Lawlis, 2005). The self-concept develops as a consequence of intrapersonal and
interpersonal relationships within the self, family, peer and school systems. In Figure 2.1, I
conceptualise the above in terms of the child with ADHD. My reasoning allowed me to
deduce that despite a child with ADHDs best efforts to act empathetically towards others,
his/her behaviour may be characterised by a lack of self-regulation, which probably effects in
his/her behaviour being construed as abrasive, intolerable and ill mannered. This, in turn,
possibly results in his/her relationships being characterised by rejection and dislike, anxiety
and tension. Constant and enduring negative feedback negatively affects his/her selfconcept. Such negative feedback has an impact on the manner in which he/she may respond
to people and situations in the future. This in turn has negative connotations for holistic
performance and achievement (Wicks-Nelson et al. 2000). Children with negative selfconcepts tend to have a pessimistic view of life and are critical and judgemental in their
behaviour and conversation (Kruger, 1998). They tend to be extremely sensitive to the
opinions of others and lack self-confidence within social and academic situations, possibly
resulting in the avoidance of challenging situations as well as in destructive behaviour
(Kruger, 1998).
In Figure 2.2 I illustrate the main aim of the study, which was to investigate the impact of selfconcept awareness on the child with ADHDs emotion-focused coping through the use of an
intervention. I placed particular emphasis on the altering of existing cognitive appraisals,
which may have influenced the childs choice of emotion-focused coping strategies. Brooks
(1994) and Ebershn (2006) support the assumption that the self- concept is an effective
coping mechanism. For this reason I assessed a childs self-concept prior to and after the

intervention (through the use of interviews, self-report inventories and checklists). This
allowed me to ascertain the impact of the intervention as well as to determine the relationship
between self-concept awareness and emotion-focused coping.
Based on the statements of Brooks (1994) and Ebershn (2006), my working assumption
was that through greater self-concept awareness, the child with ADHD could be able to alter
their cognitive appraisals thus impacting more positively on their self-concept and ultimately
on their emotion-focused coping. Although changes, if any, in the childs emotion-focused
coping cannot be solely attributed to changes of the self-concept, such information was
valuable in determining the impact of the intervention on self-concept awareness as well as
the influence of this awareness on emotion-focused coping. In the next section, I discuss the
relevance of emotion- focused coping to a child with ADHD.

Socialising
Child with ADHD
Perceived as:
-Abrasive
-Ill-Mannered
-Intolerable
-Egotistical
Negative
-Aggressive
-Insensitive

Relationships
characterised
by:
-Rejection
-Dislike
-Anxiety
-Tension

Negative
Feedback

DSM-IV Characteristics
Hyperactivity
Siblings
- Often fidgets with hands or
feet or squirms in seat.
- Often gets up from seat when
remaining seated is expected.
- Often runs about or climbs
when and where it is not
appropriate.
- Often has trouble playing or
enjoying leisure activities quietly.
- Is often on the go or often acts
judgemental, sensitive or as driven
by a motor.
- Often talks excessively.

Teachers
Friends

Parents

Impulsivity
- Often blurts out answers before questions
have finished.
- Often has trouble waiting ones turn.
- Often interrupts or intrudes on others.

Figure 2.1: Conceptualising the research study

Negative self-concept

Limited and ineffective

coping repetoire

Pessimistic, critical
judgemental,
sensitive to opinions,
lacks self-confidence,
avoids challenge,
destructive behaviour
possible

Cognitive
Appraisal

Cognitive
Appraisal

Feedback

SelfConcept

Emotionfocused
coping

Figure 2.2: Self-concept awareness cycle addressed in the intervention

2.3. Fundamental Underpinnings of Coping

2.3.1. Introduction to Coping

Traditionally, coping mechanisms were considered defence mechanisms used to maintain,
as opposed to defend from mental illness, and were characterised by distortions, and even
denial, of reality (Dombeck, 2006). According to Dombeck (2006), coping strategies that
were reliant on such distortion and denial were chosen out of the desire to appease negative
emotions rather than to deal directly with the stressful situation itself. More recently, however,
research has focused on coping strategies that promote health and well-being. Dombeck
(2006) states that people form habitual modes and methods of managing stress and coping
with difficult emotions. The strategies chosen and employed tend to be useful in assisting to
immediately diffuse and manage stressful situations, but not all strategies are as effective as
others - which could result in a negative impact on an individuals well-being. Dombeck
(2006) forges a strong association between emotional maturity and the individuals choice of
coping strategies, stating that emotionally immature individuals tend to respond reactively to
stressful situations.

Literature offers various definitions of coping. For the purpose of this study, I aligned myself
with the definition of coping as offered by Pearlin and Schooler (2007), as cited in Barganoir

(2007), who define coping as a response to strains that occur within the individuals
environment which serve to prevent, avoid or regulate emotional stress. What was
particularly appealing about this definition was that it placed specific emphasis on
psychological and social resources as well as on the value of the individuals coping
responses. By emphasising the role of social resources, those within the systems that the
individual interacts in, namely friends and family, shared the responsibility for coping.
Psychological resources such as the self-esteem, self-denigration and feelings of control
were included and are pertinent areas that I explored in the study. This definition fell well
within the confines of the definition as offered by Lazarus and Folkmans transactional model,
which highlights the role of situational cognitive appraisals - the single most important factor
associated with both the self-concept and emotion-focused coping. I believe this definition
supports the move away from the needs-based to the asset-based approach (Ebershn,
2006). Thus, cognitive appraisals play a fundamental role in the self-efficacy beliefs of the
individual and ultimately in whether one deems a situation is stressful or not. Acknowledging
this, stress is defined as the negative emotional state which occurs as a response to events
which are perceived (through cognitive appraisals) as taxing or exceeding ones ability to
cope (Weir, 2003). In alignment with this definition of stress and for the purpose of the study,
I defined coping as behavioural and psychological efforts to master, endure, diminish, or
decrease stressful events (Mischara, 2007).

I will now make a distinction between two types of coping strategies - problem-solving
strategies and emotion-focused coping strategies.

2.3.1.1 Problem- Solving Coping Strategies

Problem-solving strategies involve actively engaging in changing the nature of the stressor
and/or the manner in which it is perceived in an attempt to alleviate stressful situations. Much
of the literature classifies problem-solving strategies as active, more adaptive coping
strategies. Examples of problem-solving strategies include actively resolving an argument or
conflict or investing more time into activities (Mischara, 2007). Problem-solving coping
strategies do not form the focus of this enquiry.

2.3.1.2 Emotion- Focused Coping Strategies

The second group of coping strategies, emotion-focused strategies, formed the focus of this
study. I chose to focus on emotion-focused coping strategies, as children with ADHD tend to
employ emotion-focused coping strategies ineffectively, resulting in heightened, as opposed
to diminished, levels of anxiety and stress (Gonzales & Sellers, 2006). Emotion-focused
coping strategies were generally classified under avoidant-coping strategies as they did not

change the actual stressful situation, but allowed for the regulation of emotional
consequences of stressful events (Taylor, 1998). Emotion-focused coping strategies include
activities, such as drug abuse; or mental states, such as withdrawal and denial, which deter
the individual from actively addressing the stress-provoking situation (Taylor, 1998). Taylor
(1998) suggests that although the employment of emotion-focused strategies may provide
short-term stress relief, used for an extended period of time such avoidant emotion-focused
coping strategies may become a psychological risk factor. When exposed to prolonged and
intense unaddressed stress, individuals may experience severe emotional problems as well
as the development of anxiety and depression (Jeeva, 2000).

However, the mere identification of coping strategies was not sufficient and an evaluation of
emotion- focused coping strategies was required.

2.3.1.3. Conceptualisation of Coping in this study

It became apparent to me that few literature sources discussed emotion-focused coping as a
positive and adaptive way of dealing with stress, necessitating such an investigation. Such
research is particularly relevant for the child with ADHD who tends to use less effective
emotion-focused coping strategies as I explained in 2.1. Iwasaki (2007) conducted a study
particularly useful in exploring emotion-focused coping as a positive and adaptive way of
dealing with stress. He investigated the effectiveness of various coping strategies selected
and utilised to deal with a variety of stressful situations.

In Figure 2.3, I illustrate my understanding of Iwasakis (2007) contentions. He paid special

attention to general and leisure-related coping strategies. (For the purpose of elucidation,
leisure-related coping strategies fall under the umbrella of emotion-focused coping). Iwasaki
(2007) argued that the effectiveness of the coping strategy the individual chose should be
situationally contextualised, as opposed to looking at the coping strategies in isolation. He
suggests that leisure-related coping strategies (such as social and esteem support) are
globally more effective than general coping strategies when dealing with a variety of stressful
situations (namely academic, interpersonal, controllable an uncontrollable events as well as
events which threaten the self-esteem). He states that in such situations the communication
and expression of true intent, thoughts and feelings tend to take place in an informal and
relaxed environment. It is through these interactions that stronger relationships throughout
the systems are encouraged, which bolsters the possibility of social support. Iwasaki (2007)
further states that empowerment, emotional support, palliative coping and satisfaction with
advice (all of which are emotion-focused coping strategies) were likely to yield positive
outcomes, particularly when dealing with personal and interpersonal stressors.

Stressful Situations
Personal and
Interpersonal
stressors

Academic
Interpersonal
Controllable events
Uncontrollable events
Events threatening self-esteem

Cognitive, scholastic, social &

emotional challenges of the child with
ADHD

Effective emotion- focused coping strategy

Emotion-focused coping strategies

Stronger relationships encouraged

Social support
Esteem support
Empowerment
Emotional support
Palliative coping
Satisfaction with advice

Better possibility of social support

Adaptive/ maladaptive for the

individual

Informal and relaxed environment

Figure 2.3: When may emotion-focused coping be relevant?

Iwasakis (2007) study allowed me to posit the possibility that emotion-focused coping
strategies could be effective and even necessary in certain situations. Of particular relevance
to my study, was that a child with ADHD (hyperactive-impulsive type) seemed to have a
limited network of leisure-related friends, which provided them with little opportunity to
experience, and be empowered by, the social and esteem support provided by such a
network. This may result in children with ADHD employing less effective emotion-focused
coping strategies.

In acknowledging the fact that each persons chosen emotion-focused coping

strategies are different and unique, it is important to ascertain whether the emotionfocused coping strategies are adaptive or maladaptive for the individual. Although not
comprehensive, Gonzales & Sellers (2002) outlined possible indicators of ineffective and
effective emotion-focused coping. These indicators provided me with a useful point of
reference when evaluating participants reactions during and after the intervention in my
study:
Ineffective coping strategies manifested in:

Verbal abuse or physical aggression. The child with ADHD engaged in direct,

active and physical aggression, which manifested behaviourally in activities such as

punching, kicking and pinching. Direct, active and verbal aggression manifested in hurling
insults. Indirect, active and physical acts of aggression manifested in obstructing an
individuals thoroughfare (Net Industries, 2008)

Passive-active aggression. This passive aggression manifested itself in direct,

passive and physical acts of aggression such as playing a joke on others, avoidance,
internalizing, projecting blame and learned helplessness.

Passive-direct aggression. Passive-direct aggression manifested in tattling as well

as in the spreading of malicious rumours and gossip (Net Industries, 2008).

Indirect-passive physical and indirect active-verbal aggression: Indirect, passive

and physical aggression manifested in resistance and refusal to perform requested tasks.
Indirect-active verbal aggression manifested in responding to others with resistant answers
or completely refusing to speak (Net Industries, 2008).

The above mentioned emotion-focused coping strategies interfered with academic, social or
occupational functioning, involving unhealthy or dangerous practices i.e. substance abuse,
tending to promote avoidance (which may have been beneficial if the stressor was
uncontrollable but over extended periods of time may have resulted in chronic physiological
arousal) and were associated with negative adjustment and decreased immune functioning.

Effective coping strategies manifested in:

Taking positive problem-solving action and avoiding abusive verbal language

or physical aggression. In this manner, the child acknowledged and assumed responsibility
for their role in the problem. Such accountability allowed for personal growth through positive
reappraisal.

Seeking social support from friends or significant adults. Through the seeking

and gaining of emotional support the child felt empowered due to being able to effectively
communicate and work through stressful experiences.

Examining the situation from another perspective. This allowed the child to make

a cognitive effort to detach from the situation temporarily to create a more positive outlook
(distancing).

Using relaxation methods. By employing relaxation methods, the child attempted to

modulate feelings or actions regarding the problem, which required of him to exercise
significant amounts of self-control.

Throughout the process of data collection and analysis, the above-mentioned coping
strategies presented themselves. As delineated above, I needed to co-determine with the
participants whether the chosen coping strategies were indeed adaptive or maladaptive for
them within their context, providing clear support for this argument. I applied this information
to determine the impact of the intervention on the emotion-focused coping of the child with
ADHD. (Evidence for the effectiveness (or not) of the intervention on influencing emotionfocused coping were indicated by the participants coping strategies becoming more effective
post-intervention based on the above indicators). Refer to chapter 4 in this regard.

2.3.2. Coping Strategies and the Child with ADHD (hyperactive-impulsive type)
The framework above provided the backdrop against which to discuss the coping of the child
with ADHD. Hudiberg (2007) defines emotion-focused coping as the utilisation of behavioural
and cognitive strategies to deal with conditions that are viewed as fixed and beyond ones
control. It has been my experience as an interventionist working with children with ADHD that
more often than not, emotion-focused coping strategies were utilised seemingly ineffectively.
The following example practically elucidates this process: a child with ADHD who was
involved in a conflict with a fellow classmate may have lacked adequate self-control to
modulate his feelings regarding the source of conflict in order to distance himself for long
enough to diffuse the situation and deal with it at a later stage. This may have resulted in him
becoming physically and/or verbally aggressive towards his peer. When being reprimanded
for this action, he had difficulty in acknowledging his role in the conflict. This lack of
accountability made it difficult for a positive reappraisal of the situation to take place; which
may have resulted in the child with ADHD experiencing the situation negatively, thus reenforcing a negative self-concept and influencing future appraisals of self and situations.
Thus, if the basic features of a child coping effectively were the possession of a healthy selfesteem and sense of self competence, which promotes feelings of control, ownership and
optimism, then ineffective coping strategies manifested behaviourally in underachievement, a
lack of perseverance, acting out behaviour, substance abuse, and heightened physiological
arousal and frustration (Gonzales & Sellers, 2006).

As I illustrated above, despite possessing an average to above-average intelligence, children

with ADHD may have developed a poor self-esteem and a negative self-concept due to
difficulties experienced within the social, emotional and academic realms. If a child believes
that he/she has the inner resources to cope with a situation, the likelihood of experiencing
stress is minimal. However, if he/she perceives his/her resources as inadequate to deal with
the situation, he/she may feel threatened and may experience stress. This example also
clearly illustrates the centrality of factors that contribute to ones response to stress; namely

issues of explanatory styles and personal control. Feelings of personal control has a direct
influence on the childs self-efficacy beliefs. Therefore, the more control they feel they have
within a situation, the less likely they were to experience stress.

2.3.3. How do these challenges associated with ADHD impact on the child with
ADHDs chosen coping strategies?
Diener, Lucas and Oishi (2002) support the assertion that the individuals locus of control is a
strong determinant of subjective well-being. They make particular reference to cognitive and
affective evaluations of situations that are influenced directly by the amount of control one
perceives he has over the situation. According to Ebershn (2006), having a sense of control
over a situation allows for one to experience positive emotions, which, in turn, influences
ones self-efficacy, self-confidence, sense of autonomy and self-resilience. This feeling of
control allows the individual to persevere through hardship whilst remaining optimistic.
Ebershn (2006) too emphasises the centrality of the locus of control by stating that that
those who cope well with stress believe that they have personal influence over what happens
to them, tending to employ more active coping strategies due to their belief that they can
personally initiate change. Those who perceive situations as falling beyond their locus of
control, however, tend to employ avoidant, emotion-focused strategies (Taylor, 1998).
Ebershn (2006) and Ginorio, Yee, Banks and Todd-Bazemore (2007) agree that those who
cope poorly with stress tend to feel they have less control over their lives and have a poorer
prognosis for psychological adjustment with their behaviour being characterised by learned
helplessness. Persistent feelings of self-blame, as well as an external locus of control, could
result in poor adjustment and depression.

Literature infers that children with ADHD exhibit an external locus of control. The child with
ADHD tends to perceive reality in an idealistic, unfounded and unconventional manner
resulting in the distortion of reality leading to further social isolation and discomfort (Gonzales
& Sellers, 2002). This may result in enduring and intense experiences of negative effect with
these deep-seated feelings of inadequacy resulting in anxiety and depression. As many as
sixty per cent of children diagnosed with ADHD progress into adulthood with persisting, and
even worsening, symptoms associated with ADHD (Jeeva, 2007). Biederman (1993) and
Shekim (1990 as cited in Barkley & Murphy, 1996) state that approximately fifty per cent of
children with ADHD become adults with ADHD who suffer from substance abuse disorders;
with approximately forty per cent suffering from anxiety disorders and thirty five per cent
suffering from major depressive disorders.

A study conducted by Contugno (1995) supports my assumption that due to limited coping
capacity, the well-being of the child with ADHD is at risk. Findings of Contungos (1995)
study reveal that children with ADHD have limited coping capacity, which may result in an
avoidance of affect-laden stimuli, difficulties with self and interpersonal perceptions and
problems with social reality perception. Such research implies that many children with ADHD
do not perform to their true potential, with a number of studies, like Contugnos, highlighting
the ineffectiveness of the coping strategies they tend to employ. There is ample evidence to
suggest that that the current interventions designed for and emotion-focused coping
strategies employed by children with ADHD are ineffective in assisting them to deal
effectively with stress, which seemed to be resulting in a large number of children with ADHD
developing co-morbid psychological disturbances as adolescents and adults.

Having said this, Mischara (2007) states that children have the capacity to become aware of
the manner in which coping strategies are chosen by understanding the situation as well as
personal resources and habits. Is appears that the self-efficacy beliefs of a child with ADHD
lead to the employment of ineffective emotion-focused coping strategies, which made the
need to change cognitive appraisals of critical importance if the child was to adapt to and
cope more effectively when confronted by stressors. Children who felt overwhelmed by a
situation had evaluated that the personal resources they had at their disposal were
insufficient to meet the demands of the situations, which resulted in a stressed response
characterised by a lack of belief that they possess the ability to change the situation or their
responses to the situation (external locus of control).

Thus, the need existed to enhance the coping strategies of children with ADHD in order for
them to function optimally within their environments. The need to identify and develop
effective coping strategies in childhood became of fundamental importance if children with
ADHD were to be able to effectively confront and deal with life stressors. For this reason
Hertzfeld and Powell (1986), as cited in Gonzales and Sellers (2002), advocated that stressmanagement programs have modules on the establishment and maintenance of a healthy
self-esteem implicit within them. Brooks (1994) identified several factors that enable children
to become more able to face and deal with difficulty and to increase productivity - namely, a
healthy self-esteem and a sense of competence, which permits the establishment and
maintenance of a sense of optimism, ownership and personal control. For they, like
Ebershn (2006), support the belief that the self-concept is an effective coping mechanism,
which makes self-concept awareness fundamental in successful emotion-focused coping
(Lazarus & Folkman, 1994, as cited in Gonzalez and Sellers, 2002). It was necessary to
facilitate the process of self-concept awareness in such a manner to guide, challenge and

scaffold the child through the process, using the tension and anxiety experienced because of
greater awareness to influence their emotion-focused coping positively. Thus, an intervention
to develop and enhance coping skills was much needed in order for children to be better able
to understand their reactions within various situations and to be exposed to various coping
strategies.

Figure 2.4 below serves as a point of reference when elucidating Barkleys (1999) definition
of ADHD. Figure 2.4 also outlines the manner in which I understand the role that ADHD plays
(and how it impacts on) the child with ADHDs self-concept, awareness thereof and ultimately
their coping:

The inability to inhibit responses

This resulted in negative interpersonal outcomes, which influenced the self-concept (which is
a social construct)

Impaired Executive functioning

Characterised by deficits in self-regulation, impairment in goal-orientated behaviour as well
as difficulty adapting socially and behaviourally

Inaccurate self-appraisal (inaccurate understanding of strengths, limitations and

resources) which influenced situational appraisals and ultimately self-efficacy
(motivation and perseverance)
Children with ADHD have difficulty in accurate self-appraisals possibly leading to learned
helplessness (which was the presenting problem that came to the attention of educators and
parents alike)
Subjective well-being is rooted in personal control, which influences the appraisal of
situations and events and whether they are evaluated as being stressful or not determining
the emotion-focused coping strategies selected. Children with ADHD view situations as being
beyond their control and fixed. This results in a lack of accountability and negative appraisals
of events. This confirms negative self-appraisals.

Deficits in functional, adaptive behaviour

Figure 2.4 Conceptualisation of ADHD (Based on Barkleys (1999) Definition)
2.4. What interventions exist to impact on self-concept awareness and emotionfocused coping?

Gonzales and Sellers (2002) suggest that there is a heightened level of awareness in
literature concerning the difficulties that children with ADHD experience. This has resulted in
the creation of interventions centred on cognitive aspects, behavioural manifestations and
treatment modalities. However, little research had focused on the social and emotional
functioning of children with ADHD (which was congruent with the conceptualisation of ADHD
as appearing in this study) - all of which played a pivotal role in levels of motivation.
Goldstein (1999) states that in order for treatments to be effective, they cannot be removed
from their immediate point of performance. I am of the opinion that self-concept awareness
was an intangible resource intrinsic to the individual at every point of performance.
Self-concept awareness as a resource could support beliefs such as that of Gonzales and
Sellers (2002) who outlined pertinent literature, which supported the need for programmes to
increase the ability of children to cope with stress by relying on internal resources. Learning
to cope successfully with stress was a pivotal determinant in the long-term psychosocial,
emotional and physiological effects of stress. This created the need for a study to be
conducted that explored the levels of psychological distress experienced by children with
ADHD, in an attempt to develop interventions aimed at the acquisition and development of
effective coping strategies. Such an intervention placed emphasis on the role of selfconcept awareness as the motivator of behaviour - it was through the self-concept that self
and situation appraisals were made and coping strategies selected, and it is these principles
that are encapsulated in Ebershns (2006) asset- based life skills facilitation programme.

However, many children do not have the necessary life skills to cope effectively. Children
with ADHD may lack intrapersonal skills, and subsequently, interpersonal knowledge. This
results in an external locus of control, no assumption of personal responsibility, as well as
negative appraisals that manifest in ineffective coping strategies. Despite their best
intentions, most reviewed interventions were needs-based as opposed to asset-based which
seemed to perpetuate the cycle of helpless passivity that children with ADHD exhibited.
Based on the large percentage of children with ADHD who become adults with persistent
and worsening symptoms of ADHD, the need existed for the implementation of an
intervention programme that empowered the child with ADHD to meet the demands of a
dynamic and ever-changing world.

There are several suggestions put forward regarding possible interventions that may be
beneficial to the child with ADHD. Mischara (2007) states that children have the capacity to
become aware of the manner in which coping strategies are chosen through understanding
of the situation, as well as personal resources and habits. Ebershn (2006) clearly articulates
the role that life-skills facilitation plays in the facilitation of coping. I aligned myself with

Ebershns (2006) assertion that the identification of inaccurate thoughts was not sufficient in
the acquisition of adaptive life skills, with particular reference to children with ADHD. This is
because the child with ADHD has an established understanding and knowledge of what
needs to be done, but struggles with the practical execution of this knowledge. She
emphasises that children should be supported in their endeavour to cope in an independent
manner in order for them to cope innovatively with the stressors that they face (Ebershn,
2006). Ebershn (2007) developed an intervention which encourages cognitive regulation
intervention strategies as a means of altering thoughts, ideas, assumptions, selfcommunication, basic philosophies (and therefore cognitive structures and appraisals) that
people use for themselves, others and situations (Ebershn, 2006: 69).

Through this

intervention, childrens self-communication at an intrapersonal level was influenced which, in

turn, resulted in the acquisition of more established external interpersonal behaviour skills.

For my study, I selected Ebershns (2006) framework in conjunction with Krugers (1998)
programme (refer to Appendix K), where I provide a detailed outline of my intervention).
Whilst acknowledging the role and existence of deficiencies, the interventions focused on the
strengths, abilities and resources available to children with ADHD that could assist them in
best coping within their respective environments. By integrating the two programmes, all
participants, including the child with ADHD, were involved in the process of assessment and
evaluation. The reason for selecting the intervention as developed by Ebershn (2006) was
twofold. The first was that the programme focused on key areas in which the child with
ADHD was deficient, due to impaired executive functioning and poor self-regulation, namely emotional, cognitive and behavioural regulation - all of which are prerequisites for effective
emotion-focused coping and adaptation (self-awareness and reflexivity play a pivotal role).
The second reason for selecting this intervention was that the programme had been
implemented successfully with South African children.

As is illustrated in Figure 2.5, the intervention I chose is based on the theoretical assumption
that the self-concept is situation-specific and that self talk enables cognitive awareness and
self-regulation (Figure 2.5 is an integration of Figure 2.1 and Figure 2.2 to indicate how the
studys intervention may theoretically impact on a child with ADHDs coping). Furthermore,
through cognitive and emotional regulation, behaviour is impacted on and restructured
(Ebershn, 2006). The most fundamental theoretical underpinning of this intervention is that
it allows for the child with ADHD to involve himself/ herself in the proactive management and
regulation of his/ her thoughts, feelings and behaviour (Ebershn, 2006). Such
empowerment forms the foundation of effective emotion-focused coping, for it allows the
child to experience a sense of control and to assume accountability. Children who become

stressed often feel as though they lack the ability to change the situation and their responses
because of ineffective coping strategies.

DSM-IV Characteristics
Hyperactivity
- Often fidgets with hands or
feet or squirms in seat.
- Often gets up from seat when
remaining seated is expected
- Often runs about or climbs
where it is not appropriate.
- Often has trouble playing or
enjoying leisure activities quietly.
- Is often on the go or often acts
judgemental, sensitive or as driven
by a motor.
- Often talks excessively.

Perceived
as:
-Ill-mannered
when and
-Abrasive
-Intolerable
-Egotistical
show offs
-Aggressive

Impulsivity
-Insensitive
- Often blurts out answers before
questions have finished.
- Often has trouble waiting ones turn.
- Often interrupts or intrudes on others.

Figure 2.5: Working assumptions of changes in coping post-intervention

The intervention I chose in this study was particularly helpful in this regard. It placed
emphasis on the central life skill of conscious proactive self-talk, which assisted the child in
monitoring and regulating his behaviour proactively, facilitating more adaptive coping. The
intervention explored the process of cognitive regulation, identity formation theory and
emotional regulation - all of which are key aspects of effective emotion-focused coping.
Ebershn (2006) asserts that interpersonal knowledge is borne from greater self-awareness
and that this is the foundation for teaching facilitation. The programme incorporated elements
of reflexivity to accompany self-awareness, which were pivotal for adaptation. The primary
aim of the intervention was to allow the child with ADHD to internalise the intrapersonal skills

learnt and to apply them in a real life situation in order to confront and adapt to stressors
using effective emotion-focused coping.

I stress the link between children with ADHD and their situations to other contexts and
relationships. Of fundamental relevance to this intervention is the acknowledgement that (i)
the self exists within a larger system, and (ii) the role that the meso-, macro- and micro
systems play in the formation and maintenance of the self-concept. Thus, in order for the
self-concept and emotion-focused coping strategies to be changed sustainably, one needs to
include members from as many systems as possible (including the parents, educators and
therapists of children with ADHD as participants in the research process). Benefits of these
decisions are that they allow various members to come to a greater understanding of the lifeworld of the participant as well as making the intervention more sustainable.

2.5. Conclusion
This chapter allowed me to position my study within a theoretical framework of existing
literature. I commenced the study by exploring the fundamental underpinnings of ADHD, the
challenges experienced by children with ADHD and how these challenges impact on the
childs self-concept awareness and their chosen coping strategies. Thereafter, I discussed
the underpinnings of coping as well as the coping strategies that children with ADHD
generally employ. By concluding with the exploration of intervention, I linked self-concept
awareness and intervention within the context of the asset-based approach.

Based on this discussion, it appears that the child with ADHD is predisposed towards
emotion-focused coping and may be more inclined to employ emotion-focused coping
maladaptively (keeping cognisant of the fact that emotion-focused coping may be deemed
adaptive as well as maladaptive). However, it is maladaptive emotion-focused coping which
probably leads to negative feedback from significant others, which may result in a negative
self-concept. The intervention I chose for this study incorporates key theoretical areas in
which the child with ADHD is deficient, (due to impaired executive functioning and poor selfregulation) namely: emotional, cognitive and behavioural regulation - all of which are
prerequisites for effective emotion-focused coping and adaptation (of which self-awareness
and reflexivity play a pivotal role). I hope that the self-concept awareness of the child with
ADHD was heightened by engaging with this intervention, resulting in more adaptive
emotion-focused coping. Due to adaptive emotion-focused coping strategies, the child with
ADHD may have been able to foster increased social support and subsequent positive
feedback through the relationships that developed. As a result of this, I hope that the positive

feedback may have resulted in a positive self-concept, and ultimately, more adaptive
emotion-focused coping.

In the next chapter, I discuss the empirical study that I conducted based on the theoretical
framework as outlined in this chapter. I further explain the methodological choices that I
made within the context of my study.

Chapter 3: Paradigmatic Assumptions

3.1 Introduction
Chapter two provided a theoretical framework for my study. Based on the literature reviewed
in the previous chapter, I planned and carried out my research study in which I strove to
explore and describe (i) the relationship (if any) between self-concept awareness and
emotion-focused coping in children with ADHD and (ii) how an intervention might (might not)
impact on the self-concept awareness and emotion-focused coping of children with ADHD.

In this chapter, I will discuss the purpose of my study through the exploration of my
paradigmatic assumptions within the parameters of my research questions. I will explore the
strengths and limitations of my meta-theoretical and methodological choices as well as how I
attempted to address each of the identified challenges. Furthermore, I will explore the role
that I assumed in the research study as well as the ethical considerations undertaken in
order to ensure that my study was trustworthy. This chapter will be followed by a discussion
of my findings in Chapter four.

3.2 Purpose of the Study and Research Questions

The purpose of this descriptive and exploratory study was to explore the association between
the self-concept awareness and emotion- focused coping of children diagnosed with
Attention Deficit Hyperactivity Disorder (hyperactive-impulsive type). This study was
exploratory as I aspired to gain new insights into the association between self-concept
awareness and emotion-focused coping. I strove to explore the possible impact of an
intervention on the self-concept awareness and emotion-focused coping repertoire of
children with ADHD. Engaging in exploratory research enabled me to define, clarify and
explore both of these multifaceted and complex constructs in great detail facilitating idea
generation and concept testing (Wolfinbarger, 2007). It also allowed me the flexibility to
select research tools I deemed most appropriate to investigate these constructs, allowing for
me to re-establish priorities and direction for my study as it became appropriate to do so

(Childers, 2007). Despite the advantages of exploratory research, I was cognisant of the
limitations which could have presented themselves.

Literature indicates that exploratory research relies heavily on the expertise and training of
the researcher who facilitates discussion (Wolfinbarger, 2007). Such facilitated discussions
took place in my study in the form of in-depth interviews (refer to 3.8). As a scholar of
psychology, the ability to create a relaxed, conducive environment which facilitates
exploration through involvement, flexibility, empathy, understanding, encouragement and
positive regard has formed part of my training and daily practice.

In addition, the study was descriptive in nature as I aimed to describe the impact that the
intervention had (or did not have) on the self-concept awareness and emotion-focused
coping strategies of children with ADHD. Descriptive research provided me with the platform
to explore the feasibility of this intervention through observation, analysis and rich
descriptions of the child participants self-concept awareness and emotion-focused coping
strategies pre- and post-intervention (Koh & Owen, 2000). It was through these thick
descriptions that I could indirectly assess the impact of this intervention.

As stated in chapter 1, the study therefore aimed to answer the following primary research
question:

What is the association between self-concept awareness and emotion-focused coping of

children diagnosed with ADHD?

In order to address the above-mentioned primary question, the following sub-questions were
explored:

To what extent were the children with ADHDs self-concept awareness impacted on
(or not) by the intervention?

How were the children with ADHDs emotion-focused coping strategies impacted on
(or not) after the intervention?

To what extent did self-concept awareness influence (or not) the child with ADHDs
emotion-focused coping strategies?

To what extent were children diagnosed with ADHD able to transfer the selfawareness skills and knowledge acquired from the intervention into their everyday
interactions within the school and home?

3.3 Paradigmatic Assumptions

3.3.1. Introduction
Research paradigms consist of working assumptions that govern the manner in which I think
about and reflect on the experiences being investigated, as well as the actions that ensue
(Ferreira, 2006). I entered the research process with my understanding of different concepts
based on literature reviewed as well as my thoughts, feelings and values which informed my
frame of reference (Ferreira, 2006). I selected the interpretivist paradigm (meta-theory),
following a qualitative approach (methodological paradigm).

3.3.2. Metatheoretical Paradigm

The research study aimed to gain a rich description, understanding and interpretation of the
participants perceptions of the relationship between the participants self-concept awareness
and emotion-focused coping strategies. In order to understand this complex phenomenon, I
needed to gain insight into the discovery of meaning, which forms the core of interpretivism
(Myers, 2000). Interpretivism argues the existence of multiple realities over time and space,
acknowledging that research is a process characterised by interaction and shaped by the
personal histories, biographies, gender, race and experiences of the participants; including
those that share their setting and me (Denzin & Lincoln, 2000).

In order to achieve the aims of the study, I chose the interpretivist paradigm. By utilising
interpretivism, I place emphasis on the subjective and unique experiences of children with
ADHD as well as how their self-concept mirrors these experiences and perceptions. The
interpretivist paradigm suggests that the nature of reality is fluid. It further states that multiple
realities exist and are borne from the individuals subjective experience of his external world
(Babbie & Mouton, 2004). Empathetic identification is essential in the process of achieving
intersubjectivity and in understanding the nature of the participants reality. Through
empathetic identification, I was able to achieve a greater understanding and level of insight
into the generation and sustenance of the values that make up the meaning systems and lifeworlds of the participants (Denzin & Lincoln, 2000). To be able to identify with the
participants empathetically, I assumed the role of participant observer (a key underpinning of
the interpretivist paradigm) (Schurink, 1998; Garrick, 1999; Cohen, Manion & Morrison,
2003). (Refer to 3.8.2.).

The nature of interpretivism is to preserve the original voice of the participants as far as
possible with as little interpretation as possible. In order to achieve this, when documenting
collected data, I transcribed the actual words of the participants, and allowed for the actual
words of the participants to surface during data analysis (refer to Appendix E for an example

of transcription and Appendix M for data analysis). By trying to preserve the original voice of
the participants, I acknowledged that each participants reality was subjective, unique and
valid in terms of the manner in which they develop their self-concepts and employ emotionfocused coping strategies.

Despite trying to capture the voices and perceptions of the participants through the recording
of their actual words, my interpretations were not free of personal interpretation and
attribution of meaning. I acknowledged that the interpretivist paradigm allowed me to be a cocreator of meaning and attempted to address this by writing up my research study in the first
person and in an informal style - allowing the reader to hear my voice (Ferreira, 2006).
Throughout my research study, I aspired to use language typical of the qualitative approach
(Ferreira, 2006).

Also, I needed to remain aware of the ever-present limitations that presented themselves
during the research process. Acknowledging that meaning is socially constructed, I was
aware that my presence in all interactions could alter the settings and behaviours of the
participants (Bogdan & Biklen, 1982, Guba & Lincoln, 1981 & Patton, 1990). In addition to
this, I needed to be aware at all times of my perceptions and possible biases. I addressed
both of these limitations through reflection-in-action as well as by reflecting on my role as
interventionist and researcher within my reflective journal and with my supervisor (Denzin &
Lincoln, 2000). The second limitation presented itself in the form of time. Being the only tool
for data collection, analysis and interpretation required much involvement on my part, making
the process time consuming (Bogdan & Biklen, 1982, Guba & Lincoln, 1981 & Patton, 1990).

3.3.3. Methodological Paradigm

I employed a qualitative paradigm in this study. My choice to work from a qualitative
paradigm was guided by the purpose and nature of my study as well as by my belief as a
researcher that there is no single, objective reality; but that reality is a subjective, context
bound experience, which makes it a tool to better understand and describe the world of
human experience. Denzin and Lincoln (1994) define qualitative research as research
conducted within the natural settings of the participants in order to gain insight into the
meanings that the participants attach to their life worlds. Qualitative research advocates that
the whole is greater than the sum of its parts, with the context proving crucial when
attempting to understand the situation. The qualitative paradigm is an inductive process and
as such I did not make attempts to understand the situation or phenomenon being studied by
introducing pre-existing expectations into the setting (Mouton & Marais, 1991).

As qualitative researcher, I regarded the participants and myself as active agents in the
construction and meaning making of their realities (Mouton et. al. 1991). Through
acknowledging and respecting this relationship between the researcher and participants, we
established a relationship based on trust. Throughout the research process, I remained
cognisant of the importance of maintaining intersubjectivity as well as understanding the
outcomes of the observations and interviews through the lens of the participants personal
knowledge. I was required to understand and interpret the situation through gaining insight
into the meaning the participants had attached to the situation, which was embedded within
the context of their social interactions (Mouton, et. al. 2005).

As stated by McMillan & Schumaker (2001), the hallmark of qualitative research is the level
of detail that the narratives of the participants contain which makes their stories appear alive
and real. Through understanding the narratives of the participants, the reader is transported
into the world of the participant. In order to capture this rich detail and authenticity, I placed
emphasis on naturalistic observation and fieldwork (refer to Appendix B for example of field
notes) while capturing data, as well as on recording the exact words and terms used by the
participants as far as possible (Mouton et. al. 1991). (Refer to Appendix L for examples of
visual data and Appendix J for examples of transcriptions).

Lofland (1971) as cited in Mouton & Marais (1991) outlines four elements he deems
necessary in a qualitative study, which I utilised, namely:

I became rigorously engrossed in the participants contexts in order to gain a detailed

acquaintance with the subjective worlds of the participants. I achieved this through
the analysis of the participants acts, activities, meanings, participation, relationship
and setting; (refer to Appendix N for example of reflective journal)

I detailed the situations that the participants were in; (refer to Appendix I for example
of field notes)

I aimed for an in-depth understanding of the manner in which the participants

navigated and coped with the situations that they were in; (refer to Appendix N for
example of reflective journal)

I integrated and analysed data collected about the participants interactions, locations,
situations and strategies in order to portray an in-depth picture of the reality of the
participants. (Refer to Appendix N for example of reflective journal and Appendix M
for example of data analysis).

Critics of the qualitative approach believe that one of the greatest weaknesses of qualitative
research is that an element of humanness is maintained throughout the research process

(Mouton & Marais, 1991). They assert that this makes it impossible to escape the subjective
experience (which forms the core of quantitative, positivist research). However, for the
qualitative researcher, this is a great strength of the approach. The humanness informs the
qualitative researcher of the subtleties of the situation needed to understand the richness
and depth of the participants life-worlds through detailed exploration and allows for the
reader to have a detailed understanding of the phenomenon being explored (Mouton &
Marais, 1991). I remained acutely aware and cognisant of the strengths and weaknesses
posed by subjectivity and throughout the research process constantly reflected on this in my
research journal as well as with my supervisor. A second weakness of the qualitative
research process proved to be the demand it placed on time and commitment (Mouton &
Marais, 1991). I attempted to address this weakness by providing approximate time frames
for the intervention sessions as well as by delineating the time needed to conduct my
research.

3.4 RESEARCH DESIGN

3.4.1 Introduction
I conducted the study using an intervention research design as conceptualised by Rothman
and Thomas (1994). They define intervention research as the development of knowledge
about interventions, how to apply this knowledge into social practice and the effectiveness of
the intervention within a particular setting. They offer an integrated model of intervention
research in an attempt to design and develop interventions to enhance the well-being of the
individual and school community. Intervention research places a strong emphasis on the
participation of all participants throughout the research process.

3.4.2 Intervention Research Design

Intervention research design comprises three main elements, namely intervention knowledge
development (results generated which could be used to gain insight to and solve problems),
intervention knowledge utilisation (apply knowledge generated from theory and research to
human behaviour) and intervention design and development (focuses on the development of
new interventions and provides empirical grounds for altering existing interventions) (Thomas
& Rothman, 1994).

Bender (2002) states that although the stages of intervention in intervention research are
presented sequentially, this is a dynamic process that evolves throughout the intervention
and in the face of opportunities and challenges. Based on Thomas & Rothmans model,
Bender (2002) further states that each phase has distinctive tasks to carry out in order to

complete the needs of the phase, with each completed stage carried through into the
introduction of the next phase. Thomas and Rothman (1994) offer the following integrated
model of Intervention Research (which I utilised in designing the study) comprising six
phases and corresponding activities. I discuss my application of the phases in Chapter 4.

Phase 1: Problem analysis and project planning

Phase 2: Information gathering and synthesis
Phase 3: Design
Phase 4: Early Development and Pilot testing
Phase 5: Evaluation and advanced testing
Phase 6: Dissemination

Using intervention research presented with a number of limitations (Thomas & Rothman,
1994) which will now be explored. Intervention was time and labour intensive, particularly in
the case of this study as I was directly and wholly involved in the actual intervention as well
as in the observation and interviewing of the participants. Secondly, the terminology used for
different intervention strategies was vast and may result in the study not being easily
comparable due to varying terminology. I addressed this challenge through concept
clarification as outlined in Chapter 2. Thirdly, the lack of literature available on intervention
research made it difficult to apply a standard and well-researched design to my study.
Lastly, my study made use of a control participant in order to evaluate the impact (or not) of
the intervention adding which added credibility to my study. Both participant and control
participant were selected on the same criteria (refer to 3.5.2.1) and both received the
intervention at different times (refer to figure 3.1). The control participant received the
intervention on completion of the study (Myers & Dynarski, 2003). Throughout the study, both
participants, their parents, their educators and their therapists were granted access to all
services not provided by the intervention process and by the school, such as other
therapeutic interventions (Myers & Dynarski, 2003).

Despite the above-mentioned weaknesses, there were several advantages to using this
research design. The results yielded from the research provided the opportunity to evaluate
the materials and programmes currently used by the school, with the possibility of introducing
new, more effective interventions should the intervention positively impact on the selfconcept awareness and emotion-focused coping of children with ADHD. By establishing
rapport with the participants, I gained a rich understanding of and insight into the participants
behaviour and responses, which most other research designs would not permit. Intervention

research design also created opportunities for future empirical research questions and
investigation (Goodwin, 2002).

3.5 Selection of Participants

3.5.1 Introduction
Comprehensive inquisition of a phenomenon within its natural context exemplifies Qualitative
research. The interpretivist paradigm is characterised by the emphasis it places on multiple
and unique perspectives of the participants within situation-specific contexts, prioritising
description and exploration over generalisation (Jacobs, 2007). Qualitative samples are
therefore generally small due to the time and resources required to conduct such a study.

I selected purposive sampling for the purpose of my study (Babbie & Mouton, 2004). One
can define purposive sampling as a process in which one selects a sample based on
experience and knowledge of the group sampled. Employing purposive sampling was
advantageous by allowing me to analyse the data as the sampling progressed (Jacobs,
2007). This gave me the flexibility to add to or change the sample criteria according to the
information that emerged. Sampling in this way ensured the vigorousness of the theories
generated, which correlated with the essence of qualitative research - to gain an in-depth,
rich understanding of the phenomenon. In table 3.1 I provide an outline of the participants in
this study.

Table 3.1 Outline of participants in this study

Gender

Age

Grade

Child 1

Male

10

Child 2

Male

11

Gender

Occupation

Parent 1

Female

41

Nurse

Parent 2

Female

38

Accounts Clerk

Gender

Grade

Educator 1

Male

Educator 2

Female

Gender

Grade

Occupation

Female

Psychologist

Therapist 1

Therapist 2

Female

Speech Therapist

Therapist 3

Female

Occupational
Therapist

Therapist 4

Female

Intern Psychologist

Therapist 5

Female

Speech Therapist

Therapist 6

Female

Occupational
Therapist

Jacobs (2007) outlines steps to be undertaken when selecting a sample (which I adhered to
in my study):

3.5.2 Define the population

Last year, I was employed in the capacity of an intern educational psychologist at a
government remedial school catering for the special education needs of learners from Grade
1- Grade 12. In the capacity of intern psychologist and member of a multi-disciplinary team2, I
worked with a number of learners as well as their parents, educators and therapists. This
granted me access to research participants, making it viable for me to request volunteers
from a group of people who met the general requirements of the study (Goodwin, 2002). I will
now discuss the three groups of participants.

3.5.2.1 Children with ADHD

I purposively selected two children with ADHD to participate in the study based on the
following criteria:

The child displayed symptoms of ADHD (hyperactive-impulsive type).

The child spoke English as their first language.

The childs intellectual ability fell within the below-average-to-average range at the
time of intervention.

The child came to the attention of the schools multidisciplinary team2 displaying
ineffective emotion-focused coping.

I selected both children with ADHD from the intermediate phase. Child 1 is a male, aged 11
and currently in Grade 5. Child 2 (the control participant) is a male, aged 10 and currently in
Grade 4. I chose boys for the sample because literature identified that boys, particularly preadolescent boys, formed part of a high-risk group of the population (refer to 2.2.2). Both
learners underwent pre- and post- intervention assessments, however only Child 1 partook in
2

The multi-disciplinary team consisted of an educator, assigned speech therapist, occupational therapist and
psychologist/ intern psychologist. The multi-disciplinary team would meet once a week to discuss the progress
of identified learners and to adapt Individualised Education Plans (IEP) accordingly.

the intervention initially, with Child 2 (the control participant) receiving the intervention on
completion of the study. I conducted all interviews and intervention sessions in English. In
both cases, the parent/s, educator/s and therapists of the children were involved in the
research process. (Refer to Figure 3.1. for an outline of the research process). The Head of
the Learning Support division, under whom I was completing my internship as an educational
psychologist, contacted the parent/s of the participants. I then met with the parents and, by
means of a consent letter (Appendix A), obtained informed consent from them for their
children to participate in the study (refer to 3.11.1).

3.5.2.2.Parent/s of children with ADHD

I purposively selected the parents of the children with ADHD because they provided vital
biographical information, as well as observations of behaviour within the home and peer
situation. Aligned with qualitative research, this information assisted me in better
understanding the context within which each child functions. Also theoretically, based on
social cognitive theory (refer to 2.2.3. in Chapter 2), the environment plays a crucial role in
the development of a childs self-concept. Parental information thus provided me with insight
into stressors that children with ADHD were experiencing within their environments.

The Head of the Learning Support division, under whom I was completing my internship as
an educational psychologist, contacted the parent/s of the participants. I then met with the
parents and, by means of a consent letter (Appendix A), obtained informed consent from the
parents for them and their child to participate in the study.

3.5.2.3. Educators and Therapists

I purposively selected the educators and therapists that work with the child participants. This
group of participants consisted of educators, occupational therapists and speech therapists.
This team met once a week to discuss the scholastic and therapeutic progress of identified
learners within the class. I engaged with the therapists using formal interviews (refer to
3.8.3.). Educators and therapists were in the position to volunteer relevant background
information about the learners, with specific emphasis on current emotion-focused coping
strategies that had emerged through assessments as well as therapeutic interventions.
Through my interactions with the respective therapists, I evaluated the following aspects
before and after the intervention: the childs relationships and interactions within the
therapeutic setting; the extent to which the therapists felt that the learners self-concept
manifested within the school setting and the influence that this had on his emotional and
social functioning. These interviews allowed me to determine the nature of the relationship

between self-concept awareness and emotion-focused coping strategies from the

perspective of the educators and therapists.

3.6. Research Process

In figure 3.1 I represent the various phases undertaken during the research process. As
discussed, although the stages of the intervention are presented sequentially below, this is a
dynamic process that evolves throughout the intervention and in the face of opportunities and
challenges.
Intervention with Control Participant:

Figure 3.1: Research Process

-I conducted each of the 6 intervention sessions.

-I conducted the intervention sessions in the schools playroom.
-I conducted the intervention sessions twice a week over a
period of 30-40 minutes each day with the learner individually.

Literature Review and Contextualisation of the study

Integration of Ebershn and Krugers Intervention (See Appendix

A for final intervention) Literature Review and Contextualisation of
the study

Selection of Participants:
Purposeful selection of:
-2 Learners with ADHD
-2 parent/s, 2 educator/s and 6 therapists that work with these learners

Baseline Assessment:
-What? Assess both learners:
-Self-concept awareness (analysis in accordance with indicators
presented in Appendix N and explored in chapter 2)
-Emotion-focused coping (analysis in accordance with indicators
presented in Appendix O and explored in chapter 2)
-With whom? Assessed with:
-Learners
-Parents
-Educators
-Therapists
-By means of:
Documented by:
-Formal interviews (Schedule)
Audio taped
Field Notes
Draw-a-Person drawing (DA-P)
Kinetic Family Drawing (K-F-D)
-How is your Self- Concept self-report inventory
-Non- participant observations

Intervention with Child 1:

-I conducted each of the 6 intervention sessions.
-I conducted the intervention sessions in the schools playroom.
-I conducted the intervention sessions twice a week over a period of 30-40
minutes each day with learner individually.
-I made use of audio and visual (photographs) data collection tools to
record my interventions. I transcribed these interactions.
-I made use of participant observation.

Report:
Producing the report forms the final stage of analysis. This
included examples, the analysis of extracts as well as
relating the analysis back to the research question and
literature and compiling a report thereon.
Data Analysis, Interpretation and Literature
Control:
Thematic analysis was used in data analysis and interpretation.
Braun and Clarke (2006, 4) define thematic analysis as a
means for identifying, analysing and reporting themes within
data. This involved the identification, exploration and
interpretation of themes that emerge from the data as well as
the integration of these interpretations with the existing body of
literature.
Braun and Clarke (2006, 87) delineate the following phases of
thematic analysis:
Familiarisation with the data. In order to familiarise
myself with the data, I was required to prepare
transcripts of the data (where applicable), the reading
of data and the documentation of primary thoughts
and ideas.
Generating initial codes. This requires the
identification and documentation of repeated patterns
of meaning which emerge across data sets. The
researcher is required to collect data relevant to each
code.
Searching for themes. This entails collating the codes
into potential themes and then collating data relevant
to each theme.
Reviewing themes. This requires that one evaluate if
the themes correlate with (a) the coded extracts and
(b) the data set. This evolved into a thematic map for
analysis.
Defining and naming themes. This involves the
continuous analysis of the identified themes allowing
for the themes to be clearly identified.
Producing the report forms the final stage of analysis.
This included examples, the analysis of extracts as
well as relating the analysis back to the research
question and literature and compiling a report
thereon.

Post- Intervention Assessment:

-What? Assessed both learners:
-Self-concept awareness (analysis in accordance with indicators presented in Appendix N)
-Emotion-focused coping (analysis in accordance with indicators presented in Appendix O)
-With whom? Assessed with:
-Learners
-Parents
-Educators
-Therapists
-By means of:
Documented by:
-Formal interviews (Schedule)
Audio taped
Field Notes
Draw-a-Person drawing (D-A-P)
3.7 DATA COLLECTION
Kinetic Family Drawing (K-F-D)
-How is your Self- Concept self-report inventory
- Non- Participant observations

3.7.1 Introduction
I employed formal interviews and observation as primary data collection strategies (Babbie &
Mouton, 2004). I supplemented these data collection techniques with visual data (refer to
Table 1.1. in Chapter 1 for overview).

3.7.2 Observation

3.7.2.1 Introduction
I made use of observation as a data collection technique. I observed the learners within a
number of settings, using both participant and non-participant observation (Babbie & Mouton,
2004). During the intervention sessions, I used participant observation, thereby actively
engaging in the intervention with the participants whilst simultaneously observing them
(Bailey, 1987). Through participant observation, I more accurately understood the
perceptions of and meanings attached to their life worlds (Bailey, 1987). I needed to remain
cognisant of the risks involved in observing others as a researcher (Babbie & Mouton, 2004).
Observation underpinned all other methods of data collection. When observing the children
within the classroom, I used non-participant observation (refer to Appendix O for an
outlining the times and places of observation with each child). During this time, I assumed
the role of observer in order to study the behaviour of the participants within their natural
settings (Bailey, 1987). Through observing the child participants both during the intervention
sessions as well as within group situations, I evaluated the information collected from the
intervention sessions, as well as from other stakeholders (refer to Appendix D for indicators
used for self-concept awareness and Appendix E for emotion-focused coping strategies
observed). This allowed me to either validate or refute the information that I gathered as well
as allowing me to evaluate the personal meaning I had attributed in my reflective journal.

3.7.2.2 Documentation of Observations

I kept a journal comprising of field notes as well as reflections to record the behaviour of the
children with ADHD (Babbie & Mouton, 2004). This allowed me to firstly capture my
observation, and secondly, to ascertain whether the behaviour I was observing was ongoing
or intermittent. These field notes (Appendix I) included detailed descriptions of what actually
happened, as well as my interpretations of what I believed had happened (Babbie & Mouton,
2004). I also recorded my observations during the intervention sessions. I strove to gain a
more detailed and intimate understanding of the individuals thoughts and feelings through
the primary relationship I had with the participants (Bailey, 1987).
3.7.2.3 Strengths and Limitations of Observations
The absence of control, possibility of observer bias and subject reactivity as well as ethical
considerations of privacy and informed consent were some of the challenges I encountered
when using observation as a method of data collection (Goodwin, 2002). Due to an absence
of control, I drew inferences from observations with care and caution (Goodwin, 2002). The
second challenge could have presented itself in the form of observer bias, which may have
occurred when I decided what to observe and omit based on preconceived notions
(Goodwin, 2002). I made use of behaviour checklists to address the risk of observer bias
(refer to this checklist in Appendix F) which allowed for the identification of pre-defined target
behaviours (refer to Appendix C) as well as allowing for the recorded interactions to be
viewed by another observer in order to ascertain if the records were congruent (Goodwin,
2002). I also engaged in reflection at every stage of the research process, both on my own
and with my supervisor. This encouraged introspection of my thoughts and feelings (refer to
Appendix N for example of reflective journal). Subject reactivity presented as the third
possible challenge, which could have become a concern if the participants were acutely
aware that they were being audio recorded during the intervention (Goodwin, 2002). Thus,
although the participants were aware if recordings, I used as many indirect, unobtrusive
methods as possible. This meant concealing the dictaphone as much as possible,
particularly when working with the child participants (Goodwin, 2002). I obtained informed
consent and voluntary participation from each of the child participants, their parent/s and
educators, and discussed the limits to privacy and confidentiality thoroughly with them (refer
to 3.11).

Despite the above-mentioned challenges, there were a number of strengths associated with
using observation as a method of data collection. I achieved falsification and inductive
support through observation (Goodwin, 2002). Through observation, I explored the
participants nonverbal behaviour, which was sometimes more telling than their verbal
explorations and accounts, allowing me to have familiarity with the subject participants
(Babbie & Mouton, 2004).

3.7.3. Guided Interviews to determine self-concept awareness and emotion-focused

coping as outlined by the indicators in Chapter 2

3.7.3.1. Introduction
For the purpose of my study, the reason for using formal interviews was two-fold. Firstly to
use as a tool to determine the impact (or not) of the intervention and secondly to gain a rich
and in-depth understanding of the participants perspective based on their interactions
(Denzin & Lincoln, 2000). By using formal interviews, I gained rational and emotional
information and responses from the participants.

There were a number of advantages to using formal interviews as methods of data collection.
Interviewing eliminated many of the problems encountered by issuing a questionnaire, such
as minimising responses such as I dont know or failure to answer certain questions.
Interviewing also reduced the possibility of misunderstanding questions by giving clarification
and guidance (Babbie & Mouton, 2004). By using structured interviews, I gathered rich and
diverse information. (Refer to Appendix O for a schedule of dates and places when I
conducted guided interviews).

3.7.3.2. Guided Interviews

Guided interviews took place before and after the intervention with both childrens parent/s,
therapists and educators to capture data that would serve to explore the learners emotionfocused coping and self-concept awareness (Denzin & Lincoln, 2000) (refer to Appendix D
for indicators used to explore self-concept awareness and Appendix E for emotion-focused
coping strategies observed). This ensured that I asked all participants the same sets of
questions with little variation, minimising interviewee bias (Babbie & Mouton, 2004).

The meanings the participants attached to their situations and experiences became explicit
through the guided interviews. I gained insight into the values, beliefs, thoughts and
cognitions that influenced the parents understanding of ADHD and their perceptions of the
impact thereof on the childrens self-concepts. These interviews provided insight into how the
parent participants felt ADHD had or had not impacted on their childs emotion-focused
coping. My responsibility was to establish balanced rapport (Babbie & Mouton, 2004) - I
had to be approachable and yet direct and impersonal - which the structure of the
interpretivist, qualitative paradigm supported. Through active listening, I did not evaluate the
responses of the participants, but rather, allowed for them to feel heard and understood

(Babbie & Mouton, 2004). Thus, I gained insight into the holistic functioning and development
of the child through rich contextual information from multiple people.

3.7.3.3. Documentation of Guided Interviews

During the guided interviews, I made detailed field notes (refer to Appendix I) and I used a
dictaphone to record the interviews. I then transcribed the actual words used by the
participants (refer to Appendix E). This presented me with the opportunity to review the
interview during data analysis and interpretation in order to ascertain if my transcription was
complete and accurate (refer to Appendix D for indicators used to document self-concept
awareness, Appendix E for indicators used to document emotion- focused coping strategies
and Appendix H for interview schedule).

3.7.3.4 Strengths and Limitations of Guided Interviews

Denzin and Lincoln (2000) identify a number of limitations to be aware of when making use
of guided interviews as a source of data collection. Many participants are unfamiliar with the
interviewing situation, resulting in them assuming roles which influence the accuracy of the
information that they render. Factors that influence participants responses included social
desirability, response deviation and response acquiescence (Babbie & Mouton, 2004).

The first possible limitation is respondent behaviour. This could occur when participants
give responses which are pleasing to the interviewer but prevents the interviewer from
gaining an accurate understanding of how participants perceive themselves and their life
worlds. Memory lapse may also influence the behaviour and responses of the participants. A
second limitation of the guided interview is the nature of the task. When engaging in a
guided interview, I paid close attention to the sequence of questions and well as to asking
the questions as they appeared. By applying such rigour to the interviewing situation, I
addressed the threat of inaccurate response behaviour and interviewer error.

Working from an interpretivist paradigm emphasises the role of context in the creation of
meaning. Although using a structured interview eliminated a large amount of independent
judgement, the context could not be divorced from the creation of meaning. This interview
was a social interaction that took place within a context (Denzin & Lincoln 2000). As a
researcher, I needed to be aware of how this interaction influenced participants responses
and behaviour. According to Kahn & Kanell (1975) as cited by Denzin & Lincoln (2000), it
was important for me to understand the extent to which the participants responses and
behaviour were influenced by their life worlds and their contexts, and how this context either

promoted or hindered the responses they rendered. I encouraged this awareness through
reflecting in my reflective journal (refer to example in Appendix N).

3.7.4 Visual Data

3.7.4.1 Introduction
Denzin & Lincoln (2000) advocate that photographs are the mirror of the memory allowing
us to capture the nuances of everyday life. Harper, as cited in Denzin & Lincoln (2000)
summarises the value of photographs in the production of meaning by stating that a
sequence of photos provides a link between first person accounts and cultural narratives
which transcend both time and space. I took photographs of the work produced by the
participants during the intervention sessions. In this manner, I gathered information regarding
various aspects of the participants social lives, which impacted on their self-concept as well
as their coping strategies. The value of the photographs were two-fold; firstly, to provide
factual information about the work that the participant produced and secondly, to offer
evidence of how the knowledge, skills and values explored in the intervention sessions were
integrated into their final pieces of work (Denzin & Lincoln, 2000). By using the photographs
for this purpose, I collected information that contributed to my data analysis (refer to
Appendix L for examples of visual data).

The visual data collected (refer to example in Appendix L) provided valuable information
regarding (a) self-perceptions, (b) self-awareness and (c) coping strategies as well as being
a manner in which to (d) document the process the participant went through during the
intervention (refer to 4.3.1.1).

3.7.4.2 Documentation of Visual Data

I used visual data as a data collection strategy, in the form of photographs. The photographs
were taken of the activities completed before (D-A-P), during (dream chart, list of signature
characteristics) and after (D-A-P) the intervention sessions, particularly the participants
completed activities after each session. Ethically the artefacts and activities photographed
throughout the intervention sessions remained the property of the participants on completion
of the study.

3.7.4.3. Strengths and Limitations of Visual Data

I support Denzin & Lincoln (2000) who state that photography as a method of data collection
is empirical, in that it captures the participant at a certain moment in time. However, I use the
term empirical with caution as photographs (despite allowing me to visually document the

research process) cannot be deemed credible pieces of information, for the nature of
observation is interpretive (Denzin & Lincoln, 2000). Aware of the fact that photographs
depict a social reality which is co-constructed, I attempted to ensure that photographs formed
part of the crystallisation process (refer to 3.12.2). I did not interpret photographs in isolation
from other sources of data, contributing to the credibility of my study. In the context of my
study, photographs concretised (Denzin & Lincoln, 2000. p. 725) the observations that I
made within the field enhancing crystallisation in the study (refer to 3.12.2).

Using photographs, I formed visual narratives of the research process. Acknowledging that
the observations were interpretive by nature, I guarded against the threat of researcher bias.
I needed to be fully aware that the reality depicted within photographs was a reality borne out
of the choices and decisions made by me as a researcher (Denzin & Lincoln, 2000). Through
this reflexivity, I established boundaries and planned data collection strategies with my
supervisor as well engaged in reflection within my reflective journal (Ebershn & Eloff, 2007)
(refer to 3.8.5).

In order to contextualise the visual data within the confines of my study, I obtained detailed
knowledge of the participants (Denzin & Lincoln, 2000). I obtained this case history through
compiling a detailed history of each of the learners from various participants, namely their
parents, educators and therapists. By having a detailed knowledge of the participants, I
extended my knowledge of the child participant, for this was the ultimate aim of the study: to
gain a rich and in-depth understanding of the impact of an intervention in increasing selfconcept awareness in order to impact on emotion focused coping.

3.7.5 Reflective Journal: Reflexivity

3.7.5.1 Introduction
As a qualitative, interpretivist researcher working with an intervention research design, the
nature of the research was reflective in that local and substantial meanings were an
invaluable part of the research process (Denzin & Lincoln, 2000). Thus, I assumed the role of
researcher and interventionist- both of which informed the choices that I made throughout the
research process (Ferreira, 2006).

As Ferreira (2006) (in support of Kelly, 2000) eloquently articulates, conducting research
from an interpretivist paradigm required of me to assume both an insider and outsider
perspective. When engaging with the participants during intervention sessions as well as
with their parents, educators and therapists, I assumed an insider approach to allow for the

expression of the participants thoughts, values, feelings and impressions. I then assumed an
outsider perspective when interpreting their thoughts, feelings, and impressions, trying at all
times to capture and reflect the actual voices of the participants whilst pursuing an answer to
my research questions (Ferreira, 2006).

Engaging in discussion and activity with participants for an extended period required me to
engage in reflection during and after action in order to attribute my meaning to the research
process acknowledging that I too was a participant in the research process. Denzin &
Lincoln (2000) define reflection- in- action and self-reflection as a dynamic, fluid process. I
was able to reflect on the impressions and recollections throughout the research process
outside the permitted boundaries dictated by theory using a reflective journal (Denzin &
Lincoln, 2000) (refer to Appendix N).

In order to differentiate between the dual role of researcher and interventionist, I liaised
closely with my supervisor and reflected on this process within my reflective journal. I
employed empathetic neutrality (Ferreira, 2006) to interact with participants in an
empathetic yet nonaligned way.

This was especially important, as I was the sole tool for

data collection, analysis and interpretation (Denzin & Lincoln, 2000).

3.7.5.2 Documentation of Reflections

Throughout the research process I reflected within my reflective journal (refer to example in
Appendix N). I documented my thoughts, feelings and working assumptions based on the
literature I had reviewed and the information that has presented itself. This allowed me to
reflect on the information collected, my personal thoughts and feelings thereof as well as
allowing me to work towards the analysis and interpretation of the data. Denzin & Lincoln
(2000) regard the reflective journal as a documentary tool, which fits in with the notion of
crystallisation.

3.7.5.3 Strengths and limitations of a reflective journal

In keeping a reflective journal (refer to example in Appendix N), I reflected on my personal
experiences of the research process in order to be aware of the role I played in my
interactions with participants. This allowed me to reflect on my thoughts and feelings about
the research process in order to differentiate between my thoughts and feelings, and those of
the participants. This type of self-reflection enhanced the credibility of my study. In addition to
this, I believe that by keeping a reflective journal, I evaluated personal growth throughout the
research process. Through increased awareness borne from reflexivity, I enhanced not only
the research process, but also my personal and professional development.

Despite striving to write detailed notes in my reflective journal whilst interacting with the
participants, I found it difficult to do, as I was engaging as completely as possible with the
participants. I addressed this possible limitation by writing reflective notes as soon as
possible after the actual interactions had taken place in order to remember as much of the
detail as possible. Audio recordings of the sessions as well as field notes made during the
sessions facilitated the process of writing reflective notes after the sessions.

3.8 Data Analysis and Interpretation

3.8.1 Introduction
Data analysis involved the identification of themes, which emerged from various data
sources. I obtained the primary sources of information used for analysis from observation,
interviews, visual data and my reflective journal. I was guided throughout the process of data
analysis and interpretation by my research question - whether a self-concept awareness
intervention encourages self-concept awareness in children with ADHD; and secondly,
whether increased self-awareness impacts on emotion-focused coping (refer to Appendix M
for examples of data analysis).

I used thematic analysis in data analysis and interpretation. Braun and Clarke (2006) define
thematic analysis as a means for identifying, analysing and reporting themes within data.
This involved the identification, exploration and interpretation of themes that emerged from
the data as well as the integration of these interpretations with the existing body of literature.

Braun and Clarke (2006) delineate the following phases of thematic analysis (refer to
Appendix M for examples of data analysis):

Familiarisation with the data. This required that transcriptions be prepared (where
applicable), the reading of data and the documentation of primary thoughts and
ideas.

Generating initial codes. This required the identification and documentation of

repeated patterns of meaning which emerged across data sets. I was required to
collect data relevant to each code.

Searching for themes. This entailed collating the codes into potential themes and
then collating data relevant to each theme.

Reviewing themes. This required me to evaluate if the themes correlated with (a) the

coded extracts and (b) the data set.

Defining and naming themes. This involved the continuous analysis of the identified
themes allowing for the clear identification of the themes.

Producing the report forms the final stage of analysis. This included examples, the
analysis of extracts as well as relating the analysis back to the research question and
literature and compiling a report thereon.

3.8.2. Analysis and Interpretation of Text

The analysis and interpretation of text encompassed a number of data sources, namely
interview transcripts, documented observations, field notes and the reflective journal. I
conducted thematic analysis along the guidelines provided by Braun & Clarke (2006) as
detailed above in order to analyse the textual data.

I linked identified themes within my theoretical model, and tabulated the themes according to
the frequency at which they occurred. This allowed me to reveal the content
comprehensively within each of the sources of information (Neuman, 2003). Once I had
ascertained the frequency of themes, I interpreted these themes. In order for the content
analysis to be reliable and credible, I examined and interpreted the information within the
boundaries of relevant contextual information gathered from the visual data as well as from
interviews and observations (Neuman, 2003).

3.8.3. Analysis and Interpretation of Visual Data

I attempted to align visual data with textual transcriptions (Ebershn & Eloff, 2007). I utilised
the following strategies as postulated by Ebershn & Eloff (2007) during the inductive
analysis of visual data (refer to Appendix L for examples of the analysis of visual data):

I provided a detailed depiction of the physical environment (what I saw, what the
colours were, where and how the objects/ people were placed, what people were
wearing).

I transcribed adjectives next to the objects detailed above.

I documented emotional observations in my research journal.

I reflected on the photographs in relation to the social, historical and cultural context
attributing meaning to different people in different social contexts.

Throughout the process of analysis and interpretation, I made notes according to my

conceptual framework.

I identified categories based on the above-mentioned descriptions and colour codes.

I never interpreted visual data in isolation from other sources of data.

3.9 Intervention

3.9.1 Introduction
I selected Ebershns (2006) asset- focused life skills facilitation programme for use in my
study in conjunction with Krugers (1998) programme (Refer to Appendix K where I provide a
detailed outline of my intervention). Krugers programme provided me with the self- concept
inventory which allowed me to assess the child participants self- concept awareness both
pre- and post-intervention. By integrating the two programmes, all participants, including the
child with ADHD, were involved in the process of assessment and evaluation.

Prior to the commencement of the intervention sessions, I obtained baseline information

through the use of formal interviews as well as the D-A-P, K-F-D, how is your self-concept
inventory and observation with the child and the child participants parent/s, educators and
therapists. The intervention sessions were then conducted twice a week over a period of
three weeks. Each session lasted between 30-40 minutes. All intervention sessions were
conducted in the schools playroom.

3.9.2 Pre- and post- intervention

In order to evaluate the impact (or not) of the intervention on child participants self-concept
awareness and emotion-focused coping strategies, I was required to asses their selfperceptions, self-awareness and coping strategies before (baseline image) and after the
intervention. In alignment with the interpretivist paradigm, it was important for me to capture
not only reports from significant others on the child participants perceptions of their life
worlds, but to allow for the child participants to be able to describe how they perceived their
life worlds through the use of various instruments, which I discuss in the following sections:

3.9.2.1 Draw-a-Person Technique (D-A-P)

I selected the Draw-a-Person Goodenough Test (Machover, 1926) as a tool for data
collection. I selected the D-A-P to gain insight into both childrens self-perceptions. I issued
both child participants with the same instruction both pre- and post-intervention; draw me a
picture of a person. Child 1 engaged with the task instantaneously. Child 2 refused to speak
and to perform the task. After a long while, he requested to complete the tasks home. When
Child 2 returned the next week with his drawing, I noted that he depicted himself within a

family unit and without a body. During the pre-intervention assessment, I asked each of the
child participants to tell me about the person that they had drawn. Child 1 described the
various characteristics of his grandmother. Child 2 refused to speak. During the postintervention assessment, Child 1 hastily drew his D-A-P, and was reticent when requested to
elaborate on his drawing. I analysed and interpreted the D-A-P to either support of refute the
themes that emerged from the formal interviews and my observations (Examples of each of
the D-A-P can be viewed in Appendix T).

3.9.2.2 Kinetic-Family Drawing (K-F-D)

I selected that Kinetic- Family- Drawing (Burns & Kaufman, 1970) as a tool for data
collection. I selected the K-F-D to provide insight into the participants perceptions of their
family environments as well as their roles therein. I requested of both children to draw me a
picture of your family. This request was given during both the pre- and post- intervention
assessment phase. During the pre-intervention assessment, Child 1 completed the activity in
my presence, with Child 2 requesting to complete the activity at home. As was the case with
the D-A-P, Child 2 refused to engage in a verbal exploration of the drawings he made. During
the post-intervention assessment, Child 1 hastily completed the K-F-D in my presence, once
again being reticent to elaborate further on his drawing. I analysed and interpreted the K-F-D
to either support or refute themes that emerged from the formal interviews and observations
(Examples of the K-F-D can be viewed in Appendix T).

3.9.2.3. Brinks Incomplete Sentences

I selected Brinks Incomplete Sentences (1986) to gain insight into both childrens appraisals,
thoughts and feelings about their intrapersonal and interpersonal well-being. Both of the
children requested to complete this activity at home during both pre- and post- intervention
assessment phases, also, both children were unwilling to explore their responses to these
questions in the first session. I analysed and interpreted this data to either support or refute
themes that emerged from the formal interviews and observations (Examples of incomplete
sentences viewed in Appendix T).

3.9.2.4. How is your self-concept inventory

I used the how is your self-concept inventory from Krugers (1998) life skills program as a
tool for data collection as it provided the child participants with an opportunity to assess their
own self-concepts in order to determine their strengths and weaknesses and reflect on those.
Both children were given this inventory to complete during both pre- and post intervention
assessment (refer to process drawing figure 3.1). Once again, both children requested to

complete the sentences at home. I analysed and interpreted the inventory data to either
support or refute themes that emerged from the formal interviews and observations
(Examples of each of the how is your self-concept inventory can be viewed in Appendix T).

As has been stated, Child 2 requested to complete all activities at home. However, he did not
return the post-intervention instruments despite repeated requests. This was noted and taken
into consideration against the backdrop of other findings which emerged during the childs
post-intervention assessment. Having said this, I used the instruments that I received back in
conjunction with other data, to determine if an association (if any) between the child
participants self-concept awareness and emotion- focused coping could be established.

The inclusion of these data sources (3.10.2.1- 3.10.2.4) added fewer insights into the selfconcept awareness and emotion-focused coping strategies of the child participants than
other sources of data did. The activity- based drawings by Child 1 produced during the
intervention provided more insight into his self-concept awareness and emotion-focused
coping strategies than did his drawings made during pre- and post-intervention assessment.
With hindsight, I would have assessed the childrens self-concept awareness and emotionfocused coping strategies qualitatively through participant and non-participant observations.
Therefore, I recommend that in future studies, researchers assess children with ADHDs selfconcept awareness and emotion-focused coping strategies qualitatively (possibly by means
of participant and non-participant observation) to either support or refute themes which
emerge from other data sources (refer to 5.7.3).

3.10 Ethical Issues

I anticipated the possibility of negative outcomes associated with the study, and took the
necessary steps to protect the participants in the study as recommended by the American
Psychological Association as outlined by Elmes, Kantowitz and Roediger (1999). I took the
following steps to ensure that my research remained ethically sound throughout the research
process (Elmes, Kanotwitz and Roediger, 1999):

3.10.1. Informed Consent and Voluntary Participation

In order to attain informed consent, I informed the participants of all aspects of the research
that could influence their willingness to participate in the study (Elmes, Kanotwitz & Roediger,
1999). I obtained written consent from the Department of Education (Appendix A) to conduct
the study, as well as from the School Principal (Appendix A), the educators (Appendix A), the
parents of the learners who are participating in the study (Appendix A), the learners
themselves (Appendix A) and the School Governing Body (Appendix A) and ethical

clearance from the faculty ethics committee (Appendix B). I provided comprehensive
information about what the participants were required to do during the research project. With
the control participant, his parents and educators, I discussed that the control participant
would receive the intervention on completion of the study. I also attained consent from the
participants to make audio footage of the interviews and intervention sessions as well as to
take photos of all artefacts made in the intervention sessions, as the actual artefacts remain
the property of the child. I gave both the participants the opportunity to accept or decline
participation in the study (Elmes, Kanotwitz & Roediger, 1999). I informed the participants of
the purpose of the study, the procedures that would take place, their right to anonymity and
confidentiality as well as the possible advantages and disadvantages of the study. I
concluded this discussion by informing them that they had the freedom to withdraw from the
study at any time (Elmes, Kanotwitz & Roediger, 1999).

3.10.2. Protection from Harm and Debriefing

Prior to the commencement of my study, I explained to the child participants and their
parents that my primary role was that of a researcher and my secondary role was that of a
therapist. I further elucidated that should it be deemed necessary for the child participants to
consult with a psychologist on completion of the study, I would make a referral in this
respect.

The research participants were able to contact me preceding their participation in study,
which allowed them to receive help and support should they have needed it as a
consequence of being participants in the research study (Elmes, Kanotwitz & Roediger,
1999). I protected the participants from harm by, prior to the study, explaining the purpose of
the research as well as answering any questions in order to minimise misunderstandings
(Elmes, Kanotwitz & Roediger, 1999). I provided the participants with the contact details of
professionals that they could consult with should they experience any negative emotions
after the commencement of the study.

3.10.3. Confidentiality and Anonymity

I upheld the principles of confidentiality, anonymity and privacy throughout the research
process in order to protect the participants from any harm (Elmes, Kanotwitz & Roediger,
1999). I ensured this by not revealing the identities of the participants and treating all data
collected in a confidential manner. I ensured that all data collected was securely stored at the
faculty of Educational Psychology at the University of Pretoria.

3.11 QUALITY CRITERIA

3.11.1 Introduction
According to Lincoln and Guba, as discussed in Babbie & Mouton (2004), the most crucial
indicator of fine qualitative research is trustworthiness, which is delineated in the impartiality
of research findings and conclusions. The main thrust of trustworthiness, then, is how one
can influence the audience to believe that the findings and conclusions are credible enough
to be transferred (Babbie & Mouton, 2004). Babbie & Mouton (2004) describe Lincoln and
Gubas model of trustworthiness as follows:
3.11.2. Credibility
Credibility assesses the compatibility between constructed realities and the meanings
attached to them through interpretation (Babbie & Mouton, 2004). Seale (2000) proposes
that credibility replace truth value. Therefore, the role of the researcher is to strive towards
crystallisation in order to construct a complete understanding of the participants unique and
dynamic situation from multiple perspectives (Babbie & Mouton, 2004). Seale (2000) further
suggests intensive engagement in the field, constantly engaging in crystallisation exercises,
as well as exposing the final research report to fellow peers for criticism, to challenge and
question working assumptions and establish credibility. I encouraged credibility by
crystallising my data, which assisted me in gaining insight into the various systems and
perspectives of the same phenomenon through the analysis of relationships and information
from multiple sources of data (child participants, parents, educators, therapists) (Babbie &
Mouton, 2004). This added depth and richness to the study encouraging convergence and
replication (Babbie & Mouton, 2004).

The data collected provided information from multiple sources about the child with ADHDs
self-concept awareness and emotion-focused coping. I made use of various sources of data
to ensure crystallisation. Through crystallising my data, I developed a meticulous, intricate,
thoroughly equitable understanding of a phenomenon from multiple angles of approach thus
ensuring credibility (Richardson, 1992 as cited in Denzin & Lincoln 2000, p. 392).
Crystallisation allowed me to capture the dynamic social life worlds of the participants
through the process of reflecting and refracting - creating ever-changing images and
pictures of reality (Richardson, 1992 as cited in Denzin & Lincoln, 2000. p. 873).
Accordingly, the ultimate aim of the study was not to find answers to questions posed, but to
continually question positioning the study within the parameters of qualitative, interpretivist
research.

I needed familiarity with the various contexts and factors pertaining to each of the
participants therein in order to generate rich and credible findings. Thus, I established

adequate rapport with the research participants. The reciprocal interaction between
participants and myself was the vehicle through which the participants were able to discuss
their experiences in their own words within a confidential and anonymous environment.
Through these interactions, I was granted access to various pieces of situational, attributional
and environmental information which assisted me in understanding the unique and dynamic
context of the participants (Babbie & Mouton, 2004) (refer to discussion on intervention in
chapter 4).

3.11.3 Transferability
Babbie & Mouton (2004) describe transferability as the extent to which generated findings
can be applied in other contexts and with other respondents. As the study relies on ascribed
meaning, I focused on transferability as opposed to generalisation. I ensured transferability
by provided a description of contextual data generated during the study (refer to field notes in
Appendix to I for an example). This required that I document and transcribe information with
much detail, accuracy and precision (Babbie & Mouton, 2004) (refer to Appendix I for an
example of field notes and Appendix E for an example of a transcription). By engaging in
purposive sampling, I provided a detailed description of the context and allowed for ease in
selecting locations and informants for future studies.

3.11.4. Dependability
Babbie & Mouton (2004) describe dependability as the ability to repeat the study with the
same or similar participants within the same or similar contexts and yield similar findings.
This required of me to outline the details of both the research and intervention process. They
further assert that should the study demonstrate credibility, it would be sufficient to determine
the presence of dependability. The data and information underwent a process inquiry audit
(Babbie & Mouton, 2004). During this process, I engaged extensively with the participants of
the study as well as with my supervisor, taking heed of their contributions during data
analysis. This strengthened the likelihood of my findings being dependable and comparable
to similar situations and similar participants.

3.11.5. Confirmability
Babbie & Mouton (2004) define confirmability as the degree to which the findings are a direct
product of the study and not personal biases (refer to evidence in appendices). In order to
ensure this, I was required to form a confirmability audit trail (Babbie & Mouton, 2004). This
appears contradictory to the interpretivist approach, for my values and motives play an
incremental role in the research process. With this awareness, I attempted to understand and

interpret the intentions and meanings that underlie the different interactions as completely as
I could to ensure the appropriateness of my findings through crystallisation.

3.12. CHALLENGES OF THE STUDY

As a researcher conducting a qualitative study, the risk of researcher-induced bias was a
challenge to the study, for the study relied on the ability to establish rapport with the
participants as well as on my perceptions and interpretations. Despite this presenting itself as
a challenge, it was indeed the essence of this qualitative study, for the purpose of the study
was to gain an in-depth and rich understanding of the participants life worlds and
subsequent experiences. I addressed this challenge by continuously reflecting on my
thoughts, feelings and actions, both within my journal and with my supervisor.
The selected methods of data collection and analysis were time consuming. Despite this
being a challenge, the time spent on collection and analysis added to the credibility of my
study through the richness of the descriptions that I provided.

The complexity of Attention Deficit/Hyperactivity disorder was another challenge for related
factors influenced the results of the study. My presence as interventionist influenced the
manner in which the participants engaged with the activities and questions posed. I
attempted to address this barrier through reflection, as well as by observing the child
participants within a number of environments, such within the classroom and intervention
sessions, in order to achieve crystallisation of information before identifying and
contextualising themes.

I was aware of the influence that the above-mentioned challenges could have on the study. I
attempted to give a full account of the challenges faced during the research process in my
final report and I included the measures that I had put in place to address and accommodate
these challenges.

3.13. Conclusion
In this chapter, I explored my paradigmatic assumptions within the confines of my research
questions and the purpose of my study. I explored the strengths and limitations of my
methodology as well as how I attempted to address each of these challenges. Furthermore, I
explored the role that I assumed in the research study as well as the ethical considerations
undertaken in order to ensure that my study was trustworthy. In chapter four, I discuss the
findings of my research study.

Chapter 4
Data Analysis, Discussion of Results and Literature Control

4.1 Introduction
In this chapter, I will discuss how the intervention research design was conducted (Rothman
& Thomas, 1994). I will provide a detailed discussion of the self-concept awareness and
emotion-focused coping themes which emerged through thematic analysis of the data
collected during the study. In conjunction with the discussion of the results, I will engage in a
literature control which involves an exploration of the results of the study against the
background of existing literature. In addition to this, I will discuss the feasibility of a
relationship between the childrens self-concept awareness and emotion-focused coping
strategies.

4.2. Conducting the Interventionist Research

Phase 1: Problem analysis and project planning

Rothman and Thomas (1994) define the first stage of intervention research as problem
analysis and project planning. It is during this stage that I identified and involved
participants in the intervention process (Bender, 2002). I purposefully chose the child
participants based on the selected criteria (refer to 3.5.2.) and similarly purposefully selected
their respective parents, educators and therapists (refer to table 3.1 for outline of participants
in this study).

I contacted the parents of both child participants and arranged to meet with them to discuss
the research process with them. During these meetings, I obtained informed written consent
from the parents (see Appendix A for an example). Thereafter, I met with the child
participants and explained the research and intervention process to them and obtained their
informed consent. I then contacted and met with the child participants respective educator

and therapists, explained the research process to them and obtained their informed consent.
Individual sessions (of approximately 30-40 minutes) with the participant were scheduled and
implemented during times that were suitable for both myself and the child participant. I
collaborated closely with participants in order to establish rapport. Establishing rapport was
essential in order for me to gain the co-operation of the participants, which in turn played a
pivotal role in the research process (Bender, 2002) (Refer to Appendix O for the research
schedule indicating dates and duration of contact with all the participants during the research
process).

By establishing a collaborative relationship (Bender, 2002: 71) with the participants (the
educator/s, parent/s, therapists and child with ADHD), I gained access to participants as
well as to resources needed to conduct the research (Bender, 2002). I gave a letter of
informed consent (Appendix A) to the school principal, the educator/s, the parent/s, the
therapists and the children with ADHD in order to gain access. I was in a position to
holistically define and analyse the coping strategies of children with ADHD by engaging with
the participants. From these interactions, I was able to identify specific objectives for the
intervention.

Through formal interviews with the participants, observations and by engaging learners in
various self-reporting activities, I identified and analysed the problem (Bender, 2002) (refer to
Figure 3.1. and 3.8). The primary goal and objective of the study was to explore the impact
of self-concept awareness on emotion-focused coping strategies. With the aid of the pre- and
post- intervention interview schedule (Appendix H), emotion- focused coping indicators
(Appendix E) and self-concept awareness indicators (Appendix D) used during observations,
I assessed and explored the child with ADHDs emotion-focused coping strategies before
and after the intervention according to his/her educator/s, parent/s and therapists (refer to
3.11). I used this information to assess the impact of the intervention during the data analysis
phase.

Phase 2: Information gathering and synthesis

Thomas and Rothman (1994), state that the key activities of this phase are the use of
existing information sources, the studying of natural examples and the identification of
elements of successful models (refer to chapter 2). This investigation allowed me to explore
the interventions designed and implemented in the past to address the emotion-focused
coping strategies of children with ADHD in order to address the identified concerns from
another perspective.

As discussed in Chapter 2, the intervention selected for this study is based on Ebershns
(2006) framework; this was used in conjunction with Krugers (1998) programme. Ebershn
(2006) advocates that through the acquisition of life skills, child participants are encouraged
and scaffolded to cope more effectively with stress in order to flourish. Ebershn suggest the
following (which ultimately promote increased self-concept awareness) to facilitate coping:

To achieve self-knowledge. This includes an understanding of selfconfidence and growth (self- regulation: self awareness).

To develop values and attitudes which emphasize independence and an internal

locus of control (self-regulation and self-motivation).

The establishment of necessary skills for effective functioning (in terms of selfregulation this equates to empathy and interpersonal skills).

In Table 4.2 I present the goals of the intervention sessions (Ebershn, 2006).

Whilst acknowledging the role and existence of deficiencies, the interventions focused on the
strengths, abilities and resources available to children with ADHD, which could assist them in
best coping within their respective environments. Using both programmes, all participants,
including the child with ADHD, were involved in the process of assessment and evaluation.
Acknowledging that the needs of each child are unique, I was required to adjust intervention
sessions accordingly. For example, when discussing his feelings, the participant has
requested to draw a feelings chart. This for an interaction to evolve into one which explore
the feelings he experienced, when they were experienced, what he thought and
consequently, how he acted in each of these situations. Such accommodations were
invaluable in the intervention process, for it allowed for the child participant to communicate
in a way that was comfortable and familiar to him (refer to Appendix K for a detailed
description of the intervention used).

Phase 3: Design
Thomas and Rothman (1994), state that the third stage of intervention research design to be:
design, early development and pilot testing. This phase is characterised by the designing of
an observational system and the specification of the procedural elements of the intervention
(Thomas & Rothman, 1994). Based on a theoretical framework, I developed a checklist
(Appendix C) for myself to use throughout the research process to relate my observations to
the two main constructs in my research question; namely self-concept awareness and
emotion-focused coping strategies. The primary aim of intervention research is to
demonstrate the relationship that exists, if any, between the intervention and the behaviours

that define the problem as well as the inclusion of a programme that makes up the
intervention (Ibid. 2002). In order to establish if a relationship existed between the
intervention and the behaviours, I analysed both pre- and post- intervention data, particularly
in terms of the key concepts detailed above. As stated, I used an intervention that was
designed, piloted and previously implemented by Ebershn (2006) as well as self-monitoring
and reporting questionnaires drawn from Krugers (1998) programme and completed both
pre- and post- intervention. I was involved in all observations and interventions undertaken
throughout the research process. I documented my dual role as researcher and
interventionist in my reflective journal (refer to section 3.8.5 and Appendix N). I implemented
the intervention over six weeks, with 30-40 minute sessions once a week.

Table 4.1: Goals of the Intervention

Intervention

The goals of this session are:

session:
Intervention
session 1
Intervention
session 2

- Involve and to establish a relationship between the children participant and the researcher.
-Become aware of an ideal self-identity.
- Ecosystemiclly, identify various identities which exist in different life settings (life roles).
- Knowledge and awareness of mental and physical characteristics: embedded in identity- starting point of selfawareness.
- The process of forming positive and negative self-concepts.
- The process of forming realistic and unrealistic self-concepts.
- Real-life evidence for positive, negative, realistic and unrealistic evaluations (self and situational appraisals).
- The central role of self-talk in identity formation.

Intervention
session 3

- Self-talk is individually controlled by the people themselves.

- The personal control takes place with the help of cognitive processes.
- The cognitive regulation principles are represented by the ABC model of RBT.
- Cognitive dialogue (self-talk) is the continuous crystallisation of self-identity in different situations.

Intervention
session 4

- Knowledge and understanding of Emotional Intelligence (EQ) as being representative of emotional regulation.
- Provisional awareness of how CPS is a common factor in identity formation and cognitive and emotional regulation.
- Awareness and regulation of emotions through using CPS.
- Self-efficacy (perseverance, delayed gratification, optimism, motivation) through using CPS.
- Empathy through using CPS.
- Proactively managing relationships (as an introduction to the following session).
- The central role of CPS in emotional regulation, and thus EQ.
- Intrapersonal involvement, experience and meaning attribution with the help of CPS.
- Understanding that intrapersonal (emotional) skill determines the level of interpersonal emotional skill.
- The former is therefore a precondition for social maturity (as intro to following session)

Intervention
session 5

- Last two EQ skills of emotional regulation: (i), empathy arising out of the use of CPS and (ii) proactive management of
relationships.
- The central role of CPS in the effective realisation of these EQ skills.
- Interpersonal involvement, experience and meaning attribution as a result of CPS.
- The level of interpersonal emotional proficiency determines the level of interpersonal emotional proficiency.
- Life-skilled behaviour is the observable consequence of intrapersonal proficiency.
- CPS may facilitate agency in a person to behave proactively and not reactively in life situations.

Intervention

- Awareness of the link between the content of all sessions.

session 6

Phase 4: Early Development and Pilot testing

According to Rothman and Thomas (1994), the intervention develops during the phase of
early development and testing. For the purpose of this study, I made use of an intervention
that was designed, piloted and previously implemented by Ebershn (2006). In order to
determine the impact of this program on children with ADHD, I made use of pre- and postintervention checklists (Appendix G) to ascertain the impact of the intervention on the childs
self-concept awareness and emotion- focused coping. This provided me with a platform from
which to assess the childs emotion-focused coping strategies over the course of the
intervention, and how able he was to transfer learnt knowledge and skills to his environment.
Based on the findings, it appears that the intervention targets key areas in which the child
with ADHD is deficient, but there were a number of accommodations I needed to make to the
intervention to make it more suitable to the needs of the child participant. For example, the
subtheme of avoidance of written tasks (inclusive of drawing tasks) and homework tasks
emerged at several intervals during the pre- intervention, intervention and post-intervention.
Thus, the child participants both asked to complete tasks requiring writing and drawing at
home. In terms of homework tasks assigned, often the child participants would come to the
sessions without their homework tasks being done, which would require me to explore those
tasks with them during the intervention session. I later make a related recommendation for
future practice (refer to 5.7.2).

Phase 5: Evaluation and advanced testing

Rothman and Thomas (1994) outline four activities in this phase of evaluation and advanced
testing, namely selecting an experimental design and collecting and analysing data. I discuss
these issues in 4.3.

4.3. Results of the thematic analysis

I will be exploring the subthemes that emerged through thematic analysis both pre- and postintervention of the participant and the control participant in this chapter. I will illustrate the

manner in which the subthemes were grouped together followed by a more detailed
discussion of the results of the thematic analysis.

4.3.1. Results of the thematic analysis: Pre-intervention

In total, I identified seven subthemes identified through thematic analysis. I grouped these
subthemes together into three themes; self-concept awareness, adaptive emotion- focused
coping strategies, and maladaptive emotion-focused coping strategies. Table 4.2 outlines the
results of thematic analysis conducted, indicating the frequency of the subthemes that were
reported during pre-intervention assessment.
Table 4.2 Results of the thematic analysis indicating emotion-focused coping and selfconcept awareness themes as well as subthemes and categories: Pre-intervention
THEME 1: SELF-CONCEPT AWARENESS (PRE-INTERVENTION)
Subthemes

Categories

1.1 Knowledge of and insight into

Self-confidence (9)3

the self-concept
1.2 Skills to interact with others

Self-awareness (13)
Positive interactions with others (13)
Negative interactions with others (12)

1.3 Knowledge of the importance

Identification and expression of feelings(4)

of growth and change

THEME 2: ADAPTIVE EMOTION-FOCUSED COPING STRATEGIES (PRE-INTERVENTION)
2.1 Seeks social support from
significant others

Seeks social support from significant others to communicate and work

through stressful situations (9)
Reliance on social support to deal with stressful situations (9)
Use of relaxation methods in order to examine the situation from
another perspective.

THEME 3: MALADAPTIVE EMOTION- FOCUSED COPING STRATEGIES (PRE-INTERVENTION)

3.1 Direct- active physical
aggression in response to

Physical aggression directed at others in response to stressful

situations (16)

stressful situations.
3.2 Indirect-active physical

Heightened physiological arousal in response to a stressful situation (5)

aggression in response to
stressful situations.
3.3 Direct- passive aggression in

Helplessness (15)

response to stressful

Internalising (16)

situations.

Avoidance (16)
Projecting blame (8)

Withdrawal (12)

The following discussion presents the results of thematic analysis depicting emotion-focused
coping strategies and self-concept awareness of children with ADHD pre-intervention- thus a
baseline image of the Child 1 and Child 2s self-concept awareness and emotion- focused
coping.

THEME 1: SELF-CONCEPT AWARENESS (PRE-INTERVENTION)

Table 4.3: Definition, subthemes, indicators, exclusions and exceptions related to the
theme of self-concept awareness (pre-intervention)

Definition

Implementation of agency in a cognitive system implies that certain beliefs,

values and/ or goals represented in the system become, if implicitly, attributed
to the self of the agent. When the cognitive system becomes explicitly aware of
this attribution, it acquires a self-regulation capacity allowing it to control,
modify and develop its self-concept together with the attitudes attributed to the
self, adjusting to dynamically changing contexts and personal experience. The
leverage of self-awareness understood in this sense consists in increased
robustness, flexibility and integrity of the cognitive system, as illustrated by a
paradigm of self-regulated learning (Samsonovich, A, Kitsantas, a, Dabbagh, N
& De Jong, K,
Subthemes (1.1)Knowledge and insight into the self-concept, (1.2) interactions with others
and (1.3) knowledge of growth and change.
Indicators
All the instances from the raw data where participants made use of phrases
such as confident, self-esteem, he likes himself, flaunt them, selfunderstanding, awareness and understanding of abilities, and confident
were considered to be descriptive of this theme. This includes comments about
self- awareness and self-confidence as a result of being aware and actualising
their abilities.
Exclusions Instances when the participants referred to overly confident, a bully and
excited were not considered part of this theme. It is noted that although there
are similarities between them, they were broken up for the purpose of this
study.
Exceptions This refers to responses such as competence which one or more of the
participants indicated, but which do not fall directly within this theme.
In table 4.3 I provide a definition of self-concept awareness, the subthemes that make up this
theme, the indicators and exclusions used during data analysis to determine the
constituencies of this theme as well as responses deemed exceptions to this theme. Eight
participants reported that both Child 1 and Child 2 displayed some level of self-concept

awareness (refer to Figure 4.1 and Figure 4.2). Three participants commented on the
definition of self-awareness as having an accurate understanding of ones strengths and
weaknesses. This theme consists of three subthemes; (1.1) knowledge and insight into
the self-concept, (1.2) interactions with others and, (1.3) knowledge of growth and
change. I now discuss the categories which make up these subthemes.
SUBTHEME 1.1: KNOWLEDGE AND INSIGHT INTO THE SELFCONCEPT
Self-confidence and self-awareness are categories which form part of the subtheme
knowledge and insight into the self-concept. Findings indicated that the child participants
were both confident in engaging in activities that they felt competent in, but would avoid
situations that were deemed overwhelming. This subtheme supports literature which states
that people only engage with situations when they feel competent enough to do so and will
persevere in these situations, and will avoid situations when feeling incapable of dealing with
them (Schunk, 1981; Schunk & Hanson, 1985; Schunk, Hanson, & Cox, 1987 in Pajares &
Schunk; 2001). In the case of Child 1, results indicate that he was aware of his welldeveloped social skills, using them to his advantage interpersonally. Conversely Child 2 was
only aware of his inabilities and weaknesses, seemingly resulting in withdrawal and
avoidance of situations that he appraised as too demanding. The same patterns of
withdrawal and avoidance of demanding situations was reported in the case of Child 1. Thus,
both children withdrew or avoided tasks they deemed demanding and challenging failed at in
the past. Having said that, Child 2s therapists also mentioned Child 2 lacked metacognition.
As metacognition is required to process and reflect on himself and situational appraisals, he
possibly had difficulty in challenging these negative appraisals of himself and situations. I
relate this result to Barkleys (1999) assertion that impaired executive functioning leads to
inaccurate understanding of strengths, limitations and resources which influence situational
appraisals.

CATEGORY: SELF-CONFIDENCE
Table 4.4 Definition, indicators, exclusions and exceptions related to the category
self-confidence (pre-intervention)

Definition
Indicators

Exclusions

Freedom from doubt and a belief in yourself and your abilities (Wordnet, 2000)
All the instances from the raw data where participants made use of phrases
such as confident, good self- concept, self-esteem, he likes himself, flaunt
them were considered to be descriptive of this theme.
Instances when the participants referred to overly confident were not

considered part of this theme. It is noted that although there are similarities
between them, they were broken up for the purpose of this study.
Exceptions This refers to responses such as competence which one or more of the
participants indicated, but which do not fall directly within this theme.
In table 4.4 I provide a definition of self-confidence, the indicators and exclusions used
during data analysis to determine the constituencies of this category as well as responses
deemed exceptions to this category. Four participants reported that Child 1 and Child 2 were
self-confident. This was a theme predominantly mentioned in the case of Child 1, with the
exception of one comment being made about the positive self-confidence of Child 2. All
reports indicate that the both children felt confident when engaged in verbal tasks and less
confident when engaged in tasks requiring written expression. Thus, there seems to be a link
between a perceived sense of competence and self-confidence. It was further reported that
Child 1s self-concept was rooted in a good self-concept and a positive self-esteemresources which he draws on to assist him to cope. This category is supported by the
following quotations:

very confident to talk among his classmates but with a topic that he could control
and that he knew. (Therapist 4 (Child 2), unit 8)

in terms of school I think hes quite confident here except when he realises that
there is something that he cant do (Parent 1 (Child 1), unit 1,2,3,8)

I think he has quite a good self-concept (Therapist 3 (Child 1), unit 5,8)

it (social skills) gives him a good grounding because the confidence is there and
the self-esteem is there and that puts him on firmer footing. (Therapist 3 (Child 1) unit
5,8)

when its verbal, hes competent and the confidence comes out but he struggles
with written work. (Therapist 2 (Child 1), unit 5,8)

people like him and he likes himselfthat in general he is positive. (Therapist 3

(Child 1), unit 8,9)

He knows he has good social skills and hell use them and flaunt them. (Therapist 3
(Child 1), unit 8, 9)

very competent in my groups and very happy to come to me and he is very

competent, there is no doubt about that. (Therapist 3 (Child 1), unit 8,9)

he has certain resources that he draws on, he knows that he has good social skills
and he knows that he functions optimally when hes on his medication (Therapist
3 (Child 1), unit 8,9)
CATEGORY: SELF-AWARENESS

Table 4.5 Definition, indicators and exclusions related to the category self-awareness
(pre-intervention)

Definition
Indicators

Exclusions

Awareness of oneself as an individual (Wordnet, 2000)

All the instances from the raw data where participants made use of phrases
such as self-understanding, awareness and understanding of abilities,
knowing his inabilities , he knows and aware were considered to be
descriptive of this theme.
Instances when the participants referred to self-esteem, self-concept were
not considered part of this theme. It is noted that although there are similarities
between them, they were broken up for the purpose of this study.

In table 4.5 I provide a definition of self-awareness, the indicators and exclusions used
during data analysis to determine the constituencies of this category as well as responses
deemed exceptions to this category. In total, five participants commented on the childrens
self- awareness. This category was explored differently by different participants. The majority
of the reports made by Child 2s therapists indicated that his self-awareness pivoted around
awareness of his limitations, inabilities, negativity and his syndrome which seem to result in
the employment of maladaptive emotion- focused coping strategies such as withdrawal (refer
to theme 3), avoidance and over reliance on support structures (refer to theme 2 and Figure
4.1). Child 2s therapists also referred to the role of metacognition in self-analysis and selfawareness, stating that Child 2 lacked the ability to engage in such metacognitive activity
(impeding self-reflection and self-discovery) and ultimately impeding his choice of emotionfocused coping strategies. In contrast to these reports, Child 1s educator and therapists
indicate that Child 1 had an acute understanding of his strengths (good social skills) and
resources (medication) which contributed to his self-confidence. Thus reports about Child
1s self-concept awareness were based in a generally positive awareness of self
whereas reports about Child 2s self-concept awareness indicated a generally negative
awareness of self. This category is supported by the following quotations and visual data
(refer to Appendix P for visual data):

he has certain resources that he draws on, he knows that he has good social skills
and he knows that he functions optimally when hes on his medication (Therapist
3 (Child 1), unit 8,9)

He knows he has good social skills and hell use them and flaunt them. (Therapist 3
(Child 1), unit 8, 9)

I dont think our kids are very aware (Therapist 4 (Child 2), unit 9, 13)

I think there is awareness, because there are comments like I havent taken my
Ritalin. (Therapist 5 (Child 2), unit 9,13,7)

its awareness of your own abilities and capabilities. (Therapist 4 (Child 2), unit

9,13)

I think that the kids feel and know when theyre left out and when theyre not doing
well, but theyre not constantly aware ofintrospective about analysing themselves.
(Therapist 4 (Child 2), unit 9)

him knowing his inabilitiesso hes got a good, wellI think hes a good
understanding of where he is (Therapist 4 (Child 2), unit 9)

I think that he is aware and thats why he holds back (Therapist 5 (Child 2), unit
9,1,2)

his awareness of his symptoms and his syndrome, its making him step back as a
way of coping (Therapist 4 (Child 2), unit 1,2,9)

His heightened sense of awareness I think has been contained within a negative
framework within the context of ADHD. So much is resolved around ability and
inability. He doesnt have an internal, good understanding of where he is. But on a
surface level, he does know where his limitations are and he does have a good selfconcept, he knows where his limitations are. His awareness at the moment is
negative, because hes not given the opportunity to get positive reinforcement.
(Therapist 4 (Child 2), unit 9)

Im not sure to what level hes aware of themI think he is aware of them but I am
not sure to what level and extent hes aware of themI think he bases it on other
peoples responses. (Parent 2 (Child 2), unit 5,9)

we have cognitive structures to know that if Im not good but they dont have the
cognitive awareness. Its not ability. (Therapist4 (Child 2), unit 9,13)

I dont think he has the cognitive skills to, in himself, to fight the negativity
(Therapist 4 (Child 2), unit 13)

Figure 4.1: Child 1s interpretation4 of the D-A-P5 activity

Figure 4.2: Child 2s6 interpretation of the D-A-P7 activity.

SUBTHEME 1.2: SKILLS TO INTERACT WITH OTHERS

Positive interactions with others and negative interactions with others are categories
which form part of the subtheme skills to interact with others. Child 1s involvement in
interpersonal relationships was referred to 25 times; whereas Child 2s interpersonal
relationships were not discussed. Child 1 had superior social skills and was able to
communication and converse well with others which assisted him in making friends. Bos,
Schumm & Vaughn (2003) comment that although children with ADHD are able to attract
friends, they often find it difficult to meaningfully attach with others over longer periods of
time. Having said this, it was also reported that Child 1 was able to engage more
constructively with a smaller group of friends as opposed to a larger group setting. In a
bigger group setting, Child 1 struggled to socialise. He tended to be intolerant of those
around him. Therapist 1 reported that he did not know when to inhibit certain responses and
behaviours, which resulted in him experiencing difficulty in negotiating and coming to a
compromise in discussions. Therapist 1 further reported that others became irritated by his
impulsive and hyperactive behaviour which would lead to confrontation and conflict.
CATEGORY: POSITIVE INTERACTIONS WITH OTHERS

Table 4.6 Definition, indicators, exclusions and exceptions related to the category
positive interactions with others (pre-intervention)
Definition

Positive interpersonal relations with significant others.

Indicators

All the instances from the raw data where participants made use of phrases
such as empathises better with, friends, popular, socialises, gets along
with, enjoy one anothers company, good social skills, good pragmatics
were considered to be descriptive of this theme.
Instances when the participants referred to confidence were not considered
part of this theme. It is noted that although there are similarities between them,
they were broken up for the purpose of this study.

Exclusions

Exceptions This refers to responses such as confidence and competence which one or
more of the participants indicated, but which do not fall directly within this
theme.
In table 4.6 I define positive interactions with others, the indicators and exclusions used
during data analysis to determine the constituencies of this category as well as responses
deemed exceptions to this category. Four participants commented on Child 1s positive with
a number of significant others. No reports were made about Child 2 engaging in positive
interactions with others. This seems to be linked to Child 2s over reliance on support and
the tendency to avoid and withdraw from unfamiliar situations. Child 1s educator and
therapists reported that his good social skills and sound pragmatics were strengths. They
further reported that Child 1 was aware of these strengths and that he drew on them when
needed. They reported that these strengths assisted him in making friends and contributed
to him being well-liked by his peers. This category is supported by the following quotations
and visual data:

He empathises better with his friends than with others in the class. Ive noticed that
as opposed to how he behaves in the bigger group. I think that at times he can be
overly confident with his friends. (Therapist 1 (Child 1), unit 11)

Most girls liuk (like) me. (Child 1, unit 11)

I think hes the popular child. I think he doesnt have a problem with making
friends (Therapist 2 (Child 1), unit 11)

he seems to have a good relationship with his mother (Therapist 3, (Child 1)

unit 11)

he socialises okay I mean very much in his small group of friends (Therapist 1
(Child 1), unit 11)

thats why I think he gets along better with people like xxx, because hes more
verbal and the quiet one and they enjoy and laugh at each other. (Therapist 2 (Child
1), unit 11)

thats why xxx and him enjoy one anothers company so they both are verbal and
but the one makes sense more of the time. (Therapist 2 (Child 1), unit 11)

he seems to be quite popular in his class, in my opinion, people like him

(Therapist 3 (Child 1), unit 11)

I think that he is quite perceptive about stuff like that. (Therapist 1 (Child 1), unit 5,
10, 11)

hes got more social skills than a lot of the children in that class and he uses it
positively to his gain. He knows he has good social skills and hell use them and
flaunt them. (Therapist 3 (Child 1), unit 5, 10, 11)

he has certain resources that he draws on; he knows that he has good social

skills (Therapist 3 (Child 1), unit 9, 11)

hes fine and hes popular and hes good at sport (Therapist 3 (Child 1), unit 8,
11)

in our social skills groups he has good pragmatics. He actually understands

(Therapist 2 (Child 1), unit 8)

Figure 4.38: Child 1s drawing of a positive interpersonal interaction

CATEGORY: NEGATIVE INTERACTIONS WITH OTHERS

Table 4.7 Definition, indicators, exclusions and exceptions related to the category
negative interactions with others (pre-intervention)
Definition
Indicators

Exclusions

Exception

Negative interpersonal relations with significant others.

All the instances from the raw data where participants made use of phrases
such as angry those around him, intolerant, inflexible, stubborn, overly
confident, annoyed and irritated with him, friction, boundaries, clash were
considered to be descriptive of this theme.
Instances when the participants referred to outbursts and totally loses it,
throws a wobbly, sometimes uses violence, kicking, attacking, Ill beat you
up, climbed into, throws things around, goes to aggression, anger,
aggression, crying, frustration, internalises were not considered part of this
theme. It is noted that although there are similarities between them, they were
broken up for the purpose of this study.
This refers to responses such as nobody can bad mouth me which one of the
participants indicated, but which do not directly fall within this theme.

Table 4.7 provides a definition of negative interactions with others, the indicators and
exclusions used during data analysis to determine the constituencies of this category as well
as responses deemed exceptions to this category. Five participants reported that Child 1
and Child 2 had negative interactions with others. Again, most of the reports were from the
educator and therapist of Child 1. It was reported that Child 1s peers confront him when his
impulsive and hyperactive behaviour became destructive which lead to confrontation.
Consequently direct- active physically aggressive coping strategies (refer to 3.2) resulted,
which was the fourth subtheme identified. The theme of negative interactions with others is
supported by Gonsalez & Sellers (2002) and Bos, Schumm & Vaughn (2003) who state that
children with ADHD (hyperactive- impulsive type) tend to make impulsive decisions, struggle
to engage in turn taking when having a conversation, have difficult withholding a response or
reaction, delaying gratification, preventing distractions from interfering with ongoing activities
and being intrusive of boundaries which see them acting reactively to situations. Gonzales &
Sellers (2002) further state that hyperactive behaviour tends to cause conflict between the
learner and his peers. However, reports did not indicate that Child 1s impulsive and
hyperactive behaviour resulted in exclusion from formal or informal social situations.

Child 2s educator made a statement about his negative interactions with his peers, namely
that he acted aggressively on the playground at times. The reason given for this was
because Child 2 tended to prefer relying on his non-verbal skills as opposed to his verbal.
Thus, direct- active physical aggression seemed to be a way in which Child 2 tried to
communicate with others. As mentioned previously, negative social interactions with both
children seem to (in the majority of the reports) be linked to direct- active physical
aggression, particularly in the case of Child 1. Thus, the theme of negative interactions with
others seems closely linked to the maladaptive emotion- focused coping subtheme of directactive physical aggression (refer to 3.2). In the case of Child 1, reports indicate that
although he interacted positively within a smaller group situation and amongst his friends, he
tended to be inflexible and intolerant in larger group social situations possibly resulting in
conflict. His hyperactivity in the class situation tended to annoy his class mates. His
therapists noted that he experienced difficulty in his relationship with his cousin as well as
with a classmate. This category is supported by the following quotations and visual data:

he gets angry with others around him (Educator 1 (Child 1), unit 2,3,4)

I dont like people who cause trouble. (Child 1, unit 2,3)

he isnt very tolerant of others around them (Therapist 1 (Child 1), unit 3,10)

It makes me very angry when I lous (lose) friends. (Child 1, unit 2,3)

Can be quite stubborn as well. If he sees something in one way, thats it. Hes not
very flexible or you cant really negotiate with him if hes made up his mind about

something thats it. He battles to see the other side of the situation. To take other
points into consideration. This is how he experiences it thats how it is and thats the
right way. (Therapist 1 (Child 1), unit 11)

he empathises better with his friends than with others in the class) Ive noticed
that as opposed to how he behaves in the bigger group. I think that at times he can
be overly confident with his friends. (Therapist 1 (Child 1), unit 11)

but there are kids that get, at times, very annoyed and irritated with him, especially
when hes in one of his hyper modes when the kids want to work and hes all over the
show. (Therapist 1 (Child 1), unit 11)

.. and him and xxx? Sometimes a bit of friction? (Therapist 1 (Child 1), unit 1, 5,
11,12)

does push the boundaries at times. He doesnt know when he should pull himself
back. (Therapist 1 (Child 1), unit 11)

think that him and xxx clash some times and they dont get on very well and he
doesnt like xxx very much. (Therapist 1 (Child 1), unit 5, 10, 11, 12)

havent you seen him throw a wobbly when hes like cross I think it was in
response to somebody. Something that somebody said. (Therapist 1 (Child 1) 1, 3, 5,
12)

didnt have anything positive to say about his dad. (Therapist 1 (Child 1), unit
11,12)

but on the playground he can be a bully hes always kicking. (Educator 2 (Child
2), unit 11, 12)

he had to be pulled off this kid and I think because this kid was running me down
without actually knowing me it made him really stressed and nobody can bad mouth
me (Parent 2 (Child 1), unit 4, 5,12)

Figure 4.49: Drawing depicting the use of direct- active physical aggression in response to
being perceived as weak, fallible and out of control.
SUBTHEME 1.3: KNOWLEDGE OF THE IMPORTANCE OF GROWTH AND CHANGE
The identification and expression of feelings are categories which form part of the
subtheme knowledge of the importance of growth and change. Child 2s therapists reported
that he struggled to express the way he felt, which often resulted in him acting indifferent in
most situations. I relate this phenomenon to impaired executive functioning which limited
Child 2s ability to verbally express and communicate his thoughts and feelings to others
(Barkley, 1999).
CATEGORY: IDENTIFICATION AND EXPRESSION OF FEELINGS

Table 4.8 Definition, indicators and exclusions related to the category identification
and expression of feelings (pre-intervention)

Definition

The identification and expression of feelings associated with significant

experiences.
Indicators
All the instances from the raw data where participants made use of phrases
such as doesnt show emotion, cant broaden the theme, expressing what
they feel, say I feel, he was indifferent were considered to be descriptive of
this theme.
Exclusions Instances when the participants referred to internalises, sad, angry were not
included in this theme. It is noted that although there are acute resemblances
between them, they were broken up for the purpose of this study.
Exceptions This refers to responses such as he was indifferent which one or more of the
participants indicated. These phrases do not directly fall within this theme, but
they are related to it.
Table 4.8 provides a definition of expression and identification of feelings, the indicators and
the exclusions used during data analysis to determine the constituencies of this category as
well as responses deemed exceptions to this category. Three participants mentioned that
Child 2 struggled to identify and express his feelings as well as the intensity of his feelings.
This seems to be related to poor self-awareness resulting from a lack of metacognitive
activity. However, two of the participants also briefly explored the possibility that Child 2 not
explicitly identifying and expressing his feelings may have manifested as indifference (a
coping strategy employed to conceal stress he experienced). This category is supported by
the following quotations:

. cant broaden the theme... can say I feel sad but cant describe the

grading of sad they feel the basic sad, happy they cant elaborate on those and

say I feel frustrated because he did this or he did that. Theyll only say that they are
sad lack of expressing what they really feel (Therapist 6 (Child 2), unit 9, 13)

he doesnt show emotion at all. (Educator 2 (Child 2), unit 9)

he doesnt (show emotion) he was indifferent (Therapist 5 (Child 2), unit 9)

maybe indifference is masking how stressed he is. (Therapist 5 (Child 2), unit 9)

THEME 2: ADAPTIVE EMOTION-FOCUSED COPING STRATEGIES (PRE-INTERVENTION)

Table 4.9: Definition, subthemes, indicators, exclusions and exceptions related to the
theme adaptive emotion- focused coping strategies (pre-intervention)

Definition

Emotion- focused coping, which consists of dealing with the emotional

consequences of enduring a stressful situation, is allegedly a better choice for
passive stressors that are not dependent upon ones actions (Levine, Koch &
Stern, 2008)
Subthemes (2.1) seeking social support from significant others, (2.2) examining the
situation from another perspective and (2.3) using relaxation methods.
Indicators
All the instances from the raw data where participants made use of phrases
such as examines the situation from another perspective, social support, use
of relaxation methods, asks for assistance, gets the support, this is what I
must do, no youre not, no but, self-soothing, acceptance were considered
to be descriptive of this theme.
Exclusions Instances when the participants referred to see what my reactions are,
anything hes told he is, tense muscles, withdrawal and avoid were not
considered part of this theme. It is noted that although there are similarities
between them, they were broken up for the purpose of this study.
Exceptions This refers to responses such as I say to him, I make him, the way I speak to
him, Ill try read him, you have to intervene, more than one of the participants
indicated, but which do not fall directly within this theme. They have been
included under adaptive emotion-focused coping strategies as they assisted in
emotional regulation. Thus, although not self-advocated, these emotionfocused coping strategies are adaptive.
Table 4.9 provides a definition of adaptive emotion-focused coping strategies, the
subthemes that make up this theme as well as the indicators and exclusions used during
data analysis to determine the constituencies of this theme as well as responses deemed
exceptions to this theme. Nine participants reported that both Child 1 and Child 2 attempted
to make use of adaptive emotion- focused coping strategies. As was stated above, despite
these coping strategies not always being self-employed, they did assist emotional regulation.
Thus, for the purpose of this study, I classified these coping strategies as adaptive emotionfocused coping strategies. This theme consists of three subthemes; (2.1) seeking social

support from significant others, and (2.2) use of relaxation methods in order to (2.3)
examine the situation from another perspective.

The second most prominent subtheme that emerged from thematic analysis was seeking
social support from significant others in order to communicate and work through
stressful experiences, which included social support, reliance on external support
structures and re-framing a situation with social support. The reported instances of Child 1
and Child 2 utilising this coping strategy was 14 times respectively. The use of this strategy
seemed almost exclusively used by the participants within their home environments with
their mothers. Gonzales & Sellers (2002) state that seeking support is an adaptive
emotion- focused coping strategy only when the child feels empowered enough to
adequately communicate and work thorough stressful experiences. Both Child 1 and Child 2
were more inclined to rely on social support to employ relaxation methods and to reframe
situations as opposed to employing them autonomously. Both mothers reported that their
children sought their guidance, re-assurance and advice when unsure on how to approach
stressful situations. Both mothers seemed to assume the role of regulating the child
participants emotional responses to stressful situations. They both expressed that their child
would not be able to employ these strategies independently and without their intervention.
Child 1s mother assisted her child in employing relaxation methods (such as breathing,
temporarily detaching from situations) in order to prevent direct- active and indirect- active
physical aggression to emerge in response to stressful situations. Child 2s mother assured
her son that she supported him regardless of the outcome of the situation. Both parents reframed stressful situations for their children, however Child 1 demonstrated the ability to do
re-frame independently on occasion.

Literature indicates that reliance on external support structures could be related to

impaired executive functioning which results in difficulty to inhibit responses, as well as
regulating behaviour through the use of various modes of inner speech; working memory and
control of emotions as well problem-solving and effective communication. All of these modes
influence a childs ability to exercise self-control, their internal working models of self (WicksNelson et al. 2000). Such manifestations of impaired executive functioning have a direct
bearing on a childs ability to exercise self-control. Consequently, their internal working
models of self are influenced as well as the way others perceive them (ultimately influencing
their relationships) (Bos, Schumm & Vaughn, 2003). In referring back to Barkleys (1999)
definition of ADHD, the childs reliance on external support structures (as a result of impaired
executive functioning) supports the assertion that children with ADHD have difficulty forming
accurate self-appraisals. As a result of this, children with ADHD exhibit behaviour

characterised by learned helplessness. Their reliance on external support structures reenforces their external locus of control, resulting in a lack of accountability and negative
appraisals of events, confirming negative self-appraisals.

Reliance on external support structures is a subtheme closely related to that of the

employment of passive- active aggression in dealing with stressful situations. It seems that
the children appraised their resources as being insufficient in meeting the demands of the
challenging situation, appraised situations as too demanding and outside of their locus of
control. As stated by Ebershn (2006), feeling no control over a situation results in one
experiencing negative emotions, which, in turn, influences ones self-efficacy, selfconfidence, sense of autonomy and self-resilience. Thus, due to poor self-efficacy and a lack
of self-confidence, the participating children with ADHD felt dependant on the support of
significant others. Findings suggest that this support was sought from significant adults as
opposed to peers.

SUBTHEME 2.1: SEEKS SOCIAL SUPPORT FROM SIGNIFICANT

OTHERS

Table 4.10 Definition, indicators and exclusions related to the subtheme seeks social
support from significant others (pre-intervention)

Definition
Indicators

Exclusions

Support (and in some instances reliance on this support) provide by friends,

relatives, educators and therapists
All the instances from the raw data where participants made use of phrases
such as asks for guidance, support, doesnt want to ask me, learnt to
accept him were considered to be descriptive of this theme.
Instances when the participants referred to see what my reactions are,
anything that he is told he is, its because of were not considered part of this
theme. It is noted that although there are similarities between them, they were
broken up for the purpose of this study.

Table 4.10 provides a definition of seeks social support from significant others, the
indicators and exclusions used during data analysis to determine the constituencies of this
category as well as responses deemed exceptions to this category. Seeks social support
from significant others to communicate and work through stressful situations and
reliance on social support from significant others to deal with stressful situations are
categories which form part of the subtheme seeks social support from significant others.

CATEGORY: SEEKS SOCIAL SUPPORT FROM SIGNIFICANT

OTHERS TO COMMUNICATE AND WORK THROUGH STRESSFUL
SITUATIONS

Table 4.11 Definition, indicators and exclusions related to the category seeks social
support from significant others to communicate and work through stressful situations
(pre-intervention)

Definition
Indicators

Exclusions

Support provide by friends, relatives, educators and therapists

All the instances from the raw data where participants made use of phrases
such as support, acceptance, encouragement were considered to be
descriptive of this theme.
Instances when the participants referred to come from else where, external
input, re-assured, second opinion were not considered part of this theme. It
is noted that although there are similarities between them, they were broken up
for the purpose of this study.

Table 4.11 provides a definition of seeking social support from significant others to
communicate and work through stressful situations as well as the indicators and exclusions
used during data analysis to determine the constituencies of this category. Both childrens
educators, therapists and parents reported the central role that social support played in
enabling the children to work through stressful experiences. This was a theme particularly
prominent within the home environment. Child 1 became irritated if offered assistance
within the school environment. Child 2 avoided and withdrew from difficult tasks. Therapist 5
(Child 2) mentioned the important role that the family played in the development and
maintenance of a childs self-concept and self-esteem. This statement is supported by
comments made by both Parent 1 and Parent 2 about the manner in which they adapted
their lifestyles and ways of communicating with their child in order to make them feel
understood within the home environment. These accounts seem to starkly contrast the
statement made by Therapist 6 (Child 2) who stated that our children dont have that positive
family structure. This category is supported by the following quotations:

he sometimes looks at you and asks for guidance without actually asking its just
the way he looks at you (Parent 1 (Child 1), unit 5)

He just looks at me with those eyes (Therapist 3 (Child 1), unit5)

also your kind of support structure (Therapist 4 (Child 2), unit 5)

but the self-esteem and the self-concept is also reliant on the family structure.
(Therapist 5 (Child 2), unit 5)

our kids dont have that positive family structure. (Therapist 6 (Child 2), unit 5)

we just sort of like changed to his sort of behaviour to sort of like accommodate
him and to make him feel that whatever hes doing is not always right but we give him
that re-assurance that its ok. (Parent 2 (Child 2), unit 5)

but with family and friends and whatever we have, learnt to accept him whether
if he feels like doing or playing we leave him be and if he doesnt feel like playing,
well encourage a bit and well leave him. (Parent 2 (Child 2), unit 5)

My family is close. (Child 1, unit)

he seems to have a good relationship with his mother and I think that he gets the
support that he needs from home. (Therapist 3 (Child 1), unit 5)

he doesnt want to ask me to explain it againhe gets very irritated and very
angry and he wants to get everything right (Educator 1 (Child 1), unit 1,5)

CATEGORY: RELIANCE ON SOCIAL SUPPORT TO DEAL WITH

STRESSFUL SITUATIONS

Table 4.12 Definition, indicators and exclusions related to the category reliance on
social support to deal with stressful situations (pre-intervention)

Definition

The reliance on external support structures to be able to employ

relaxation
methods in an attempt to modulate his feelings.

Indicators

Exclusions

All the instances from the raw data where participants made use of phrases
such as gotta come from somewhere else, relies on external input,
reinforcement, re-assured, the way I speak to him, Ill re-assure him, he
relies on see what my reaction is were considered to be descriptive of this
theme.
Instances when the participants referred anything that he is told he is, its
because of were not considered part of this theme. It is noted that although
there are similarities between them, they were broken up for the purpose of this
study.

Table 4.12 provides a definition of reliance on social support to deal with stressful situations
as well as the indicators and exclusions used during data analysis to determine the
constituencies of this category. Child 2s therapists and parent commented on his reliance on
the above mentioned social support structures. He relied heavily on maternal reassurance and encouragement to regulate his emotions in order to be better able to
engage with his environment. Child 2s mother reported that his reliance on external support
structures, particularly the support provided to him by his parents may have resulted from a

negative self-awareness. Negative self- awareness seemed to have influenced his selfappraisals. This category is supported by the following quotations regarding Child 2:

Its gotta always come from else where (Therapist 4 (Child 2), unit 1,5)

He relies on an external input. (Therapist 4 (Child 2), unit 1,5)

His awareness at the moment is negative, because hes not given the opportunity to
get positive reinforcement. (Therapist 4 (Child 2), unit 1,5)

Hes got to be constantly re-assured that whatever you do, we happy with what you
doing. (Parent 2 (Child 2), unit 1,5)

but not knowing and feeling very insecure waiting for that re-assurance type thing.
(Parent 2 (Child 2), unit 1)

not like hell do in voluntarily, youll have to re-assure him that like go and play
with other children (Parent 2 (Child 2), unit 1,5)

we give him that re-assurance that its ok. (Parent 2 (Child 2), unit 5)

like the stuff that he learns at school he will come and say or ask if its wrong or if
its not.(Parent 2 (Child 2), unit 5)

Im not sure if its really wrong or if its to see what my reaction is as opposed to
his teachers (Parent 2 (Child 2), unit 5)

he might know that whatever it is its wrong and then he just wants to have
clarification or want you like second opinion type of thing. (Parent 2 (Child 2), unit 5)

CATEGORY: USE OF RELAXATION METHODS IN ORDER TO REEXAMINE THE SITUATION FROM ANOTHER PERSPECTIVE
Table 4.13 Definition, indicators and exclusions related to the category use of
relaxation methods in order to examine the situation from another perspective (preintervention)

Definition
Indicators

Exclusions

The use of relaxation methods in an attempt to modulate his feelings.

All the instances from the raw data where participants made use of phrases
such as whistling in class, self-soothing, the way I speak to him, Ill say to
him, I make him, Ill try to read him, you have to intervene were considered
to be descriptive of this theme.
Instances when the participants referred to see what my reactions are,
anything that he is told he is, its because of were not considered part of this
theme. It is noted that although there are similarities between them, they were
broken up for the purpose of this study.

Table 4.13 provides a definition of use of relaxation methods in order to re-examine the
situation from another perspective as well as indicators and exclusions used during data

analysis to determine the constituencies of this category. Child 2 seemed to be able to selfemploy relaxation methods. However he did not seem to consciously make an effort to
utilise this coping mechanism. The employment of relaxation methods, such as whistling at
the end of a class for example, may have been a result of behaviour inhibition (whistling
being his way of releasing the pent up emotion that culminated during class time). This
category is supported by the following quotations regarding Child 2:

Hes been whistling in class and doing all of these funny things. (Educator 2 (Child
2), unit 2)

I think that that is also his way of self-soothing as a result of more stress.
(Therapist 4 (Child 2), unit 2)

because then maybe its (whistling in class and doing all of these funny things)
taking all of his supra- metacognitive skills to inhibit himself and then its too much
and overload of work or whatever and then its just too much with the overload of
work and stuff and he cant inhibit anymore (Therapist 5 (Child 2), unit 2, 12)

Thus in terms of the baseline results, Child 2 relied on social support to be able to mediate
and cope with stressful experiences. However, both children relied on social support to be
able to employ relaxation methods for long enough to be able to re-examine the social
situation from another perspective, particularly Child 1. In the Case of child 1, when he
started to react with direct- active physical aggression, his mother pre-empted and
intervened before this response was actualised. She encouraged him to temporarily detach
from the stressful situation (which evoked emotions such as frustration and anger) in order to
employ relaxation methods to decrease physiological arousal (such as breathing). She
then encouraged him to return to the activity/ situation that made him feel overwhelmed and
to attempt to confront it again. Due to his reported tendency to act impulsively, Child 1s
mother stated that he would not be able to employ this coping strategy independent of her
support. This category is supported by the following quotations:

for me its the way that I speak to him, I dont know. Like Ill say to him calm down,
think before you do something so hes fine. And I dont laugh or say anything try
again and get it right. (Parent 1 (Child 1), unit 2,3,5)

If you feel that youre getting angry, then back away from it for a while and then
start again (Parent 1 (Child 1), unit 2,3,5)

I make him go outside to calm down and then come and try again. (Parent 1 (Child
1), unit 2,3,5)

I try to read Im like that but sometimes its difficultbecause he cant do it

(Parent 1 (Child 1), unit 2, 3, 5)

Ill just say to him just go away and come back. Go and breathe outside
(Parent 1 (Child 1), unit 2,3,5)

(asked if has ever tried to use the strategy himself) no, no he cant. (Parent 1
(Child 1), unit 2,3)

he gets himself in a tizz before he realises that he should have just waited a bit
(Parent 1 (Child 1), unit 2, 3)

he doesnt know when to stop and you have to intervene to tell him to stop
(Parent 1 (Child 1), unit 3, 5)

it didnt matter that I went onto the field and said calm down (Parent 1 (Child 1),
unit 3, 5)

Despite being reliant on social support to regulate his emotions when confronted with a
stressful situation, Child 1 seemed able to independently re-examine and re-frame
potentially stressful situations in order to create a more positive outlook should he not be in a
heightened state of physiological arousal. This category is supported by the following
quotations regarding Child 1:

... he accepts the situation says no but my moms just the nurse and I dont have
the money therefore I dont have to like cry to buy like things like everyone else
(Educator 1 (Child 1), unit 10)

I would say that actually makes him actually know what is happening if he has to
deal with everything nicely you know just deal with it and know that this is how I must
do it (Educator 1 (Child 1), unit 9)

However, both children seemed to negatively appraise themselves when confronting

failure in some form, influencing self and situational appraisals, and ultimately the childrens
inability to autonomously employ relaxation methods for long enough to re-appraise
situations. This re-enforced the reliance of both children on their mothers to challenge their
negative self-appraisals. Both the mothers commented on their sons reliance on maternal
support to challenge situational appraisals they made when they experienced failure. This
category is supported by the following quotations:

and then hell say oh, Im so stupid and Ill say to him no, youre not stupid...
(Parent 1 (Child 1), unit 1,2,3,5)

then I all the time I like to encourage him and say think about next time or next time
youll do better its ok for now and when you do the next one, who knows, maybe youll
get ninety out of a hundred That type of thing. (Parent 2 (Child 2), unit 1, 5)

THEME 3: MALADAPTIVE EMOTION-FOCUSED COPING STRATEGIES (PRE-INTERVENTION)

Table 4.14 Definition, subthemes, indicators, exclusions and exceptions related to the
theme maladaptive emotion- focused coping strategies (pre-intervention)

Definition

Under some conditions, the experience and expression of emotion may bring
negative consequences (Lopez, Shane, Snyder, 2002)
Subthemes (3.1)Indirect- active physical aggression (heightened physiological arousal),
(3.2) Direct- active physical aggression (physical aggression) and (3.3) Directpassive aggression (withdrawal, internalising, projecting blame, avoidance,
helplessness).
Indicators
All the instances from the raw data where participants made use of phrases
such as outbursts and totally loses it, throws things around, throws a
wobbly, pulled off, goes to aggression, sometimes uses violence, Ill beat
you up, kicking, attack, climbed into, anger, aggression, eyes, face,
tizz, flapping around, he starts crying, gets very emotional, cries out of
frustration, irritable, totally overwhelmed, gets very upset, justify his
shortcomings, struggles, holding back, excuse, blames others, its
because of, see what my reactions are, anything that he is told he is, oh,
Im so stupid, internalises it, someone says, bully, kicking, muscles are
tense, gets emotional, sad, inhibit, withdraw, pulls back, takes the back
seat, doesnt venture, pray for the bell, step back, sit and see, inhibited,
feedback from others, what theyre saying, they hear, the messages that
they get, other peoples responses, avoid, shows indifference,
psychosomatic symptoms such as head aches, tummy aches, excuses were
considered to be descriptive of this theme.
Exclusions Instances when the participants referred to examines the situation from
another perspective, social support, use of relaxation methods, asks for
assistance, gets the support, this is what I must do, no youre not, no but,
self-soothing and acceptance were not considered part of this theme. It is
noted that although there are similarities between them, they were broken up
for the purpose of this study.
Exceptions This refers to responses such as hyper, without thinking, impulsive,
restless which more than one of the participants indicated, but which do not
fall directly within this theme.
Table 4.14 provides a definition of maladaptive emotion-focused coping strategies, the
subthemes that made up this theme as well as the indictors and exclusions used during data
analysis to determine the constituencies of this theme and responses that were exceptional
to this theme. Both the childrens parents, educators and all therapists reported that the boys
made use of maladaptive emotion- focused coping strategies. This theme consists of three
subthemes; (3.1) indirect- active physical aggression (3.2) Direct- active physical
aggression and (3.3) Passive- direct physical aggression.

Reports indicate that Child 2 employed direct, active physical aggression on the
playground. Therapist 5 conjectured that this coping strategy could be a result of a limited
verbal expression capacity. Reports further indicate that Child 2 often withdrew from social

situations, but with encouragement, joined in to play with others. Through exclusion from
formal and informal social situations, Child 2 did not make himself available to gain esteem
or social support from his peers perpetuating his isolation. Such negative interpersonal
outcomes seem to have resulted in a negative self-concept, limited efficacy and a limited
coping repertoire (Wicks-Nelson et al. 2000).

SUBTHEME 3.1: INDIRECT- ACTIVE PHYSICAL AGGRESSION

Table 4.15 Definition, indicators and exclusions related to the category indirect- active
physical aggression (pre-intervention)

Definition

For the purpose of this study, any action characterised by aggression directed
at oneself.

Indicators

Exclusions

All the instances from the raw data where participants made use of phrases
such as discomfort, any reference to a change in physiology i.e. eyes, face,
tizz, flapping around were considered to be descriptive of this theme.
Instances when the participants referred to hyper, fidgety,
restless, irritated, totally overwhelmed were considered unrelated to this
theme. It is noted that although there are resemblances between them, they
were broken up for the purpose of this study.

Table 4.15 provides a definition of indirect- active physical aggression as well as indicators
and exclusions used during data analysis to determine the constituencies of this subtheme.
Heightened physiological arousal is a category which forms part of the subtheme indirectactive physical aggression:
CATEGORY: HEIGHTENED PHYSIOLOGICAL AROUSAL IN
RESPONSE TO STRSSFUL SITUATIONS
Table 4.16 Definition, indicators and exclusions related to the category heightened
physiological arousal in response to stressful situations (pre-intervention)

Definition

Chronic physiological arousal resulting in negative adjustment

(Net Solutions, 2008)

Indicators

Exclusions

All the instances from the raw data where participants made use of phrases
such as discomfort, any reference to a change in physiology i.e. eyes, face,
tizz, flapping around were considered to be descriptive of this theme.
Instances when the participants referred to hyper, fidgety,
restless, irritated, totally overwhelmed were considered unrelated to this
theme. It is noted that although there are resemblances between them, they
were broken up for the purpose of this study.

Table 4.16 provides a definition of heightened physiological arousal in response to stressful

situations well as the indictors and exclusions used during data analysis to determine the
constituencies of this category. Two participants referred to instances in which heightened
physiological arousal was a precursor for more direct- active aggression. The childrens
mothers tried to decrease physiological arousal in an attempt to facilitate more adaptive
coping and functioning (congruent with the need for external support structures to employ
relaxation methods) (refer to theme 2). Child 1s mother reported that she tried to intervene
to facilitate the use of relaxation methods in order to prevent the employment of aggressive
emotion-focused coping techniques (refer to 3.2). This category is supported by the following
quotations:

you can see that minute in his eyes that hes going to attack you and his face just
changes (Parent 1 (Child 1), unit)

If you feel that youre getting angry, then back away from it for a while and then start
again (Parent 1 (Child 1), unit)

he gets himself in a tizz before he realises hes in his little tantrum and little
world (Parent 1 (Child 1), unit)

he was very stressed for his age. His muscles are very tense and we have to
massage his shoulders (Parent 2 (Child 2), unit 2, 5)

SUBTHEME 3.2: DIRECT- ACTIVE PHYSICAL AGGRESSION

Physical aggression is a category which forms part of the subtheme direct- active physical
aggression:
CATEGORY: PHYSICAL AGGRESSION
Table 4.17 Definition, indicators and exclusions related to the category physical
aggression as well as exceptional responses to this category (pre-intervention)
Definition

Overt behaviour aimed at physically causing personal injury to a thing or

another person (Net Solutions, 2008)
Indicators
All the instances from the raw data where participants made use of phrases
such as throw things around, outbursts and totally loses it, throws a wobbly,
pulled off, goes to aggression, sometimes uses violence, Ill beat you up,
kicking, attack, climbed into, anger, aggression were considered to be
descriptive of this theme.
Exclusions Instances when the participants referred to agro, totally overwhelmed,
frustration, sad, crying, emotional, internalises, gets very upset, use as
an excuse, irritated were considered unrelated to this theme. It is noted that
although there are resemblances between them, they were broken up for the
purpose of this study.
Exceptions This refers to responses such as hyper, without thinking, and impulsive
which one or more of the participants indicated, but which do not fall directly
within this theme but which may be symptoms of ADHD, which influence the
participants overt behaviour.
Table 4.17 outlines a definition of physical aggression, the indictors and exclusions used
during data analysis to determine the constituencies of this category and exceptional
responses to this category. Should social support not be available to address heightened
physiological arousal, Parent 1 reported that Child 1 exhibited physical aggression. This
was reported as occurring in both the home and school settings. Educator 1 reported that
Child 2 used physical aggression on the playground. Reasons for the children employing this
coping strategy seemed to be due to negative self appraisals (possibly resulting in them
becoming overwhelmed or frustrated by situational demands). Therapist 5 suggested that
Child 2 made use of physical aggression (possibly in an attempt to compensate for a poorly
developed ability to engage in social discourse). This category is supported by the following
quotations and visual data:

when he doesnt get things right hes like doing that (hitting fist on the table)
(Educator 1 (Child 1), unit )

he was very stressed for his age. His muscles are very tense and we have to
massage his shoulders and like, we should do it actually everyday, but we dont.
(Parent 2 (Child 2), unit 2, 5)

when hes totally overwhelmed he has those outbursts and he totally loses it.
(Therapist 1 (Child 1), unit 2)

havent you seen him throw a wobbly when hes like cross? (Therapist 1 (Child 1),
unit 1,2,3,4,5)

he has that short, what do you call it, anger thing he gets angry with others around
him and hell just throw things (Educator 1 (Child 1), unit 5)

he doesnt know how to deal with the fact that he isnt able to do it and then he
projects anger, aggression (Parent 1 (Child 1), unit 1)

he cant deal with the aggression (Parent 1 (Child 1), unit 2, 3)

he cant handle that and from that crying he goes to aggression (Parent 1 (Child
1), unit 3)

goes in guns blazing (Parent 1 (Child 1), unit 2,3,4)

... he sometimes uses violence as well to sort of show Im not weak, Ill beat you up
and lets see whos weak. (Parent 1 (Child 1), unit 1)

and thats where the kicking and the karate comes in. (Parent 1 (Child 1), unit 1)

you can see that minute in his eyes that hes going to attack you and his face just
changes (Parent 1 (Child 1), unit 1)

If you feel that youre getting angry, then back away from it for a while and then start
again (Parent 1 (Child 1), unit 2,3,4)

he gets himself in a tizz before he realises hes in his little tantrum and little
world (Parent 1 (Child 1), unit 1)

he just climbed into this guy (Parent 1 (Child 1), unit 4)

he had to be pulled off this kid (Parent 1 (Child 1), unit 4)

but on the playground he can be a bully hes always kicking. (Educator 2 (Child
2), unit 11, 12)

hes also a bully, but I dont think hes as bad as (child 2)...I think its because of
(child 2)... (Educator 2 (Child 2), unit 11,12)

it seems to be helping him because hes going for nonverbal skills. (Therapist 5,
unit 11, 9)

Figure 4.510 : Child 1s depiction of the use of direct- active physical aggression in response
to being teased. I denote the use of the shapes i.e. stars and triangles with heightened
physiological arousal.

SUBTHEME 3.3: DIRECT- PASSIVE AGGRESSION

Table 4.18 Definition, indicators and exclusions related to the subtheme directpassive aggression (pre-intervention)

Definition

Any actions characterised by avoidance, internalising, projecting blame,

learned helplessness.

Indicators

Exclusions

All the instances from the raw data where participants made use of phrases
such as the way I speak to him, Ill say to him, I make him, Ill try to read
him, you have to intervene were considered to be descriptive of this theme.
Instances when the participants referred to see what my reactions are,
anything that he is told he is, its because of were not considered part of this
theme. It is noted that although there are similarities between them, they were
broken up for the purpose of this study.

Table 4.18 outlines a definition of direct- passive aggression as well as the indictors and
exclusions used during data analysis to determine the constituencies of this subtheme. The
most dominant emotion- focused coping strategy employed by both children was that of
direct- passive aggression in response to stressful situations. Both children employed
indirect- active aggressive coping strategies such as helplessness, internalising, projecting
blame and avoidance. Child 1s mother, educator and therapists reported that Child 1 used
direct-passive aggressive coping strategies 35 times and Child 2 32 times. The same
participants further reported that Child 1 used passive- active aggressive techniques such as

helpless behaviour (crying), avoidance (avoiding engagement with a task/ situation which
appeared too demanding), projecting blame (blaming external forces to justify behaviour) and
internalising (forming his identity on others opinions of him) which hindered him from
achieving his goals. In addition, Child 2 employed avoidance tactics in response to stressful
situations (which Child 1 did not employ). Internalising is commented on by Cooley (1902)
who asserts that the self-concept is a by-product of social interactions. The children in the
study tended to internalise negative feedback from others, which resulted in a negative self
and situational appraisals. This finding is supported by Banduras (1997) social cognitive
theory which states that people engage with situations only when they feel competent
enough to do so, and avoid situations when feeling incompetent in dealing with them, much
in the same way that both of the participants did. Whether or not one engages with a
situation is based on the individuals self-efficacy beliefs, stating that self-efficacy beliefs
heavily influence the choices that one makes as well as the behaviour that results from those
choices (Schunk, 1981; Schunk & Hanson, 1985; Schunk, Hanson, & Cox, 1987 in Pajares &
Schunk; 2001).

As findings from the study suggest, children with ADHD are confronted with failure and
negative criticism both within the class and playground setting. As stated by Kruger (1998),
such negative interpersonal outcomes result in children with ADHD being extremely sensitive
to the opinions of others. In the child participants, these outcomes seem to have resulted in
poor self-efficacy beliefs as well as avoidance behaviour- which ultimately determined the
manner in which they respond to people and situations. In order to avoid future failures,
children with ADHD may project blame onto others in situations that they feel they have little
control over (with this lack of control resulting from the belief that their actions will have little
positive bearing on the situation). As a result of feeling disempowered, children with ADHD
allow for others to assume responsibility for decision-making.

Being negatively appraised across a number of settings influenced the self-efficacy beliefs of
children with ADHD. Thus, the lower the childs self-efficacy, the less likely he may be to
persevere in the face of obstacles and the more likely he may be to experience extreme
amounts of anxiety and stress when confronted with stressful situations which was evident
during pre-intervention assessment (Schunk, 1981; Schunk & Hanson, 1985; Schunk,
Hanson, & Cox, 1987 in Pajares & Schunk; 2001). Ebershn (2006) and Ginorio, Yee, Banks
and Todd-Bazemore (2007) agree that those who cope poorly with stress tend to feel they
have less control over their lives and with their behaviour being characterised by learned
helplessness. Persistent feelings of self-blame, as well as an external locus of control, could
result in poor adjustment and depression. Thus, the self-efficacy beliefs of children with

ADHD have direct and significant bearing on the emotion-focused coping strategies that they
employ, which in the case of pre-intervention functioning, resulted in the employment of
predominantly passive- active aggressive coping strategies.

I regard the emotion-focused coping strategies explored above as maladaptive as they result
in negative consequences. As such, childrens emotional, social and academic functioning
was impacted negatively (refer to 2.3.1.2 in chapter 2).

Helplessness, avoidance, projecting blame, internalising, and withdrawal are categories

which form part of the subtheme passive- direct physical aggression:
CATEGORY: HELPLESSNESS

Table 4.19 Definition, indicators and exclusions related to the category helplessness
(pre-intervention)
Definition
Indicators

Exclusions

Powerlessness revealed by an inability to act (Miller, 2006)

All the instances from the raw data where participants made use of phrases
such as he starts crying, gets very emotional, cries out of frustration,
irritable, totally overwhelmed, gets very upset were considered to be
descriptive of this theme.
Instances when the participants referred to agro, internalises, sees himself as
others say he is, I am stupid were considered unrelated to this theme. It is
noted that although there are resemblances between them, they were broken
up for the purpose of this study.

Table 4.19 outlines a definition of helplessness as well as the indictors and exclusions used
during data analysis to determine the constituencies of this subtheme. Four of the
participants referred to instances in which the childrens behaviour was characterised by
helpless behaviour. Crying was reported as occurring predominantly within the home
environment with irritability and frustration manifesting predominantly within the class and
therapeutic environment. Child 1s mother reported that her child cried when he felt frustrated
or angry as a result of feeling perceived as fallible or weak. Child 1 responded with frustration
when unable to successfully complete a task, as well as when he was told to do two tasks
simultaneously (possibly creating a stressful situation). Feelings of frustration were common
to both children, with Child 1 and Child 2 experiencing feelings of helplessness and crying
(possibly as a result of not meeting their own expectations as well as the expectations of
others). This category is supported by the following quotations:

when he isnt able to be all then he becomes aggressive and very emotional
(Parent 1 (Child 1), unit 1,3)

awakening of hey I cant do that and then he doesnt know how to deal with the
fact that he isnt able to do it and then he projectsor cries out of frustration. (Parent
1 (Child 1), unit 1,3)

when he realises that there is something that he cant dohe starts cryingthat
happens a lot here at school (Parent 1 (Child 1), unit 1,3)

he gets teased for crying (Parent 1 (Child 1), unit 1,2,4,5)

from that crying he goes to aggression (Parent 1 (Child 1), unit 1,2,4,5)

knows who he is and what he wants and what he wants out of life, but I think
because of, of the way that he handles stress- hes very emotional (Parent 1 (Child
1), unit 1,2,3,4,5)

when he doesnt get things right hes like doing that (hitting fist on the table)
(Educator 1 (Child 1), unit 3)

I dont think he comes to school in a good mood and hes just irritable the whole
day. (Therapist 1 (Child 1), unit 3, 5)

there is something else that he doesnt like to hear that he knows already, he gets
very irritated (Educator 1 (Child 1), unit 3, 5)

and he got irritated (Therapist 1 (Child 1), unit 3,5)

when hes totally overwhelmed he has those outbursts and he totally loses it.
(Therapist 1 (Child 1), unit 2)

somebodys asking him to do something he gets very upset. (Therapist 1 (Child

1), unit 2, 3)

he would like to take things to the extreme or, I dont know...if he wants to do
something, he wants to do it to the extreme, no fault type of thing If its not what he
expects, he gets quite sad about it (Parent 2 (Child 2), unit 1, 2)

when we shout at him he gets like very emotional you know like feel want to start
crying or I dont know if its his way of not coping that makes him so emotional
(Parent 2 (Child 2), unit 1,2)

in a sense that it (stress) makes him emotional, forgetful (Parent 2 (Child 2),
unit 1,2)

CATEGORY: INTERNALISING
Table 4.20 Definition, indicators and exclusions related to the category internalising
(pre-intervention)

Definition

To incorporate, as through learning, socialization and identification (Miller,

2006)
Indicators
All the instances from the raw data where participants made use of phrases
such as see what my reactions are, anything that he is told he is, oh, Im so
stupid, internalises it, feedback, someone says and what theyre saying
were considered to be descriptive of this theme.
Exclusions Instances when the participants referred to its the way that I talk to him, just
doesnt know how to deal with it, asks you for guidance without actually
asking, were considered unrelated to this theme. It is noted that although there
are similarities between them, they were broken up for the purpose of this
study.
Exceptions This refers to responses such as becomes unsure which one of the
participants indicated but which does not fall directly within this theme but is
related to the theme.
Table 4.20 illustrates a definition of internalising, the indicators and exclusions used during
data analysis to determine the constituencies of this theme and exceptional responses to this
theme. It seems as though internalising contributed to both childrens reliance on
external support structures and direct- active aggression. Five participants stated that
the children internalised feedback from those within their home and school environments.
Two of the participants highlighted the role that academic self-concept played in informing
their behaviour. Therapist 6 (Child 2) stated that the feedback that children with ADHD
receive is predominantly negative as a consequence of repeated failure. This assertion is
supported by a statement made by Child 1s mother that her child assimilated negative
appraisals and feedback more readily than he did the positive, possibly resulting in
stress. Furthermore, Therapist 3 (Child 1) stated that at times Child 1 did internalise positive
feelings and feedback when he experienced success within the therapeutic environment
(possibly resulting in feelings of self-confidence). This category is supported by the following
quotations:

you create your self concept from the feedback that you get from others so its just
your own perception (Therapist 6 (Child 2), unit 5)

so you create a self-concept around what theyre saying (Therapist 6 (Child 2),
unit 5)

they get a lot of negative feedback and build their self-concept on I cant actually
do this or I cant actually achieve this when they actually have the potential but there
are so many behaviour factors coming in that they get reprimanded because they not
sitting still and they not focusing so they feel that theyre not living up to the standard.
(Therapist 6 (Child 2), unit 5)

If youre not good at school, thats what counts. It makes no difference if youre a
champion horse rider. Not in the school environment (Therapist 5 (Child 2), unit
1,5)

kids with ADHD experience failure from when they were small. They hear no,
youre not doing what Im expecting from you. So from very early age they have to
cope with failure. Failing over and over because they are not meeting the criteria you
know. Not academically, not behavioural wise (Therapist 6 (Child 2), unit 1,2,5)

all of the messages that they get are negative and youre not coping and youre
not doing well so thats where that comes from (Therapist 6 (Child 2), unit 1,2,5)

So even though youre good as sport, who cares, Ernie Els doesnt care if you can
read or write as long as you can play golf. But they dont get that (Therapist 6
(Child 2), unit 1,5)

he sees himself as being anything that he is told he is and he internalises it

(Parent 1 (Child 1), unit 5)

he seems to remember more of the negative than the positive. That sticks in his
mind the most. It doesnt matter that someone says that hes good and that hes not
so bad. He will hang onto the bad points and not the good. (Parent 1 (Child 1), unit 5)

oh, Im so stupid (Parent 1 (Child 1), unit 2,3,5)

hes very sensitive (Parent 1 (Child 1), unit 5)

people like him and he likes himself He does well in (Therapist 2)s group and
my group therapyhe is positive he does very well in OT and speech- hes a star
there especially with my stuff thats spatial very competent in my groups and very
happy to come to me and he is very competent, there is no doubt about that
(Therapist 3 (Child 1), unit 5, 8)

what he sees at home he sort of like see it that thats the way that it should be...
(Parent 2 (Child 2), unit 5)

he will say oh ok, I understand now because my teacher said so (Parent 2

(Child 2), unit 5)

I think he bases it on other peoples responses. (Parent 2 (Child 2), unit 5)

Child 1s mother did not explicitly mention internalising, however, she did report self-doubt:

if he gets teased, like he desperately wants to be a singer and he did that in class
and apparently everybody laughed and him and he becomes unsure but he still, its
still something that he wants to do I think. So I think he knows what he wants and the
teasing makes him unsure (Parent 1 (Child 1), unit 1, 5)

CATEGORY: AVOIDANCE

Table 4.21 Definition, indicators and exclusions related to the category avoidance
(pre-intervention)
Definition
Indicators

Exclusions

Deliberately avoiding, keeping away from or preventing from happening

(Weber, 1913)
All the instances from the raw data where participants made use of phrases
such as justify his shortcomings, struggles and holding back were
considered to be descriptive of this theme.
Instances when the participants referred to externalises, its because of
and blames others were not included in this theme. It is noted that although
there are acute resemblances between them, they were broken up for the
purpose of this study.

Table 4.21 provides a definition of avoidance as well as the indicators and exclusions used
during data analysis to determine the constituencies of this theme. When the children
appraised tasks and situations as challenging and frightening (Therapist 2, Child 1) they
employed avoidance techniques. Avoidance behaviour was noted predominantly in the
classroom setting but also in therapeutic settings where performance was emphasised.
Child 1 tried to avoid written tasks. Avoidance was not commented on within Child 1s home
environment, but was noted in Child 2s home environment. Child 1 made excuses as to
why he was unable to engage with certain tasks resulting in delay to start a task and not
completing tasks within the allocated time frame. His educator commented that his
avoidance behaviours result in him appearing disorganized (Educator 1, Child 1). When
made aware of his behaviour by his educator and therapists, he attempted to avoid
reprimand (for not starting tasks and not completing tasks timorously) by making excuses to
justify his behaviour. Child 2 attempted to avoid potentially stressful situations by
withdrawing from them, and sometimes developing psychosomatic symptoms (possibly
due to the intensity of the emotions experienced). This category is supported by the following
quotations:

I think that happens when he finds things difficult and frightening he uses it as an
excuse to justify his shortcomings. (Therapist 2 (Child 1), unit 1)

that he is actually holding back and you find that he cant complete the task on time
really because of that. (Educator 1 (Child 1), unit 6)

hes at that age where he thinks that he can use that as an excuse. (Therapist 2
(Child 1, unit 6)

hes actually becoming slow in finishing off his tasks like others in his class
because hes putting that (excuses) first (Therapist 2 (Child 1), unit 6)

those things they make you a disorganised person (Educator 1 (Child 1), unit 6)

he uses that as an excuse sometimes (Educator 1 (Child 1), unit 6)

at times hes managing at times he uses that just as an excuse (Educator 1

(Child 1), unit 6)

when its verbal, hes competent and the confidence comes out but he struggles
with written work. (Therapist 3 (Child 1), unit 2)

maybe he doesnt understand a certain concept and he doesnt want to ask me to

explain it again he will try to fiddle around and when there is something else that he
doesnt like to hear that he knows already, he gets very irritated (Educator 1 (Child
1), unit 6).

he definitely doesnt want to try... If its one word answers, one line answers yes,
but when he has to engage in a narrative or a discourse, he always wants to be the
fifth person and there are four people in the group, and hes hoping that the bell will
go before its his turn. (Therapist 5 (Child 2), unit 1,2)

he wasnt the only one who didnt do it but he reallyyou could see the look on his
face- praying for the bell. (Therapist 5 (Child 2), unit 1,2)

..he avoids (Educator 2 (Child 2), unit 2)

showing that indifference or hoping that the bell will go. (Therapist 6 (Child 2), unit
2)

Hes not risking the possibility that he could be right (Therapist 4 (Child 2), unit
1,2)

like with a test. He will always want to get the best and with the result he puts
pressure on himself and he has headaches and tummy aches and all kinds of
reasons not to do it because of his fear of what the results may be (Parent 2 (Child
2), unit 2)

hell try and avoid those people. (Parent 2 (Child 2), unit 2)

Despite these similarities in emotion- focused coping strategies employed, two coping
strategies employed were unique to each child. In the case of Child 1, he projected blame
and Child 2 withdrew from potentially stressful situations.

CATEGORY: PROJECTING BLAME

Table 4.22 Definition, indicators and exclusions related to the category projecting
blame (pre-intervention)
Definition

To project or attribute (inner conflicts or feelings) to external circumstances and

Indicators

Exclusions

causes (American Heritage Dictionary, 2000)

All the instances from the raw data where participants made use of phrases
such as externalises, blames others, its because of, were considered to
be descriptive of this theme.
Instances when the participants referred to use as an excuse, justify, holding
back, internalises were considered unrelated to this theme. It is noted that
although there are resemblances between them, they were broken up for the
purpose of this study.

Table 4.22 provides a definition of projecting blame as well as the indicators and exclusions
used during data analysis to determine the constituencies of this theme. In the case of Child
1, projecting blame was noted primarily within the therapeutic environment and the
classroom. Therapist 1 noted that Child 1 was acutely aware of the influence of the
environment on him, explicitly stating that he did not readily accept his influence on his
environment. All three of Child 1s therapists were unanimous in agreeing that he projected
blame to avoid accountability of inappropriate behaviour (which could possibly result in
reprimand). This category is supported by the following quotations regarding Child 1:

I think that he also externalises a lot in that he blames others (Therapist 1, unit
3, 4)

its other peoples problem or responsibility. (Therapist 1, unit 4)

He doesnt accept it within himself. (Therapist 1, unit 4)

when he misbehaves he says you know Im ADHD so maybe I didnt take my

medication today so thats why Im naughty (Educator 1, unit 7)

he has insight into his environment and the influences of it but he wont always
accept his role in it but um, and how he influences it at times (Therapist 1, unit 7)

then Ill reprimand him and hell say sorry ma'am, Im waiting for the medication to
work (Therapist 3, unit 7)

Sometimes he can use that to his advantage and tell you like I have ADHD so I
didnt take medication today (Educator 1, unit 7)

It would make me very happy if you did not give me any homework. (Child 1, unit 7)

CATEGORY: WITHDRAWAL
Table 4.23 Definition, indicators and exclusions related to the category withdrawal
(pre-intervention)
Definition
Indicators

The act of or process of withdrawing (Wordnet.com)

All the instances from the raw data where participants made use of phrases

Exclusions

such as inhibit, take the back seat, doesnt venture, holds back, praying for
the bell, withdraw, step back, pulls back, sit and see, inhibited were
considered to be descriptive of this theme.
Instances when the participants referred to avoid were considered unrelated
to this theme. It is noted that although there are similarities between them, they
were broken up for the purpose of this study.

Table 4.23 provides a definition of withdrawal as well as indicators and exclusions used
during data analysis to determine the constituencies of this theme. Child 2s mother and all
three of his therapists reported that his behaviour was characterised by withdrawal. They
reported withdrawal to be a consequence of him fearing failure. Two participants stated that
Child 2s fear of failure (and consequent withdrawal) could be a result of an awareness of his
inabilities. Furthermore, Therapist 5 suggested that Child 2s withdrawal may manifest in
inhibition in a group situation. This category is supported by the following quotations
regarding Child 2:

you ask him what do you think you know he wont freely say I think this could be
a solution you know like he will wait to hear if someone else comes up with a
solution. I think hes also afraid of getting negative feedback in case its wrong you
know. (Therapist 6, unit 1,2,4,5)

inhibits himself in case he makes a mistake so hed rather take the back seat
rather than be spontaneous and make a mistake. (Therapist 5, unit 1,2,4,5,11)

he doesnt venture (Therapist 6, unit 1,2)

he always wants to be the fifth person and there are four people in the group
(Therapist 5, unit 1,2,4,5)

I think that he is aware and thats why he holds back (Therapist 5, unit 1,9)

him knowing his inabilitiesI think hes good understanding of where he is and
thats probably making him withdraw himself and thats probably his way of coping
and dealing with his stress. (Therapist 4, unit 1,2,9)

step back as a way of coping (Therapist 4, unit 1,9)

he would rather withdraw himself . (Therapist 6, unit 1,9,11)

puts a lot of pressure of him like with stress because then he like sort of pulls
back (Parent 2, unit 2)

like change of environment...hell sort of just wait a while and see what it brings
out but he wont just like adapt easily. Like if we were to visit just a stranger or a friend
of mine. He would first sit and see before he plays with other children (Parent 2,
unit 2,5)

when he stress, he sort of like just goes quiet and pulls back. (Parent 2, unit 2)

I think (child 2) is inhibited- his spontaneity is inhibited occasionally the topic

overwhelms him and then you see glimpses of his potential is so exciting for him
that he blossoms and shows his potential but unless the intention and the motivation
of the topic overwhelms him, then he forgets himself so to speak, and he is generally
quite inhibited and hell take the back seat and I thinkits not a laziness, hes a very
obliging and cooperative kid but its aathere is an attitude of um, like, to inhibit
himself in case he makes a mistake so hed rather take the back seat rather than be
spontaneous and make a mistake. (Therapist 5, unit 2,3)

4.3.1.1 Discussion of the baseline results

At the pre-intervention assessment it appears that both participants had limited connections
with their intrapersonal realms. This limited awareness into their self-concept seemed to
result in the use of passive aggression and active aggression in response to stressful
situations. These coping strategies impacted negatively on their interpersonal functioning. In
this regard, they had difficulty in being tolerant and flexible in group situations, did not always
use effective social skills and responded negatively to criticism. As a result of poor
intrapersonal and interpersonal competencies, they seemed to struggle with identifying,
communicating and expressing internal and external causes of stress, which again
influenced their ability to interact with others. Thus, it appeared that their limited self-concept
awareness resulted in less effective emotion- focused coping strategies.

4.3.2. Results of the thematic analysis: Post-intervention

In total, seven subthemes were identified through thematic analysis. As was done in the
baseline assessment, subthemes have been grouped together into three themes; selfconcept awareness, adaptive emotion- focused coping strategies and maladaptive emotionfocused coping strategies. Table 4.24 outlines the results of thematic analysis conducted,
indicating the frequency of the subthemes that were reported.

Table 4.24 Results of the thematic analysis indicating emotion-focused coping and
self-concept awareness themes, subthemes and categories: Post-intervention
THEME 4: SELF-CONCEPT AWARENESS (POST-INTERVENTION)
Subthemes

Categories

4.1 Knowledge of and insight into the self-

Self-awareness (22)11

concept

Self-confidence (8)

4.2 Skills to interact with others

Positive interactions with others (3)

Negative interactions with others (6)

4.3 Knowledge of the importance of

Identification and expression of feelings (4)

growth and change

Demonstrating effective ways of responding to others when

under stress
(4)

THEME 5: ADAPTIVE EMOTION-FOCUSED COPING STRATEGIES (POST-INTERVENTION)

5.1 Use of relaxation methods
5.2 Re-examining situations from another
perspective
THEME 6: MALADAPTIVE EMOTION- FOCUSED COPING STRATEGIES WHICH
REMAINED MALADAPTIVE (POST-INTERVENTION)
6.1 Direct, active physical aggression

Physical aggression (8)

6.2 Direct- passive aggression

Projecting blame (3)

Withdrawal and avoidance (17)
Internalising (3)

The following discussion presents the results of thematic analysis depicting emotion-focused
coping strategies and self-concept awareness of children with ADHD post-intervention.

THEME 4: SELF- CONCEPT AWARENESS (POST-INTERVENTION)

Eight participants commented on Child 1 and Child 2s level of self-concept awareness.

Three participants commented on the definition of self-awareness as having an accurate
understanding of ones strengths and weaknesses. This theme consists of three subthemes;
(4.1) knowledge and insight into the self-concept, (4.2) interactions with others and,
(4.3) knowledge of growth and change.

SUBTHEME 4.1: KNOWLEDGE AND INSIGHT INTO THE SELFCONCEPT

As was the case in the discussion of baseline results, self-confidence and self-awareness
are categories which form part of the subtheme knowledge and insight into the self-concept
during post-intervention assessment:
CATEGORY: SELF- AWARENESS

Post-intervention findings suggest a marked increase in Child 1s self-awareness and

self-confidence. Four participants reported that Child 1 was more self-aware not only of his
limitations, but also of his positive and negative characteristics (refer to Figure 4.6) seemingly
resulting in a more positive self-image and greater sense of self-confidence. This theme
emerged in both the home and school environment. Most of the participants reported that
Child 1 was more aware of his strengths, his weaknesses and his ADHD symptoms. This
greater self-concept awareness possibly signifies one way in which Child 1 came to a greater
understanding of the manner in which his cognitive appraisals informed his self-concept and
the extent to which his self- concept influenced his behaviour both positively and negatively
thus informing his choice of emotion-focused coping strategies (Ginorio, Yee, Banks and
Todd-Bazemore, 2007). Child 1 started to more readily accept personal responsibility for his
actions, allowing him to gain perspective on and positively appraise the situation. Having this
insight seemed to motivate Child 1 to persevere at reaching his goals. He was also more
aware of the impact of his ADHD symptoms on his behaviour which allowed him to attain a
more balanced view of situations. Most of the participants stated that Child 1 was more
aware of his short-term and long-term goals and was motivated and determined to reach
them. Thus, findings suggest that post-intervention Child 1 possessed a healthy self-esteem
and sense of self-competence.

Surprisingly Child 1 transferred this awareness into everyday settings despite his impaired
executive functioning. This result challenges the more traditional conceptualisations of ADHD
which advocate that deficient cognitive constructs and capacity result in defective behaviour
(Steer, 2007). This finding illustrates that the possibility exists that by developing cognitive
regulation interventiongies as a means of altering thoughts, ideas, assumptions, selfcommunication, basic philosophies (and therefore cognitive structures and appraisals) that
people use for themselves, others and situations (Ebershn, 2006: 69), Child 1 was able to
exercise self-control by inhibiting responses and regulating behaviour through the use of
inner speech; working memory and control of emotions; and more effective communication
and problem-solving (Wicks- Nelson et al. 2000).

This category was supported by the following quotations and visual data regarding Child 1:

I dont know if its because hes growing up, but he has done a lot of growing up in
the last two months um yeah he knows more about himself, he knows what he wants,
and hes quite determined about getting what he wants now. I think he knows he
knows hisnot his boundaries, his not his limits, he knows hes goals (Parent 1,
unit 9)

what he wants to do in the long-term (Parent 1, unit 8,9)

I think that he definitely has a greater awareness (Therapist 2, unit 9)

he is somewhat better informed I think. (Therapist 1, unit 9)

obviously aware of it (ADHD) and hes aware it influences his behaviour

(Therapist 3, unit 9,13)

I think that hes self-aware, he knows what its about and how it influences him
and that helps him to deal with it and put it into perspective. (Therapist 1, unit 9)

because of his self-concept, almost motivates himself (Therapist 2, unit 9)

he knows hell say, look maam, I know that I am good at this and he does
well hell say I know how to do this and hell do it (Therapist 3, unit 8,9)

and he knows what hes not good at either. (Therapist 3, unit 9)

Figure 4.612: Child 1 exploring his positive and negative characteristics.

With reference to Child 2, four participants reported that despite having a basic
understanding of his strengths, limitations and ADHD diagnosis, Child 2s depth of selfawareness remained inadequate. Results of the study indicate that Child 2s selfawareness seemed to decrease. One of the contributing factors to this could be that he had
been refusing to take his medication for approximately one month prior to the postintervention assessment. The assumption is that this could have been his way of assuming
control over a seemingly overwhelming situation. The lack of control experienced by Child 2
seemed to result in diminished ability to adequately cope with stress (Ebershn, 2006).
Ginorio, Yee, Banks and Todd-Bazemore (2007) support this notion, stating that the child
who copes poorly with stress tends to feel less in control of his life. The lack of control results
in behaviour characterised by learner helplessness. Child 2s continued use of maladaptive
emotion-focused coping strategies such as passive-active aggression (internalising,
withdrawal, avoidance, refusal to speak and learned helplessness) manifested in an
over-reliance on social support, underachievement, a lack of perseverance, heightened
physiological arousal, anxiety and frustration (Gonzales & Sellers, 2006).

Bandura (1997)

supports this finding adding that children (such as Child 2) engage in activities where they
experience a sense of competence, and avoid situations they appraise as difficult and
overwhelming (Schunk, 1981; Schunk & Hanson, 1985; Schunk, Hanson, & Cox, 1987 in
Pajares & Schunk; 2001). Possibly Child 2 appraised many situations in this way resulting in
his use of maladaptive emotion- focused coping strategies. This inadequate self-awareness
seems was a more profound limitation in post-intervention assessment than it was
during the baseline assessment.
Child 2s educator and therapists further reported that his difficulty to use metacognitive
strategies severely impacted his ability to become more self-aware and to employ different
emotion- focused coping strategies. This is supported by Contugos (1995) study which
found that children with ADHD have limited coping capacity as a result of impaired executive
functioning which results in an avoidance of affect-laden stimuli, difficulties with self and
interpersonal perceptions and problems with social reality perception. These reports are
supported by Wicks- Nelson et. al. (2000) who state that impairments in executive
functioning result in cognitive deficits which manifest behaviourally in difficulties such as the
regulation of behaviour through the use of inner speech; working memory and control of
emotions; problem-solving and effective communication- all of which are explicitly linked to
self-control. Thus, findings support Steers (2007) conceptualisation of ADHD being a
disorder characterised by impaired executive functioning which sees children engaging in
negative self and situational appraisals, impairing their motivation and perseverance and
ultimately employing coping strategies which result in deficits in functional behaviour
influencing his intrapersonal and interpersonal functioning (Bos, Schumm & Vaughn, 2003).

This category is supported by the following quotations regarding Child 2:

I dont think that he has the meta-cognitive abilities to actually conceptualise the
self (Therapist 5, unit 9)

He just 'is' you know he is as opposed to doing it. (Therapist 5, unit 9)

There is no process of thinking of ways to cope with the stress (Therapist 4, unit 2)

he lacks the metacognition process to process his own little world and then get the
skills. (Therapist 4, unit 9)

hes not one of those kids that runs for therapyhe doesnt have that process of
'metacogniscising'. (Therapist 5, unit 9)

so theres a lack of metacognition you know he was aware not to say the swear
words (Therapist 5, unit 9)

Hell say oh, Im good at this and hell do it (Educator 2, unit 8, 9)

I think he knows that theres something because he takes meds (Therapist 4, unit
9, 13)

Im not sure he does (self-concept awareness influence his coping)cause he

doesnt have that metacognitive- I wouldnt say skills- but he hasnt had someone
do a lot of reflection for him (Therapist 5, unit 9)

he seems to be unaware or isolated from his own metacognitive or cognition

(Therapist 4, unit 9)

know if hes really got an idea of what ADHD is all about but also in a way he does
because my sisters child is also like a very busy child and he sees to him I think you
need Ritalin so in a way I think that he does but not to the full extent at times he
said because he cant keep still (Parent 2, unit 10, 11, 13)

In contrast to Child 1s improved intrapersonal and interpersonal efficiency, Child 2s mother

further reported that Child 2 harboured a negative self-image. She believed the negative selfconcept to result from feelings of insecurity and a low self-esteem. She further reported that
as a result of his poor self-image, Child 2 negatively appraised situations before actually
engaging with them. This category is supported by the following quotations regarding Child 2:

its a lot of insecurities and I would say low self-esteem (Parent 2, unit 1)

(when asked if poor self-image influences ability to cope) I think it does he hasnt
done it and hes already seen the negative side of it or whatever (Parent 2, unit
1,2)

CATEGORY: SELF-CONFIDENCE
Child 1s heightened level of self-concept awareness seemed to contribute to a greater
sense of self-confidence. Child 1 found academic activities increasingly important. As an
example he set goals for himself which he wanted to achieve. Child 1s mother stated that his
self-confidence kept him motivated when working towards actualising his goals, and working
through aligned obstacles. As a result of seemingly more positive self-appraisals, he
apparently similarly appraised situations more positively (possibly believing that others
similarly appraise him positively). This increased sense of self-confidence eliminated Child
1s concern in anticipating negative outcomes of meetings (such as parent feedbacks). This
category is supported by the following quotations regarding Child 1:

he knows hes goals and hes not scared to fight for it anymore and his selfconfidence has improved. (Parent 1, unit 8,9)

I think he has more self-confidence now than what he had (Parent 1, unit 8)

this is who I am, you either like me or you dont like me (Parent 1, unit 8, 9, 11).

he thinks hes brave, which he is. I mean, hes not shy (Parent 1, unit 8,9,11)

I said to him that I was going to be seeing his mother now and he said that of
course I will only say nice things about him (Educator 1, unit 8)

when I talked about the feedbacks he said I hope I had only good things about him
at home that that I only had good things to say about his work, him at school, his work
and how he is behaving (Educator 1, unit 8)

he wasnt worried about it (parent feedbacks) (Educator 1, unit 8)

very much a take me as I am (Therapist 3, unit 8,9,11)

he wants to do well in school. (Parent 1, unit 8,9)

SUBTHEME 4.2: SKILLS TO INTERACT WITH OTHERS

Positive interactions with others and negative interactions with others are categories
which form part of the subtheme interactions with others:

CATEGORY: POSITIVE INTERACTION WITH OTHERS

The manner in which Child 1 interacted with and responded to others under stress was
influenced by greater intrapersonal efficiency. As a result of greater self-awareness, a
more positive self-image and greater self-confidence, three participants reported that
(instead of aggressively responding to criticism) Child 1 responded by ignoring what was
said, verbally responding, as well as articulating his view of a situation. This category is
supported by the following quotations regarding Child 1:

He answers back if there is something that needs to be answered or he just

ignores the whole thing saying that thats fine and that it doesnt matter (Educator
1, unit 5,8)

they were all accusing each other of things and some of them were accusing him
of teasing him and he just said its not true what you say and I cant identify myself
with that and thats not how I meant what I was doing to come over kind of like thats
your problem if thats how you view it (Therapist 3, unit 5,9,10,12)

he does get very defensive if someone accuses him of things that he didnt do. He
gets quite offended. (Therapist 1, unit 5,12)
CATEGORY: NEGATIVE INTERACTIONS WITH OTHERS

Two participants reported that Child 2 continued to be inappropriate and bold during
socialisation with his friends. When outside his small circle of companions, it was reported
that Child 2 still tended to withdraw. Therapist 5 stated that Child 2 continued to be overly
involved in his own world. Seemingly this sustained withdrawal resulted in Child 2 continuing
to experience difficulty in engaging with others. This category is supported by the following
quotations regarding Child 2:

hes very cheeky with his peers (Therapist 5, unit 11)

it was very inappropriate (Educator 2, unit 11)

I think that in a group situation he tends to mind his own business when hes in a
group of two and two then he interacts but its usually if he has a partner with him.
(Therapist 5, unit 8, 10, 11)

he doesnt really bear a grudge (Therapist 5, unit 5,10,12)

Hes more in his own world although hes got friends. (Therapist 5, unit 11)

in his own little worldhes not in that relationship with the other. (Therapist 5,
unit 9,11)

SUB-THEME 4.3: KNOWLEDGE OF THE IMPORTANCE OF GROWTH AND CHANGE

The identification and expression of feelings and demonstrating ways of responding to

others when under stress are categories which form part of the subtheme knowledge of
the importance of growth and change:
CATEGORY: IDENTIFICATION AND EXPRESSION OF FEELINGS
Parent 1 reported that as a result of her sons increased self-awareness and selfconfidence, he demonstrated the ability to identify and express his feelings to significant

others. This theme is supported by the following quotations and visual data regarding Child
1:

but I said that then you must go and speak to Mr. xxxx and tell him how you feel
that you think its not fair and that you have to do homework for everyone else
(Parent 1, unit 3)

Figure 4.713: Child 1 using a feelings chart to identify and express the happy, sad and
angry feelings in response to significant experiences.

CATEGORY: DEMONSTRATING EFFECTIVE WAYS OF RESPONDING

TO OTHERS WHEN UNDER STRESS

Child 1 seemed to have developed greater respect for the feelings and beliefs of others
which he communicated through empathy. This impacted on the way he responded to
others when under stress, which was markedly different to the manner in which he
responded pre-intervention, namely through the employment of aggression. Results further
suggest that through a heightened self-concept awareness and greater intrapersonal
efficiency, Child 1 increased his external interpersonal behaviour skills (a pre-existing
strength). These interpersonal skills seemingly resulted in increased social support from
significant others, namely his mother, educator and therapists (Bos, Schumm & Vaughn,
2003). Therapist 1 mentioned that Child 1s tolerance for criticism seemed to have increased

(he employed relaxation methods and positive re-appraisal of situations autonomously).

However, Child 1 continued react aggressively if stress was ongoing. This category is
supported by the following quotations:

he said its ok mom, we understand these things, you were working which is
wow whereas before, he would have had a rant and a rave and a its not fair, you
dont love me kind of thing. (Parent 1, unit 10,11)

he said its ok mom, we understand these things, you were working he was
able to think through ok mom is working, I cant bug her- although it was really
something that he needed (Parent 1, unit 10,11)

its ok mom, you dont have to waste your money (Parent 1, unit 10,11)

He knows financially sometimes its a struggle and like if I want to go and buy him
a McDonalds, hell say its ok mom, you dont have to waste your money he
knows when theres no money or whatever he knows. (Parent 1, unit 10,11)

we were discussing feelings and he discussed anger and he discussed the time
when a child bad mouthed his mother and he said that sometimes its not better to
hurt people and that there are other ways other than hitting to get out your anger he
has learnt that thats not how to go about things. (Therapist 2, unit 5,9,11)

I find that he doesnt react as quickly in stressful situations I get the impression
that you need to push him further now a days to get that reaction from him (Therapist
1, unit 5,12)

THEME 5: ADAPTIVE EMOTION-FOCUSED COPING STRATEGIES (POST-INTERVENTION)

Four participants reported that Child 1 attempted to make use of adaptive emotion- focused
coping strategies. No reports were made about Child 2 attempting to use adaptive emotionfocused coping strategies. This theme consists of two subthemes; (5.1) use of relaxation
methods in order to (5.2) examine the situation from another perspective. The
subthemes which make up this theme are now discussed.

SUBTHEMES: 5.1 USE OF RELAXATION METHODS IN ORDER TO 5.2

RE-EXAMINE A SITUATION FROM ANOTHER PERSPECTIVE

Child 1 was more able to regulate his emotional reactions to situations through the
autonomous employment of relaxation methods. With greater emotional regulation, he
identified and assertively expressed his emotions without apprehension (avoiding physically
aggressive reactions). Post-intervention Child 1 had a well- developed understanding of the
reciprocity between himself and his environment (i.e. when others tease him, his mother
working night shifts). Results indicate that this interactional awareness facilitated his use of
different, more effective, emotion- focused coping strategies. In this regard, he ignored
others when they teased him (detaching from the situation for long enough to regulate his
emotional reactions) and re-appraised a potentially stressful situation (i.e. acknowledging the
demands of his mothers occupation and learning to accept it). The above mentioned findings
are supported by Mischaras (2007) study which found that children have the capacity to
become aware of the manner in which coping strategies are chosen by understanding the
situation as well as personal resources and habits. Through increased self-concept
awareness (when confronted with a potentially stressful situation) the child is better able to
identify and rely on his inner resources to effectively problem-solve and confront the
situation. He further stated that such empowerment formed the foundation of effective
emotion-focused coping (Mischara, 2007).

This category is supported by the following quotations regarding Child 1:

what I did I just leave him to calm down he went back to fetch his chair, I didnt
even tell him to stop, I kept quiet and carried on with whatever we were doing in
class (Educator 1, unit 2,4,5,12)

he said that you should rather sit down and calm yourself down and think about the
situation first (Therapist 2, unit 9,12)

I think if theres an opportunity to think about it, then he can regulate it. (Therapist
1, unit 2,3,4,5)

he just needs someone to calm him down (Therapist 2, unit 2,4,5,12)

hes not afraid to tell people how he feels now (Parent 1, unit 8,9)

he doesnt go for second best anymore (Parent 1, unit 8,9,11)

we were discussing feelings and he discussed anger and he discussed the time
when a child bad mouthed his mother (Therapist 2, unit 5,9,11)

Child 1 demonstrated the ability to employ relaxation methods (which seemed to be a

precursor for re-appraising potentially stressful situations) (refer to Figure 4.7). Three
participants reported that Child 1 was able to examine situations from another perspective in
order to create a more positive outlook. However, for the majority of the time, Child 1 needed

support from significant others to re-appraise situations. Based on the reports of Child 1s
therapists and educator, much of Child 1s re-framing took place after conflict situations. This
subtheme is supported by the following quotations and visual data regarding Child 1:

I said to him you know, dont get so upset because he doesnt know me, he
doesnt know what goes on so it doesnt bug me so it shouldnt bug you (Parent 1,
unit 2, 5)

you know, I dont like my father, he put me very close to the geyser and it was too
hot What was he thinking? Does he think that Im an animal? And there was
another guy who said no, that area is very cold your father actually cares about you
and its not like temperatures in South Africa, its very cold there and your father
knows that youre going to be very cold if he puts you away from where the geyser
room then he said ok, I didnt know that your father actually cares about you
because he knows that you are from South Africa and that youre going to feel to cold
there on the other side (Educator 1, unit 1, 5, 12).

think about the situation first (Therapist 2, unit 9,12)

I think that hes self-aware, he knows what its about and how it influences him
and that helps him to deal with it and put it into perspective. (Therapist 1, unit 9)

THEME 6: MALADAPTIVE EMOTION- FOCUSED COPING STRATEGIES WHICH REMAINED

MALADAPTIVE (POST-INTERVENTION)

Table 4.25: Definition, subthemes, indicators, exclusions and exceptions related to the
theme maladaptive emotion- focused coping strategies which remained maladaptive
(post-intervention)

Definition

Under some conditions, the experience and expression of emotion may bring
negative consequences (Lopez, Shane, Snyder, 2002)
Subthemes Direct- active physical aggression in response to stressful situations (physical
aggression), indirect- active physical aggression in response to stressful
situations (heightened physiological arousal) and passive- active physical

Indicators

Exclusions

Exceptions

aggression in response to stressful situations (withdrawal, internalising,

projecting blame, avoidance, helplessness).
All the instances from the raw data where participants made use of phrases
such as outbursts and totally loses it, throws things around, throws a
wobbly, pulled off, goes to aggression, sometimes uses violence, Ill beat
you up, kicking, attack, climbed into, anger, aggression, eyes, face,
tizz, flapping around, he starts crying, gets very emotional, cries out of
frustration, irritable, totally overwhelmed, gets very upset, justify his
shortcomings, struggles, holding back, excuse, blames others, its
because of, see what my reactions are, anything that he is told he is, oh,
Im so stupid, internalises it, someone says, bully, kicking, muscles are
tense, gets emotional, sad, inhibit, withdraw, pulls back, takes the back
seat, doesnt venture, pray for the bell, step back, sit and see, inhibited,
feedback from others, what theyre saying, they hear, the messages that
they get, other peoples responses, avoid, shows indifference,
psychosomatic symptoms such as head aches, tummy aches, excuses were
considered to be descriptive of this theme.
Instances when the participants referred to examines the situation from
another perspective, social support, use of relaxation methods, asks for
assistance, gets the support, this is what I must do, no youre not, no but,
self-soothing and acceptance were not considered part of this theme. It is
noted that although there are similarities between them, they were broken up
for the purpose of this study.
This refers to responses such as hyper, without thinking, impulsive,
restless which more than one of the participants indicated, but which do not
fall directly within this theme.

Table 4.25 provides a definition of maladaptive emotion-focused coping strategies which

remained maladaptive, the subthemes which made up this theme as well as the indicators
and exclusions used during data analysis to determine the constituencies of this theme and
exceptional responses to this theme. As was the case in the discussion of baseline results,
direct- active physical aggression and direct- passive physical aggression are
subthemes which forms part of maladaptive emotion-focused coping strategies which
remained maladaptive during post-intervention assessment. These subthemes are now
explored in detail regarding Child 1:

SUBTHEME 6.1: DIRECT- ACTIVE PHYSICAL AGGRESSION

Physical aggression is a category which forms part of the subtheme direct- active physical
aggression:
CATEGORY: PHYSICAL AGGRESSION
Child 1s Therapist 3 reported that Child 1 still responded defensively to criticism which he
may have experienced as unfounded and inaccurate. Two participants reported that Child 1
still reacted to others with direct- active physical aggression on occasion. In this regard,

Child 1s mother stated that his tendency to react assertively towards others with directactive physical aggression may be attributed to Child 1s increased self-confidence. This
category is supported by the following quotations regarding Child 1:

he still fights a lot he still gets very angry... I dont know if he knows how to handle
that yet but hes better than when he used to cry just sit down and cry, but thats a lot
better. I dont know if its a good thing- hes moving from withdrawal to aggression.
(Parent 1, unit 3,4,5,12)

I think because he has more self-confidence now than what he had- I suppose
that thats where the aggression is coming from now because he feels good about
himself and he thinks that nobody can stop him (Parent 1, unit 3,4,5,12)

I think the aggression is just- he cant control it(Parent 1, unit 1,2,3,4,5)

he was very angry, very very angry he pushed the buttons (Therapist 1, unit
4,5,12)

he was provoked really badly so he (educator) allowed for him to carry on,
obviously not to hurt anyone, but he must go through his emotions and then he
settled after that (Parent 1, unit 2,4,5)

I think he was trying to protect me, because it was all about me (Parent

1, unit 4,5)

if people persist with it, he gets angry then he really loses it (Therapist 1, unit
3,5,12)

if you push him and theres no reason, then hes going to snap. (Therapist 1, unit
4,5,12)

SUBTHEME 6.2: DIRECT- PASSIVE AGGRESSION

Projecting blame is a category which forms part of the subtheme direct- passive physical
aggression:

CATEGORY: PROJECTING BLAME, WITHDRAWAL, AVOIDANCE

AND INTERNALISING
Two participants referred to instances in which Child 1 still projected blame. Projecting
blame was noted primarily within the therapeutic environment. Both participants reported that
Child 1 was acutely aware of the influence of his ADHD symptoms on his behaviour, often

using this awareness as a means to justify his behaviour (thus possibly avoiding reprimand).
This category is supported by the following quotations regarding Child 1:

on a Monday morning, he will say that his Ritalin isnt working yet (Therapist 3,
unit 7,13)

Im ADHD wait till it (medication) starts to work and then Ill be better (Therapist 3,
unit 7,13)

Hell come into your class after second break and hes laughing and giggling and hell
say its because of my ADHD maam (Therapist 2, unit 7,13)

With the exception of indirect- passive verbal aggression, Child 2 maintained his coping
repertoire, namely dominant emotion-focused coping strategies (direct- passive physical
and indirect- passive verbal aggression).

The coping strategies employed by Child 2 continued to distance him from his support
structures. In this regard, his mother reported feelings of frustration at his persistent
challenging and avoidance, whereas his educator ignored him when he refused to work.
This finding is supported by Rutherford (2007) who postulates that significant others do not
have an accurate understanding of the cause and consequences of the behaviour exhibited
by children with ADHD, resulting in judgement and subsequent punishment through
exclusion. The thoughts and feelings related to exclusion are internalised by the child with
ADHD, leaving him believing that despite his greatest efforts, he can do little right
(Rutherford, 2007). Iwasaki (2007) supports Rutherfords (2007) assertion that through
exclusion from formal and informal social situations, the child seems to have a limited
network of leisure-related friends, which provides him with little opportunity to experience,
and be empowered by, the social and esteem support provided by such a network. Thus, he
does not have the opportunity to gain esteem or social support thus perpetuating feelings of
isolation. Such negative interpersonal outcomes seem to re-inforce a negative self-concept,
limited efficacy and a limited coping repertoire making school a place of little pleasure;
negatively influencing performance and achievement therein (Wicks-Nelson et al. 2000).

Chid 2 continued to internalise, withdraw and avoid. Child 2 remained sensitive to the
opinions and feedback of others, continuing to internalise the appraisals of others and
isolating himself from others. This theme is supported by the following quotations regarding
Child 2:

with the school stuff theres also the kind of thing like what did the teacher say?
Am I good am I not good (Parent 2, unit 5, 11)

like the other day when I said to him youre just becoming impossible he wrote a
note and said I think that I should move out of the house and I said why do you want
to move out of the house and he said that its because you said that I was
impossible (Parent 2, unit 1,5)

hell say that its because you dont love me anymore and I say that its not
because I dont love you, its because youre doing things wrong (Parent 2, unit 1,5)

When child 2 felt unable to successfully engage with a task or when part of a larger group, he
still attempted to avoid possible negative outcomes by withdrawing from situations. This
avoidance and withdrawal manifested behaviourally in him refusing to speak/ respond,
fidgeting or physically withdrawing from the stressful situation. This category is supported by
the following quotations regarding Child 2:

when he cant do anything, hell draw back and sit there and not say anything
(Educator 2, unit 1,2,9)

on his own, he tends to mind his own business. (Therapist 5, unit 1,11)

sounds like he withdraws (Therapist 4, unit 2)

there would be nothing to protect him emotionally but instead of finding a coping
strategy that could help him in that situation, he just withdraws (Therapist 4, unit 2,
9)

he just pulls back. (Parent 2, unit 1,2)

when he gets reprimandedgoes to his room and either plays on his own or
talks (Parent 2, unit 2, 5)

So as opposed to handling it, he would rather move away from it (Parent 2, unit 2)

with me he sulks he knew that he couldnt do it and that it was a lot of work and
then he chose to do nothing about it and just lie on his arms and sulk. (Educator 2,
unit 2,3,9)

hes falling asleep in class too now we dont know if its the medication or if its
stress. (Therapist 5, unit 2, 9)

he avoids the writing in my therapy, sometimes he avoids the writing he just

doesnt get started (Therapist 5, unit 2)

hes been hiding his meds (Therapist 5, unit 1)

theres the sulking about what has just happened but not about what happened
yesterday (Therapist 5, unit 2,3,11)

when a situation would be um challenging tasks like a little bit overwhelming he

sulks (Educator 2, unit 2,3)

also complex verbal instructionshe doesnt process them accurately (how

deal with that) delay tacticssometimes he plays with the things around him and with
his hands and stuff. (Therapist 5, unit 2,3)

if he knows that hes done something wrong and he gets a reprimand, then he
sulks (Parent 2, unit 2,5)

he just cant handle it because like I said he just shuts down completely or hell
just decide to have a nap or hell decide to watch TV you know that sort of like
soothing and his way of coping with things (Parent 2, unit 1,2)

then well go are you sulking again and is there something wrong and hell say no
but hes definitely sulking (Parent 2, unit 2,3,5)

Child 2 remained reliant on maternal support in being able to deal with stressful situations
that he was unable to avoid or withdraw from. This supported by the following quotations:

if hes in a strange environment then that is stressful for him. Hell want to come
lay on you or hell want attention or something (Parent 2, unit 2)

4.3.2.2. A Comparative Discussion of the results that emerged: Post-intervention

Post-intervention findings indicated that Child 1 continued to use physical aggression in
response to actions and deeds of others. However, the latter coping strategy was reportedly
used less often (and often used as a last resort to dealing with feelings of frustration and
anger). It was not reported that the Child 2 continued to use physical aggression. This may
be due to him discontinuing his medication. He subsequently relied more on passiveaggressive coping strategies. Child 1s use of passive- aggressive strategies apparently
decreased dramatically. Both children used relaxation methods in order to regulate their
emotions, however Child 2 to a lesser degree than before. Furthermore, Child 2 continued to
make use of external support structures to communicate and work through stressful
situations. Child 1 demonstrated greater levels of self-awareness. In this regard, he was able
to identify and express feelings associated with significant events (with both positive and
negative attributes). His better developed ability to assertively express his feelings seemed to
have contributed to a greater sense of self-confidence, which saw him setting goals for
himself and putting in plans to achieve them. The heightened level of intrapersonal
awareness in Child 1 seemingly permeated into the interpersonal realm as he seemed aware
of others emotional states.

Child 2 seemed less able to communicate and work through stressful experiences with
social support. In addition, Child 2 seemed more withdrawn. Avoidance became a more

prominent coping strategy. Child 2s coping strategies could possibly be a result of

discontinuing medication.

4.4. Conclusion
This chapter provided a detailed discussion of the self-concept awareness and emotionfocused coping themes which emerged through thematic analysis of the data collected
during the study. The themes as well as subthemes and exceptions were presented and
discussed during both pre- and post- intervention. In addition to this, there was a discussion
about the relationship between the childrens self-concept awareness and emotion-focused
coping strategies employed both pre- and post- intervention. I will engage in a literature
control in the following chapter, as well as conclusions of the study and recommendations.

Chapter 5
Conclusions and recommendations

5.1 Introduction
In this chapter, I draw my study to a conclusion. I attempt to answer my research question,
after which i will conclude my study. Finally, I discuss the imitations and contributions of the
study with the chapter closing with recommendations for further research.

5.2 Discussion of findings

Findings of the study indicated that Child 1s self-concept awareness had increased, with this
awareness being transferred into a number of other settings despite his impaired executive
functioning. Child 1s increased self-concept awareness led to amplified use of adaptive
emotion-focused coping strategies (namely the use of relaxation methods and the reappraisal of situations). However, findings also indicated that maladaptive emotion- focused
coping strategies (namely direct- active physical aggression and direct-passive aggression)
remained.

In the case of Child 2 (who did not receive the intervention), no mention was made of him
employing adaptive emotion- focused coping strategies. He continued to employ maladaptive
emotion- focused coping strategies (namely direct- passive physical aggression and indirectpassive verbal aggression).

5.3 Addressing the research questions:

5.3.1. What is the association between self-concept awareness and emotion-focused

coping of children diagnosed with ADHD?
The findings of the study indicate that increased self-concept awareness positively impacts
on emotion- focused coping of the child participant with ADHD. Through the intervention,
Child 1 became more acutely aware of his strengths, assets, resources and limitations which
seemingly allowed him to arrive at a greater understanding of the manner in which he
influences and responds to his environment and visa versa. Greater self-concept awareness
also gave him insight into what motivated his behaviour and his response to situations. As
his self-concept awareness increased, so too did his ability to employ cognitive and
emotional regulation. This was a key factor in him decreasing the use of maladaptive coping
strategies (such as strategies reliant on direct- active and direct- passive aggression). This
improved cognitive and emotional regulation positively impacted on and re-structured the
childs behaviour. Increased self- concept awareness seemed to have contributed to
increased employment of adaptive emotion- focused coping strategies (relaxation methods
and the positive re-appraisals of events). In turn, increased adaptive emotion-focused coping
strategies resulted in stronger relationships with significant others. These relationships with
others were characterised by support, strength and positive regard, re-enforcing feelings of
optimism and control, and ultimately on the childs emotion- focused coping strategies
employed. Thus, the findings of this exploratory study confirm that a relationship exists
between self-concept awareness and emotion- focused coping in a child with ADHD.
Findings of the study also suggest the possibility that greater a childs self-concept

awareness, the more able he could be to employ more effective an adaptive emotionfocused coping strategies.

5.3.2. Sub-questions

To what extent were the children with ADHDs self-concept awareness

impacted on (or not) by the intervention?

Findings suggest that the intervention facilitated a more proactive involvement by Child 1 in
the identification, management and regulation of his thoughts, feelings and behaviour, giving
him a sense of control. The intervention explored and challenged pre-existing cognitive
appraisals of the self and of situations, which ultimately resulted in a heightened awareness
of the manner in which the self-concept is formed and how it influences his functioning.
Greater self-concept awareness seemed to be one way in which Child 1 came to a greater
understanding of the manner in which his cognitive appraisals inform his self-concept and the
extent to which his self- concept influences his behaviour both positively and negatively
(Ginorio, Yee, Banks and Todd-Bazemore, 2007). This resulted in greater intrapersonal and
interpersonal efficacy resulting in a growth in confidence, a sense of control and more of a
willingness to readily assume responsibility, despite demonstrating externalising behaviour
on occasion (Ebershn, 2006).

How were the children with ADHDs emotion-focused coping strategies

impacted on (or not) after the intervention?

Findings of the study confirmed that the two participants (children with ADHD) were
predisposed towards emotion-focused coping and were more inclined to employ emotionfocused coping maladaptively (keeping cognisant of the fact that emotion-focused coping
may be deemed adaptive as well as maladaptive). However, it is maladaptive emotionfocused coping which theoretically leads to negative feedback from significant others,
possibly resulting in negative self-appraisals and a negative self-concept formation. The
intervention developed Child 1s ability to engage in emotional, cognitive and behavioural
regulation - all of which are prerequisites for effective emotion-focused coping and
adaptation. Through heightened self-concept awareness, Child 1 was better able to employ
more adaptive emotion- focused strategies such as the employment of relaxation methods,
the positive re-appraisal of situations and the seeking of social support. Due to the
employment of more adaptive emotion-focused coping strategies, Child 1 fostered increased
social support and subsequent positive feedback through the relationships that developed,
thus resulting in more effective emotion- focused coping.

To what extent were children diagnosed with ADHD able to transfer the self-

awareness skills and knowledge acquired from the intervention into their everyday
interactions within the school and home?
An aim of the intervention was to allow the child with ADHD to internalise the intrapersonal
skills learnt and to apply them in a real life situation in order to confront and adapt to
stressors using effective emotion-focused coping. Findings of the study indicate that Child 1
was able to transfer the skills learnt from the intervention sessions into his everyday
interactions within the home and school environment, positively impacting on the manner in
which he approached situations and responded to others when under stress. Child 1s
mother described the change in her childs emotion-focused coping strategies as a
maturation, in that he was more acutely aware of his goals, strengths and limitations and
persevered to actualising them. This report was supported by Child 1s educator and
therapists. It was also noted that he explicitly shared accounts of his heightened self-concept
awareness and more adaptive emotion- focused coping strategies within the therapeutic
environment.

5.4. Conclusions of the study

The study confirmed that children with ADHD (in this study) cope with stressful situationsalmost exclusively- by employing both positive and negative emotion- focused coping
strategies. Maladaptive emotion- focused coping strategies employed by both participants at
several intervals were characterised by direct and indirect acts of aggression. Adaptive
emotion- focused coping strategies employed by both participants at various intervals
included the seeking of social support to communicate and work through stressful situations,
the employment of relaxation methods and re-framing stressful situations. During preintervention assessment, both children were only able to employ adaptive emotion- focused
coping strategies with the support of significant others. During post-intervention assessment,
Child 1 was more able to self-employ these emotion- focused coping strategies which
seemingly impacted positively on his feelings of personal control as well as on his
interpersonal relationships.

Findings of the study support the assumption that social support networks act as stress
buffers as they provided the boys with ADHD with affirmation and a sense of belonging. Preintervention, both child participants experienced problematic interpersonal interactions, the
outcome of which was them struggling to meaningfully bond with friends and maintain
friendships, resulting in them presenting with a low self-esteem and limited efficacy. This saw
the children form part of a limited social support network, particularly within the school
environment. Forming part of a limited support network possibly reinforced their belief that

they did not have the inner resources to cope with demanding situations thus evaluating
them as stressful (and employing ineffective coping strategies). The results of the study also
indicate that if children with ADHD perceive situations to be out of their control, they
seemingly employ avoidant, emotion-focused coping strategies. These appraisals apparently
result in learned helplessness, avoidance, internalising, externalising and withdrawal
(probably reinforcing their negative self-concept and sense of self-efficacy). However, the
intervention seemed apt in mediating a process of encouraging reflexivity, confirming
Ebershns (2006) claims that changes in self-concept due to greater cognitive awareness
and regulation results in changed situational appraisals and coping behaviour.

With greater intrapersonal awareness, Child 1 demonstrated a more realistic and accurate
understanding of his strengths, limitations and behaviours. This insight formed the foundation
for more effective interpersonal functioning which was demonstrated by him responding more
constructively to criticism; and more empathetically to the feelings and actions of others. This
behaviour possibly impacted positively on his self-concept and emotion-focused coping
which were also reinforced by stronger relationships with others (characterised by support,
strength and positive regard). These findings confirm the assumption that if a child with
ADHD is able to come to a greater level of personal competence (accurate self-assessment
and self-regulation) through increased self-concept awareness, he seems more able to
catch himself making inaccurate self-appraisals which negatively influence his choice of
coping strategies, and relationships.

When compared to existing literature on ADHD, self-concept awareness and emotionfocused coping, it is clear that because of an inability to inhibit responses and impaired
executive functioning, children with ADHD are likely to have limited self-concept awareness.
This limited self-awareness results in inaccurate self and situational appraisals and,
consequently, in the use of maladaptive emotion- focused coping strategies (which result in
deficits in functional behaviour influencing intrapersonal and interpersonal relationships).
However, results of the study indicate the possibility that children with ADHDs self-concept
awareness and emotion- focused coping can be positively impacted by an intervention that
focuses

emotional,

cognitive

and

behavioural

regulation.

This

finding

challenges

assumptions that impaired executive functioning (synonymous with ADHD) will always result
in deficits in functional, adaptive behaviour regardless of intervention, pharmaceutical or
therapeutic.

Thus, it seems as though a link exists between increased self-concept awareness and
positive changes in adaptive emotion- focused coping. The possibility exists that children

with ADHD may prefer to use relaxation methods and re-appraisals of situations as adaptive
emotion- focused coping strategies. Also, it seems as though children with ADHD are more
emotion- focused in coping with maladaptive emotion-focused coping remaining persistent
(even if self-concept awareness increases). These maladaptive emotion-focused coping
strategies may be maintained because of habitual patterns of coping being stronger and
more established than those that are newly acquired. So, although new adaptive emotionfocused coping strategies are acquired, existing maladaptive emotion- focused coping
remains unlearnt. The findings and conclusions drawn are all hypotheses as this was an
exploratory study. These hypotheses could be explored in further investigations.

5.5. Limitations of the study

The study focused on a specific group of participants, namely two male children with ADHD
being educated within a remedial school environment, and their respective mothers,
educators and therapists. The results therefore are gender specific. They do reflect the
responses of male children and their mothers, educators and therapists about the manner in
which self-concept awareness and emotion- focused coping reveals itself within this specific
context. The possibility exists that the responses received from participants about the selfconcept awareness and emotion- focused coping strategies of female children with ADHD
and children with ADHD (inattentive type) may be different. However, as this exploratory
study was qualitative from an interpretivist paradigm, the primary aim of the study was to
capture and reveal the voices of the participants, relating their perceptions about the childs
self-concept awareness and emotion- focused coping.

Furthermore,

the

Draw-A-Person

(D-A-P),

Kinetic-Family

Drawing

(K-F-D),

Brinks

Incomplete Sentences and the How is your self-concept inventory seemed inappropriate to
assess the self-concept awareness and emotion- focused coping of the child participants in
this study. Thus, I recommended that future research focus on the qualitative assessment of
the child participants self-concept awareness and emotion-focused coping possibly by
means of participant and non-participant observation (refer to 5.7.3).

5.6. Contributions of the study

Findings contribute to the following knowledge bases; children with ADHDs coping,
emotion- focused coping theory and self- concept awareness theory. Findings of the study
confirm that children with ADHD cope with stressful situations predominantly by employing
emotion- focused coping strategies, which seems to remain unchanged regardless of
intervention. This is significant when working with children with ADHD within the home and
school environment. As most literature places emphasis on the negative adjustment and

coping strategies of children with ADHD, my study contributes to existing literature on

emotion- focused coping strategies and how the use of these strategies can be adaptive as
well as maladaptive, particularly in children with ADHD. Furthermore, my study could
contribute to and extend on existing literature on therapeutic interventions designed to
facilitate coping in children with ADHD, with particular emphasis on the facilitation of coping
from a positive psychology, asset based approach. The findings of my study challenge
assumptions that impaired executive functioning (synonymous with ADHD) will always result
in deficits in functional, adaptive behaviour regardless of intervention, pharmaceutical or
therapeutic.

In addition, my study not only identified the childrens level of self-concept awareness and
the emotion-focused coping strategies employed, but explored each of the constructs in
detail. Each of the constructs were explored to come to a greater understanding of the
different contexts in which emotion- focused coping strategies were employed and how this
was related to Child 1s appraisals of self and the situation, which ultimately influenced his
cognitive and emotional regulation. Thus, I theorise that limited self-concept awareness
(manifesting in a lack of knowledge and insight into the self-concept which results in negative
interactions with others and a lack of personal change and growth) result in maladaptive
emotion- focused coping strategies (acts of aggression). However, increased self-concept
awareness (manifesting in a more thorough understanding of ones strengths, assets,
resources and limitations resulting in more positive interactions with others and personal
growth and change) results in the mployment of more adaptive emotion- focused coping
strategies (seeking social support in order to communicate and work through stressful
experiences, re-appraising stressful situations and the employment of relaxation methods).
As previously discussed, it appears that having insight into the child with ADHDs selfconcept awareness and emotion-focused coping strategies could inform the practices of his/
her educators, therapists and parents.

In terms of practitioner contributions, my study placed emphasis on the perspectives and

inputs of a number of stakeholders, each playing a fundamental role in scaffolding the
development of self-concept awareness and emotion- focused coping. Other than
contributing to theoretical findings, my study could inform the practices of professionals,
educators and parents in both remedial and mainstream schooling environments who are
searching for alternative interventions to make use of with the aim of equipping learners with
ADHD with adaptive emotion-focused skills within the classroom and school setting.

5.7. Recomendations

5.7.1. Recommendations for practice:

Based on the previous discussion, it is obvious that professionals working with children with
ADHD (including parents) could benefit from an understanding of a childs current level of
self-concept awareness and the emotion- focused coping strategies s/he employs within
various settings. Such insight may be especially important should one choose to make
adaptations to a coping- intervention to more acutely meet the needs of a child. By
understanding a childs current level of self-concept awareness and emotion- focused coping
strategies s/he employs, parents and professionals may be able to scaffold greater selfconcept awareness and adaptive emotion- focused coping within children with ADHD.

Furthermore, it is important to remain aware of the manner in which emotion- focused coping
strategies are developed and maintained within a family, school and peer system. One needs
to have an acute understanding of the demands made on a child within various settings and
how these may impact on his/her self and situational appraisals, as well as the emotionfocused coping strategies that s/he chooses to employ. Such perspective could enable one
to establish if emotion-focused coping strategies are adaptive for the individual child within a
situation, or leads to maladaptive coping. Such an intervention process requires close and
regular collaboration and communication between parents, educators and therapists.

5.7.2. Recommendations for Training

It could be beneficial for training programmes in the field of education and educational
psychology to include facets on emotion-focused coping strategies employed by children with
ADHD, and how these are impacted on by their self-concept awareness. Such knowledge
could equip those working with children with ADHD within the class and therapeutic
environment. Understanding why children with ADHD employ the coping strategies that they
do and how to support and scaffold the maintenance of existing adaptive emotion-focused
coping strategies and the acquisition of new, more adaptive emotion- coping strategies
seems a valuable training tool. In addition, knowledge in this regard could equip
professionals in communicating insights to parents to understand a childs intrapersonal
functioning, and how to support the process of greater self-concept awareness and emotionfocused coping.

5.7.3. Recommendations for Future Research

The findings of my study denote emerged hypotheses deeming future research. I
recommend the following investigations:

Further research is needed to determine the association between self-concept

awareness and emotion- focused in children with ADHD (inattentive type).

Further research is needed to determine the association between self-concept

awareness and emotion- focused coping in girls with ADHD (hyperactive- impulsive
type) which would determine if the same emotion- focused coping strategies are
employed by both genders and types of ADHD.

A comparative study employing different types of interventions to ascertain their

impact on children with ADHDs self-concept awareness and emotion-focused coping.

Further research is needed to determine the association between self-concept

awareness and emotion- focused coping strategies using a larger, more diverse
sample size.

I recommend that researchers assess children with ADHDs self-concept awareness

and emotion-focused coping strategies qualitatively (possibly by means of participant
and non-participant observation) to either support or refute themes which emerge
from other data sources as opposed to using instruments for this purpose.

5.8. Concluding Remarks

Children with ADHD are more inclined to employ emotion-focused coping strategies when
responding to stressful situations, with maladaptive emotion-focused coping which leading to
negative feedback from significant others, ultimately influencing ones appraisals of self and
situations resulting in a negative self-concept. However, few children with ADHD are aware
of their self-concepts, probably as a result of much of the literature depicting their impaired
executive functioning as being fixed and impenetrable, ultimately influencing the
interventions that are chosen to assist children with ADHD cope with stressful situations.
Through the use of an intervention research design, this study explored the role of an
intervention in facilitating this self-concept awareness in order to ascertain the association
between self-concept awareness and emotion- focused coping with results indicating that
there was indeed an association between self-concept awareness and emotion- focused,
with increased self-concept awareness resulting in the employment of more adaptive
emotion- focused coping strategies. Those who work with children with ADHD and their
families should have an acute understanding of the self-concept awareness and emotionfocused coping strategies of the child with ADHD and determine the relationship between the
two in order to more closely facilitate the development of both constructs with the aim of
empowering children with ADHD to self-advocate through increased self-awareness and the
employment of more adaptive emotion- focused coping strategies in response to stressful
situations.

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