ABSTRACT
Family conflicts and violence cases in Kenya is on increase on daily basis. Most of these cases emanate from disagreement among the family members who suffer silently with their personal problems due to difficulties of accessing family therapy for assistance and resolution of disputes at homes. Kenya has about 100 psychiatrists and most of them are in major cities in the country (Meyer & Ndetei, 2015). Families residing in marginalized areas face difficulties of accessing the therapeutic services due to limited counseling centers and poverty. Marginalization is costly to both family therapy and the mental health field (Shields & McDaniel, 2007). This has led family members to take wrong actions like committing suicide, physical violence and among other serious problems in the society. Every forty seconds, an individual commit suicide (Word Health Organization, 2019). The application and integration of the information technologies into family therapy is still not fully implemented in the country despite the increased vices among families. Kenya’s health information system currently does not address particular conditions related to mental health and mental health interventions monitoring (Ministry of Health Kenya, 2020).
The research focused on developing an integrated family therapy prototype to address timely access to family therapy by family members for conflict resolutions at homes. The prototype implementation involved integration of a Short Message Service (SMS) API for instant notification. Functional requirements were gathered and analyzed for the development of the prototype. The prototype was quantitatively evaluated using a usability test on 143 enthusiasts’ selected using systematic sampling in different areas within Nairobi. Family therapy prototype system usability analysis was done and users’ feedbacks collected. It was found that, 87% of the users of the prototype system were satisfied with acceptance of the system. The results demonstrate that the family therapy prototype is effective in addressing accessibility of family therapy by family members for timely conflicts resolutions at homes to enhance good morals and well-being to the society and country at large.
TABLE OF CONTENTS
DECLARATION i
ACKNOWLEDGEMENT ii
ABSTRACT iii
DEDICATION vi
LIST OF ACRONYMS AND ABBREVIATIONS vii
LIST OF FIGURES AND TABLES vii
DEFINITION OF TERMS viii
CHAPTER ONE: INTRODUCTION
1.1 Background 1
1.2 Problem statement 2
1.3 Objectives 3
1.3.1 Main Objectives 3
1.3.2 Specific Objectives 3
1.4 Research questions 3
1.5 Significance and outcomes 4
1.6 Assumptions and limitations 4
CHAPTER TWO: LITERATURE REVIEW
2.1 Overview of family therapy in Kenya 5
2.2 Home conflicts and family therapy 6
2.3 Role of ICT in family therapy 8
2.4 Family therapy in conflict resolutions 10
2.4.1 Murray Bowen’s family systems model 11
2.4.2 Brief solution-focused therapy 11
2.5 Proposed conceptual model 13
2.6 Theoretical Framework 14
2.6.1. Theory of Technology Acceptance Model (TAM) 14
2.6.2 Unified Theory of Acceptance and Use of Technology (UTAUT) 15
2.6.3 Technological Organizational and Environmental (TOE) 16
2.7 Conceptual Framework 17
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Research design 18
3.2 Sources Data 19
3.3 Data Collection Methods 19
3.3.1 Observation 19
3.3.2 Interview 19
3.3.3 Questionnaires 20
3.3.4 Published literatures 20
3.4 Data analysis 20
3.4.1 Thematic analysis 20
3.4.2 Statistical analysis 20
3.5 Software Development Methodology 21
3.5.1 The waterfall model 21
3.6 Prototype development procedures and programming tools 23
3.7 Testing 24
3.8 Evaluation 25
3. 9 Project schedule 25
CHAPTER FOUR: ANALYSIS AND DESIGN
4.1 Analysis 26
4.1.1 Feasibility Analysis 27
4.1.2 Requirement specification 27
4.1.2.1 Functional Requirements 27
4.1.2.2 Non-Functional Requirements 29
4.2 Prototype Design 30
4.2.1 Prototype system architecture 30
4.2.2 User interface design 32
4.2.3 Models 33
4.3 Database Design 34
CHAPTER FIVE: RESULTS AND DISCUSSION
5. 1 Prototype Implementation 35
5.1.1 The Model View Controller (MVC) 35
5.1.2 Prototype interface 36
5.2 Testing and Evaluation 40
5.3 Methods 42
5.4 Research Findings and Discussions 43
CHAPTER SIX: CONCLUSION AND RECOMMENDATIONS
5.1 Summary of research findings 50
5.2 Conclusions 51
5.3 Research Limitations 52
5.4 Recommendations 52
REFERENCES 53
A PPENDICES 58
Appendix 1: Interview Questions 58
Appendix 2: Prototype summative evaluation 59
LIST OF ACRONYMS AND ABBREVIATIONS
ICT - Information Communication Technology WHO - World Health Organization
BSFT - Brief Strategic Family Therapy
KNCHR- Kenya National Commission on Human Rights SDLC - Software Development Life Cycle
MVC - Model View Controllerp
LIST OF FIGURES AND TABLES
Figure 1. Proposed conceptual model 13
Figure 2: Technology Acceptance Model 14
Figure 3: Unified Theory of Acceptance and Use of Technology 15
Figure 4: TOE Framework 16
Figure 5: Conceptual framework 17
Figure 6: The waterfall model 21
Figure 7: Prototype development 23
Figure 8: Gantt chart 28
Figure 9: Family member use case diagram 28
Figure 10: Family therapists use case diagram 29
Figure 11: Administrator use case diagram 29
Figure 12: Context diagram 30
Figure 13: Flowchart 31
Figure 14: Design diagram 32
Figure 15: Prototype use case diagram 33
Figure 16. Database design 34
Figure 17: Model view controller (MVC) 35
Figure 18: User interface 36
Figure 19: Gender distribution 43
Figure 20: Age distribution 44
Figure 21: User satisfaction 45
Figure 22: Effectiveness of the prototype 46
Figure 23: Efficiency of the prototype 47
Figure 24: Prototype overall performance 48
Table 1: Interview questions 26
Table 2: Prototype functional testing 41
Table 3: Gender distribution 43
Table 4: Age distribution 44
Table 5: User satisfaction 45
Table 6: Effectiveness of the prototype 46
Table 7: Efficiency of the prototype 47
Table 8: Prototype overall performance 48
DEFINITION OF TERMS
Information Communication Technologies (ICTs) - All technologies such as the internet, computers, software and other applications/services that assist family members’ access family therapy services for conflict resolutions.
Family therapy - psychotherapy designed to help family members handle emotional problems, mental illnesses and improve communication for resolution of conflicts.
Therapy - treatment of mental and emotional problems.
Poverty - absence of some basic needs or capabilities by people for acceptable level of functioning such as access to necessary resources.
Conflicts - a serious disagreement or argument for a period of time which can escalate to violence.
Family conflict - refers to active disagreement or opposition among family members
Family therapists - are psychotherapists that help family members handle emotional problems, mental illnesses and improve communication for resolution of conflicts.
Faith based leaders - recognized people by faith community for authority and influence on leadership roles in faith institutions.
Software development life cycle - is a process that involve the designing, development and testing of the family therapy prototype system.
CHAPTER ONE
INTRODUCTION
The section presents background to the problem, problem statement, objectives, research questions, research outcomes and the significance.
1.1 Background
The number of family conflicts and violence cases in Kenya is increasing day by day. Most of these cases emanate from disagreement among the family members. Family members suffer silently with their personal problems due to difficulties of accessing family therapy for assistance. The difficulties faced by families in accessing timely family therapy for resolutions of disputes at homes has resulted in animosity and increased cases of mental illnesses among family members in the Country. The most frequent diagnosis of mental illnesses made in general hospitals include stress, depression, substance abuse and anxiety disorders. (Ndetei et al, 2008). Families residing in marginalized areas face difficulties of accessing the therapeutic services due to limited counseling centers and poverty. Marginalization is costly to both family therapy and the mental health field (Shields & McDaniel, 2007). This has led family members to take wrong actions like committing suicide, physical violence and among other serious problems in the society.
Kenya has about 100 psychiatrists and most of them are in major cities in the country (Meyer & Ndetei, 2015). The increased vices have resulted in tremendous pressure on counseling centers’ staff and long therapeutic sessions due to large numbers of family members who want to make the most of their time during counseling. Family problems are painful and traumatic and are the major cause of conflicts in the country. The media report on social problems such as robbery, suicide, truancy, drug abuse, murder is on the increase on daily basis. Every forty seconds, an individual commit suicide (Word Health Organization, 2019). It is estimated that one in every 10 people suffer from a common mental disorder. Kenya being one of 28% of World Health Organization member states have no separate mental health budget, and mental health expenditure by government is 0.01% of the total expenditure (Ministry of Health Kenya, 2020).
Strengthening families in crisis through timely family therapy provides the most natural way of dealing with many psychological problems and conflicts in the country. This enables family members to communicate emotions without fear which is the basis of healthy attachment (Bowlby, 1988 & Johnson, 2004). Incorporation of local counselors and faith based leaders in the communities using information technology can assist decongest counselling centers with limited number of family therapists and provide timely resolutions to family problems. To improve the systems of interactions, family therapy provides a structured form of psychotherapy that reduces distress and conflict between family members (Varghese, 2020). Addressing family problems and issues of concern in an appropriate manner helps in streamlining well-being, morals and behavior among family members in the country.
1.2 Problem statement
As in other developing countries, Kenya faces many challenges in implementing ICT in family therapy and mental health such as inadequate ICT skills among professionals in mental health, ICT infrastructure challenges, economic challenges, social and political issues. Kenya being one of 28% of World Health Organization member states have no separate mental health budget, and mental health expenditure by government is 0.01% of the total expenditure (Ministry of Health Kenya, 2020).
The application and integration of the information technologies into family therapy is still not fully implemented in the country despite the increased vices among families. Kenya’s health information system currently does not address particular conditions related to mental health and mental health interventions monitoring (Ministry of Health Kenya, 2020). Family members face difficulties in locating and accessing timely family therapeutic services for assistance on their personal problems particularly in marginalized areas causing them to take wrong directions resulting in conflicts. This remains a limiting factor in the delivery of quality family therapy and counseling services. There is a need to integrate ICT into the traditional face-to-face counselling for the diversity in counselling delivery (Obi et al. 2012). Full integration of modern information technology and provision of clear accessibility ways for family therapy services is crucial to alleviate crisis situations faced by family members.
1.3 Objectives
1.3.1 Main Objectives
The main objective of the study was to develop an integrated family therapy prototype for easy accessibility of family therapy by family members to help resolve home conflicts as soon as disagreement arises.
1.3.2 Specific Objectives
i. To investigate accessibility of family therapy by family members and how family therapy can be used for resolution of home conflicts using family therapy prototype system.
ii. To determine the communication needs for the family members and implement a family therapy prototype system where family members can access and request family therapy as soon as disagreement arises.
iii. To develop a family therapy prototype system that can help incorporate professional therapists, local communities’ counselors or faith based leaders in family therapy for timely home conflict resolutions.
1.4 Research questions
i. How can modern information technology systems be used to address family therapy services accessibility by family members for home conflicts resolutions?
ii. How can families’ communications needs be addressed to help reduce conflicts at homes as soon a disagreement arises?
iii. How can professional therapists, local communities’ counselors or faith based leaders be incorporated in family therapy using family therapy prototype system to help in provision of timely home conflict resolutions?
1.5 Significance and outcomes
The research add value to the families and society at large by giving insights and recommendations on how to resolve conflicts using family therapy techniques. This prompt early discovery of conflicts at homes while at the same time minimizing the increased vices among members of the family. The aim of the research was to help in provision of timely resolution of conflicts and ensure well-being and good morals among family members and the society at large.
1.6 Assumptions and limitations
The research involved investigation and evaluation of family therapy and its application for conflict resolutions at homes. This involved application of family therapy prototype in handling emergencies conditions among family members and incorporating local communities’ counselors and faith based leaders in family therapy to help families in accessing timely assistance for conflict resolutions.
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