Social Work - Research Publications
Permanent URI for this collection
Search Results
1 - 10 of 261
-
ItemTrajectory of adjustment difficulties following disaster: 10-year longitudinal cohort study(Cambridge University Press, 2024-03)BACKGROUND: Although much is known about psychopathology such as post-traumatic stress disorder (PTSD) and depression following bushfire (also known as wildfire), little is known about prevalence, trajectory and impacts for those experiencing general adjustment difficulties following exposure to these now-common events. AIMS: This was an exploratory analysis of a large cohort study that examined the prevalence, trajectory and risk factors of probable adjustment disorder over a 10-year period following bushfire exposure. METHOD: The Beyond Bushfires study assessed individuals exposed to a large and deadly bushfire across three time points spanning 10 years. Self-report survey data from participants from areas with moderate and high levels of fire-affectedness were analysed: n = 802 participants at Wave 1 (3-4 years post-fires), n = 596 at Wave 2 (5 years post-fires) and n = 436 at Wave 3 (10 years post-fires). Surveys indexed fire-related experiences and post-fire stressors, and comprised the six-item Kessler Psychological Distress Scale (probable adjustment disorder index), four-item Posttraumatic Stress Disorder Checklist (probable fire-related PTSD) and nine-item Patient Health Questionnaire (probable major depressive episode). RESULTS: Prevalence of probable adjustment disorder was 16% (Wave 1), 15% (Wave 2) and 19% (Wave 3). Probable adjustment disorder at 3-4 years post-fires predicted a five-fold increase in risk for escalating to severe psychiatric disorder (i.e. probable fire-related PTSD/major depressive episode) at 10 years post-fires, and was associated with post-fire income and relationship stressors. CONCLUSIONS: Adjustment difficulties are prevalent post-disaster, many of which are maintained and exacerbated over time, resulting in increased risk for later disorder and adaptation difficulties. Psychosocial interventions supporting survivors with adjustment difficulties may prevent progression to more severe disorder.
-
ItemNo Preview AvailableInfant Access Program Evaluation( 2022-03-30)This project was commissioned by the Eastern Health Foundation to evaluate the implementation of the ‘Infant Access Program’ (IAP). The IAP seeks to improve access to specialist infant mental health services for children aged 0-5 years with mental health difficulties in the Maroondah City and Yarra Ranges local government areas. This report provides an overview of the evaluation method, key findings, and recommendations for future IAP research and program development to build the evidence base in infant mental health service provision. The program evaluation project used a mixed methods approach to evaluate the implementation of the Infant Access Program (IAP). The aims of the project were: - To identify existing models and programs designed to improve access to mental health services for children aged 0-5 years that have been implemented nationally and internationally in health and mental health sectors. - To evaluate if the IAP facilitates access to mental health services for children aged 0-5 years with mental health difficulties and their families. - To assess if the IAP is delivering mental health services to the target population: children at-risk of mental health difficulties. - To understand the experiences of clinicians who implemented the IAP. Findings: Despite the lack of specific research on this topic, the scoping review identified several broad themes for IAP to consider: (1) accessibility for at-risk populations (2) the importance of early detection of infants in need of mental health services and interventions; (3) the promotion of culturally responsive services and interventions; (4) ensuring the sustainability of IMH services and programs; and (5) the integration of innovative interventions to improve existing practice models. A total of ten participants (CYMHS clinicians and EMCH nurses) consented into this evaluation. The participants provided mental health and nursing services to three local government areas in the Melbourne’s eastern region. During the implementation period (May – October 2021), two CYMHS clinicians and four EMCH nurses collected IAP activity data related to thirteen infants and young children and their families who were consulted or referred to the program. Following the Infant Access Program Evaluation implementation period, semi-structured qualitative focus groups were conducted with the ten CYMHS clinicians and EMCH nurses to gain an understanding of their experiences of implementing the IAP in practice. The analysis of the IAP activity data and focus group discussions demonstrate that the IAP does facilitate access to mental health services for children aged 0-5 years with mental health difficulties and their families. Access to specialist mental health support for most children and families was rapid, with most children meeting the CYMHS clinician at a first joint home visit only 14 days after the initial consultation with the EMCH nurse. This rapid response demonstrates the IAP is nimble and flexible in offering infant mental health services in a time sensitive manner. The program received referrals for infant mental health services for its intended target population: infants and children and their families experiencing known risk factors for poor mental health outcomes. Families with a range of complex psychosocial risk factors can often experience significant challenges in accessing specialist services such as infant mental health intervention for their child despite having concerns about their social and emotional development. The IAP managed the initial engagement with families by leveraging the existing relationship the family had with the EMCH nurse, however, there were challenges with maintaining engagement and delivering mental health interventions. Although the initial access to the IAP is a strength of the current design, further consideration is needed as to the ways in which to meaningfully engage with families of infants and children with mental health difficulties that are acceptable and sustainable. The IAP had the full support of all the CYMHS clinicians and EMCH nurses who were involved during the implementation phase of this evaluation. The experience of clinicians and nurses working in partnership, bringing skills sets of mental health clinicians and maternal child health together was considered a strength of the IAP design. The access and rapid response from the CYMHS clinicians to consult and meet with the families was also valued. This ensured a timely response to the needs of infants and children with mental health difficulties and capitalised on the readiness and willingness of families to engage with mental health services. The clinicians and nurses recognised the challenges of working with a population that is at-risk in our community. Establishing trust with the families was identified as the key to successful engagement with IAP. Creative ways of engaging families were also important, offering choice for when and where to meet the IAP clinician.
-
ItemProtocol for a randomised controlled trial of a healthy relationship tool for men who use intimate partner violence (BETTER MAN)(BMC, 2023-12-02)BACKGROUND: Intimate partner violence (IPV) is common globally, but there is a lack of research on how to intervene early with men who might be using IPV. Building on evidence supporting the benefits of online interventions for women victim/survivors, this study aims to test whether a healthy relationship website (BETTER MAN) is effective at improving men's help seeking, their recognition of behaviours as IPV and their readiness to change their behaviours. METHODS/DESIGN: In this two-group, pragmatic randomised controlled trial, men aged 18-50 years residing in Australia who have been in an adult intimate relationship (female, male or non-binary partner) in the past 12 months are eligible. Men who report being worried about their behaviour or have had others express concerns about their behaviour towards a partner in the past 12 months will be randomised with a 1:1 allocation ratio to receive the BETTER MAN website or a comparator website (basic healthy relationships information). The BETTER MAN intervention includes self-directed, interactive reflection activities spread across three modules: Better Relationships, Better Values and Better Communication, with a final "action plan" of strategies and resources. Using an intention to treat approach, the primary analysis will estimate between-group difference in the proportion of men who report undertaking help-seeking behaviours for relationship issues in the last 6 months, at 6 months post-baseline. Analysis of secondary outcomes will estimate between-group differences in: (i) mean score of awareness of behaviours in relationships as abusive immediately post-use of website; (ii) mean score on readiness to change immediately post-use of website and 3 months after baseline; and (iii) cost-effectiveness. DISCUSSION: This trial will evaluate the effectiveness of an online healthy relationship tool for men who may use IPV. BETTER MAN could be incorporated into practice in community and health settings, providing an evidence-informed website to assist men to seek help to promote healthy relationships and reduce use of IPV. TRIAL REGISTRATION: ACTRN12622000786796 with the Australian New Zealand Clinical Trials Registry: 2 June 2022. Version: 1 (28 September 2023).
-
ItemNo Preview AvailableNon-psychotic Outcomes in Young People at Ultra-High Risk of Developing a Psychotic Disorder: A Long-Term Follow-up Study(OXFORD UNIV PRESS, 2024-02-16)BACKGROUND: The majority of individuals at ultra-high risk (UHR) for psychosis do not transition to a full threshold psychotic disorder. It is therefore important to understand their longer-term clinical and functional outcomes, particularly given the high prevalence of comorbid mental disorders in this population at baseline. AIMS: This study investigated the prevalence of non-psychotic disorders in the UHR population at entry and long-term follow-up and their association with functional outcomes. Persistence of UHR status was also investigated. STUDY DESIGN: The sample comprised 102 UHR young people from the Personal Assessment and Crisis Evaluation (PACE) Clinic who had not transitioned to psychosis by long-term follow-up (mean = 8.8 years, range = 6.8-12.1 years since baseline). RESULTS: Eighty-eight percent of participants at baseline were diagnosed with at least one mental disorder, the majority of which were mood disorders (78%), anxiety disorders (35%), and substance use disorders (SUDs) (18%). This pattern of disorder prevalence continued at follow-up, though prevalence was reduced, with 52% not meeting criteria for current non-psychotic mental disorder. However, 35% of participants developed a new non-psychotic mental disorder by follow-up. Presence of a continuous non-psychotic mental disorder was associated with poorer functional outcomes at follow-up. 28% of participants still met UHR criteria at follow-up. CONCLUSIONS: The study adds to the evidence base that a substantial proportion of UHR individuals who do not transition to psychosis experience persistent attenuated psychotic symptoms and persistent and incident non-psychotic disorders over the long term. Long-term treatment and re-entry into services is indicated.
-
ItemNo Preview Available"We are a unique breed": strategies to enhance physical activity participation for preschool-aged children born extremely preterm, a mixed-methods study(Taylor and Francis Group, 2023-11)PURPOSE: Preschool-aged children (three to five years old) born preterm participate in less physical activity (PA) than term-born children. Circus activities (a type of recreational PA) are a potential avenue to increase PA rates, but further insight into how to tailor these to address the participation gap is needed. This study investigated barriers and facilitators informing participation in recreational PA for preschool-aged children born extremely preterm and explored strategies to enhance participation in circus activities. MATERIALS AND METHODS: Sequential mixed-methods study utilizing surveys (n = 217), interviews (n = 43), and a focus group (n = 6) with key stakeholder groups (parents, coaches, and clinicians). Qualitative data (Framework Method) and quantitative data (descriptive statistics) were mixed during preliminary and final analyses. RESULTS: Five themes were developed from the mixed data: the crucial role of the coach and the need for specific training, the therapeutic role of PA and promoting outcomes beyond the physical, the impact of communication and class planning, consideration of convenience and cost, and finally, the role of clinicians. CONCLUSIONS: Barriers, facilitators, and strategies were identified which may be used to modify or co-design circus-based PA interventions to enhance participation and improve rates of PA for preschool-aged children born extremely preterm.IMPLICATIONS FOR REHABILITATIONFamilies consider recreational physical activities to be part of the therapeutic agenda for their preschool-aged children born extremely preterm.Key stakeholders feel that recreational physical activity should target outcomes beyond the physical.Coach attributes and capability impact participation of children born preterm and their families, and may be enhanced with specific training.Clinicians should be engaged in design of recreational physical activities for children born preterm.
-
ItemNo Preview AvailableFamily Violence and Abuse against Non-Parental Caregivers: An Australian Perspective(SAGE Publications Ltd, 2021)There has been significant discourse around the use of language in the context of domestic and family violence and inconsistencies in language present in policy, legislation, practice, and research. This has resulted in the lack of agreement on a definitive and overarching description of domestic and family violence (Tinning, 2010; Boxall et al., 2015). The Australian Government has adopted the United Nations (1993: 3) definition which states that violence against women is gender-based and results in or is likely to result in physical or psychological harm.
-
ItemThe Delivery of Person-Centered Care for People Living With Dementia in Residential Aged Care: A Systematic Review and Meta-Analysis(OXFORD UNIV PRESS INC, 2024-05-01)BACKGROUND AND OBJECTIVES: Person-centered care is the gold standard of care for people living with dementia, yet few systematic reviews have detailed how it is delivered in practice. This mixed-methods review aimed to examine the delivery of person-centered care, and its effectiveness, for people living with dementia in residential aged care. RESEARCH DESIGN AND METHODS: A systematic review and meta-analysis. Eligible studies were identified across 4 databases. Quantitative and qualitative studies containing data on person-centered care delivered to people with dementia living in residential aged care were included. Meta-analysis using a random-effects model was conducted where more than 3 studies measured the same outcome. A narrative meta-synthesis approach was undertaken to categorize verbatim participant quotes into representative themes. Risk of bias was undertaken using quality appraisal tools from the Joanna Briggs Institute. RESULTS: 41 studies were identified for inclusion. There were 34 person-centered care initiatives delivered, targeting 14 person-centered care outcomes. 3 outcomes could be pooled. Meta-analyses demonstrated no reduction in agitation (standardized mean difference -0.27, 95% confidence interval [CI], -0.58, 0.03), improvement in quality of life (standardized mean difference -0.63, 95% CI: -1.95, 0.70), or reduced neuropsychiatric symptoms (mean difference -1.06, 95% CI: -2.16, 0.05). Narrative meta-synthesis revealed barriers (e.g., time constraints) and enablers (e.g., staff collaboration) to providing person-centered care from a staff perspective. DISCUSSION AND IMPLICATIONS: The effectiveness of person-centered care initiatives delivered to people with dementia in residential aged care is conflicting. Further high-quality research over an extended time is required to identify how person-centered care can be best implemented to improve resident outcomes.
-
ItemNo Preview AvailableWorking with kinship care families(Cambridge University Press, 2023-04-30)Kinship care is the fastest growing type of out-of-home care and is the preferred placement option for children who are unable to live with their parents. Kinship carers, particularly grandparents, may experience more vulnerability than foster carers and be exposed to specific stressors related to being kinship carers. This chapter will explore the challenges, needs and resources for kinship carers and the children in their care. Kinship care is among the fastest growing forms of formal and informal out-of-home care in Australia and is the preferred option for formal out-of-home care in Australia. Kinship care is defined as ‘family-based care within the child’s extended family or with close friends of the family known to the child, whether formal or informal in nature’ (United Nations General Assembly, 2010). There is common agreement that formal kinship care occurs in the instance where children have been placed with kin following some form of statutory (e.g., child protection services) intervention or court-ordered placement.
-
ItemTrauma-informed care within residential aged care settings: A systematic scoping review(Wiley, 2023-12)OBJECTIVES: The importance of trauma-informed care (TIC) within residential aged care (RAC) settings has been increasingly recognised. TIC would ensure that older people who have experienced trauma over their lifetime have their needs better understood and accommodated. This scoping review examined the extent to which TIC has been applied within RAC settings. METHODS: A scoping review was conducted according to Cochrane recommendations and the PRISMA-ScR checklist. A systematic search of six databases (Embase, Emcare, CENTRAL, CINAHL, PsychInfo and Medline) was performed in July 2022 and March 2023 and peer-reviewed primary research, in English and involved RAC staff or residents (aged 65 years and over) providing or receiving TIC were eligible for inclusion. Studies focused on trauma intervention, assessment, screening, or treatment were excluded. Thematic synthesis was performed to extract themes relating to trauma-informed practice, barriers and enablers to TIC, and outcomes from the application of TIC approaches. RESULTS: Five articles were included. There was little evidence of the implementation of TIC interventions in RAC settings. Only one study examined the application of a TIC framework in a RAC setting. However, there was some evidence that approaches that consider resident's experience of trauma have emerged from practice experience and been used in RAC as an extension of person-centred care. CONCLUSIONS: Whilst trauma-informed approaches to resident care are emerging through practice experience, and despite policy recommendations to do so, there is little evidence that formal TIC interventions or frameworks have been applied to RAC internationally. This study highlights a gap in research and practice and makes several recommendations for further research and implementation of TIC in RAC.
-
ItemShifting practice in domestic violence: child protection workers partnering with mothers(Interdisciplinary Research in Motherhood, 2019-12-05)Child protection services have struggled with domestic and family violence (DV) and how to respond to it. Historically it has been slow to recognise the impact of domestic violence on children. Once identified, child protection services have been slow to recognise that affected children are usually best safeguarded by workers supporting the non-offending parent, typically, the child’s mother in situations of DFV. The focus on assessing mothers for their protection or failure to protect their children in the face of fathers who use violence has become characteristic of much child protection practice which has failed to engage constructively with the challenges of domestic violence. Many issues have emerged as problematic, highlighting the poor ‘fit’ between the traditional child protection lens and the demands of an effective response to domestic violence. These include: an exclusive focus on the ‘best interests’ of the child without due regard for two victims of domestic violence (child and usually the child’s mother); the lack of engagement with fathers who use violence; the necessities of engaging with diverse communities; the problems with developing effective domestic violence interventions when separation has not occurred. These are not the problems of an individual practitioner, but rather point to the structural and cultural change required by organisations to support workers to shift their practice. This chapter will draw on recent research (a national case reading of child protection files in Australia) to highlight the gaps in understanding the impacts of DV on parenting skills, and the gaps in recognising and documenting mothers’ strengths and efforts to keep their children safe. Sometimes this has involved mothers being deemed as ‘non-compliant’ with child protection instructions. An intersectional lens will be taken to explore a feminist perspective on child protection practice. The framework developed by Safe & Together™ will be used to inform the chapter and bring a feminist lens which is inclusive of the needs of children for agency, safety and protection. There is evidence that supporting the mother–child relationship is the most effective way of keeping children safe where there is domestic violence. Strategies required at an organisational and a practitioner level will be explored, including the need for a differential response to children exposed to DFV. This response recognises that not all children are significantly affected by DFV and not all mothers find their parenting significantly compromised. While partnering with mothers, it should be recognised that children may have different perspectives on violence and have their own views about what keeps them safe.