General Practice and Primary Care - Theses
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Item“They have their own agenda”: Women domestic violence survivors’ accounts of seeing psychologists( 2023-08)Domestic violence (DV) is common in Australia with around a quarter of women experiencing physical, emotional or financial abuse by a partner during their lifetime. Survivors of DV often experience long lasting effects on their mental and emotional wellbeing and DV is strongly associated with a diagnosis of mental disorder. In Australia, the main pathway to receiving support for mental and emotional wellbeing is through government subsidised sessions with a psychologist in private practice. However, despite the prevalence of DV and the predominance of psychologists as the avenue of support, little is known about women survivors’ experiences in consulting psychologists. To address this gap, this thesis aimed to explore women’s experiences and expectations when consulting with psychologists after DV. This was done by asking two research questions: what were the experiences of seeing psychologists for women survivors of DV and what did women survivors of DV expect from psychologists? Semi-structured interviews with 20 women survivors were conducted. These interviews explored their accounts of consulting with psychologists and whether their experiences met what they expected from these consultations. The data from these interviews was analysed using Reflexive Thematic Analysis and the findings are presented in three groups of themes. Chapter Four presents two themes: ‘mirroring abuse or being supportive’ and ‘it did me quite a bit of damage’. This chapter discusses how psychologists often mirrored the abusive tactics of DV. These findings show how this was harmful and retraumatising and hindered further helpseeking by the women survivors. Chapter Five presents three themes: ‘see all of me’, ‘see me for my expertise’ and ‘don’t impose an agenda on me’. This chapter discusses how psychologists also often replicated the power and control dynamics of DV. These findings discuss the nature of power in the relationship between the survivors and the psychologists. Chapter Six, the final findings chapter, presents three themes: ‘narcissist description was helpful, ‘not all bad all the time’ and ‘structural explanations’. This chapter discusses how most psychologists showed a willingness to work with the women survivors to explore why their individual partners used DV. The women survivors found this helpful to their healing and to restoring their sense of self, replacing the negative view of self that their partners had engendered. These findings showed that, overall, many of the practices of psychologists did not meet what these women survivors wanted and expected. The findings suggest that whether or not the women survivors’ experiences with psychologists met their expectations was most likely to be connected to the psychologists’ general approach to practice or their worldview. To address this, the findings were synthesised to develop a DV Practice Framework to represent significant aspects of practice related to worldview. This is described in Chapter Seven. This framework was then applied to the trauma informed-care paradigm that is currently influential in the mental health system, as outlined in Chapter Eight. The resulting Trauma and Domestic Violence-informed Practice Model offers guidance to psychologists to help them develop a ‘whole of practice’ approach to working with survivors of DV.
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ItemAustralian young women's perceptions of dating and dating violence( 2019)Dating violence, or intimate partner violence, in young people’s relationships is a serious, prevalent and important public health concern. It is estimated that approximately one in four Australian young women have experienced dating violence. Despite the well-known burdens of dating violence on Australian young women’s health and well-being, little is known about how Australian young women perceive dating violence in their romantic relationships. This qualitative study explored Australian young women’s perceptions of dating, other romantic relationships, and dating violence. Social constructionist and feminist theoretical perspectives informed the study design. Young women aged 17 to 25 years, were recruited from a range of social and occupational backgrounds if they screened positive for dating violence. Individual narrative interviews were conducted with 35 young women, from across urban and rural Australia, who had predominantly had romantic relationships with young men. Interviews were conducted face-to-face or via telephone. The interviews were analysed using a thematic approach while ensuring that the young women’s stories remained at the forefront of the analysis. This was followed by the application of social script theory with a feminist lens, as an explanatory framework, to better understand the young women’s perceptions of romantic relationships and dating violence. The young women shared stories of their experiences of romantic relationships which were predominantly with young men. Findings revealed that the young women had experienced a range of casual and committed romantic interactions. The young women discussed their experiences and perceptions of these relationships and their roles within them. The young women’s perceptions of romantic relationships, particularly committed ones, were overwhelmingly gendered and scripted. These scripts were reminiscent of romantic fairy tale narratives, such as Beauty and the Beast, which the young women strived to live by. This perception influenced how they made sense of and recognised dating violence within these relationships and therefore how they responded. The young women struggled to leave their abusive relationships and exit was usually only possible if a crisis occurred or if the young man left the young woman. An exit model was formed which highlights these pathways and also the defining gendered roles of the young woman and young man. The young women’s perceptions of dating and dating violence were in conflict with their perceptions of gender equality and feminist identities. While the young women in this study perceived themselves to be liberated individuals in the current wave of feminism, in contrast, their dating and relationship scripts were informed by oppressive and patriarchal master narratives, such as romantic fairy tales. This study contributes to a better understanding of dating and dating violence in the Australian context from the perspective of a typical Australian young woman living in the year 2015. The findings from this study are useful and important to inform policy and practice for the primary and secondary prevention of dating violence. Existing patriarchal social scripts should be challenged with feminist counterstories that empower young women and contribute to practical implications for promotion of gender equality.
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ItemEngaging new fathers: learning from baby makes 3( 2016)Intimate partner violence is a global phenomenon with significant social, economic and health costs. The importance of engaging men in preventing intimate partner violence is well established with strategies that engage men as fathers through parenting programs showing some promise. Australia’s world first national primary prevention framework identifies gender inequality as the central driver of intimate partner violence. The transition to parenthood is a critical moment in the production of gender inequality and often leads to a retraditionalisation of gender roles for heterosexual couples. This life transition presents a prime opportunity to promote gender equality and engage fathers in interventions that seek to prevent intimate partner violence from ever occurring. While policies and programs are increasingly seeking to engage men in violence prevention, engagement frameworks in the primary prevention field are underdeveloped. Current research focuses on the manner in which men are drawn into prevention work rather than the engagement process itself. Existing Australian primary prevention programs tend to focus on engaging boys in school-based respectful relationships programs with little attention paid to reaching adult men. This study sought to fill these gaps by developing an engagement model for fathers and exploring its application to intimate partner violence primary prevention strategies. Aligning with the gendered lens of our national framework my research explored how gender impacts on service providers’ engagement with new fathers in respectful relationships programs delivered in health settings. Framed by a constructivist epistemology and ontology I employed a case study research design using the Baby Makes 3 (BM3) program, a three-week respectful relationships program for first time parents incorporated into New Parent Groups run by Maternal and Child Health Services in the Eastern Metropolitan Region of Victoria, as an illustrative example. I collected data from multiple sources including interviews with fathers who participated in the program and the Maternal and Child Health Nurses who recruited parents into the program as well as focus groups with the facilitators who led the program. To identify the gender phenomena that influence father engagement in this context I applied a novel analytical framework combining a three-phase father engagement model with a multidimensional theory of gender. This multi-level, multi-phase framework was used as a heuristic through which the evidence about the gendered phenomena that impact on service providers’ engagement with new fathers in the BM3 program were analysed. In terms of ‘getting’ fathers to attend BM3 in the first instance this study found that a complex, multidimensional interplay of gender related factors shapes men’s father identities, behaviours and ultimately their decisions to participate. In particular this study revealed that men’s differing paternal role identities and the gendered Maternal and Child Health Service setting play critical roles in fathers’ participation decisions. In regards to retaining father attendance and actively engaging them in the program the single-gender father group work led by male facilitators who are themselves fathers was key. BM3’s father group work provided a homosocial environment where men could engage in non-traditional gender practices and form intimate connections with other fathers.