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.