Social Work - Research Publications

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    Tensions in the therapeutic relationship: emotional labour in the response to child abuse and neglect in primary healthcare.
    Kuruppu, J ; Humphreys, C ; McKibbin, G ; Hegarty, K (Springer Science and Business Media LLC, 2022-03-17)
    BACKGROUND: Child abuse and neglect (child abuse) is a prevalent public health issue linked to survivors experiencing a higher risk of health issues such as obesity, heart disease and major depression. Given the significant impact of child abuse on health, general practitioners (GPs) and primary care nurses (nurses) are well-placed to respond to child abuse. However, research shows that responding to child abuse is difficult for health practitioners, especially the act of reporting child abuse. The present study aimed to understand how GPs and nurses experience the response to child abuse in primary healthcare. METHODS: This study employed qualitative methods. Twenty-six in-depth individual and group interviews were conducted with 30 GPs and nurses. The interviews were audio recorded with consent, transcribed verbatim and thematically analysed. RESULTS: The participants were mostly metropolitan-based female GPs. Participants were sampled from two settings: private general practice and community health; and Doctors in Secondary Schools, a program that places GPs and nurses in high schools. Thematic analysis generated four themes: blowing trust out of the water; riding the reaction wave; opening a hornet's nest; and battling emotions. Participants felt that, in considering child abuse, they were betraying the trust of the therapeutic relationship and thus, had to manage their patients' reactions to preserve the therapeutic relationship. They used strategies that created shifts in perception in both themselves and their patients to help maintain the therapeutic relationship. Participants often felt that they had to compromise their professional code of ethics to fulfil their mandatory reporting obligations. Thus, they experienced internal emotional battles when responding which led to some experiencing burnout or vicarious trauma and others resilience. This complex interplay of relationship and emotional management was placed in the context of emotional labour theory. We contend that our participants undertook emotional labour across three levels: internal, organisational and systemic. CONCLUSIONS: We conclude that the emotional labour exerted in the response to child abuse can be diminished by: developing strategies for therapeutic relationship management; undertaking an internal, organisational and systemic values assessment; and facilitating communication between health professionals and the child protection system.
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    Responding to Students Living with Domestic and Family Violence.
    Fogden, L ; Humphreys, C ; Allen, K-A ; Reupert, A ; Oades, L (Routledge, 2021)
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    KODY, an all-of-family response to co-occurring substance use and domestic violence: protocol for a quasi-experimental intervention trial
    Kertesz, M ; Humphreys, C ; Fogden, L ; Scott, K ; Laslett, A-M ; Tsantefski, M (BMC, 2022-02-12)
    BACKGROUND: The co-occurrence of domestic violence with alcohol and other drugs significantly increases the severity of abuse and violence experienced by family members. Longitudinal studies indicate that substance use is one of few predictors of men's continued use of, or desistance from, violence. Recent developments in men's behaviour change programs have focused on men's attitudes and behaviour towards their children, and the exploration of interventions that address the needs of all family members. However, the research evidence is limited on the most effective elements of men's behaviour change programs in promoting the safety and wellbeing of child and women victim survivors. This study aims to build on the existing evidence by trialling the KODY program which addresses harmful substance use by men who also perpetrate domestic violence; the safety and wellbeing of women and children; the needs of children in their own right, as well as in relationship with their mothers; and the development of an 'all-of-family' service response. The evaluation of these innovations, and the ramifications for policy development to support less fragmented service system responses, provide the rationale for the study. METHODS/DESIGN: A quasi-experimental design will be used to assess the primary outcomes of improving the safety and wellbeing of mothers and children whose (ex)partners and fathers respectively participate in KODY (the trial program), when compared with 'Caring Dads standard' (the comparison group). Psychometric tests will be administered to fathers and mothers at baseline, post-program and at 3-month follow up. Data collection will occur over three years. DISCUSSION: By building the evidence base about responses to co-occurring domestic violence and substance use, this study aims to develop knowledge about improving safety outcomes for women and children, and to better understand appropriate support for children in families living at the intersection of domestic violence and substance use. It is anticipated that study findings will point to the ramifications for policy development to support less fragmented service system responses. TRIAL REGISTRATION: An application for registration with the Australian and New Zealand Clinical Trials Registry ( https://www.anzctr.org.au/ ) was lodged on 20 December 2021 (Request number: 383206)-prospectively registered.
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    Tipping the Scales: Factors Influencing the Decision to Report Child Maltreatment in Primary Care
    Kuruppu, J ; McKibbin, G ; Humphreys, C ; Hegarty, K (SAGE PUBLICATIONS INC, 2020-04-07)
    Child maltreatment (CM) is an important public health issue linked to significant physical and mental health complications across the life span. Given the association between CM and health, general practitioners (GPs) and primary care nurses (PNs) are well-placed to identify and respond to this issue and are mandated to report suspected CM in many jurisdictions. Research has found that primary care doctors and nurses need support when responding to CM. This scoping review sought to answer the following question: What factors influence GPs and PNs decision to report CM when fulfilling their mandatory reporting duty? By exploring these factors, areas where support is needed were pinpointed. A systematic search was run across four databases: Medline (Ovid), PsycINFO, Embase, and CINAHL. Articles that reported on studies conducted in a location that had mandatory reporting legislation specific to CM and had a study population sampled from primary care were included in analysis. Thirty-three articles met the inclusion criteria. This review found that four principal factors influenced the decision to report CM: personal threshold of suspicion of abuse, relationship with the family, faith in the child protection system, and education and discussion. We conclude that improving the support and training to address these four areas may be beneficial for GPs and PNs in responding to CM.
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    How can mental health practitioners collaborate with child welfare practitioners to improve mental health for young people in out of home care?
    Monson, K ; Herrman, H ; Moeller-Saxone, K ; Humphreys, C ; Harvey, C (WILEY, 2021-01-21)
    BACKGROUND: Young people who grow up in out of home care have higher risk of poor mental health outcomes than peers who grow up with their family-of-origin. Interagency collaboration is an important service-level intervention to improve access to mental healthcare. However, few descriptions of collaboration provide guidance about collaboration between individual practitioners. AIM: This substudy aimed to contribute to a larger study-the Ripple project-through exploring the experiences of practitioners working across child welfare and mental health services regarding collaboration in the care of young people; and to identify practices that might enhance collaborative work and improve mental health outcomes. METHODS: Practitioners from across child welfare and mental health services were purposively sampled and participated in focus groups. Recordings and transcriptions of focus groups were analysed to identify themes within and between groups. A cross-sector expert advisory group was involved in this work. RESULTS: Focus groups were convened with 43 practitioners. We identified four themes during analysis, these were: shared understanding of the history and context of problems; specific skills and practices; self-awareness of workers and carers; and involving and supporting carers. CONCLUSIONS: A number of practices were identified that might lead to enhanced collaboration between agencies and across interdisciplinary care teams. Supporting mental health practitioners to adopt these might assist interagency and interdisciplinary working.
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    An online healthy relationship tool and safety decision aid for women experiencing intimate partner violence (I-DECIDE): a randomised controlled trial
    Hegarty, K ; Tarzia, L ; Valpied, J ; Murray, E ; Humphreys, C ; Taft, A ; Novy, K ; Gold, L ; Glass, N (ELSEVIER SCI LTD, 2019-06-01)
    BACKGROUND: Evidence for online interventions to help women experiencing intimate partner violence is scarce. We assessed whether an online interactive healthy relationship tool and safety decision aid (I-DECIDE) would increase women's self-efficacy and improve depressive symptoms compared with an intimate partner violence information website. METHODS: In this two-group pragmatic randomised controlled trial, we enrolled women who had screened positive for any form of intimate partner violence or fear of a partner in the 6 months before recruitment. Women aged 16-50 years currently residing in Australia, who had safe access to a computer and an internet connection, and who answered positively to one of the screening questions in English were eligible for inclusion. Participants were randomly assigned (1:1) by computer to receive either the intervention or control website. The intervention website consisted of modules on healthy relationships, abuse and safety, and relationship priority setting, and a tailored action plan. The control website was a static intimate partner violence information website. As the initial portion of the website containing the baseline questions was identical for both groups, there was no way for women to tell which group they had been allocated to, and the research team were also masked to participant allocation until after analysis of the 12-month data. Data were collected at baseline, immediately after completion of the website, at 6 months, and 12 months. Primary outcomes were mean general self-efficacy score (immediately after website completion, and at 6 months and 12 months) and mean depression score (at 6 months and 12 months). Data analyses were done according to intention-to-treat principles, accounting for missing data, and adjusted for outcome baseline scores. This trial was registered with the Australian New Zealand Clinical Trials Registry, ACTRN 12614001306606. FINDINGS: Between Jan 16, and Aug 28, 2015, 584 patients registered for the study and were assessed for eligibility. 422 eligible participants were randomly allocated to the intervention group (227 patients) or control group (195 patients). 179 (79%) participants in the intervention group and 156 (80%) participants in the control group completed 12-month follow-up. Mean self-efficacy at 6 months and 12 months was lower for participants in the intervention group than for participants in the control group, although this did not meet the prespecified mean difference (6 months: 27·5 [SD 5·1] vs 28·1 [4·4], imputed mean difference 1·3 [95% CI 0·3 to 2·3]; 12 months: 27·8 [SD 5·4] vs 29·0 [5·0], imputed mean difference 1·6 [95% CI 0·5 to 2·7]). We found no difference between groups in depressive symptoms at 6 months or 12 months (6 months: 22·5 [SD 17·1] vs 24·2 [17·2], imputed mean difference -0·3 [95% CI -3·5 to 3·0]; 12 months: 21·9 [SD 19·3] vs 21·5 [19·3], imputed mean difference -1·9 [95% CI -5·6 to 1·7]). Qualitative findings indicated that participants found the intervention supportive and a motivation for action. INTERPRETATION: Our findings highlight the need for further research, development, and refinement of online interventions for women experiencing intimate partner violence, particularly into the duration needed for interventions. Although we detected no meaningful differences between groups, our qualitative results indicated that some women find an online tool a helpful source of motivation and support. FUNDING: Australian Research Council.
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    Participatory practice guideline development at the intersections of domestic and family violence, mental distress and/or parental substance use
    Heward-Belle, S ; Kertesz, M ; Humphreys, C ; Tsantefski, M ; Isobe, J (Emerald, 2022)
    Purpose: It is well established that the service system has a poor history of responding holistically to address the needs of children and families living with co-occurring complexities such as domestic violence, parental mental health and/or substance use. The purpose of this conceptual paper is to describe the developmental process and content of guidelines created to inform practice at the intersections of domestic violence, mental health and alcohol and other drug services, ensuring that the tactics of coercive control are visible in contexts of complexity. The approach: The guidelines were developed through undertaking a literature review, followed by a practice-led research approach with practitioners from 33 organisations across three Australian states. Communities of practice comprised of practitioners providing interventions to children and families were central to the approach. Data that informed the development of the guidelines included a literature review, ethnographic notes, qualitative interviews, quantitative surveys, and reflections. Findings: Practice-led research engaged practitioners in the development of guidelines to promote an integrated response to working with families experiencing domestic violence, substance use and mental health issues. The integrated approach drew from the Safe & Together Model, emphasising partnering with women survivors, pivoting to the perpetrator, focusing on children’s safety and wellbeing, promoting worker safety, collaborating across agencies, and influencing organisational change. The process demonstrated the usefulness of this integrated approach, using practitioner-based examples. Originality/value: Successful iterative processes to develop the guidelines were undertaken to support cultural change towards holistic and collaborative work across multiple sectors and organisations.
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    Beyond co-occurrence: Addressing the intersections of domestic violence, mental health and substance misuse
    Humphreys, C ; Heward-Belle, S ; Tsantefski, M ; Isobe, J ; Healey, L (WILEY, 2021-12-12)
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    Safe at home? Housing decisions for women leaving family violence
    Diemer, K ; Humphreys, C ; Crinall, K (WILEY, 2017-03-01)
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    Interventions to improve supervised contact visits between children in out of home care and their parents: a systematic review
    Bullen, T ; Taplin, S ; McArthur, M ; Humphreys, C ; Kertesz, M (WILEY, 2017-05-01)