Social Work - Research Publications

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    Protocol for a randomised controlled trial of a healthy relationship tool for men who use intimate partner violence (BETTER MAN)
    Hegarty, K ; Tarzia, L ; Medel, CN ; Hameed, M ; Chondros, P ; Gold, L ; Tassone, S ; Feder, G ; Humphreys, C (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).
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    Non-psychotic Outcomes in Young People at Ultra-High Risk of Developing a Psychotic Disorder: A Long-Term Follow-up Study
    Spiteri-Staines, AE ; Yung, AR ; Lin, A ; Hartmann, JA ; Amminger, P ; Mcgorry, PD ; Thompson, A ; Wood, SJ ; Nelson, B (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.
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    "We are a unique breed": strategies to enhance physical activity participation for preschool-aged children born extremely preterm, a mixed-methods study
    Coulston, F ; Spittle, A ; McDonald, C ; Remedios, L ; Toovey, R ; Cheong, J ; Sellick, K (TAYLOR & FRANCIS LTD, 2023-12)
    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.
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    Family Violence and Abuse against Non-Parental Caregivers: An Australian Perspective
    MacRae, A ; Breman, R ; Vicary, D ; Shackelford, TK (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.
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    The Delivery of Person-Centered Care for People Living With Dementia in Residential Aged Care: A Systematic Review and Meta-Analysis
    Berkovic, D ; Macrae, A ; Gulline, H ; Horsman, P ; Soh, S-E ; Skouteris, H ; Ayton, D ; Heyn, PC (OXFORD UNIV PRESS INC, 2023-05-05)
    BACKGROUND AND OBJECTIVES: Person-centred 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-centred 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 four databases. Quantitative and qualitative studies containing data on person-centred 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 three studies measured the same outcome. A narrative meta-synthesis approach was undertaken to categorise verbatim participant quotes into representative themes. Risk of bias was undertaken using quality appraisal tools from the Joanna Briggs Institute. RESULTS: Forty-one studies were identified for inclusion. There were 34 person-centred care initiatives delivered, targeting 14 person-centred care outcomes. Three outcomes could be pooled. Meta-analyses demonstrated no reduction in agitation (standardised mean difference -0.27, 95% CI -0.58, 0.03), improvement in quality of life (standardised 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 (for example, time constraints) and enablers (for example, staff collaboration) to providing person-centred care from a staff perspective. DISCUSSION AND IMPLICATIONS: The effectiveness of person-centred 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-centred care can be best implemented to improve resident outcomes.
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    Working with kinship care families
    MacRae, A ; Vicary, D ; Heward-Belle, S ; Tsantefski, M (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.
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    Trauma-informed care within residential aged care settings: A systematic scoping review
    Macrae, A ; Berkovic, D ; Ryan, J ; Hatzikiriakidis, K ; Ayton, D (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.
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    Shifting practice in domestic violence: child protection workers partnering with mothers
    Humphreys, C ; Kertesz, M ; Healey, L ; Mandel, D ; Zufferey, C ; Buchanan, F (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.
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    Identifying the Patterns of Family Contact for Children in Care
    Kertesz, M ; Humphreys, C ; Corrales, T (ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2022-01-02)
    Contact between children in care and family members is complex and often emotionally difficult for all concerned. In the context of a wider Australian cross-jurisdictional intervention trial, focusing on contact between children in long-term care and their parents, a snapshot survey of 901 children in Victorian foster care and kinship care placements was undertaken. The aim was to determine which children had seen parents, siblings or extended family members within a 12-month period, and how practitioners explained lack of contact between children and their parents. The study found that most children had had contact with parents or other family members, though children in long-term care were less likely to have seen their parents than those where reunification was still a possibility. Practitioners’ views on why parental contact had not occurred for 18% of the sample illustrate the complexity of the issues involved in contact. IMPLICATIONS To support children’s best interests, professionals should be clear about the purpose of family contact and provide support appropriate to that purpose. With children in long-term care less likely to see their parents, professionals have a role in helping these parents adjust to a new role. Developing strategies to maintain meaningful connections between children in long-term care and their parents may be more effective for children’s best interests than the current emphasis on actual visits.
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    'Who's got my back?': Worker safety in the context of domestic abuse
    Humphreys, C ; Isobe, J ; Kertesz, M (Wiley, 2024)
    The safety of practitioners working in the area of domestic abuse is a current subject of research and practice concern, as services endeavour to better understand constantly evolving tactics of violence and abuse and respond appropriately. This paper reports on a subset of findings from a practice-led research project focussed on capacity-building workers and their organizations to address domestic abuse, which highlighted the ongoing concerns expressed by practitioners—particularly female practitioners—about their own physical, emotional, and professional safety. Ethnographic notes were taken of Community of Practice discussions in four regions of New South Wales, Australia, involving 69 senior health practitioners from a range of service streams: specialist domestic abuse, mental health, substance use, and child protection. Themes identified through thematic analysis included the following: a tailored approach to practising safely; attending to physical safety; threats to professional identity; promoting emotional well-being; documentation to support worker safety; and attending to cultural safety. These themes are encapsulated in the practitioner question: Who's got my back?—highlighting the importance of legislation, policy, and practices that provide an environment in which safety and support are embedded in a culture of care at every organizational level.