Social Work - Research Publications

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    Family-centred care for children with traumatic brain injury and/or spinal cord injury: a qualitative study of service provider perspectives during the COVID-19 pandemic
    Pollock, A ; D'Cruz, K ; Scheinberg, A ; Botchway, E ; Harms, L ; Amor, DJ ; Anderson, V ; Bonyhady, B ; Knight, S (BMJ PUBLISHING GROUP, 2022-06-01)
    OBJECTIVES: COVID-19 has led to rapid changes in rehabilitation service provision for young people living with traumatic brain and/or spinal cord injury. The aim of this project was to understand the experiences of rehabilitation service providers during the acute response stage of the COVID-19 pandemic. Specifically, we aimed to identify innovative approaches to meeting the ongoing needs of young people with traumatic brain and/or spinal cord injury during this time. SETTING: This study was conducted at a research institute and involved remote interviews with key informants around Australia and internationally. PARTICIPANTS: Key informants from 11 services supporting children and/or adolescents with traumatic brain injury and/or spinal cord injury were interviewed using a semistructured interview guide. Interviews were transcribed and analysed using inductive thematic analysis. RESULTS: Three key themes emerged: (1) recognising and responding to the experiences of families during the pandemic, (2) the impact of greater use of telehealth on care delivery, and (3) realising opportunities to enhance family-centred care. CONCLUSIONS: These themes capture shifting perspectives and process changes relevant to longer term practice. Research findings suggest opportunities for future service development, enabling service delivery that is more family centred, flexible and efficient in meeting the needs of families. Understanding these experiences and the changed nature of service delivery provides important insights with implications for future service improvement.
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    The Clinical Utility of the Adolescent and Young Adult Psycho-Oncology Screening Tool (AYA-POST): Perspectives of AYA Cancer Patients and Healthcare Professionals.
    Patterson, P ; McDonald, FEJ ; Allison, KR ; Bibby, H ; Osborn, M ; Matthews, K ; Sansom-Daly, UM ; Thompson, K ; Plaster, M ; Anazodo, A (Frontiers Media SA, 2022)
    Objective: Routine psychosocial screening and assessment of people diagnosed with cancer are crucial to the timely detection of distress and provision of tailored supportive care; however, appropriate screening tools have been lacking for adolescents and young adults (AYAs), who have unique needs and experiences. One exception is the recently validated AYA Psycho-Oncology Screening Tool (AYA-POST) for use with young people aged 15-29 years, which comprises a distress thermometer and age-specific needs assessment. This study investigates the clinical utility of this measure, as well as the subsequent service responsiveness within the Australian Youth Cancer Services. Method: In total, 118 AYAs and 29 healthcare professionals: (HCPs) completed surveys about the clinical utility of the AYA-POST; a subset of 30 AYAs completed a 3-month follow-up survey assessing service responsiveness. Descriptive statistics (frequencies/means) were computed for all items, with chi-square analyses used to explore whether perceived clinical utility varied with AYA age, AYA sex, HCP discipline or HCP length of time using the AYA-POST. Results: Participants' responses demonstrate high levels of satisfaction with the tool, evidencing its appropriateness, practicability and acceptability. Moreover, the AYA-POST was reported to facilitate communication about psychosocial needs and prompt referrals, indicating good service responsiveness. Ratings of clinical utility did not differ significantly between AYA and HCP groups. Conclusion: This study demonstrates that the AYA-POST is an appropriate tool in the psychosocial screening of AYAs with cancer, facilitating the identification of distress and unique concerns in this population and valuable in triaging and tailoring care for young cancer patients.
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    Identifying and dismantling racism in Australian perinatal settings: Reframing the narrative from a risk lens to intentionally prioritise connectedness and strengths in providing care to First Nations families.
    Hine, R ; Krakouer, J ; Elston, J ; Fredericks, B ; Hunter, S-A ; Taylor, K ; Stephens, T ; Couzens, V ; Manahan, E ; DeSouza, R ; Boyle, J ; Callander, E ; Cunningham, H ; Miller, R ; Willey, S ; Wilton, K ; Skouteris, H (Elsevier BV, 2022-04-26)
    INTRODUCTION: The perinatal period is a time when provision of responsive care offers a life course opportunity for positive change to improve health outcomes for mothers, infants and families. Australian perinatal systems carry the legacy of settler-colonialism, manifesting in racist events and interactions that First Nations parents encounter daily. OBJECTIVE: The dominance of a western risk lens, and conscious and unconscious bias in the child protection workforce, sustains disproportionately high numbers of First Nations infants being removed from their parents' care. Cascading medical interventions compound existing stressors and magnify health inequities for First Nations women. DESIGN: Critical discourse was informed by Indigenous ways of knowing, being and doing via targeted dialogue with a group of First Nations and non-Indigenous experts in Australian perinatal care who are co-authors on this paper. Dynamic discussion evolved from a series of yarning circles, supplemented by written exchanges and individual yarns as themes were consolidated. RESULTS: First Nations maternity services prioritise self-determination, partnership, strengths and communication and have demonstrated positive outcomes with, and high satisfaction from First Nations women. Mainstream perinatal settings could be significantly enhanced by embracing similar principles and models of care. CONCLUSIONS AND RELEVANCE: The Australian Anti-racism in Perinatal Practice (AAPP) Alliance calls for urgent transformations to Australian perinatal models of care whereby non-Indigenous health policy makers, managers and clinicians take a proactive role in identifying and redressing ethnocentrism, judgemental and culturally blind practices, reframing the risk narrative, embedding strength-based approaches and intentionally prioritising engagement and connectedness within service delivery.
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    Hierarchies of affectedness after disasters
    Brady, K ; Gibbs, L ; Harms, L (ELSEVIER SCI LTD, 2021-10-13)
    Disasters result in a range of impacts that significantly disrupt the health and wellbeing of those affected. After disasters, a hierarchy of affectedness may be explicitly or implicitly developed, where those affected are compared to each other, and to people affected by disasters in other locations. When an individual's sense of place is so significantly disrupted, these hierarchies are critical to improving the understanding of recovery trajectories, including mental health and well-being outcomes. These hierarchies have practical implications that influence the health outcomes of those affected, including eligibility for disaster aid, support services, and the way that people affected by disasters relate to others in their community. This paper expands the 'hierarchy of affectedness' concept coined by Andersen (2013) using findings from a qualitative study in Australia and New Zealand. Using a letter writing research method, twenty people who had been impacted by a range of disasters in different locations described what they considered helpful and unhelpful in the recovery. One emergent finding in this study was that hierarchies of affectedness are negotiated between impacted individuals, others affected in the same community, and outsiders. These hierarchies served as a helpful sense-making tool for some people impacted by disasters, while causing considerable secondary stress for others. Based on these findings, we offer an expansion to Andersen's existing model of hierarchies of affectedness in post-disaster settings.
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    High-Risk Cases at the Intersection of Domestic/Family Violence and Child Protection: Learning from Practice
    Tsantefski, M ; Young, A ; Wilde, T ; O'Leary, P (SPRINGER/PLENUM PUBLISHERS, 2021-02-20)
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    Human capital and child protection: A research framework in the CRC context
    Wulczyn, F ; Parolini, A ; Huhr, S (PERGAMON-ELSEVIER SCIENCE LTD, 2021-08-10)
    Since it was adopted November 1989, the Convention on the Rights of the Child has shaped the objectives for child protection systems around the world. Generally, those objectives fall along three dimensions: permanency, safety, and well-being. However, despite well-being receiving increasing attention in light of evidence that points to the importance of early childhood experiences on life course outcomes, child protection systems have so far struggled to find clear definition of well-being as a developmental construct. In this article, we propose a definition of child well-being that draws on the economic literature pertaining to skill formation and human capital. We argue that human capital, as a multidimensional concept that incorporates cognitive skills, non-cognitive skills, and health, should be added to the list of considerations policy makers contemplate when their attention turns to well-being provided there is research evidence for doing so. To that end, we discuss the several advantages the human capital framework offers within a child protection context. We then describe a theoretical framework and analytical approach to the study of skill formation. We are particularly interested in dynamic models wherein the skills one has influence the rate at which new skills are acquired, with specific emphasis on risk and protective factors across the life course of childhood. Overall, our discussion highlights how a dynamic model of human capital formation aligns with Convention on the Rights of the Child and notions that children in child protection systems have a right to develop the abilities they will need to be responsible adults.
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    Community views on 'Can perinatal services safely identify Aboriginal and Torres Strait Islander parents experiencing complex trauma?'
    Chamberlain, C ; Gray, P ; Herrman, H ; Mensah, F ; Andrews, S ; Krakouer, J ; McCalman, P ; Elliott, A ; Atkinson, J ; O'Dea, B ; Bhathal, A ; Gee, G (WILEY, 2022-04-26)
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    Supporting Aboriginal and Torres Strait Islander Families to Stay Together from the Start (SAFeST Start): Urgent call to action to address crisis in infant removals COMMENT
    Chamberlain, C ; Gray, P ; Bennet, D ; Elliott, A ; Jackomos, M ; Krakouer, J ; Marriott, R ; O'Dea, B ; Andrews, J ; Andrews, S ; Atkinson, C ; Atkinson, J ; Bhathal, A ; Bundle, G ; Davies, S ; Herrman, H ; Hunter, S-A ; Jones-Terare, G ; Leane, C ; Mares, S ; McConachy, J ; Mensah, F ; Mills, C ; Mohammed, J ; Hetti Mudiyanselage, L ; O'Donnell, M ; Orr, E ; Priest, N ; Roe, Y ; Smith, K ; Waldby, C ; Milroy, H ; Langton, M (WILEY, 2022-01-26)
    Reducing the rate of over-representation of Aboriginal and Torres Strait Islander children in out-of-home care (OOHC) is a key Closing the Gap target committed to by all Australian governments. Current strategies are failing. The "gap" is widening, with the rate of Aboriginal and Torres Strait Islander children in OOHC at 30 June 2020 being 11 times that of non-Indigenous children. Approximately, one in five Aboriginal and Torres Strait Islander children entering OOHC each year are younger than one year. These figures represent compounding intergenerational trauma and institutional harm to Aboriginal and Torres Strait Islander families and communities. This article outlines systemic failures to address the needs of Aboriginal and Torres Strait Islander parents during pregnancy and following birth, causing cumulative harm and trauma to families, communities and cultures. Major reform to child and family notification and service systems, and significant investment to address this crisis, is urgently needed. The Family Matters Building Blocks and five elements of the Aboriginal and Torres Strait Islander Child Placement Principle (Prevention, Participation, Partnership, Placement and Connection) provide a transformative foundation to address historical, institutional, well-being and socioeconomic drivers of current catastrophic trajectories. The time for action is now.
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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.