Social Work - Research Publications

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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.
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    Public Health Directives in a Pandemic: Paradoxical Messages for Domestic Abuse Victims in Four Countries
    Gregory, S ; Holt, S ; Barter, C ; Christofides, N ; Maremela, O ; Mwanda Motjuwadi, N ; Humphreys, C ; Elliffe, R ; Stanley, N (MDPI, 2022-11)
    When the COVID-19 pandemic manifested urgent concerns were raised around the globe about the increased risk that public health restrictions could pose for victims of domestic abuse. Governments, NGOs and community services swiftly responded to convey the message that services for victims were operational and restrictions did not apply to those fleeing harm. This paper reports on the various approaches used to communicate this public health messaging during COVID-19, further highlighting strengths and learning which could inform future crises messaging. It utilises data gathered through a rapid review and mapping of policy and practice initiatives across 4 high-middle income countries: UK, Australia, South Africa and Ireland. Four themes were identified: (1) Top-down: National media messaging; (2) Top-down: Political leadership; (3) Traditional media vs. social media and (4) Bottom-up messaging: Localised, community-based messaging. It was found that a strong, clear top-down stance on domestic abuse was perceived as beneficial during COVID-19. However, a stronger focus on evaluation, reach and impact, particularly for minority groups may be required. Newer forms of media were shown to have potential in conveying messaging to minority groups. Community and grassroots organizations demonstrated their experiential knowledge in reaching target audiences. Harnessing this expertise for future crises messaging may be valuable.
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    Programme responses for men who perpetrate intimate partner violence in the context of alcohol or other drugs: a scoping review
    Nguyen, V ; Kertesz, M ; Davidson, J ; Humphreys, C ; Laslett, A-M (EMERALD GROUP PUBLISHING LTD, 2023-02-09)
    Purpose Substance use plays a significant role in the perpetration of much intimate partner violence (IPV). However, responses to these two issues are rarely integrated. Single focus programme responses can lead to poor outcomes for men as well as their families experiencing these intersecting issues. This scoping paper aims to establish the current state of knowledge on contextual factors influencing the development and implementation of combined programmes. Design/methodology/approach Four electronic databases were systematically searched in May 2021 and December 2021. Twenty-one peer-reviewed studies reporting on ten programmes were included. Findings This scoping review revealed that combined programme responses are an underdeveloped area of research and evaluation. The limited evidence base indicated systemic barriers hindering services’ capacity to expand this field of work, affecting implementation and outcomes. Support is required from the wider service systems to intervene in men’s perpetration of IPV in the context of substance use. Practical implications Findings in this scoping review demonstrate the importance of fostering a coordinated and collective response to IPV in the context of substance use. Combined programmes have the potential to reduce siloed practices, enabling more holistic responses for men with intersecting issues. However, researchers and policymakers must also address contextual issues hindering or enabling combined programmes’ implementation and development. Originality/value Mapping the evidence based on combined programmes provides direction for further development and research to expand this field of inquiry.
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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 (BMC, 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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    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, 2020-07)
    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, 2021-12)
    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)
    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.