Social Work - Theses
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ItemA comprehensive planning & evaluation framework for dual disability service systems: co-existing intellectual disability & mental illness( 2005)This thesis focuses upon those people who are disadvantaged through the coexistence of intellectual disability and mental illness. This group is among the most vulnerable in contemporary Australian society. The overall purpose of this research is to develop a comprehensive planning and evaluation framework for dual disability service systems. This framework will address the complex needs of people living with co-existing intellectual disability and mental illness through the development of a plausible service system model. The framework will identify the parameters, principles, boundaries, structures, components, and processes of an effective and quality DD service system. It is anticipated that the development of a service system model will provide the foundation for addressing consumer and carer needs in a comprehensive, coordinated, and systematic way.
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Item“Crisis is often when it comes out”: CATS workers’ experiences of sexual assault disclosures in crisis psychiatric settings( 2006)Crisis Assessment and Treatment Service (CATS) workers are often the first point of contact between an individual and the mental health system, thus these mental health professionals are the gatekeepers to further mental health service use and referral to other service sectors. Among the users of mental health services, there is an overrepresentation of women who have been the victim/survivors of sexual assault while research documents that these service users have a predominantly negative experience of disclosing, in other words, talking about sexual assault to mental health workers. The aim of this study was to explore the research question – what are the ways in which CATS workers understand their response to victim/survivors who disclose sexual assault in psychiatric crisis service settings? To achieve this aim, fifteen CATS workers from a Melbourne metropolitan service took part in a small scale, feminist based, exploratory study utilising a qualitative and quantitative survey design. Key findings of this research were that firstly, a majority of participants do not feel well equipped to respond to disclosures of sexual assault; secondly, workers indicated the need for training in this area; thirdly some participants held misconceptions about sexual assault including the lack of a gendered understanding; fourthly, some workers expressed a problematic understanding of trauma and awareness of how to effectively respond to a disclosure of sexual assault; and, finally, this study found minimal communication between CATS and specialist sexual assault services. The implications of these findings highlight the need for sexual assault training; a review of CATS role in relation to women disclosing sexual assault; and the need for cross-sectoral practice.
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ItemA constructivist approach to challenging men’s violence against women( 2005)This PhD by project consists of a Manual for workers engaged in men’s behaviour change programs and a dissertation that theorises the principles underpinning the approach. The Manual and the dissertation examine a constructivist approach to challenging men’s violence against women. The project, which is situated in rural Australia, is called the Men’s SHED (Self Help Ending Domestics) Project. The SHED Manual is based on a constructivist approach to men’s violence against women that reflects best practice principles within a profeminist framework. The Manual is comprised of eight sections that articulate various aspects of challenging men’s violence against women, with individuals, groups and communities. The dissertation details the journey of the project from its inception in 1994 to the beginning of 2002. Personal construct theory provides a philosophical basis for the approach being enunciated in this study and it enables an exploration of constructive alternatives in engaging and challenging men towards behaviour change. As such, it is utilised both in engaging men to become non-violent and at the same time, reflexively enabling workers and facilitators to examine ways in which they can construct more effective ways for this to happen. The project is thus one of hopeful anticipation leading to new constructive alternatives in the endeavour to stop men’s violence against women.
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ItemMusic therapy's relevance in a cancer hospital researched through a constructivist lens( 2001-09)A constructivist research paradigm informed an investigation of the relevance of music therapy (MT) in a cancer hospital, that is, (a) what did MT do(?) and (b) did it help? Over three months, criterion sampling was used to elicit interpretations from five sources: 128 patients who participated in MT, 27 patients who overheard or witnessed MT, 41 visitors, 62 staff, and the researcher who was also the MT clinician in this study. The researcher’s interpretations were recorded in a reflexive clinical journal and the respondents’ interpretations were written on anonymous open-ended questionnaires. The MT program was predominantly characterised by the use of patient and visitor selected live music. Thematic analysis, informed by grounded theory (Strauss & Corbin, 1990), and content analyses were performed on the five groups of data with the support of ATLAS/ti (Muhr, 1997) software. Many patients and visitors who experienced MT reported that MT elicited a range of affective responses and altered imaginings. Responses were especially characterised by memories being revisited but also characterised by the respondents’ “transportation” to new spaces or thoughts and physical sensations. Some staff and patients who overheard MT also reported similar experiences. The researcher, and often staff and visitors, also perceived that MT elicited affective and imagined sensations in patients.
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ItemGreat expectations: a policy case study of four case management programs in one organisation( 2007)Four different case management programs delivered by UnitingCare Community Options (UCCO) in the eastern suburbs of Melbourne were examined against the expectations of case management as a policy solution to a range of perceived policy problems at the micro-, meso- and macro-levels. The micro-level expectations were related to client and family experiences of the service system and outcomes. At the meso-level expectations were focused on perceived service delivery problems such as poor matching of services to the needs of ‘complex’ clients including a lack of integration, flexibility and responsiveness to clients’ needs and preferences. Perceived macro-level policy problems were concerned with a variety of issues including increasing rates of institutionalisation, increasing costs to governments, lack of economic efficiency and the desire to create market or quasi-market conditions in the community care service delivery sector. (For complete abstract open document)
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ItemEmerging identities: practice, learning and professional development of home and community care assessment staff( 2006-12)This thesis argues for greater recognition of assessment staff in community care/home and community care (HACC) and a more comprehensive and considered approach to preparing such a workforce. By offering deeper insights into the practice of assessment and the individuals employed in these positions, the thesis makes the case that these are emerging identities: a new specialism in the emergent space of community care. This specialism has arisen to fill the gap which has developed as a result of changing socio-cultural practices in relation to care for the frail aged and people with disabilities, and the inability of established disciplines to keep pace with the new demands of the contemporary world. The study employed a qualitative methodology using in-depth interviews with key informants with various stakeholder interests and expertise in the area of assessment and home and community care, and workers employed in assessment roles in HACC services in Victoria. The conceptual framework is represented as theoretical perspectives from current adult educational scholarship that focus on professional disciplines (including multidisciplinary/interprofessional perspectives), those that focus on communities of practice, and those that focus on the workplace. The thesis shows that HACC assessment workers are a product of contemporary workplaces and systems of health and community care. The nature of their practice derives substantially from the local contexts in which they work; there is no single profession or discipline-based narrative that drives their practice. Instead they draw from a diverse range of knowledge sources including their embodied practice. In this way, it is argued that they are emergent practitioners, whose practice and identities share many elements with traditional professions in comparable work contexts (similar levels of autonomy, reflective practices, and development and application of ‘know how’ and tacit wisdom). The case is put that their embodied practice is the site of a robust professionalism which can provide the foundation for new approaches to the education, training and development of this increasingly important and growing occupational group. A model of learning is proposed which builds on authentic learning attained in daily work activities with clients, in the workplace as a social setting, and developing the self as a resource for practice. This model is based on a hybrid approach that builds on the learning strengths of both educational institutions and the workplace.
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ItemRelationships, connectedness and engagement: a study of the multidimensional components of 'good-enough' collaborative approaches for young people with complex needs and their families( 2006)The focus of this research is an exploration of the use of collaborative intersectoral approaches to service delivery as a means of improving responsiveness to the complex needs and issues presented by vulnerable adolescents and young people. There are three central domains and contexts that inform this research:- young people with complex needs- their problematic history of access to, and engagement with a particular cohort of service systems and- the common issues that arise when these service systems interact. The central research question that this thesis has explored is:- What are the principles and guidelines that will inform services operating within an integrated collaborative approach for children, adolescents and young people with complex needs? A multi method design informed by an interpretative research paradigm utilising qualitative research methods was used which consisted of:(i) An analysis of key policy directions within Australia, United Kingdom and United States relating to young people with complex needs.(ii) An analysis was undertaken of current local, national and international literature that relates to policy, program and practice for children, adolescents and young people with complex needs.(iii) In-depth interviews conducted with five stakeholder groups involved with an inter-sectoral service initiative consisting of cross-sector care teams providing a therapeutic service to young people living in residential units.
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ItemAn analysis of experiences of psychosocial recovery from road trauma( 2001-12)Understandings of the longer-term experiences of recovery from road trauma are limited. Many studies to date have examined the psychological and psychiatric consequences of road accidents in the short term, but few have moved to a focus on the psychosocial and subjective aspects of recovery, and the longer-term challenges of this process. (For complete abstract open document)
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ItemEvaluation of the Bilingual Case Management Program in community mental health services in Melbourne( 2001-06)This thesis describes the evaluation of a program to employ bilingual staff in case management positions in community mental health services in Melbourne, Australia. A literature review showed that no previous research in Australia had investigated the impact of bilingual staff on clients of mental health services. While research conducted in the USA shows that ethnic matching (matching clients and clinicians on the basis of language or ethnic background) increases service use, its impact on outcome domains such as social functioning remains uncertain. (For complete abstract open document)
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ItemReaching out beyond itself: a framework for understanding the community involvement of local church congregations( 2004-01)Historically, religious congregations and other church organisations have had a long involvement in the provision of community services in English-speaking societies. Nonetheless, despite the development since the 1950's of extensive government provision, the growth of large church-sponsored agencies, and the advent of secular community services, there is reason to believe the trend for congregational involvement persists. However, there is also reason to believe that provision of services by congregations is not well understood, an issue of more significance in view of recent policy shifts, especially in the US and UK, promoting an increasing emphasis on government support for welfare service delivery by these “pervasively sectarian” groups. Within the Australian setting little is known about the contribution of local religious congregations to the provision of local community services, although limited data from the 1996 National Church Life Survey indicates in excess of 65% of congregations claim some local community involvement. (For complete abstract open document)