Social Work - Theses
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ItemAn exploratory study into the understanding health professionals have about the impact of culture on the experience of Vietnamese patients diagnosed with cancer.( 2013)Primary research focused on health professional understanding of the impact of culture on the cancer experience of Vietnamese patients does not exist in Australia. Australia’s population continues to grow in diversity with more cultures merging and emerging through waves of migration and the birth of new generations. The Vietnamese population represents one of the most recent waves of migration to Australia, with the Vietnamese population in Australia more than tripling over the past 30 years. However, there remains no published research about how this population gives meaning to their experience of cancer; a disease which has significant impacts on health, wellbeing and quality of life. This exploratory study was based at Peter MacCallum Cancer Centre, Australia’s only tertiary public hospital dedicated to cancer treatment, research and education. It aimed to describe demographic characteristics of Vietnamese patients and explore the understanding of health professionals about the impact of culture on the cancer experience of Vietnamese patients and their family. This study employed a Practice-Based Research (PBR) methodology across three Phases including Clinical Data Mining (CDM), health professional focus groups and clinical case studies. Results from this research describe the demographic detail of the Vietnamese patient population attending the specialist cancer centre and reveal that there is an absence of comprehensive psychosocial assessment by health professionals and therefore limited referral for support services such as social work. Outcomes from the focus groups illustrate the complex awareness that health professionals have of culture and the challenges this presents in providing cancer care for this population. Recommendations from this study suggest a model of targeted education for health professionals and interpreters to increase cultural and psychosocial competence in providing cancer care for this population. It is recommended that an evidence-informed model of care, integrating a Vietnamese Cultural Advocate into the cancer system, as cultural interface between health professionals, health system and patient and family would be of benefit to the care received by Vietnamese patients and their families.
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ItemAn exploratory study into the psychosocial effects and patient experience of women undergoing treatment for locally advanced cervical cancer( 2013)The field of psycho-oncology has expanded over the last thirty years and there has been much research focussed into the general cancer patient experience and into specialist areas like breast cancer. However, there is limited literature that outlines the psychosocial needs and patient experience of women undergoing combined chemotherapy and radiotherapy for locally advanced cervical cancer. In a country like Australia, this group of patients is a small sample of the overall cancer population, however clinical practice indicates that these patients often have high psychosocial needs. This study was based at Peter MacCallum Cancer Centre, a specialist cancer centre in Melbourne. It aimed to illustrate socio-demographic, psychosocial stressors, service utilisation and information about the consumer experience for this patient population. This study employed a practice-based research methodology comprising three Phases including clinical case studies, clinical data mining and consumer interviews. Results from the research outline socio-demographic details of these patients who attend this specialist cancer centre, and indicate that cervical cancer patients experience high levels of psychosocial stressors and needs and are high users of social work services. Outcomes from the consumer interviews illustrated patient preferences for peer support and attention to post treatment survivorship needs. Recommendations from this study suggest that there would be benefit to a model of psychosocial intervention focussed on supportive care specifically for patients with locally advanced cervical cancer. Recommendations also suggest benefit to a patient pathway that is evidence-informed and patient focussed and that incorporates psychosocial factors alongside the medical treatment continuum.
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ItemSocial work supervision practice in Australia: does the rhetoric match the practice?( 2012)This research explores the practice of social work supervision in Australia. The thesis uses a mixed method design to collect data about current supervision practice. Quantitative data was collected through an online survey with 675 respondents completing the survey. The preliminary data from the survey was then used to conduct semi structured focus groups, separated for supervisees and supervisors, from the statutory, non-government and health/counselling sectors. Using Bourdieu’s concepts of habitus, capital and field, this research challenges how social work supervision is practised, spoken about and used in the current neoliberal environment. The thesis is that social work supervision in Australia has become a mechanism by which the ethical mandate of social work practice is compromised under neoliberalism. The research showed that a quantitative mapping of supervision in the field provides a picture consistent with traditional or orthodox modes of supervision as detailed in the literature. However, the qualitative research provided contrasting information that suggested that the orthodox picture is not complete. Beneath the surface it was seen that supervision was posing challenges to social work practice not only in its modes and methods, but also by its omissions, where professional focused supervision is not provided or reduced, challenging the support practitioners need to act in a manner consistent with social work’s ethical mandate.
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ItemLives unseen: unacknowledged trauma of non-disordered, competent Adult Children Of Parents with a Severe Mental Illness (ACOPSMI)( 2012)This theoretical thesis attempts to make visible the needs of adult children of parents with a severe mental illness (ACOPSMI), a population which has attracted little scholarly attention to date. It employs a methodology in which established trauma and alternative grief theories are applied to existing multidiscipline, scholarly and lay ACOPSMI literature. The thesis attempts to broaden the definition of ACOPSMI to include non-disordered, competent individuals. It argues that the unique, trauma-based needs of ACOPSMI are not being adequately met within existing family-focused policies and practice, which focus on the needs of parents with an SMI to the potential detriment of their adult offspring. Limitations, implications, and recommendations of this research are outlined.
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ItemSocial work in secure forensic mental health inpatient services: towards cultural competence( 2011)International migration has moved to the forefront of the global agenda and has become a challenge for governments around the world. According to the Department of Immigration and Citizenship [DIAC] (2007), Australia has become “one of the most culturally diverse societies of the 21st century” with more than six million migrants having arrived since 1945 (p.1). This is despite Australia’s history of racist immigration and indigenous policy, and continued social disadvantage and discrimination experienced by many indigenous and CALD (Culturally & Linguistically Diverse) Australians. Secure forensic mental health inpatient services, like many services, are not meeting the needs of the indigenous and CALD population. This paper will use a critical literature review, from a critical theory and social constructionist perspective, to answer three fundamental questions: What are the problems for indigenous and CALD patients in secure forensic mental health inpatient services? What factors contribute to, and sustain, these problems? What can social workers do about these problems? While cross-cultural forensic mental health research is scarce and often methodologically flawed, key themes emerge. Secure forensic mental health inpatient services are influenced by a complex, socially constructed tangle of institutions, policies and practices. The ‘caring’ mental health system and the ‘custodial’ criminal justice system often have conflicting goals and expectations. Furthermore, public and media perceptions of danger frame the policy context. This leaves patients commonly experiencing discrimination, disempowerment and social exclusion. However, patients from indigenous and CALD populations are further marginalised and have reduced ‘social quality’ (social inclusion, socio-economic security, social cohesion and empowerment) (Huxley & Thornicroft, 2003). The literature attributes this to factors including: discriminatory and reactive government policies, an ethnocentric mental health system that relies on culturally invalid classification systems, and culturally incompetent clinicians and organisations. Social workers have been implicit in these systemic failures through their lack of contribution to the literature and their lack of influence in forensic mental health. This is despite the compatibility of the social work person-in-environment perspective, and its focus on social justice and social quality, with good cross-cultural practice. Frequent references to ‘unexplored’ socio-cultural and environmental factors in the literature, and a mental health policy shift in Victoria towards social inclusion and community development, provide a timely opportunity for social work to assert itself. In this paper, my purpose is to demonstrate how social workers can affect structural change on a professional ecosystem that impedes culturally competent practice. Through this conceptual framework, I have developed Culturally Competent Guidelines for Social Workers in Secure Forensic Mental Health Inpatient Services. These guidelines aim to provide social workers with tools that might empower them to become more culturally competent clinicians, and in the process, enable them to strive for social justice by improving social quality and cultural competence at all levels.