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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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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ItemAn exploratory study into the use of Christian spirituality in counselling( 2012)A growth in popularity of Christian counselling (Buri 1990; Garzon, Worthington et al. 2009; McMinn 2010) and use of Christian spirituality in psychology (Richards 2010) highlights the need for more research exploring the effectiveness of Christian counselling (Pargament 1999; Koenig 2007; Pargament 2007; Rice 2009; Richards 2010). In order to explore the unique role of Christian spirituality and how it impacts on mental health, a grounded theory approach has been used to research how counsellor-client relationships, counselling methodology and faith in a supernatural God have influenced Christian counselling outcomes and client satisfaction. Clients and counsellors were categorised according to their counselling methodology: pastoral care, Christian psychology, Christian (prayer) Ministry, and Biblical counselling – all categories suggested by McMinn et al (2010). A fifth category combining Christian psychology and prayer ministry was added as this was prevalent amongst the participant responses received. Themes around the influence of love and authority in impacting mental health and of healing by the Holy Spirit emerged from participant comments. Client participants indicated that they trusted Christian counsellors more than secular counsellors, partly because they both held the same Christian world view and also because they believed the counsellor considered the will of God within the sessions. Counsellor participants demonstrated that they use both secular and spiritual therapies. A hierarchical organizational chart inspired by Attride-Stirling’s (2001) networking approach, unraveled a thematic pathway to sustained mental and emotional health. This pathway began with clients first having their immediate needs met and experiencing Christian love from their counsellor. They began to feel they have value to God and to realise that God loves them. As this belief is appropriated in their lives they increasingly were able to overcome their mental and emotional problems and came to seek out truth from the Bible and to submit to its teachings in a gradual process called sanctification. An hypothesis has emerged from the ordering of these themes that suggests: “Spirituality as used in Christian counselling supports sustained improvement in mental and emotional health.”
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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.
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ItemWomen and their journals: navigating depression through consciousness-raising, resistance and action( 2009)Depression in women is a major mental health issue and social work practitioners can, at some stage in their careers, expect to work with women experiencing depression. Journal therapy, the use of writing for therapeutic purposes, is one example of support and intervention offered to women. The use of journal therapy and specifically the use of journalling by women in Women’s Journalling Groups were investigated in this research. Limited research had been undertaken in the area of journal therapy with women experiencing depression. The research was undertaken in four phases and used a modified form of grounded theory to develop the research design and to identify and articulate ideas about women’s use of journalling during depression. Phase one established the baseline knowledge for the research through a Co-operative Inquiry underpinned by feminist research principles. Findings from the Inquiry identified: Two key methods of journalling and women’s responses to depression: • The Considered Acknowledgement, Acceptance and Contemplation framework • The Proactive Resistance, Rehearsal, Agency and Action framework; Four key narratives that women had created about their journalling and their understanding of depression in women: • Identification and expression of emotions; • Identity, sense of self and self-value; • Structural and social roles, relationships and expectations; and • Transformative choices, opportunities and accomplishments; Phase two involved the conceptualising, formalising and transfer of this knowledge into the development of a Women’s Journalling Group program. Through the facilitation of two Women’s Journalling Groups in phase three, the journalling activities were found by women to be relevant and meaningful for them in assisting them to understand their depression and move toward recovery. Phase four included the final stage of knowledge utilisation and transfer. A most significant and new finding from this research was that journalling undertaken by the women was a form of action in response to their depression. Far from being a passive, ruminative, purposeless pastime, journalling was an evolving and sustaining action that enabled the women to gain insights and understandings into themselves and their depression. Journalling activities enabled women to identify and express the many feelings and thoughts that attached to their depression. In reaching clearer understandings of themselves and their depression and in gaining confidence in making choices about their future, women were engaged in processes of consciousness-raising and resistance. Resistance to social and structural expectations, roles and stereotypes was important for the women who could then redefine and redevelop their authentic sense of self and identity. Resistance could occur on an individual level in the journal and on a collective level within Women’s Journalling Groups. The major outcomes of this research have resulted in a model of journalling that has been used to develop a theoretically grounded Women’s Journalling Group program. Whist some further developmental work is required with the program, it nevertheless provides a tested therapeutic intervention that can be offered to women experiencing depression.