Social Work - Theses
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ItemYoung men speak: a study of mid-adolescence and masculinity( 1999)This study investigated the effect of dominant notions of masculinity in the lives of mid-adolescent males. A qualitative research design, based on the analysis of transcripts of in-depth interviews with eight sixteen and seventeen year-old young men, confirmed the existence of a harsh masculine culture that impinged significantly on their behaviour and attitudes. The findings are identified a possible turning point in young men’s lives, where they begin to develop highly valued close relationships with a small group of friends or mates, with whom they share and emotional bond, and around whom they feel less pressure to prove their manliness. While they described the possibility of sharing thoughts, and feelings and experiences, there were nevertheless limits to what was allowed to be spoken even between the closest of friends. These restrictions were attributable to the sanctions that operated to maintain an environment significantly influenced by dominant notion of masculinity, and in which these friendship groups were embedded. The young men conformed to the tacit restrictions on intimacy, from fear of exposing themselves as weak or poorly skilled. Nevertheless, participants demonstrated a developmental readiness for intimacy, and were beginning to experience emotional engagement with male or female peers. The study suggests the need for a new concept that values and acknowledges a sense of emotional connectedness in the absence of sharing verbalised thoughts and feelings. With intimacy constrained, and little discussion of personal issues, young men had inadequate knowledge of the complexity of problems that might confront them, and few models of coping strategies. Consequently, they risked feeling isolated and unresourced in times of stress. Similarly, while they recognised signs of stress in others, they had few helping skills. In any case, dominant masculinity required that young men handle their own problems, without showing any vulnerability. Counselling was seen as an ultimate failure of manliness. There were indications of intergender rivalry, and despite attempts to be fair and equitable, an underlying belief that men should be in control in families and relationships. Rock music was clearly a potent positive element in the lives of young men, and served a variety of purposes. Alcohol gave individual and group release from the debilitating restrictions of masculinity, removing the need for self-control and allowing greater intimacy. The young men showed they were able to discriminate between “real life” and media or sporting images of masculinity, and had independently identified personal role models from within their own family or friendships circles. This study has shown the importance of understanding the adolescent male world from his own perspective. In particular, it demonstrates the degree to which masculinity impacts on the adolescent behaviour and attitudes, and highlights the necessity for Social Work practitioners to factor the masculine code of behaviour into case and programme planning. Moreover, it is suggested that Social Workers take a proactive approach to teaching young men the language and skills to understand masculinity, and to pursue identity formation and the establishment of positive relationships despite its impact on their lives.
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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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ItemReflecting on decision-making in child protection practice( 1988)The aim of the study was primarily to inform the protective services field by examining the nature of decision-making in protective intervention work, its unique features, its successes and failures. I shall argue that child protection services cannot be seen in isolation from the wider community services field of which they are a part. In addition, the discussion to follow will highlight the significant influence brought to bear on the child protection worker by those other workers in the child welfare field with whom there is constant interaction. On that basis, questions will be raised about the way in which we locate responsibility for the protection of children with one group in the community, namely the child protection services' workers.
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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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ItemUsing the emancipatory values of social work as a guide to the investigation: What processes and principles represent good practice with people on community treatment orders?( 2009)This research explores good practice with people on CTOs - via a case study of one area mental health service in Victoria. The emancipatory values of Social Work were used to guide the investigation, thereby ensuring the involvement of consumers and their families or carers. Critical Social Work theory provided an important theoretical base for the research, and both critical theory and pragmatism supported the methodology. A mixed methods approach was undertaken. This included a cluster analysis of 164 people on CTOs. Three clusters emerged from the exploratory cluster analysis. These clusters, labelled ‘connected’, ‘young males’ and ‘chaotic’ are discussed in relation to their particular characteristics. The results from the cluster analysis were used to inform the recruitment of four people on CTOs who were the central focus of case studies that represented the different clusters. Semi-structured group interviews were also undertaken to enhance the triangulation of data collection and analysis. This resulted in 29 semi-structured interviews with multiple informants, including consumers, family/carers, case managers, doctors, Mental Health Review Board members and senior managers. The data analysis was guided by a general inductive approach that was supported by the use of NVivo 7. Five principles, and the processes required to enable them, emerged from the qualitative data: 1) use and develop direct practice skills, 2) take a human rights perspective, 3) focus on goals and desired outcomes, 4) aim for quality of service delivery, and, 5) enhance and enable the role of key stakeholders. These principles are discussed and then applied to the case studies in order to consider their potential relevance to practice within a diverse community of CTO recipients. The application of the principles identified two further findings: 1) that the principles are interdependent, and 2) the relevance of the principles varies depending on the characteristics of the consumer. The two most important findings to emerge from this thesis are that: 1) people on CTOs, their family/carers, and service providers are a diverse community of people who have a range of problems, needs and preferences in relation to either being on a CTO or supporting someone on a CTO; and 2) the implementation of CTOs is influenced by social and structural issues that need to be considered in developing any recognition or understanding about what represents good practice. Recommendations relating to each of the principles are made, along with identification of future research questions. A particular focus is whether application of the principles will enable improvements in practice on a range of measures, including reducing the use of CTOs, and the experience of coercion by consumers.