Social Work - Theses
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ItemCrossing boundaries and lesson drawing: a case study of safe accommodation program transfer between Australia and India( 2008)This qualitative study examines the viability of India transferring safe accommodation for women leaving violent relationships from Australia. The objectives of the study are to examine safe accommodation programs for women leaving violent relationships in Australia and India, and identify transferable aspects from Australia to India. The service providers' account of the reality of overcoming challenges posed by cultural values and the knowledge that funding for women’s services is precarious provides the thrust of this work. This thesis argues that developing countries do not benefit from the knowledge exchange that is likely to occur between developed countries. Women's human rights principles and the “program transfer” approach inform this inquiry. A multi-method approach was chosen for developing the country case studies involving a literature review, field visits and semi-structured interviews with 10 service providers of safe accommodation services in Australia and India. Equal numbers of participants were interviewed in both countries. Expert sampling techniques were employed. The major finding of this study identifies that transfer of safe accommodation program for women leaving violent relationships between Australia and India is an aspiration particularly because of the incompatibilities that exist at various levels of service provision between the two countries. Crucially, the incorporation of the women’s human rights principles into the safe accommodation service delivery in both countries remains a challenge, and the analysis confirms that these principles remain largely unimplemented. In contrast to the popular belief that welfare programs in developed countries are consistently better than developing nations, the observations in this thesis identify that challenges remain in both country contexts. The thesis signposts areas of future research by establishing an agenda for ongoing research that is aligned with enhancing safe accommodation service provision in both Australia and India.
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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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ItemSetting policy in concrete: the impact of the built environment on older people who live in residential aged care facilities( 2008)Residents of residential aged care facilities live out the last days of their lives in an institutional environment. These facilities can potentially liberate and/or constrain. The voice of actual residents has been little explored to date. Critical gerontology, which underpins the study, demands that researchers endeavour to understand the lived experience of the older person. This thesis focuses on the impact of the built environment on older people (without dementia) who live in residential aged care facilities. Based on original research undertaken in Victoria and some of the latest thinking from Australia and overseas the study was undertaken using mixed methods. The research involved a review of the literature, in depth small group interviews with residents, staff, family and carers, and surveys and a best practice forum with architects and managers. The research identified and explored the key areas of concern for each of these stakeholders, considering how residential aged care services could do more to improve the quality of life for residents through the built environment. Three key areas emerged from the study. Firstly, the journey the residents make in their time in the RACF and how the built environment impacts on their quality of life in place and over time. Secondly, the ‘frames of reference’ the key informants to the study hold are explored and how they can impact on the design process. Finally, by analysing the data collected and placing the resident at the centre, a model is proposed which holds potential and significance in relation to the development of RACFs in the future
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ItemCrystallising meaning: attitudes of listening to illness narratives( 2008)This study involves listening to illness narratives embedded in in-depth life review processes. The method of multiple interview and multi-modal analysis and reflective responding utilised in the study aims to add to the existing field of research by expanding the understanding of what it is like to be heard or not heard, for people who are either patients, or family members. The study also aims to demonstrate how self-aware ,compassionate and reflective listening, particularly in healthcare relationships, can allow meaning to emerge from within the illness experience, thus enriching the wellbeing of patients, family members and their various healthcare professionals. Stories of disruption arising within healthcare settings often confronted me during more than forty years of nursing experience and also resonated within my personal experiences. These stories express a gulf between patients, family members, or residents in healthcare institutions, and the healthcare organization and its staff. A recurring theme was that these people felt that they had not been listened to by those they trusted to give them care, with a lasting sense of disruption to their wellbeing. In focusing on the dimensions of reflective listening and intersubjective responding, the implications of being heard on the well being of both narrator and listener can be elucidated. An objective of the research became to articulate the attributes and values of compassionate, reflective listening and elucidate the complex nature of the narrating and listening relationship. (For complete abstract open document)
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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.