Social Work - Theses
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ItemSocio-legal collaborations in Australia - models of service provision and the influence on practice( 2019)Interdisciplinary collaborations between legal and social services have emerged as a growing framework for assisting clients with high degrees of disadvantage, vulnerability and complexity. World-wide developments in the social determinants of health and access to justice have demonstrated the need for integrated approaches which break down professional silos and work with intertwined legal and social issues. The promotion of collaboration, however, has not generated a unique program or intervention structure, rather a wide diversity of forms has developed organically, be it with the common goal of assisting those in need in holistic and integrated ways. This study has mapped the nature of these collaborations across Australia, their forms and staff, and explored the influence collaborating professions are having on each other’s practice. While lawyers and social workers would seem to have a natural synergy for these programs, the study examined which professions are actually involved, how they went about collaboration and the professional practice being delivered, collective details of which have until this study remained limited. The study presented is a mixed methods project using online surveys and semi-structured interviews to explore these programs and the experiences of staff within them. Results suggest that social work practice and social workers take up a significant role in these interdisciplinary collaborations and are central to a model of effective collaboration between legal and social service professions. Social work was found to be not only the most common form of social service practice found in these collaborations but also one of the most influential upon other professions and professional practice including law. From these findings an evidence-based model of socio-legal collaborations was developed, alongside a socio-legal collaboration health check, translating the theoretical model into practical guidance for program reform and sector development. A call for social work leadership in these socio-legal settings is also made, with the results of the study demonstrating the need for social work to understand and promote their critical contribution to collaborations and to the other professional practices and client outcomes which result.
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ItemFrom suspicion to intervention: improving responsiveness to abuse of the elderly in acute and sub-acute healthcare( 2017)Background: Elder abuse is a recognised form of family violence. It is an act of harm towards an older person by someone known to them - usually within their family network or trusted social environment. Because of the private nature of elder abuse, it remains a hidden problem. Hospitalisation has been identified as offering a “window of opportunity” (Joubert & Posenelli, 2009) to support older people at risk of abuse however very few health professionals have received any training alerting them to issues of elder abuse (Dow et al., 2013). For this reason, health professionals need to be equipped with the required knowledge to be both confident and competent in supporting older people at risk of abuse. Thesis Aims: This thesis is nested with an Australian Council Linkage Grant study - number LP0989536. The aims of the research are: • To identify the barriers to health professionals’ identifying and responding to suspected elder abuse • To examine current knowledge on elder abuse and to describe models, approaches and frameworks for identifying and/or responding to elder abuse, including the education and training of health professionals • To develop an evidence informed elder abuse training intervention for health professionals working with older people in an acute, sub-acute and Emergency Department setting • To implement the training intervention and evaluate its impact on the awareness, knowledge and confidence of health professionals working at the study site, in facilitating their responsiveness to suspected elder abuse Methodology: This research has applied a sequential, mixed methods design (Creswell, 2003); across four interrelated phases. The explanatory sequential design (Plano Clark, 2011) was fixed in that it was predetermined and planned at the commencement of the research to collect analyse, and interpret both quantitative and qualitative data in a single study to investigate the same underlying phenomenon (in this case elder abuse) and training targeted health professionals to identify and respond. Phase 1: involved an extensive examination of both peer reviewed and grey literature to scope key themes - elder abuse and the health context; theoretical perspectives, the models and frameworks in place in hospital contexts for responding to elder abuse as well as effective training strategies and approaches for health professionals. The phase involved further inquiry to identify the barriers to responding to elder abuse and how these might be addressed as part of this study. A descriptive design was used and included feedback from health professionals with different roles and years of experience at the study site to obtain their perspectives via a confidential online staff survey, focus groups and in-depth interviews (n =300). Phase 2: considered the key components needed for the training intervention – the content, the targeting or selection of trainees and effective strategies or methods for delivering the training. This phase entailed conceptualisation and decision-making in relation to the knowledge, ideas and insights generated by the findings of Phase 1 to inform the development of the training intervention. Phase 3: focused on application of the knowledge synthesis and decisions made in Phase 2 to inform development of the tools and products for the training package at the study site. In this phase, consideration was given to relevant features of the policy context. This phase describes the outcomes achieved at the study site which includes a governance framework relating to the protection of vulnerable older people which was developed and implemented to support the roll out of the training intervention as part of this study. Phase 4: applied a pre - post test to determine the effectiveness of the training intervention. The training intervention was evaluated by measuring changes in knowledge and confidence to act on suspected elder abuse in a hospital setting for a targeted group of experienced health professionals. This phase used a quasi – experimental design to test the effectiveness of the training intervention. Results: The outcomes of this study have resulted in identifying and analysing the perceptions, barriers and knowledge of health professionals regarding the problem of elder abuse. This has included targeted training through a competence based framework and the development of a governance framework, hospital wide policy and a model of care. The findings from the evaluation of the training intervention demonstrate that the training package which included an evidenced informed training DVD was successful in increasing the participants’ level of suspicion and the level of confidence to deal with suspected elder abuse cases. There have been several other unintended outcomes of this research. While the training package was developed to meet the aims of this study there have been significant changes in clinical practice at the study site. Training health professions in relation to indenting and responding to elder abuse has been embedded into practice and has resulted in significant systems change including ongoing data collection at the study site relating to cases of suspected elder abuse.
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ItemThe introduction and implementation of permanent care orders in Victoria( 2019)This research investigated debates surrounding the introduction and implementation of Permanent Care Orders (PCOs), a type of guardianship, in the context of permanency for children unable to be reunified with their parents in the statutory child protection and out-of-home care system in the Australian state of Victoria. Two thematic document analyses were conducted using Applied Thematic Analysis, which facilitated rigor and reduced potential bias in the studies. The first study analysed the official records of the relevant 1984–1989 parliamentary debates to investigate the key issues and ideas that informed the introduction of PCOs in Victoria. Four primary themes were identified: the rhetoric of rights; the ‘hierarchy of family’ debate; child protection is everybody’s business; and the politics of influence. The second study analysed the publicly available submissions to a government-commissioned inquiry into the early outcomes from changes made in 2014 to Victoria’s permanency laws to investigate the implementation of PCOs in relation to the issues that triggered their introduction. Again, four primary themes were identified: the power of government; the assumption of a perfect system; disproportionate impact on the most disadvantaged; and the impact of the permanency hierarchy. Overall, the studies found that a children’s rights perspective, particularly with respect to continuity of care, family connections, culture and identity, has not been prioritised in the operationalisation of children’s right to protection and in the development of alternative permanency options. Viewed in terms of Fox Harding’s four-fold typology of ideological perspectives in Western child welfare, the findings indicate that the Victorian Government’s approach has shifted from a defence of the birth family and parents’ rights orientation, which emphasises the importance of biological families and values continuity in children’s relationships and connections with them, toward a state paternalism and child protection orientation, which more highly values legal permanency in the provision of alternative care arrangements for looked after children. The implications of the 2014 change to Victoria’s permanency hierarchy, which now positions adoption ahead of PCOs, mean that progress toward a children’s rights approach to policy development and practice in the area of child protection and out-of-home care may be further undermined. An alternative framework integrating a broad range of children’s rights and recent international research evidence is proposed with a view to stimulating thinking and debate in this politically sensitive and contentious area of social policy, practice and research.
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ItemExperiences of anger following the 2009 Black Saturday bushfires: implications for post-disaster service provision( 2018)This study investigates the question “What are the experiences of anger post-disaster?” to better understand anger following disaster and establish service provision guidance. Theoretical anger conceptualisations typically engaged in disaster recovery environments are psychological and relate to psychopathology, particularly post-traumatic stress disorder (PTSD). This research engaged anger-related theory more broadly including both psychological and sociological theory. This qualitative research was a nested study within the Beyond Bushfires: Community, Resilience, Recovery research study. A total of 38 participants including both community members and service providers were interviewed individually and within focus groups to explore anger experiences. The service provider participants were from a range of roles: direct service providers, managers and senior disaster leaders. The breadth of work forces providing recovery services were also represented: three tiers of government, emergency services, community health, counsellors, case-managers, emergency responders and hub staff. Data were gathered and analysed utilising a discourse-based narrative approach called the ‘social interaction approach’ (SIA). Anger was found to be an active emotion post-disaster: immediate, intense, and frequent, extreme, prolonged, destructive, productive, justified and connected to other emotions. Anger was experienced differently post-disaster, nonetheless, triggers for anger are considered by service providers and community members to be about real events. Traditional gendered identities within regional areas and accompanying expectations of behaviour, seemed to influence experiences and expressions of anger including aggression, violence and family violence. Analysis of community member and service provider data highlighted factors influencing anger including: a sense of community control over recovery; methods of leadership including transparency and honesty and bottom-up processes; equity of provision of financial assistance, which was integral within and between communities; and expectation in terms of whether disaster responders established clarity around services that could be provided for communities. There were limitations with the research: the research was conducted with a culturally homogenous group following one disaster in one region of Australia limiting the scope of the data, and lack of a circular process for participants to review the conclusions drawn resulted in a lost opportunity to confirm conclusions. Numerous potential future research projects are recommended, including research developing an evidence-based framework of service intervention with anger, as well as understandings of anger, gender, violence or family violence and service provision. Ten recommendations for service provision are offered as guidance outlining the approaches that a service provider could take to engage with and respond to anger within a disaster recovery environment.
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ItemMemory-making in neonatal end-of-life care( 2019)Experiencing the death of an infant places parents at risk of prolonged and profound grief, therefore providing appropriate psychosocial support for parents is crucial. Current perinatal palliative care guidelines recommend memory-making activities, such as collecting or creating mementos and spending time caring for the infant, as an important aspect of bereavement care. However, evidence to support such interventions is scant. This study used the grounded theory method described by Corbin and Strauss (2015) to explore bereaved parents’ experiences of memory-making in neonatal end-of-life care. Eighteen bereaved parents participated in extensive semi-structured interviews. The core psychosocial process underpinning parents’ experience of memory-making was identified as “Affirmed Parenthood”. This core category was supported by three key themes; “Being a parent”, “Creating evidence” and “Being guided”. “Being a parent” included spending time with the baby before and after death, touching and holding the baby, and providing physical care. “Creating evidence” captured parents’ efforts to collect or create tangible evidence of their baby’s life through photographs and other mementos, and by involving others with their baby to ensure that people outside the immediate family would have memories of their child. Finally, “Being guided” represented parents’ need to be supported and encouraged throughout the process of memory-making. Where all three key themes were addressed in bereavement care, parents experienced affirmation of the significance of their baby’s life, affirmation of the significance of their loss, and affirmation of their role as the baby’s parents.
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ItemParenting after Black Saturday: lived experiences since the 2009 Victorian bushfires( 2018)In the aftermath of disasters, parenting is often recognised for its influence on children’s wellbeing and recovery. Research has also shown that the parental role has implications for parents’ post-disaster mental health as well. However, little is known about what the experience is like for parents themselves, particularly in Australia. In February 2009, catastrophic bushfires burned across the state of Victoria resulting in tragic loss of life, significant destruction of property and land, and disruption to communities. This study explored what it has been like to be a parent since the 2009 Black Saturday bushfires. Semi-structured interviews were conducted with 22 parents (19 mothers, 3 fathers) who, along with their dependent children, survived the Black Saturday bushfires. The interviews were conducted around 6-7 years following the fires, thus offering a longer-term perspective than much of the research in this area to date. An inductive thematic analysis was conducted to explore parental experiences over the years since the disaster. The findings provide insight into parents’ experience of adjusting to life after the fires as that of being forced into a new normal. Parenting after the bushfires stood out for many as being different and difficult. For some, the extent or nature of the changes were spoken about as a loss of a valued part of their identity. Some changes stood out as new situations, ones they had never expected to face as parents. There were also challenges they considered typical of parenting which were amplified after the disaster and now felt beyond parents’ control. This study identified five parenting challenges faced by participants in the aftermath of Black Saturday: (i) parenting flexibly and finding new strategies; (ii) sticking to their values; (iii) being present and available; (iv) being patient and tolerant; and, (v) negotiating differing needs. The challenges showed ways in which the post-disaster environment (e.g., the number of demands, changes within their communities), parental mental health (their own or their partner’s trauma and grief reactions) and their children’s mental health at times undermined their efforts to be the parents that they wanted to be. Parental experiences of supports and services showed the value and nuance of relationships and indicated ways in which formal services can facilitate or strengthen social support. Additionally, the importance of reinforcements with helping children cope as well as services to assist parents’ own coping was highlighted. The findings also speak to the critical significance of childcare (in particular the availability of safe and trusted places for children) and value in facilitating opportunities for time together as a family away from the onslaught of post-disaster demands. This study contributes to understanding the complexities of parenting and unique experiences of parents post-disaster. It has provided detailed insight into parental experiences following the Black Saturday bushfires offering an opportunity to acknowledge, normalize, and validate such challenges.
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ItemThe experience of Chinese female spouses of problem gamblers in Hong Kong: a grounded theory study of multi-dimensional impact( 2019)Although problematic gambling is a widespread problem among Chinese populations across the globe, there is limited research on how it affects Chinese female spouses of problem gamblers. The purpose of this study was to explore how Chinese female spouses of problem gamblers (PGs) in Hong Kong were affected and what strategies they adopted to cope with the impact of a spouse’s problematic gambling. For the study, I have interviewed with 23 adult Chinese female spouses of PGs. These study participants were recruited from five different gambling counselling centres in Hong Kong. This study employed a grounded theory methodology in the collection and analysis of the data. Nine categories of impact experienced by participants were identified, and 17 types of paradigmatic coping strategies were identified. Based on these findings, a grounded model of multiple selves and multiple paradigms (MSMP) was constructed. The model provides a self-based theoretical framework to understand how participants perceived and interpreted the impact. The model also postulates that coping strategies were guided by three major paradigms operated by participants namely the PGs-Centered Paradigm (PGCP), Family Relationship-Centered Paradigm (FRCP) and SELF Care-Centered Paradigm (SCCP). Implications for counselling and directions for future research are discussed.
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ItemThe practice of evaluation in Australian child and family organisations( 2018)Despite reports that the demand for evaluation is at an all-time high, little is known about how child and family organisations in Australia are engaging with evaluation. Also unknown is what helps and hinders these organisations in their evaluation efforts, and how the professionals that comprise their workforce perceive evaluation. This research study surveyed 66 Chief Executive Officers, 46 internal evaluators, and 122 practitioners, to understand how child and family organisations practice evaluation, what acts as barriers and enablers to this practice, and what perceptions of evaluation are held by professionals. The study found that evaluation is understood differently by different professionals working in child and family organisations. Despite the majority of CEOs reporting clear purposes and internal motivations for their organisation’s engagement with evaluation, it was found that in some cases, the form of evaluation being undertaken and the type of data being collected may not meet that purpose. Overall, perceptions of evaluation were nevertheless mostly positive. From these findings, a critical elements framework for evaluation practice in child and family organisations has been proposed. It includes four domains: instilling a performance mindset for evaluation; assessing and communicating the purpose for evaluation; enabling the environment for evaluation; and optimising evaluation outcomes. Results of this PhD study can be used by child and family organisations across Australia to inform how they practice evaluation and how it can be used to optimise the outcomes of programs and services and, most importantly, for the beneficiaries they serve.
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ItemIdentifying the key factors shaping the construction of a social work identity in mental health( 2018)A social work identity is ‘difficult to grasp’. Relevant professional literature is scarce, though some authors have recently acknowledged that ‘Social work identity is a contested concept.’ (Mackay & Zufferey, 2015). The notion of a distinctive and unique social work identity is not well recognised or articulated by experienced practitioners, nor does it appear to be adequately emphasised in social work education and training programs. These considerations have significant implications for the profession as a whole. They become especially critical in mental health settings in which adherence to their profession’s well-established values, theories and practice standards may bring social workers into conflict with views, norms, and practices mandated by the prevailing biomedical status quo. There is limited research on social work identity in mental health settings and even less pertaining to students’ efforts to construct a professional identity in such paradigmatically unfamiliar environments. The primary objective of this research was to examine how students understand, experience, and articulate their developing professional identity and to identify specific factors influencing the ‘identity work’ of social work students immersed in mental health settings. Students from one Victorian university undertaking placements within mental health were invited to participate. The project utilised a qualitative methodology with focus groups held prior to placement and individual interviews towards the completion of participants’ 70-day (500 hour) placements. Inductive and deductive methods were used to identify key themes in the resulting data. The thesis presents findings from interviews with students at the end of 70-day placements in mental health settings. Key findings relate to what participants bring to the placement, what they observe, and what they do during the placement. Responses to specific questions about identity were considered. As participants rarely commented on their experience of supervision, reflective processes were also investigated. As services providing mental health care and treatment are paradigmatically unfamiliar to social work students, interviews were analysed for evidence of resistance to the dominant biomedical discourse. These themes were synthesised in an effort to identify key factors contributing to the construction of a social work identity in mental health settings. When asked to talk about their developing professional identity in relatively unstructured interviews students struggled to relate to the concept of a ‘social work identity’ and were unable to articulate what it might be or involve. Students were more at ease describing specific roles they had performed during their placement. However, analysis of their reflections on what they brought to placement, what they observed, and what they did during placement provided rich descriptions of a range of the factors which contributed to and influenced their developing social work identity. Interviewing students on mental health placement highlighted some of the difficulties they and others have relating to the concept of a social work identity. Further research will be required to gain greater insight into factors influencing social work identity development in these unfamiliar settings.
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ItemThe Victorian Centres Against Sexual Assault: responding to victim/survivors with intellectual disability or complex communication needs( 2018)Rates of sexual assault experienced by people with intellectual disabilities and complex communication needs are considered to be higher than for others in the community. In addition, people with disabilities can experience many barriers when trying to access support services in the aftermath of sexual assault. In the state of Victoria, Australia, the Centres Against Sexual Assault (CASAs) are funded by government to provide crisis support, counselling and advocacy to victim/survivors of sexual assault. Little information is available to guide CASA counsellor/advocates on the most helpful approaches to assist people with intellectual disabilities or complex communication needs in their recovery after sexual assault. In this exploratory study, counsellor/advocates from the fifteen Victorian CASAs were invited to participate, with 83 workers (29.4% of the workforce) completing an online survey. A mixture of quantitative and qualitative data was collected. The types of interventions used by counsellor/advocates, goals for counselling and advocacy, therapeutic approaches and adaptations, and use of counselling resources were investigated. Barriers to access were also explored. Statistically significant differences in counsellor/advocates’ training, experience, and confidence emerged from the data in relation to service provision to people with complex communication needs in comparison with victim/survivors with an intellectual disability. In addition, participants with experience in working with both groups had provided a service to a larger number of people, used a broader range of interventions, and reported a greater number of goals to have been met than those who had worked only with people with intellectual disabilities. Counsellor/advocates infrequently used a range of counselling and advocacy resources, however those who had used them found them helpful and expressed greater confidence in working with people with complex communication needs. Factors in successful interventions were described by respondents, and included making adaptations, utilising the person’s support network, being client-centred, having a positive therapeutic relationship, and taking time. Adaptations and adjustments to counselling used by counsellor/advocates were explored, with the most commonly used found to be those most easily accessible in the workplace. Findings provide direction for the CASAs in the enhancement of service provision for people with intellectual disabilities and complex communication needs, alongside highlighting the existing practice wisdom within the sector. Key recommendations for the CASAs from this study include drawing on the existing knowledge of experienced workers within each service to support and mentor fellow counsellor/advocates, along with building flexibility into the service model, to allow for adaptations and adjustments such as more sessions, outreach sessions, and more preparation time. Furthermore, working collaboratively with people with disabilities, disability advocacy groups, and disability organisations is needed to increase referrals and develop worker knowledge across the sector.