Social Work - Theses
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ItemCloaked in Strength An exploration of Aboriginal mothers’ experiences of family violence and the role of cultural practice as a tool of engagement, resilience and resistance( 2021)The violence in the lives of Indigenous women globally has been sustained and perpetuated through generations of patriarchal and colonial subjugation. As a result, a growing and important discourse on Indigenous feminist thought explores the possibilities of Indigenous women’s polity, agency and gendered standpoint. In Australia, the nature of domestic and family violence (DFV) experienced by Aboriginal women is distinct and of urgent concern as rates rapidly increase. The Cloaked in Strength study seeks to examine the lived experience of DFV of urban Aboriginal women using an Indigenous women’s standpoint and an Aboriginal woman researcher’s subjectivity. The study begins with a broad narrative review of the literature pertaining to DFV, Indigenous women and feminism, and cultural practice. A critical interpretive synthesis of the literature follows, enabling a deeper review of Indigenous mothering and DFV. The study engaged 17 Aboriginal mothers living in Melbourne through yarning interviews and a series of possum skin cloak workshops to consider their stories of DFV. The research uses a possum skin cloaking methodology to frame its engagement with Aboriginal women. Cultural practices and their restoration as a process of healing and cultural continuity are under-researched as protective factors and important mechanisms to support Aboriginal women in the context of DFV. In Aboriginal communities across south-eastern Australia, possum skin cloaks were traditionally made in preparation for the birth of a baby, were inscribed with tribal lore, and imbued the wearer with cultural identity and place. Contemporary possum skin cloak making is grounded in renewal, belonging and cultural strength – all synonymous with healing in the context of DFV. The findings are themed as Aboriginal women’s place, relationships, being and future in the context of DFV. They relate to the marginal positioning of Aboriginal women within the private and public spheres, in their communities and across society. Analysis of the interviews draws attention to the nature of Aboriginal women’s relationships and how structures of power impact their mothering and the obfuscation of accountability. The trauma of DFV is a feature of the findings, as are survival and hope. Several significant areas of discussion emerge, including the perpetuation of silences, the relationality of Aboriginal women and the support they provide one another, and the agency Aboriginal women demonstrate that informs a self-represented counter-narrative. Methodological findings related to the possum skin cloaking highlight important considerations about DFV research with Aboriginal women. These are discussed in the contexts of authorising environments, and repositioning value, agency and resistance. They explore assumptions about Aboriginal women and their citizenship value and the ways in which Aboriginal women establish safety and self-representation in contexts of violence. Tenuous DFV theorisation and the silent locations of DFV discourses are detailed throughout the discussion. An important conclusion is that DFV research is important to Aboriginal women. While Indigenous women’s feminisms vary around the world, they have a unifying feature that foregrounds Indigenous women’s gendered and cultural experiences of being in the world. Colonialism, inextricably shaped by patriarchy, uniquely positions Indigenous women worldwide in their resistance against violence. Empirical research, conducted appropriately, can un-silence Aboriginal women’s voices.
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ItemPeople with and without refugee experience co-creating a shared world through narrative practices( 2021)In this thesis, I look at Australian grassroots community initiatives where people with refugee experience share their stories with people from the established community, most without refugee experience, who listen to them. More specifically, I seek to understand how ‘ordinary’ people are responding to the problems of refugees through narrative practices. For this, I foreground an understanding of these problems as existential, consisting of experiences of worldlessness and superfluity. Through a critical, post-structural perspective and interview-based inquiry, I explore how narrative practice in storytelling can support people as they resettle and build their lives. I argue that definitional ceremony, in particular, is a powerful practice because it provides people with refugee experience the opportunity to present themselves on their own terms to others in the community. I discuss the myriad ways narrative practice supports the crafting and recounting of preferred selves. When definitional ceremonies turn listeners into active and responsive witnesses, storytellers’ understandings of themselves and their lives are validated. On the grounds that definitional ceremonies are constitutive of identities and worlds I argue that they are political and therefore have value in the pursuit of social change at the local level. Through the lens of definitional ceremony I suggest a process-oriented approach to storytelling that promotes negative capability, highlights the significance of communitas and considers the principle of an aesthetics of existence to guide and sustain grassroots action. This research introduces possibilities for anyone seeking to create storytelling events that centre the interests of people with refugee experience. More generally, it offers ideas to all those who seek to take relational responsibility in the way they engage with people with refugee experience and their stories. The theoretical and practical contributions of this research emphasise that small-scale and localised action, through meaningful narrative practices, can help address the existential problems that people with refugee experience face. Methodologically, academics who work from post-structural perspectives might be interested in my discussion on the transferability of narrative practices to research interviews, my development of resonance work to (re)present and analyse interview materials and my proposition to read back people’s narratives to reciprocate their time and effort and acknowledge their valuable contributions to knowledge.
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ItemIlluminating skills and knowledges of women who have lost a male partner to suicide: A feminist insider narrative practice research project( 2021)Abstract This qualitative exploratory study, from a feminist insider position, uses narrative practice to privilege the insider knowledge of widows , and to contribute new knowledge about how women respond to the suicide of a male partner. Narrative therapy, co-developed by Michael White and David Epston (1990), is a non-pathologising practice that situates experiences of hardship in their historical and social contexts. It supports people to free themselves from stigmas generated by contemporary attitudes and to craft preferred identities. Narrative practices arose specifically to counter discourses that marginalise and stigmatise people, and is thus particularly suited to assisting those bereaved by suicide as they are subject to significant stigmatisation. Feminist-informed qualitative research is underpinned by a reflexivity in relation to one’s own positioning, interests, values and knowledges. It ‘generates problematics from the perspective of women’s experiences’ (Harding, 1987, p. 6). In this project, I drew on my own lived experience of bereavement, which came about through the suicide of my husband and father of my children 16 years ago. Influenced by Wilkinson and Kitzinger (2013), this study does not minimise or maximise insider experience; rather it uses it in transparent ways. Seventeen women were interviewed from Australia, the United States and Canada. These women brought expertise, commitment and care to the project. The women’s rigorous contributions were thematically analysed using Braun and Clarke’s (2006) six phases of reflexive thematic analysis in a manner consistent with narrative practice and feminist understandings. The exploration of widows’ grief following the death of a spouse by suicide has been given little attention in bereavement research (Flake Ford, 2016; Miers et al., 2012). The literature that exists has not considered suicide bereavement in its specific social, political, ethical and historical contexts, and has forsaken considerations of power. This poststructuralist study questions socially constructed norms of contemporary Western culture in relation to suicide, provides openings for fresh thinking and argues for the recognition and application of insider knowledges. In this research, responses to suffering and loss are honoured and explored. Such responses have been absent or thinly described in previous studies. The ways in which women actively negotiate and break through the embodied stigma and taboo that often accompany losing a partner to suicide, and the skills and knowledges that women deemed helpful in their transition from ‘partnerhood’ to ‘widowhood’, are richly documented, witnessed and shared (see Leahy et al., 2012; Speedy, 2004). Based on the analysis of widows’ responses, this thesis offers new understandings to the field of suicide bereavement, and provides recommendations to first responders, practitioners and service providers on more supportive and less stigmatising practice responses to suicide.
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ItemWomen’s Perspectives on the Impact of Trauma on Pregnancy, Substance Use and Parenting( 2021)There are few in-depth enquiries with pregnant women affected by substance use issues that have asked them about their past trauma experiences and the therapeutic interventions they think are required in an obstetric setting to address the implications of adverse events. Large-scale studies that have examined trauma histories in alcohol and other drug (AOD) services and in the wider population suggest a significant proportion of women affected by substance use have experienced trauma. However, prevalence studies tend to refer to post traumatic stress disorder (PTSD) to understand trauma and this may not be the most appropriate reference for research or clinical interventions for a pregnant substance using population. This is a qualitative research project that explored how 12 women from the Royal Women’s Hospital, Women’s Alcohol and Drug Service (WADS) understand the impact of past trauma on recovery from alcohol and other drug use (AOD), pregnancy, healthcare, and parenting. This research also examined what interventions pregnant women affected by AOD think could assist in their recovery from substance use and trauma and improve parenting capacity in the perinatal period. Constructivist theory is the overarching methodological approach chosen for this research, that is influenced by feminist theory. Data were collected through in-depth interviewing using a semi-structured interview and included obtaining basic demographic information. Thematic analysis was used to examine the data. This research suggests that pregnant women who have issues with substance abuse are likely to be affected by interpersonal trauma that commenced in childhood. Findings suggest that structural, systems and gender related violence can compound early childhood trauma and complicate recovery processes as these women mature. The multiple and enduring forms of trauma experienced by this population resulted in detrimental implications in a variety of psychosocial domains across the lifespan and in the perinatal period. Findings suggest that PTSD diagnostic criteria will not adequately capture the impact that adverse events have had on a pregnant substance using population. This research indicates that specialist obstetric services and clinical guidelines for pregnant women affected by AOD need to incorporate theory and practice approaches related to complex trauma, neurobiology, attachment, and betrayal trauma. Findings suggest that organisations which auspice clinical care to this population need to broaden their understanding of trauma, integrate this into policy and programming, and advocate for service systems change.
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ItemShared understanding of knowledge translation in a domestic violence research network( 2021)Background: Despite significant growth in knowledge translation research, there remains a gap in our understanding of the connection between knowledge translation, domestic violence research and research networks. Knowledge translation is crucial as it creates the connection between those that produce the research and those that use the research. However, despite efforts, there is still a disconnect between researchers, practitioners and policymakers, suggesting a need to further explore this critical area of research. One framework, Integrated Knowledge Translation, offers the potential to bridge these gaps. Aims: Given the paucity of existing literature, this study explored the shared understanding of knowledge translation of a domestic violence research network. The study answered the following questions: What is the shared understanding of knowledge translation and activity in a domestic violence research network? How is a shared understanding of knowledge translation developed in a domestic violence research network? Method: The study utilised several methodological approaches, including participatory action research and realist research. The three phases of data collection included an online scoping survey; a realist informed systematic review and deliberative dialogue. Results: The scoping survey completed by 49/65 researchers found a focus on practitioners when sharing results from research with considerable gaps that included policymakers and survivors. A systematic literature review of 50 studies using a realist lens identified mechanisms of change that support knowledge translation. The synthesis of the included studies identified five potential program theories. A deliberative dialogue explored these mechanisms further and identified four key actions 1) agreement on a knowledge translation approach; 2) active promotion of dedicated leadership within an authorising environment; 3) development of sustainable partnerships through capacity building and collaboration particularly with survivors; and 4) employment of multiple strategies applying different kinds of evidence for diverse purposes and emerging populations. Conclusion: This study adds to our understanding of the meaning of shared knowledge translation by exploring the knowledge translation activity of a research network. Moreover, the mechanisms of change identified will support the knowledge translation of future research networks. The use of the deliberative dialogue has uncovered specific factors required for the successful knowledge translation of domestic violence research. These factors have been added to the Integrated Knowledge Translation capacity framework to enhance its application for domestic violence research. Future research could explore these individual, professional organisational and network factors further by evaluating them in practice. Forthcoming research could also explore these factors with input from survivors.
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ItemThe needs of foster and kinship carers and the mental health and wellbeing of children( 2020)Children and young people in foster and kinship care are far more likely to experience mental health problems than their mainstream peers (Baker, Kurland, Curtis, Alexander & Papa-Lentini, 2007; Milburn, Lynch & Jackson, 2008; Teggart & Menary, 2010; Ford, Vostanis, Meltzer & Goodman, 2011), with more than half of this cohort demonstrating a measureable need for mental health services (Tarren-Sweeney & Vetere, 2013). The input of carers has been found to be a key determinant in the outcomes for the children in their care (Blythe, Wilkes & Halcomb, 2014). This thesis seeks to build on the existing literature through three primary research questions: what is the nature and extent of the relationship between the role of carers and the mental health of children in foster and kinship care?; what unmet needs do foster and kinship carers experience, and how do these unmet needs impact on their caregiving role?; and what opportunities exist to better support carers to meet the mental health needs of children? The study utilises a mixed methodology, including a scoping review of available literature and two phases of data collection. In phase one, structured focus groups and interviews were conducted with thirty-one foster and kinship carers. In phase two, the carer version of the Carers’ and Users’ Expectation of Services survey was used to guide a further sixty-eight interviews with carers. Results were partially published in three peer-reviewed journal articles, detailing findings including a lack of systemic support for foster and kinship carers and a range of barriers which affect their ability to promote the mental health and wellbeing of children and young people in their care (Fergeus, Humphreys, Harvey & Herrman, 2018). These barriers may include insufficient resources and training, and a lack of understanding of the carer role. The study makes a substantial contribution to the understanding of the complexities of the carer-child relationship through the examination of the needs of foster and kinship carers and an analysis of how unmet needs may impact on the ability of carers to effectively discharge their role (Fergeus, Humphreys, Harvey & Herrman, 2019). Key implications for practice are discussed including the need to recognise and respond to the critical nature of the role of the carer in realising positive outcomes for children and young people in care through ensuring timely and appropriate support for carers.
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ItemSocial work education in Aotearoa New Zealand: Advancing an equity agenda through democratising and decolonising policy, programmes and practice( 2020)Purpose The profession of social work has a long-standing commitment to addressing issues of equity and disadvantage. Giving effect to democratising and decolonising practices in social work education has nevertheless presented challenges for the discipline. An integrated three-part qualitative study was undertaken to consider how social work education in Aotearoa New Zealand operationalises its commitment to an equity agenda particularly through democratising and decolonising practices across three influencing domains: policies, programmes and practices. Methods Three mixed-method, qualitative waves of research were undertaken. A document analysis of the global, Aotearoa and Australian sets of social work education standards formed the first wave. This analysis raised questions about how the equity-based agenda, conceptualised in the twin themes of democratising and decolonising practices, was being operationalised in programmes and in teaching. In the second wave of research, interviews were undertaken with social work education leaders to examine how these two themes were being operationalised across programmes of social work education in Aotearoa. In the third wave of research, focus groups and interviews were undertaken with social work educators more broadly to examine how the equity themes were being operationalised in teaching practices in tertiary institutions in Aotearoa. Findings The findings from the first wave of research identified a number of equity themes, in particular: service user and student participation, student representativeness, indigenous rights and political action, gender and cultural equity, and equitable access for students. The findings from the document analysis specifically relating to democratising and decolonising practices informed Waves 2 and 3 of the research. In Wave 2, leaders identified opportunities for advancing democratising and decolonising practices across three spheres: first, by supporting students, including engaging with the student voice, maintaining systems of representation and creating a diverse student cohort; second, by recruiting, maintaining and supporting a diverse workforce and, in particular, developing an equity-focused workforce strategy to support these aims; and third, by using leadership to advance an equity-focused social work education. In Wave 3, social work educators highlighted the challenges in operationalising democratising and decolonising teaching and learning practices. In particular, they identified the importance of addressing issues of privilege: understanding settler and White privilege and the responsibility for addressing it in the classroom context; broader issues of privilege, including racism, sexism, classism, heterosexism, ableism and ageism, and the value of an intersectional approach; the relationship between regulation and privilege; and the importance of developing decolonising frameworks for practice. Conclusion This thesis highlights both the challenges and the opportunities for developing democratising and decolonising programmes and practices in social work education in Aotearoa. In giving effect to positive change, the findings of the thesis reinforce the importance of values-based policies and practices, particularly when exploring the complexities of navigating a bicultural social work education. A number of frameworks for action are presented, including a leadership framework identifying key enabling elements that are important to the creation of equity-based programmes, and a framework supporting teaching practices that are decolonising and Treaty based. The importance of advancing policy, programme and practice equity through positive activism is reinforced.
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ItemImplementation frameworks – their usability and limitations within child, youth and family services( 2020)Purpose This thesis is located at the nexus of research-supported interventions (RSIs) in child and family services, evidence-based practice and implementation science. Within the context of Australian child and family services, it focuses on the implementation problem, i.e. the sector’s persistent problems with integrating evidence in routine practice. Its overarching goal is to examine how implementation frameworks have been and can be used to understand efforts to implement RSIs in this sector, and how these frameworks, and potentially any other implementation science concept, may be more effectively moved into routine child and family services in the future. Methods This research builds on a mixed-methods design and was conducted in three phases. During phase one, the scoping review method was used to identify studies conducted within child and family services and explore how implementation frameworks were used in the sector. In phase two, one particular implementation framework, the Consolidated Framework for Implementation Research, was applied to understand the barriers to the Australian implementation of multiple RSIs developed in the United States. The examination of the failed implementation of Multisystemic Therapy-Emerging Adults in New South Wales built on a case study design, whereas the early implementation of multiple US-based RSIs in Victoria was evaluated using mixed methods. Finally, during phase three, in developing a proposal for how to better bridge the implementation research-practice divide, the systematic integrative review method was instrumental for the development of a program logic for the role of implementation support practitioners. Results The use of implementation frameworks in child and family services studies has been cursory, and limited guidance is available on how to operationalize them in contexts of routine practice. The Australian experience with implementing US-based RSIs reflects that implementation frameworks insufficiently mirror the implementation challenges these interventions impose on stakeholders. While frameworks map implementation as a tidy and linear collection of determinants, real-world implementation occurs as a dynamic, both concurrent and recurrent interaction between multiple implementation factors. Particularly limited are the insights that frameworks provide to understand the role of the outer setting, containing, for example, policy dynamics, in an implementation. The role of implementation support practitioners may be a relevant strategy for integrating implementation research in routine child and family services, but the evidence surrounding their work and effectiveness is scarce and will require further consolidation. A first program logic outlining how ISPs may build implementation capacity in child and family services is presented. Conclusion To solve the implementation problem, strategies are needed that can help to create a new normal. One in which research-minded decisionmakers, operating in the child and family services sector, constantly request and use evidence in their daily routines, and practice-minded scientists work to spur this use in all areas of policy and practice. Implementation support practitioners may be one such strategy. To better understand the characteristics, activities, and contexts required for this role to be effective will be a key task for the decade ahead – both for the child and family services sector and the field of implementation science.
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ItemParenting while dying: Hospital-based supportive care of parents with advanced cancer( 2020)Every year in Australia thousands of parents raising minor-aged children are dying from cancer. Parenting with incurable end-stage cancer (IESC) gives rise to unique multidimensional stressors that can greatly affect the psychosocial wellbeing of parents and their children. Research shows that parenting concerns are commonly experienced and can impact on healthcare decision-making. Surprisingly, however, parenting-related support needs are not routinely addressed as part of hospital-based healthcare services. This dissertation contributes the first Australian series of interconnected studies exploring hospital-based interdisciplinary service responses to patients’ and co-parents’ parenting support needs, offered as part of routine palliative cancer care. A mixed methods exploratory design comprising three sequential linked study phases underpinned the research project. The first phase entailed data mining the hospital medical records of 74 adult patients diagnosed with IESC (27–75 years, M = 47; 61% female; received hospital palliative cancer care between September 2013–December 2015) and parenting minor-aged children. Documented clinical, sociodemographic, psychosocial and hospital-based interdisciplinary parenting support response data were collected and analysed using descriptive statistics. Using qualitative methodologies, the second and third phase studies explored multidisciplinary health professional (HP) and parent perspectives on patient/co-parent parenting supportive care needs and experiences, and factors influencing hospital-based parenting supportive care utilisation and provision. Semi-structured interviews (1 focus group, 2 individual interviews) with 12 multidisciplinary HPs working at an Australian metropolitan general hospital (8 disciplines, M = 19.7 years of HP experience) were conducted in August 2017. Following, semi-structured interviews with 12 parents (8 patients, 4 co-parents) were conducted (October–December 2017). Each phase was analysed individually using thematic analysis. Individual findings from each phase were synthesised to explore overall project findings. Analysis revealed multidimensional parenting-related support needs were experienced by a diverse sociodemographic cohort of adult patients (aged 27–75 years old; 62% female). Parenthood was largely challenging—insights into the dynamic and unique nature of parenting concerns throughout the IESC phase were provided—from IESC diagnosis to bereavement. Support needs varied in nature and timing across the IESC treatment phase for individual families. The complex psychosocial context within which parenting occurred was indicated by the broad array of pressing psychosocial issues voiced. A tailored, patient-centred, family-focused, trauma-informed, interdisciplinary approach to hospital-based parenting support was deemed optimal. However, in practice it was not always achievable, resulting in parents experiencing unmet needs. Parents and HPs viewed multisystem factors as influencing parenting support provision and utilisation. Key facilitating factors were hospital-wide systemised parenting practice procedures (e.g., parenting status screening, needs assessments and interventions), adequate clinical resourcing, targeted HP training, collaborative communication, professional supervision and a child-friendly, culturally safe hospital environment. Multidimensional psychosocial factors including emotional and psychological readiness, personality, and beliefs about death and dying impacted on parents’ engagement with parenting-related support. Using these insights, multilevel system approaches for strengthening hospital-based parenting supportive care to parents facing IESC alongside treatment are discussed. Findings together with existing parental cancer research may assist hospital management and interdisciplinary HPs engaged in policy decisions and intervention delivery to develop and implement new initiatives targeting parenting-related psychosocial distress.
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ItemInforming NDIS market stewardship through consumers’ information preferences: An exploratory study( 2020)Australia’s policies have historically seen many people with disability (PWD) confined to institutions, abused, neglected and systemically denied the right to self-determination (Barnes & Sheldon, 2010; Oliver, 1992). It follows that many PWD have typically lacked choice over which services are involved in their lives. An ideology of choice has emerged in the context of publicly funded disability services, influenced by ideas associated with neoliberalism and new public management (Fotaki et al., 2008). Some welfare-state services have been “personalised” (Needham, 2011), such as Australia’s National Disability Insurance Scheme (NDIS), which uses a marketplace model to offer consumers choice about what support to purchase (Fawcett & Plath, 2014). The NDIS is not a conventional market in a neoclassical sense – it is a quasi-market, seeking a way to manage considerations of both efficiency and equity. Within this context, there is an important role for “market stewardship” to balance these tensions (Carey, Reeders, et al., 2018). Choice can create not only self-determination for consumers, but a burden (Glendinning, 2008), and information is required to support the process of NDIS decision-making. However, there is limited evidence about what information is required. In this regard, a significant gap exists in the market stewardship literature, especially around knowledge that is driven by consumer preferences rather than provider or government priorities. This research explores what information is required for NDIS consumers to feel informed when choosing service providers. It is a social work practice research study, examining a problem identified through practice with the aim of addressing it (Sim et al., 2018). Data was collected in two phases. The first utilised semi-structured interviews (n=23) to explore informational issues in depth while gathering data to inform the construction of a survey. This survey comprises the second phase, extending the sample to test the generalisability of the results (n=201). Results show that word of mouth information from trusted interpersonal relationships is valued, as is information from and about professionals. This suggests that decades of oppression of PWD and professionalisation of service navigation have resulted in consumers’ mistrust regarding information from service providers and government (Walsh, Wilson, Baines, & Martin, 2012), which is compounded by the complexity of the new NDIS system (Malbon, Carey, & Reeders, 2018). Participants therefore rely on trusted peers and professionals for reliable information. This reliance is problematic because it stalls capacity building for both consumers and providers and decreases the urgency to implement market stewardship interventions. Furthermore, it can lead to riskier decision-making and poorer outcomes (Hakansson & Witmer, 2015; Schul & Peri, 2015) and relies on consumers having strong social networks, which puts equity outcomes at risk as well as the success of the insurance scheme. This thesis contributes new knowledge to the market stewardship literature and also to practice. Academic findings are described above. Practical recommendations include deprofessionalising service navigation in order to decrease the information asymmetry that exists; using peer advisors to distribute information throughout the sector; helping providers create trustworthy information through their marketing collateral; creating sector-wide metrics; investing in shared digital solutions in order to collate and distribute information; and localising NDIS governance so as to create rich local information.