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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ItemArchitecture and the design of therapeutic environments: the case of self harm( 2017)This thesis finds that specific design interventions in the spaces providing therapy can improve therapeutic outcomes for those who self harm. Therapeutic interventions for this service user group typically involve various forms of talking therapy, and/or medications. However these service users are amongst the most clinically challenging to treat. The physical environments in which therapy takes place have not been thoroughly examined for their contribution to therapeutic outcomes. Despite a large body of literature affirming the links between good design practice and mental wellbeing, there is a paucity of research addressing specific environmental needs of service users who self harm. Further, existing design guidance is often generic in nature, describing broad principles to be achieved through design, but offering little tangible advice for the designer to integrate these principles into a realised built environment. The research involved an exploratory qualitative design that utilised a triangulated strategy; the method of data collection included three data collection methods: systematic literature review, multi-stakeholder interviews and case study observation. Key findings from the scoping review included the paucity of design guidance for therapeutic environments and counselling workspaces specifically, and that there is no published research examining the design of therapeutic spaces for individuals who self harm, specifically. Key findings from the semi-structured multi-stakeholder interviews included a deeper understanding of the perceptions of spatiality of individuals who self harm, aspects of therapeutic environments that are supportive or unsupportive and in what ways this occurs, and potential design strategies to assist therapeutic activities and psychological engagement. Analysing built therapeutic environments found that there is a limited inclusion or implementation of design recommendations uncovered in this research in existing built spaces. Through the analysis undertaken of the literature, interviews with service users, therapists/counsellors, carers, architects and design researchers, together with a case study examination of existing built therapeutic environments, a series of design recommendations were derived. These principles have been developed from environmental aspects which were commented on by those who self harm, and supported by other interview participant groups and observations in the field. The findings from this thesis are indicative that the design recommendations assist therapeutic outcomes. However, as indicated through the exploratory qualitative analysis undertaken, the built environment is a meaningful agent in therapy. What emerged from the study was the notion that for individuals who self harm, the built environment is not merely the housing of therapy, but an active participant in the therapeutic process. The counselling workspace may be a platform for therapy to unfold in a physical sense, providing aspects such as physical privacy and safety features, but offers many more psychological support mechanisms if designed/manifested in a particular way, including psychological safety and relief, negotiation of relationships, non-verbal communication opportunities, increased body awareness, reduced dissociation, increased sensory engagement and perception, and opportunities for the development of the self. The counselling workspace has active roles in therapy, including being a mediator between therapist and service user and helping to clarify and establish boundaries, being a vehicle for communication, and being a testing ground for the problem solving abilities and aspects of the self. When the built environment design initiatives outlined in this thesis are considered carefully and articulated through design and the curation of space, architects/designers may provide a platform of engagement through counselling workspaces, resulting in positive therapeutic effect. If the design recommendations were to be integrated into the built environments delivering mental health services to individuals who self harm, then the misgivings, difficulties or negative psychological interferences reported by the service users would be mollified and/or eliminated. Therefore, therapy and therapeutic outcomes would be assisted. In this situation, counter-productive stimuli are removed or reduced, assisting the service users to maximise the benefits of their therapy.
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ItemThe experiences of parents of children who have dyslexia in Victoria, Australia: a social justice perspective( 2017)This study aimed to shed light on the experiences of parents in Victoria, Australia with a school-aged child diagnosed with dyslexia. Utilising a mixed method research design, the study examined the experiences of parents as they navigated the pathway to their child’s diagnosis and attempted to gain support for their child’s learning disability post diagnosis. Applying a social work, social justice lens, this study examined the impact of the current social policy status of dyslexia on parents and their children as they sought recognition and support within the education system. Nancy Fraser’s theory of need recognition (1989) was utilised to provide a theoretical lens with which to analyse parents’ experiences and provide insight into the current status of the recognition of dyslexia in Victoria. The findings provided insight into the struggle by parents for the recognition of the needs of children who have dyslexia. The experiences of parents presented in the findings of this study illustrated the complex terrain parents traversed in order to have their child’s dyslexia identified and to obtain support for their child’s learning needs. The findings demonstrated that parents of children with dyslexia in Victoria navigated, largely unsupported, the domain of the educational system and were predominantly responsible for identifying early signs of their child’s dyslexia and funding resources to meet their additional learning needs. As parents encountered this landscape, they negotiated many professional terrains in a largely unregulated marketplace of services and resources. Despite the existence of the Disability Discrimination Act 1992 (Cwlth) and the Disability Standards for Education 2005, the findings demonstrate that neither the state, nor the Catholic nor the independent school sectors consistently recognised or addressed the needs of children with dyslexia. This was largely a consequence of the absence of a mandated overarching educational policy framework and the consequent lack of comprehensive provision of pre-service and in-service teacher training in relation to dyslexia and resources for the identification and remediation of dyslexia. The failure of the state to provide resources resulted in an over-reliance on parents to support their child’s learning needs. This contributed to social injustice in the form of inequity for children, as the provision of resources was dependent on factors associated with children’s family of origin, economic context and the extent to which the child’s school was prepared and able to allocate resources to children with dyslexia. This study demonstrates that the lack of structural recognition of dyslexia results in a paucity of knowledge relating to dyslexia which is exacerbated by the lack of allocation of consistent and comprehensive provisions and resources to accommodate the learning needs of children with dyslexia. These deficits lead to discrimination in relation to the provision of education to children with dyslexia. Recommendations from this study include policy recognition of dyslexia, mandated teacher education relating to dyslexia and the allocation of resources for the identification, remediation and accommodation of students with dyslexia in the education system.