Social Work - Theses
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ItemThe accounts of men in an Aboriginal-controlled Alcohol and other Drug Recovery Service: contributions to relationally-informed practice( 2023-04)This thesis documents the experiences and knowledges of men at an Aboriginal-controlled alcohol and other drug service. The men participated in the project in the hope that their accounts would be helpful for others. The contributions of the men supported new ways of thinking about the delivery of respectful AoD (alcohol and other drug) services to Aboriginal peoples by ‘universal’ services, and for all peoples irrespective of culture and the kinds of services involved. A framework of relational theory is proposed, drawing on social construction and related contributions. This framework reflects the role of culture in determining identity, knowledge, meaning and lived-experience. The framework provided the theoretical basis underpinning the project. The men provided access to transcripts of narrative therapy counselling and groupwork sessions, which were then examined using a narrative inquiry methodology. The men described the importance to them of identities as Aboriginal men, fathers, family and community members. They gave accounts of how the service had contributed to significant developments in these identities. Key themes included the Aboriginal-managed nature of the service, providing an environment free from judgment, supporting recovery, healing and re-connection with culture. Relationships with staff differed from those experienced by the men in other services: including respect for culture, being ‘on the same level’, sharing of experiences and different approaches to role boundaries. The thesis draws on these accounts and literature to propose implications for universal services seeking to provide culturally-respectful and responsive support to Aboriginal men. Attention is then directed at implications for all services, irrespective of the particular sector or cultural context. Drawing on a range of literature, it is argued that all practice and research should be assumed to be ‘cross-cultural.’ Theory and practice frameworks are proposed to support this approach. A schema for a ‘borderlands’ concept of practice is proposed, drawing on Anzaldúa (1999), Bhabha (2004), Baltra-Uloa (2013) and others. In this schema, practitioners would draw on Western and Indigenous relational understandings. The schema is also applied to social research, drawing on Chilisa (2020). Both schemas include the Journey of the Self proposed by Bennett et al. (2011), as a metaphor for the progressive development of self-awareness and decolonisation of methodologies, irrespective of the cultural setting. The thesis brings attention to the limited explorations in literature of the contributions of the ‘therapeutic relationship’ to therapy and casework. It is also argued that contributions of peoples subject to therapy, casework and research to the professional and personal lives of practitioners are under-acknowledged. Frameworks proposed in the thesis could be used to explore these important areas of practice and research. Training materials prepared in association with the project are included in Appendices.
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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.