Social Work - Theses

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    Architecture and the design of therapeutic environments: the case of self harm
    Liddicoat, Stephanie ( 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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    A comprehensive planning & evaluation framework for dual disability service systems: co-existing intellectual disability & mental illness
    O'Neal, Paul Douglas ( 2005)
    This thesis focuses upon those people who are disadvantaged through the coexistence of intellectual disability and mental illness. This group is among the most vulnerable in contemporary Australian society. The overall purpose of this research is to develop a comprehensive planning and evaluation framework for dual disability service systems. This framework will address the complex needs of people living with co-existing intellectual disability and mental illness through the development of a plausible service system model. The framework will identify the parameters, principles, boundaries, structures, components, and processes of an effective and quality DD service system. It is anticipated that the development of a service system model will provide the foundation for addressing consumer and carer needs in a comprehensive, coordinated, and systematic way.
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    Evaluation of the Bilingual Case Management Program in community mental health services in Melbourne
    ZIGURAS, STEPHEN ( 2001-06)
    This thesis describes the evaluation of a program to employ bilingual staff in case management positions in community mental health services in Melbourne, Australia. A literature review showed that no previous research in Australia had investigated the impact of bilingual staff on clients of mental health services. While research conducted in the USA shows that ethnic matching (matching clients and clinicians on the basis of language or ethnic background) increases service use, its impact on outcome domains such as social functioning remains uncertain. (For complete abstract open document)
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    Women and their journals: navigating depression through consciousness-raising, resistance and action
    Western, Deborah Jane ( 2009)
    Depression in women is a major mental health issue and social work practitioners can, at some stage in their careers, expect to work with women experiencing depression. Journal therapy, the use of writing for therapeutic purposes, is one example of support and intervention offered to women. The use of journal therapy and specifically the use of journalling by women in Women’s Journalling Groups were investigated in this research. Limited research had been undertaken in the area of journal therapy with women experiencing depression. The research was undertaken in four phases and used a modified form of grounded theory to develop the research design and to identify and articulate ideas about women’s use of journalling during depression. Phase one established the baseline knowledge for the research through a Co-operative Inquiry underpinned by feminist research principles. Findings from the Inquiry identified: Two key methods of journalling and women’s responses to depression: • The Considered Acknowledgement, Acceptance and Contemplation framework • The Proactive Resistance, Rehearsal, Agency and Action framework; Four key narratives that women had created about their journalling and their understanding of depression in women: • Identification and expression of emotions; • Identity, sense of self and self-value; • Structural and social roles, relationships and expectations; and • Transformative choices, opportunities and accomplishments; Phase two involved the conceptualising, formalising and transfer of this knowledge into the development of a Women’s Journalling Group program. Through the facilitation of two Women’s Journalling Groups in phase three, the journalling activities were found by women to be relevant and meaningful for them in assisting them to understand their depression and move toward recovery. Phase four included the final stage of knowledge utilisation and transfer. A most significant and new finding from this research was that journalling undertaken by the women was a form of action in response to their depression. Far from being a passive, ruminative, purposeless pastime, journalling was an evolving and sustaining action that enabled the women to gain insights and understandings into themselves and their depression. Journalling activities enabled women to identify and express the many feelings and thoughts that attached to their depression. In reaching clearer understandings of themselves and their depression and in gaining confidence in making choices about their future, women were engaged in processes of consciousness-raising and resistance. Resistance to social and structural expectations, roles and stereotypes was important for the women who could then redefine and redevelop their authentic sense of self and identity. Resistance could occur on an individual level in the journal and on a collective level within Women’s Journalling Groups. The major outcomes of this research have resulted in a model of journalling that has been used to develop a theoretically grounded Women’s Journalling Group program. Whist some further developmental work is required with the program, it nevertheless provides a tested therapeutic intervention that can be offered to women experiencing depression.