Social Work - Theses
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Item"There's more to care than just healing from incisions" Examining the health care experiences of gynaecology patients with a history of trauma( 2023-12)This qualitative study examined the health care experiences of fifteen gynaecology patients who have experienced traumatic life events. Semi-structured interviews were conducted, and data analysed using a trauma-informed lens. Current research suggests that hospitalisation can expose this patient group to re-traumatisation, however there is little research on their perspectives and care preferences. This study provides an original contribution to the knowledge of the care experience of gynaecology patients with a history of trauma, particularly those with endometriosis.
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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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ItemAn evaluation of an assertive community linkage intervention for patients presenting to the Sunshine Hospital Emergency Department with suicidal behaviours( 2017)According to much of suicide prevention literature the strongest risk factor predictive for suicide is previous suicide attempt or deliberate self-harm. While many assessed at Sunshine Hospital Emergency Department are deemed to be in the low to medium risk category upon discharge, longitudinal risk factors remain. In 2009 Mid West Area Mental Health Service (MWAMHS) management identified an opportunity for service development and funding was secured to employ a senior clinician to provide a post ED Assertive Linkage Service (ALS). A primarily phone based community linkage service was considered the most sustainable model. In an effort to evaluate the efficacy of the ALS intervention and ultimately inform the design of the service a program evaluation was undertaken which posed the question; Does an assertive linkage service intervention for clients presenting to the Sunshine Hospital Emergency department with deliberate self- harm improve service access, quality of life and client satisfaction? The aim of the Assertive Linkage Study was to conceptualise a social work intervention that involved assertive follow-up, support and therapeutic linkage for those who presented to the Sunshine Hospital emergency department with deliberate self-harm, suicidal ideation or suicide attempt. Demographic and clinical characteristics of patients in this cohort were identified and the impact of the intervention was measured. Many of the findings were consistent to those of other comparable studies. The sample population risk for repeat suicidal behaviours was significant and the ED representation rates were high. The needs profile of the ALS cohort was generally diverse and sometimes complex demanding a flexible and eclectic approach from the ALS clinician. Social work practice needed to be client-centred and the ALS clinician could not assume that all who presented would be receptive to or perceive the need for formal community-based support. On balance the ALS intervention appeared to have made a positive difference to the clients’ experience after their emergency department presentation. It also had a positive impact on emergency department representation rates, client satisfaction and quality of life outcomes.
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ItemYoung men speak: a study of mid-adolescence and masculinity( 1999)This study investigated the effect of dominant notions of masculinity in the lives of mid-adolescent males. A qualitative research design, based on the analysis of transcripts of in-depth interviews with eight sixteen and seventeen year-old young men, confirmed the existence of a harsh masculine culture that impinged significantly on their behaviour and attitudes. The findings are identified a possible turning point in young men’s lives, where they begin to develop highly valued close relationships with a small group of friends or mates, with whom they share and emotional bond, and around whom they feel less pressure to prove their manliness. While they described the possibility of sharing thoughts, and feelings and experiences, there were nevertheless limits to what was allowed to be spoken even between the closest of friends. These restrictions were attributable to the sanctions that operated to maintain an environment significantly influenced by dominant notion of masculinity, and in which these friendship groups were embedded. The young men conformed to the tacit restrictions on intimacy, from fear of exposing themselves as weak or poorly skilled. Nevertheless, participants demonstrated a developmental readiness for intimacy, and were beginning to experience emotional engagement with male or female peers. The study suggests the need for a new concept that values and acknowledges a sense of emotional connectedness in the absence of sharing verbalised thoughts and feelings. With intimacy constrained, and little discussion of personal issues, young men had inadequate knowledge of the complexity of problems that might confront them, and few models of coping strategies. Consequently, they risked feeling isolated and unresourced in times of stress. Similarly, while they recognised signs of stress in others, they had few helping skills. In any case, dominant masculinity required that young men handle their own problems, without showing any vulnerability. Counselling was seen as an ultimate failure of manliness. There were indications of intergender rivalry, and despite attempts to be fair and equitable, an underlying belief that men should be in control in families and relationships. Rock music was clearly a potent positive element in the lives of young men, and served a variety of purposes. Alcohol gave individual and group release from the debilitating restrictions of masculinity, removing the need for self-control and allowing greater intimacy. The young men showed they were able to discriminate between “real life” and media or sporting images of masculinity, and had independently identified personal role models from within their own family or friendships circles. This study has shown the importance of understanding the adolescent male world from his own perspective. In particular, it demonstrates the degree to which masculinity impacts on the adolescent behaviour and attitudes, and highlights the necessity for Social Work practitioners to factor the masculine code of behaviour into case and programme planning. Moreover, it is suggested that Social Workers take a proactive approach to teaching young men the language and skills to understand masculinity, and to pursue identity formation and the establishment of positive relationships despite its impact on their lives.
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ItemAn exploratory study into the understanding health professionals have about the impact of culture on the experience of Vietnamese patients diagnosed with cancer.( 2013)Primary research focused on health professional understanding of the impact of culture on the cancer experience of Vietnamese patients does not exist in Australia. Australia’s population continues to grow in diversity with more cultures merging and emerging through waves of migration and the birth of new generations. The Vietnamese population represents one of the most recent waves of migration to Australia, with the Vietnamese population in Australia more than tripling over the past 30 years. However, there remains no published research about how this population gives meaning to their experience of cancer; a disease which has significant impacts on health, wellbeing and quality of life. This exploratory study was based at Peter MacCallum Cancer Centre, Australia’s only tertiary public hospital dedicated to cancer treatment, research and education. It aimed to describe demographic characteristics of Vietnamese patients and explore the understanding of health professionals about the impact of culture on the cancer experience of Vietnamese patients and their family. This study employed a Practice-Based Research (PBR) methodology across three Phases including Clinical Data Mining (CDM), health professional focus groups and clinical case studies. Results from this research describe the demographic detail of the Vietnamese patient population attending the specialist cancer centre and reveal that there is an absence of comprehensive psychosocial assessment by health professionals and therefore limited referral for support services such as social work. Outcomes from the focus groups illustrate the complex awareness that health professionals have of culture and the challenges this presents in providing cancer care for this population. Recommendations from this study suggest a model of targeted education for health professionals and interpreters to increase cultural and psychosocial competence in providing cancer care for this population. It is recommended that an evidence-informed model of care, integrating a Vietnamese Cultural Advocate into the cancer system, as cultural interface between health professionals, health system and patient and family would be of benefit to the care received by Vietnamese patients and their families.
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ItemAn exploratory study into the psychosocial effects and patient experience of women undergoing treatment for locally advanced cervical cancer( 2013)The field of psycho-oncology has expanded over the last thirty years and there has been much research focussed into the general cancer patient experience and into specialist areas like breast cancer. However, there is limited literature that outlines the psychosocial needs and patient experience of women undergoing combined chemotherapy and radiotherapy for locally advanced cervical cancer. In a country like Australia, this group of patients is a small sample of the overall cancer population, however clinical practice indicates that these patients often have high psychosocial needs. This study was based at Peter MacCallum Cancer Centre, a specialist cancer centre in Melbourne. It aimed to illustrate socio-demographic, psychosocial stressors, service utilisation and information about the consumer experience for this patient population. This study employed a practice-based research methodology comprising three Phases including clinical case studies, clinical data mining and consumer interviews. Results from the research outline socio-demographic details of these patients who attend this specialist cancer centre, and indicate that cervical cancer patients experience high levels of psychosocial stressors and needs and are high users of social work services. Outcomes from the consumer interviews illustrated patient preferences for peer support and attention to post treatment survivorship needs. Recommendations from this study suggest that there would be benefit to a model of psychosocial intervention focussed on supportive care specifically for patients with locally advanced cervical cancer. Recommendations also suggest benefit to a patient pathway that is evidence-informed and patient focussed and that incorporates psychosocial factors alongside the medical treatment continuum.
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ItemLives unseen: unacknowledged trauma of non-disordered, competent Adult Children Of Parents with a Severe Mental Illness (ACOPSMI)( 2012)This theoretical thesis attempts to make visible the needs of adult children of parents with a severe mental illness (ACOPSMI), a population which has attracted little scholarly attention to date. It employs a methodology in which established trauma and alternative grief theories are applied to existing multidiscipline, scholarly and lay ACOPSMI literature. The thesis attempts to broaden the definition of ACOPSMI to include non-disordered, competent individuals. It argues that the unique, trauma-based needs of ACOPSMI are not being adequately met within existing family-focused policies and practice, which focus on the needs of parents with an SMI to the potential detriment of their adult offspring. Limitations, implications, and recommendations of this research are outlined.
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ItemReflecting on decision-making in child protection practice( 1988)The aim of the study was primarily to inform the protective services field by examining the nature of decision-making in protective intervention work, its unique features, its successes and failures. I shall argue that child protection services cannot be seen in isolation from the wider community services field of which they are a part. In addition, the discussion to follow will highlight the significant influence brought to bear on the child protection worker by those other workers in the child welfare field with whom there is constant interaction. On that basis, questions will be raised about the way in which we locate responsibility for the protection of children with one group in the community, namely the child protection services' workers.