Social Work - Theses
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ItemHow do early childhood intervention professionals reflect on their practice?( 2014)While reflective practice is commonly considered to be an essential part of being an effective practitioner in many professions, individuals’ experiences and understandings of reflection have not commonly been explored. Most research pertaining to reflective practice has tended to focus on theoretical understandings of reflection, or in regard to pragmatic applications, on pre-service practitioners. Thus, the ways in which professionals reflect on their practice, and the strategies they use, have received only limited attention in the literature. The overall aim of this study was to explore and describe the experiences that Early Childhood Intervention (ECI) professionals had with regard to reflective practice within the Australian context. In the state of Victoria in 2009, an overarching educational framework was introduced, emphasising reflection as a core competency for practitioners in the early childhood field. Furthermore, in the same year, another document specifically for ECI professionals was published, and this also determined reflection to be fundamental. Hence the primary target group for this study was practitioners who were working in ECI in Victoria. The key areas examined in this study were the strategies ECI professionals used to reflect on their practice, the reasons why they engaged in reflection, and the barriers they faced in doing so. The research design incorporated a web-based survey of 131 Victorian ECI practitioners recruited through an ECI managers’ network. The findings indicate that there is considerable variation in how this group of practitioners understand and implement reflective practice. In this way, the study confirms the literature that suggests reflection is a contested term lacking both definitional and operational clarity. Furthermore, practitioners experienced multiple barriers in their attempts to engage in reflective practice, most notably that of time. The majority of respondents commented on the value of particular strategies, such as debriefing, supervision, and mentoring, but there was very little indication that the use of these strategies went beyond a practical or descriptive level of reflection. The role of technology in reflection is an emerging theme from this study, as is the need for time to be regularly allocated for reflection and thus for reflective practice to be embedded into respondents’ working lives. A particular contribution of this study is the greater understanding of the strategies ECI professionals use to reflect on their practice, the potential barriers they face in engaging in reflection, and directions for future research.
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ItemGreat expectations: a policy case study of four case management programs in one organisation( 2007)Four different case management programs delivered by UnitingCare Community Options (UCCO) in the eastern suburbs of Melbourne were examined against the expectations of case management as a policy solution to a range of perceived policy problems at the micro-, meso- and macro-levels. The micro-level expectations were related to client and family experiences of the service system and outcomes. At the meso-level expectations were focused on perceived service delivery problems such as poor matching of services to the needs of ‘complex’ clients including a lack of integration, flexibility and responsiveness to clients’ needs and preferences. Perceived macro-level policy problems were concerned with a variety of issues including increasing rates of institutionalisation, increasing costs to governments, lack of economic efficiency and the desire to create market or quasi-market conditions in the community care service delivery sector. (For complete abstract open document)
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ItemParenting a child with a constant life-threatening condition: the psychosocial experiences of parents whose child has Hypoplastic Left Heart Syndrome( 2012)The study described in this thesis examines the psychosocial experiences of 29 parents, of whom there were thirteen couples and three extra mothers, whose children were born with Hypoplastic Left Heart Syndrome (HLHS) and were subsequently treated with surgery. Although the children of the parents studied are surviving, their lives are constantly threatened. In contrast to the advancing surgical and medical treatment of children with this condition, very little is known about the experiences of their parents. This study, by means of interviews and psychometric testing, explores the psychosocial experiences of parents as they reflected upon the time of their infant’s diagnosis, time in the intensive care unit (PICU), time in the cardiac ward and their time since being at home. All of the parents in this study have a surviving child who had corrective surgery at the Royal Children’s Hospital, Melbourne, Australia. The study utilized an underlying pragmatic paradigm. Mixed methods were chosen because these yield complex data about the parents’ experiences and may generate different or complementary perspectives. The parents’ perceptions were examined at the specified times of their infants’ diagnoses, throughout admission in the paediatric intensive care (PICU), throughout admission in a hospital ward and while at home with their child after discharge from hospital. As well as this narrative data, data was obtained from various psychometric tests. These tests were the SCID, the PCL-C, the IOF, the MBI and the RAHC MOF. Further data was gathered from the child’s medical histories and parents completed an information sheet about their characteristics. Within each time period the parents’ experiences were theorized using concepts of losses, stressors, traumatic stress, adaptation and of the parent-child relational bond. Interviews were semi-structured. Most parents were interviewed separately. The children varied in age, but most were under six, with a small number being teenagers. All children had been discharged home. The present study has a number of unique features: It is an Australian study; it describes the experiences of both fathers and mothers; it considers parental experiences at different phases of their child’s illness and recovery; it describes key psychosocial experiences that were secondary to the child’s condition; it broadens the sample of parents in comparison to other studies; it provides a multi-professional perspective and is the first study of parents’ experiences using mixed methods. Although some of each parent’s experiences were unique, many experiences were common and were complex. Each parent responded to their child’s condition in a way that demonstrated suffering, hope, courage, and a desire to protect their child. The time of their infant’s diagnosis was shattering for parents who described traumatic stress reactions. When their infant was in the PICU parents spoke of intense distress and loss and felt alienated from their infant. Although there were many stressors for parents when their child was in the cardiac ward, the parental-child bond began to normalize and many parents experienced greater authority in their parental role. After their child’s discharge from hospital, parents felt joy but they also felt anxiety in their care-giving role. In the home environment, parents lived with losses and stressors but they also experienced adaptation and the parental-child bond became robust. Adaptation was aided by intrapsychic, interpersonal, and social factors. Communication from health professionals which was clear, compassionate and respectful also assisted parents. Thus many personal factors and attributes intermingle with professional influences to assist the parents of these children who live with a life-threatening condition.