Family Experiences of Caring for Relatives Who Have Received Electroconvulsive Therapy (ECT)

The research literature on family members’ experiences of the use of electroconvulsive therapy (ECT) is limited. This article explores the perspectives of family members whose relatives had received ECT. Drawing on a social constructionist perspective, this qualitative study collected data using in-depth interviews with nine families in South Australia, to examine how family members constructed the supports and challenges they experienced. The research found that families experienced a range of social and service system barriers, including social stigma and isolation, and limited support from health professionals. They had to negotiate caring expectations within a social context that stigmatised both mental illness and ECT. A need for ECT-specific mental health support groups was identified.

IMPLICATIONS

• Social workers’ roles in Australian hospitals could be further expanded to accommodate supporting families whose relatives have received ECT, referring families to community support, and advocating for specialist support post-ECT treatment.

• Social workers can further articulate their unique contribution to community care post-ECT treatment and advocate for supporting families.

• Increased focus on ongoing and preventative care for supporting families is a potential growth area for social workers in mental health.

     

The Experiences of Human Service Managers in Contexts of Change and Uncertainty

Against a background of rapid and widespread changes to the delivery of human services and social welfare, this paper reports on a study into the experiences of managers of human services organisations. Within an interpretive methodology, the research utilised focus group and interview methods to examine the relevance and need for business, finance, and management skills from the perspective of managers in the human services. Results indicate that managers of human service organisations need advanced business, management, and finance skills to deal with change and uncertainty in contemporary and competitive service environments.

IMPLICATIONS

• Human service organisations in Australia are subject to change and uncertainty with new models of funding and increased accountability.

• Social workers employed as managers are under pressure to lead sustainable and accountable services, while still holding to social work principles.

• Social workers who manage organisations face a challenge of how to integrate business, management, and finance skills with the values and mission of social work.

     

Acceptability of an Aboriginal Wellbeing Intervention for Supporters of People Using Methamphetamines

Families and workers often suffer significant stress while supporting people who are experiencing problems related to methamphetamine use yet there is little evidence on how best to help. Small pilot studies can provide valuable information about potential ways to intervene. This paper presents a pilot study of an Aboriginal family wellbeing intervention with workers in an Aboriginal health service. The pilot indicated that participation in the intervention improved the psychosocial empowerment and wellbeing of workers, that these workers perceived the program as relevant to families, and that this was an intervention they felt they could deliver to clients themselves.

IMPLICATIONS

• An Aboriginal family wellbeing intervention was piloted and found to improve the empowerment and wellbeing of workers. Participants regarded it as highly relevant for families supporting people using methamphetamines and other drugs.

• This research has added to our knowledge about how to assist those supporting Aboriginal people using methamphetamines and other drugs.

     

Social Work and the Natural Environment: Embedding Content Across Curricula

Social work is a profession focused on people within their environments. This is reflected in codes of ethics, where our shared mandate is to work towards individual wellbeing and social change. Recently, social work literature has promoted green and eco-social work, drawing on climate change science, notions of expanded and future justice, knowledge of the link between health and the environment, and principles of deep ecology. However, if social workers are to take up their place in a rapidly changing, globalised world, rife with environmental concerns, their education must prepare them to do this. One way of doing this is to embed curriculum on social work in relation to the natural environment in already existing units. This paper describes two examples of how this could be done based on the authors’ experiences from their respective universities.

IMPLICATIONS

• It is incumbent on social work to respond to the mounting evidence related to the environmental crisis.

• Social work is well placed in terms of theory, values, and skills to lead the way in developing an eco-social paradigm of potential relevance across disciplines.

• Social work educators need to educate students about emerging issues, such as environmental degradation. Embedding material in already existing courses, as per examples provided in this paper, provides one way of doing this.

     

Minimising Coerciveness in Coercion: A Case Study of Social Work Powers under the Victorian Mental Health Act

The balance between care and control in mental health social work is one of constant tension. In the State of Victoria, Australia, the Mental Health Act 2014 gives coercive powers to social workers employed by public mental health services. These include the power to decide if a person needs to be assessed by a psychiatrist, to “take” a person using bodily restraint, to enter premises, and to search and seize a person’s belongings. This paper applies a doctrinal analysis to examine the law, then argues that the use of these powers by social workers, where safe, may be less restrictive than when they are used by police or paramedics. The exercise of these powers may be less traumatic and stigmatising to the people who are subject to them, and social workers may be both legally and ethically obligated to use coercion when appropriate.

IMPLICATIONS

• More social work literature on the coercive powers under mental health legislation is needed as well as more guidance on using these powers for social workers in practice.

• In some circumstances, these coercive powers may be better exercised by social workers than by other professionals.

• Social workers should carefully consider their legal and ethical obligations to use these powers in some circumstances.

     

Social Work Research in the Field of Disability in Australia: A Scoping Review*

Although in Australia disability is receiving unprecedented attention with the rollout of major reforms, the body of research on disability to inform policy and practice has been found “not fit for purpose”. This scoping review of empirical research papers published by Australian social work authors between 2007 and 2015 investigated the quantity, nature, and scope of social work research on disability in Australia. We found a steady growth, an annual average of 13.8 papers, and a total of 124. Social work disability research makes a distinctive contribution; it is contextualised in service systems or policy, has a greater focus on community and civic participation and social relationships, and concentrates on adults, with either intellectual disability or traumatic brain injury. These research strengths provide foundations for building the profession’s research capacity and informing its practice and contribution to the multidisciplinary field of disability.

IMPLICATIONS

• Service system reform is increasing engagement of social workers with people with disabilities, yet disability has a low profile in the profession.

• Social work disability research has strengths in understanding service systems, social relationships, and strategies for social and civic participation, particularly with adults with cognitive disabilities.

• Increased attention to disability in qualifying and higher degree programs will better prepare students for complex practice and develop the distinctive contribution of social work research in this interdisciplinary field.

     

A National Survey of Australian Social Work Field Education Programs: Innovation with Limited Capacity

Social work field education programs globally are struggling to meet the demands of providing suitable placements for students and need to consider new and innovative placement models to both meet professional accreditation requirements and deliver high quality field education opportunities for social work students. This article reports on the qualitative responses of a national survey of Australian social work field education programs, which explored current challenges, innovative responses, and recommendations for the Australian Social Work Education and Accreditation Standards (ASWEAS) review, as well as hopes for the future of field education, and their capacity to undertake research into this area. Findings suggested that field education programs have been using incremental innovation in field education, including collaboration, partnerships, and new ways of responding to the changing student body. However, it is argued that radical structural change and additional resources will be needed for innovation to be more than merely incremental.

IMPLICATIONS

• Social work field education as a distinct pedagogy needs to be supported through evidence-based research in order to respond to current pressures.

• Collaboration in field education practice and research is valuable, but may be challenged by program competition.

• Structural innovation and accepting diversity in models could offer opportunities for social work education.

     

The Family Experience of the Crisis of Involuntary Treatment in Mental Health

While policy and practice standards emphasise the importance of engaging and supporting families of people with mental health problems, many families have reported feeling unsupported and distanced from treatment and care planning in acute inpatient units. There has been little systematic interest in the changing role and experiences of families throughout the emergence of illness, crisis, seeking of treatment, and subsequent recovery. Nineteen in-depth interviews were conducted with the next of kin of 17 people who had been admitted under an Involuntary Treatment Order in a large metropolitan hospital in the Brisbane region. A general inductive approach was used to analyse the data. While hospital admission was described as a time where, ideally, families were able to let go of being responsible for their relative's behaviour and let the health care professionals take over, for many this did not occur. We suggest four critical elements for providing recovery-oriented support to families. These include: (a) ensuring that families feel that their relative is safe and receiving the care needed; (b) keeping the family informed about their relative's progress; (c) ensuring families have access to information about the mental health system, and (d) working in partnership with the families.

IMPLICATIONS

• Family wellbeing is improved when they feel part of a supportive team.

• Instituting an open policy where families can contact ward staff easily and access information about the person they care for may alleviate families’ anxieties and minimise stress.

• Family work is enhanced when health professionals acknowledge families’ relationships, expertise, and understanding of their family member.

     

Role of Relational Case Management in Transitioning from Poverty

One-off financial assistance through emergency relief provides a short-term intervention to immediate material crisis. However, recurrent instances of clients accessing this type of assistance points to the ineffectiveness of managing financial hardship without addressing the causes of long-term poverty. This article presents findings from an external process evaluation of the Salvation Army relational case management model known as Doorways. A mixed-method design was implemented, consisting of semistructured interviews, observations, and document analysis, as well as Client Satisfaction and Wellbeing Survey. Across the seven research sites semistructured interviews were conducted with 45 clients and nine case managers, and 30 client surveys were completed. Three themes will be discussed: the Doorways philosophy; the flexible service delivery approach; and client capacity building and continuity of care. Findings illustrated the effectiveness of a relational case management approach and reaffirm the central role of relationships in transforming the lives of people experiencing poverty.

IMPLICATIONS

• The quality of relationship between case managers and their clients plays an integral role in transforming the lives of people experiencing long-term or situational financial disadvantage.

• Service delivery requires a relational and flexible approach to adequately tailor support to the individual and contextual needs of clients.

     

Social Work Registration: What’s the Contention?

In the face of consistent lobbying for the national registration of social workers by the Australian Association of Social Workers (AASW), the Council of Health Minsters maintains the view that registration is not required, placing it at odds with comparable countries around the world. One factor that shapes this current decision is the view that social work does not pose a significant risk to the health of individuals to warrant the need for this level of regulation. In light of this ongoing debate, the following article provides an overview of the discussion to date, summarising the risks, harms, and the associated costs. Additional evidence of harm and cost are then posited, followed by suggestions for further steps that can be taken to support the Council of Health Ministers making an informed decision on whether or not to include the social work profession in the National Registration and Accreditation Scheme (NRAS).

IMPLICATIONS

• Registration of social work is an under-researched topic. Research will provide much needed evidence to help understand the impact and efficacy of registration in protecting the public.

• Research will inform the Australian Association of Social Workers strategy in pursuing mandatory registration and also support the federal government in its decision making.

• Research in this area may have broader implications for other professions and government policy both nationally and internationally.

     

Testing Satisfaction with a Group-based Social Work Field Liaison Model: A Controlled Mixed Methods Study

Social work field education programs rely on the liaison process to oversee and support students during their placement and to assist them to integrate theory and practice. However, the role and importance of liaison has been threatened as social work programs seek alternative and cost-effective ways to undertake these functions. This paper presents findings from a pilot study investigating levels of satisfaction among students and field educators with an innovative group liaison model compared to a control group who experienced the standard liaison practice. Fifty-three students and 47 field educators completed the survey. Twenty-one of the students and 10 of the educators received the intervention (the group liaison); the remaining 32 students and 37 educators received the standard liaison process (the control group). Students in the intervention group reported significantly higher levels of satisfaction with all aspects of the liaison experience than students who received the standard liaison process. Field educators were more positive about liaison than students. This study reaffirms the contribution of face-to-face liaison contact to the student learning experience on placement and suggests that strengthening, rather than devaluing, the liaison role could be a useful strategy to encourage the field’s ongoing commitment to provision of quality placement-based learning opportunities.

IMPLICATIONS

• Highlights the importance of face-to-face liaison contact to the student learning experience on placement.

• Examines social work student and field educator perceptions of and satisfaction with the liaison process and content.

• Describes a group liaison model that potentially offers a cost effective way to undertake the role.

     

Towards Sustainability in Australian Social Work Field Education

The educational framework of Australian social work field education has remained static over the past few decades. Emerging challenges are creating a compelling case for change. These include increasing demand for placements, declining capacity of organisations to provide placement requirements, reduction in practitioners’ incentives and capacity to support student placements and to facilitate a work integrated learning context, and an interrelated web of policies and regulations that constrain adaptation to these changes. In a critical exploration of multiple levels of regulation and policy contexts, we argue that conventional approaches to social work field education are not sustainable given significant changes to the funding arrangements for universities and within the welfare service system. To futureproof integrative learning in social work, we advocate transformation of educational culture, policies, and design toward sustainability.

IMPLICATIONS

• Supervised placements are designed to integrate practice and academic learning but their future use as the single means for achieving this integration will be unsustainable.

• Drawing on an ecological orientation enables social work educators to position sustainability as a key consideration and response to current constraints in higher education and the field.

• Focusing on sustainability across policy, practice, and regulation contexts has potential to generate transformative change that enhances our effectiveness in futureproofing the design of integrative learning in social work.

     

Who Makes Decisions for Vulnerable Young People? Shifting Sands and Murky Waters

This paper discusses the existing guidance in Australian legislative and regulatory frameworks to inform the process of young people moving through varying stages of maturity towards independent decision-making. In the context of exploratory research to develop a stable online repository of personal documents for young people in out-of-home care, the researchers envisioned in-built, age-appropriate levels of decision-making authority, associated with what was stored, who had access, and who owned these records. They sought guidance to protect young people themselves and to support workers and other mentors. Little unqualified guidance emerged from the documentary search. Supporting any young people in the journey towards independent decision-making relies on individual judgements about the type of decision and risks involved, and the age, maturity, and experience of the young person. Above all, a supportive trusting relationship with an adult allows young people to learn through their own mistakes.

IMPLICATIONS

• Young people's competence in decision-making depends on a range of individual, familial, and social factors, and individualised guidance is necessary to support their participation.

• A supportive, trusting relationship with an adult provides the best environment for balancing vulnerable young peoples’ participation rights with their continuing needs for protection.

• The policy and practice challenge is to harness digital technologies without being distracted from the importance of relationship-based work.

     

Case Reading as a Practice and Training Intervention in Domestic Violence and Child Protection

This article explores the role of a case-reading tool, developed by the Safe and Together Institute, deployed across five Australian states, and which engaged workers from child protection (CP) and specialist domestic and family violence (DFV) services. It aimed to assess the extent to which DFV is identified in CP case files and to assess the quality of case practice from a DFV-informed perspective, as documented in the case file. The Safe and Together approach to child welfare provides a robust foundation upon which practitioners from statutory and nonstatutory backgrounds can work collaboratively and reach consensus about how best to ensure the safety and wellbeing of children living with DFV. The case reading is both a process of transformative working for practitioners and an analytical tool through which their agencies can affect systemic change.

IMPLICATIONS

• A national audit of 20 child protection case files using the Safe and Together case-reading process indicated that documented child protection practice sits at the lower end of a domestic and family violence-informed Continuum of Practice.

• Analysis indicates a need to improve: child protection engagement with fathers who use DFV, assessments of their parenting role and its impact on children and family functioning; identification of adult survivors’ protective capacities and their impact on children.

• Research in this area may have broader implications for other professions and government policy both nationally and internationally.

     

Online Teaching in Social Work Education: Understanding the Challenges

There is a rapidly growing industry of online learning and distance education programs at the Master of Social Work and Bachelor of Social Work levels both within Australia and globally. A number of best practices have emerged from the literature that warrant consideration when delivering social work programs in online learning and distance education modes. Given the significant advancements in technology that are likely to continue into the next decades, social work academic leaders and accrediting bodies must be prepared to address the changing landscape of higher education, including limited financial resources. Social work academics need to become aware and implement best practices in online learning and distance education e-teaching environments to ensure positive student outcomes, student retention, and student engagement to meet the flexibility needs of students in higher education settings. The purpose of this paper is to identify and discuss the challenges and benefits of distance education and online learning for consideration when providing a social work program in these delivery models.

IMPLICATIONS

• Given the significant advancements in technology that are likely to continue into the next decades, social work academic leaders and accrediting bodies must be prepared to address the changing landscape of higher education.

• Social work academics need to become aware and implement best practices in the distance education and online teaching environment to ensure positive student outcomes, student retention, and student engagement to meet the flexibility needs of students in higher education settings.

     

Implications for Practice: Exploring the Impacts of Government Contracts on Refugee Settlement Services in Rural and Urban Australia

This article presents the findings from a small qualitative study of Refugee Settlement Service (RSS) workers under Australia’s Humanitarian Settlement Services and Settlement Grants Program. Managers and front-line workers from five Refugee Settlement Services in rural and urban New South Wales were interviewed to examine the impact of new Government funding structures and contracts on the delivery of services and supports to newly arrived refugees. The comparative findings show that the Government’s contractual arrangements impact Refugee Settlement Services in different ways; ultimately prioritising market-like structures and undermining their core service roles. We argue that improving the relationship between Government and Refugee Settlement Services is critical to successful refugee settlement.

IMPLICATIONS

• Successful refugee settlement requires greater flexibility and responsiveness in rural and urban Refugee Settlement Service (RSSs).

• RSSs require increased autonomy and control over funding to enable locally responsive service provision for newly arrived refugees.

     

Australian Social Work Students Balancing Study,Work, and Field Placement: Seeing it Like it Is

Completing tertiary studies can involve personal and financial sacrifices for some students. Equally, past and more recent research has highlighted financial pressures for students undertaking courses with compulsory field placements, although larger national Australian studies appear to be limited in number. In a recent study, a sample of 2,320 social work students from 29 Australian universities completed an online survey on the impact of low levels of income on students’ lives and study success. Here students’ qualitative responses reveal the burden of compulsory field placement, including significant financial constraints and changes to paid work hours that, in turn, adversely affected students’ wellbeing and jeopardised the completion of their degree. The purpose of this article is to illuminate social work students’ complex study realities in order to help inform future education, policy, and practice.

IMPLICATIONS

• These findings provide insight for national bodies, universities, educators, practitioners, sector partners, and researchers into the study realities of Australian social work students.

• Reviewing policy, practice, and education in light of the findings can help contribute to a healthier, diverse social work profession.

     

Mature-aged Social Work Students: Challenges,Study Realities,and Experiences of Poverty

There has been a substantial increase in mature-aged students enrolled in higher education in recent decades. Equally, mature-aged women, often with family responsibilities, are well represented in social work degree programs. In this article, the findings from the National Study of Social Work Students (NSSWS) are examined in relation to mature-age students to better understand their study experiences, and factors that may be impeding their ability to take advantage of a university education. What is clear from the data is that many mature-age social work students were experiencing poverty at higher rates than their younger counterparts who were themselves financially struggling at higher than average rates for domestic Australian tertiary students. Here, mature-age social work students’ experiences and perspectives are presented using quantitative data and students’ own qualitative responses. The results have important implications for social work educators and administrators, and wider policy ramifications regarding student equity.

IMPLICATIONS

• These findings provide a spotlight for national bodies, universities, educators, policy makers, sector partners, and researchers into the under-researched, lived realities for mature-aged Australian social work students.

• Better understanding the grinding effect of poverty on many mature-aged social work students can spur political action to enact systemic change.

     

Creating a Culturally Safe Space When Teaching Aboriginal Content in Social Work: A Scoping Review

Teaching Aboriginal content in social work education presents risks of retraumatisation for students. There are international calls for a trauma-informed teaching model that creates cultural safety in the classroom. This study aimed to develop a trauma-informed model for social work education by reviewing the literature on cultural safety for Aboriginal peoples. This model incorporates key aspects of ensuring Aboriginal cultural safety: de-colonise social work education; collaborative partnerships; build relationships; critical reflection; develop cultural courage; and yarning and story-telling. It provides a valuable framework for creating a more equitable teaching and learning environment that also ensures the essential academic content is covered.

IMPLICATIONS

• Trauma underlies the historical, contemporary and cultural narratives of Aboriginal peoples. Students engaging in Aboriginal content that is traumatic can mean connecting with trauma that has occurred in their own lives.

• Trauma-informed teaching and learning will ensure that educators create culturally safe spaces that enable students to engage well with content.

• The adoption of the framework proposed in this paper may lead to the creation of a culturally safe space for teaching and learning in social work education.

     

Does Employment Status Vary by Demographics? An Exploratory Study of Former Refugees Resettled in Australia

This study examined the associations between employment status and demographic factors of former refugees from Ethiopia, Burma, and Democratic Republic of Congo resettled in Australia. Two hundred and twenty-two participants completed a survey, following which chi square analysis was conducted. The results indicated that country of origin, gender, education, English language proficiency (i.e., speaking, reading, and writing), and length of stay in Australia, were associated with being employed. Ethiopians, who had been in Australia for a longer duration, were more likely to be employed. Participants from Burma, whose resettlement was relatively recent, were focused on upskilling themselves. Education qualifications were associated with likelihood of securing employment. A moderate level of education, compared to high or low, provided participants more chances to gain employment. These outcomes help in understanding the employment-related experiences of individuals from a refugee background. Implications and future directions are discussed.

IMPLICATIONS

• Employment is fundamental to successful integration of refugees. Country of origin, gender, education, English language proficiency, and length of stay are associated with employment for former refugees in Australia from Ethiopia, Burma, and Democratic Republic of Congo.

• Understanding these factors can assist stakeholders to better focus their efforts when working with these populations.