Working with domestic violence: Ethical dilemmas in five theoretical approaches
Therapists working with domestic violence are trained in many different theoretical models, each based on different values and assumptions. Each model raises different ethical dilemmas. In this paper, five theoretical approaches are evaluated in relation to the ethical principals of: respect for clients' autonomy: beneficence: non-maleficence: and justice. The inverse relationship between respect for autonomy and beneficence and non-maleficence is discussed. The hierarchical asymmetry involved in the therapeutic relationship is also explored.
Opportunities and challenges of FIFO and DIDO healthcare services in rural and remote Australia
Objective: Most rural and remote regions face chronic health workforce shortages. Strategies designed to redress this problem include Fly-In Fly-Out (FIFO) and Drive-In Drive-Out (DIDO) health services. The aim of this paper is to examine the opportunities and challenges involved in these forms of service delivery. Design: Detailed review of recent literature relating to FIFO and DIDO services in rural & remote Australia. Results: FIFO and DIDO have obvious short-term benefits for rural Australians seeking health care services in terms of increasing equity and accessibility to services and reducing the need to travel long distances. However, there are significant long-term disadvantages such as the potential for burnout among FIFO and DIDO health professionals who travel long distances and work long hours, often without adequate peer support or supervision. A further disadvantage, particularly in the use of visiting medical practitioners to provide generalist services, is the lack of development of a sufficiently well-resourced local primary health care system in small rural communities.Conclusions: Given the potential negative consequences for both health professionals and rural Australians, this paper cautions against the increasing use of FIFO and DIDO services, without the concurrent development of well-resourced, funded and staffed primary health care services in rural and remote communities.
Constructing a Sense of Self Following Early Sexual Experiences with Adults: a Qualitative Research Study
The aim of this research project was to develop a fuller understanding of the process of constructing a sense of self following early sexual experiences with an adult. Using narrative inquiry, a sample of twenty-two men and women aged twenty-five to seventy were interviewed about their early sexual experiences, at the age of fifteen or under with someone over eighteen. Participants told four different narratives about these experiences: narratives of silence; of ongoing suffering; of transformation and transcendence. These four narratives have been examined in the light of the literature relating to childhood sexual abuse, and the victim and survivor discourses. To an extent they changed current conventional views about child sexual abuse. The implications for therapists working with men and women who have experienced child sexual abuse are discussed.
Modes of Supervision
In Australia and the United Kingdom, lifelong supervision has become a requirement for counsellors and psychotherapists and has been built in to the professional codes of conduct as a mandatory requirement (Neufeldt, 1999, cited in Feltham, 2000). The most commonly adopted mode of supervision in Australia is the individual mode, where a less-experienced therapist consults with a more experienced therapist about their caseload face-to-face. This form of supervision, often heavily based on case discussion, is normally conducted at least once a month and is seen as vital to the ethical practice and ongoing professional development of counsellors and psychotherapists. In this chapter we begin by describing our own personal experiences of supervision - both exceptional and ordinary. We then describe four different modes of supervision including individual, group, peer and self-supervision and the different techniques that can be used within each mode. We explore the strengths and weaknesses of each of these modes of supervision. We discuss ways of empowering supervisees to seek out the supervision that they need. In the process, we challenge the assumption that the individual mode of supervision is the most appropriate mode for counselling supervision in all cases.
Female sexual dysfunction or not knowing how to ask for what feels good?
The recently published Italian study suggesting women can only have clitoral, rather than vaginal, orgasms raises important questions about the medicalisation of female sexuality and sexual dysfunction. Many women would be happy to have an orgasm any old way, as University of Western Sydney researcher Jane Ussher points out, especially those who experience sexual difficulties. It's difficult to write about the topic of female sexuality without using negative language such as "female sexual dysfunction" or "failure" to orgasm. Much of what has been written about the female orgasm is based on phallocentric assumptions, such as that women "should" have orgasms through penetrative sexual intercourse with men. And if they don't achieve orgasm, there is something wrong with them. Many women have absorbed these culturally acceptable views and the ongoing medicalisation of female sexuality continually reinforces them.
Inaugural Edition of PACJA: Psychotherapy and Counselling Journal of Australia
One of PACJA's stated aims is to stimulate research in this field, by providing an online journal in which the findings of effectiveness and other research studies can be published. In this online journal, we intend to publish articles that contribute to the evidence base of psychotherapy and counselling in the form of theoretical essays, experiential reports, and empirical studies featuring quantitative, qualitative, or mixed-method approaches. PACJA encourages practitioners, researchers, students and educators (even if you have never published before) to submit articles for publication. The process is intended to be a supportive in order to mentor aspiring authors to contribute to the dissemination of knowledge in the counselling and psychotherapy field. The first edition lives up to PACJA's aims, with six differing articles of merit, a commentary relating theory to practice, and two book reviews.
The Challenge of Cross Cultural Counsellor Education: An article based on an action research plan
Social Work Student Views on Palliative Care Learning Resources
Many social workers are expected to work with individuals and families who are dealing with life-limiting illnesses, yet during their university education they may not have been exposed to materials that address issues related to death and dying. The Social Work Department of University of New England in Armidale, Australia designed and delivered a palliative care teaching and learning session using publicly funded online materials. Themes emerging from questionnaire and focus group data analysis included appreciation for the importance and emotional demands of the materials, sensitivity and flexibility among educators who ideally have work experience in the field, expanding presence of social work philosophy in curriculum materials and exploring spirituality, and examining culture-informed practice in greater depth. Among the implications is the need for concerted efforts to teach about death and dying using high quality accessible materials, while ensuring social work values and approaches are reflected in the content.
Navigating the Challenges of Trauma Counselling: How Counsellors Thrive and Sustain Their Engagement
This qualitative study explored the factors that help counsellors exposed to indirect trauma thrive personally and professionally, and sustain their engagement in trauma counselling work. The existing literature details the challenges of indirect trauma exposure in trauma work. However, the ways in which counsellors are able to derive rewards and maintain their engagement in trauma counselling work are less well recognised. The study used a grounded theory approach, with semistructured interviews conducted with 18 therapists. The study found four main interrelating themes: thriving in trauma work; navigating the empathic journey; empathic stamina and engaging in self-reflexivity; and sustaining interest and commitment. Important factors included attending to both the adverse and rewarding aspects of trauma work, having access to appropriate support structures, and incorporating variability and diversity in the work. This study extends the current understanding of the processes, practices, and strategies that promote the rewarding and sustaining aspects of trauma counselling work.
Collectivistic Culture of Vietnamese in Australia and the United States: Implications for Psychotherapy
Research related to psychotherapy conducted in Australia and the United States indicates that Southeast Asians are not as receptive to mental health services as their Caucasian counterparts. Prior research has explored underlying factors that result in Asian clients’ reluctance to seek therapy as a viable option to ameliorate their psychological issues. Little is understood regarding whether traditional models of therapy are well suited for Vietnamese clients. In this study, 27 Vietnamese participants over the age of 18 were recruited from Australia and the United States. Using narrative inquiry methodology, participants were invited to discuss Vietnamese attitudes towards psychological distress, how cultural values affect their attitudes towards psychotherapy and its relevance for addressing their personal concerns and psychological problems. Findings from the study related to three main themes: the collectivist perspective of Vietnamese immigrants; the cultural rift between those that maintain traditional values and those that have assimilated to a Western, more individualist perspective; and Vietnamese ideas about psychotherapy. The importance of understanding the collectivistic culture of Vietnamese clients in the context of mental health services is discussed in detail. The mismatch between traditional, individualistic therapy concepts and clients who remain collectively oriented, despite exterior adaptations to Western culture, needs to be recognized. This research challenges the field of psychotherapy to re-examine whether Western therapy adequately fulfills the needs of Vietnamese clients and highlights the importance of collectivist considerations, hierarchical relationships, communications styles, and the cultural rift. Recommendations are made for adapting psychotherapy to better suit Vietnamese clients.