No description available.

This study investigates the impact of a one year, multidisciplinary training in psycho-social intervention skills (PSI). It utilises an embedded multiple case design, drawing on experimental and qualitative methods as recommended by Morley (1989). Thus both outcome and the reasons for that outcome are assessed on an individual (student and client) basis, over the training period and for a one year follow-up period. 9 of the 19 clients made a statistically reliable improvement on the total symptoms score, and all but three made progress on their personal goals. These outcomes were not, however, all attributable to specific evidence-based interventions taught on the course. They were also related to 'non-specific' skills used by students (which were none the less based on cognitive behavioural principles), and to other events in clients' lives and their 'readiness' to engage in a process of recovery. Although students' described a change in their own attitudes and approach (and clients recognised changes in the quality of contact), outcomes may have been improved if they had used evidence based intervention skills more effectively. The use of skills appeared to be related to the adequacy of teaching and clinical supervision, the complexity and unfamiliarity of the skills, clients' level of impairment, and the time available and support provided within the workplace. The Sheffield training was developed in tandem with the local NHS Trust. It provided an opportunity to evaluate an 'organic' programme developed to meet local needs drawing on local resources. As such the findings gave an insight into issues of fidelity of training to espoused curriculum and to research evidence; transferability of evidence generated in research trials to routine practice; relevance of a training in interventions most effective on symptoms - when clients' priorities lie in the social domain; and adequacy of the evidence available for work with people who have serious mental health problems. The study concludes with recommendations for research, practices and education. Training in PSI is explicit mental health policy: a means of improving the implementation of that policy. Lipsky's analysis of policy implementation 'Street Level Bureaucracy' (1980) focuses on the role of the individual worker in policy implementation. As such it provides a useful theoretical framework in the present study, informing the individual case method, and enhancing understanding of the findings.

This thesis presents the findings from a study that explores the language and discourses of HIV/AIDS in India circulating at different levels of the policy process during the early years of the pandemic, with a particular focus upon the work of NGOs in Kolkata, West Bengal. The study was exploratory and used Walt and Gilson's (1994) analytic framework of content, context, actors and process to guide data collection. Eleven NGOs were identified for case studies using a snowballing technique. The research design used multiple methods of data collection including semi-structured interviews, informal interviews, participant observation, the keeping of a research diary, and the collection of documentary sources, including policy documents, grey literature and Behaviour Change Communication (BCC) material. The texts were analysed using discourse analysis following Carabine (2002). The study found that global and national level policies assigned a significant role to NGOs in three areas: prevention and control, care and support of people living with HIV/AIDS and the promotion of human rights. However, at the state level there was marked ambivalence about working with NGOs and considerable disagreement about the extent of the pandemic. HIV/AIDS was constructed as un-Bengali and a problem for marginalized and poor groups. The targeted interventions approach, adopted for use at the time, seemed to offer a mismatch between problem construction and responses. However several of the NGOs in the study were offering a package of holistic services in addition to the targeted interventions. NGOs faced the problem of how to share these experiences and understandings with the wider policy community as there was limited opportunity to do this. Further, the involvement of NGOs in care and support was limited and they faced difficulties in promoting a human rights based approach to their work, in part because of a lack of support from the State AIDS Prevention and Control Society (SAS). The findings suggest that, within the context of West Bengal, policies need to be realistic in the role assigned to NGOs in HIV/AIDS programming, clearly identify a role for the state in the promotion of human rights, and develop strategies to enable NGOs to contribute their knowledge and expertise to the policy process.

The aim of the research was to investigate the acceptability and feasibility of health visitors working with their clients to assess health-determining aspects of their clients' home environments and to provide evidence-informed messages about the indoor environment. The research was conducted within a Soft Systems Methodology framework. Following a pilot study in 2003, a proof of concept, feasibility study was implemented (2004 to 2007) with a convenience sample of eight health visitors conducting 29 environmental assessments in clients' homes, using a dedicated, cost effective tool kit. The health visitors were trained to monitor and provide evidence-based messages on Indoor environmental quality. Their quantitative and qualitative data from the assessments were compared against a 'gold standard' assessment carried out by an indoor environmental expert. The health visitors' opinions of the concept were investigated using participant observation and face-to-face interviews. The aim and objectives of the research were met. The health visitors were able to collect accurate data. Changes to the tool kit would be needed to adapt it specifically for health visitors. The majority of the health visitors found the concept acceptable and relevant to their work. The study has added to knowledge, in that the feasibility and acceptability of health visitors helping their clients with indoor environmental problems is now more clearly understood. It confirms previous findings that home visiting health professionals are not well informed about health-determining aspects of the indoor environment. Lack of time and resources could be a barrier to health visitors participating in research.

This thesis uses a case study of the process of conducting a systematic review in the field of substance misuse in order to analyse critically how knowledge is cumulated for the purposes of informing social policy. The analysis is grounded in two areas of social research that are seldom drawn together; the methodological (in this instance, the work of the social research methodologist Donald Campbell) and the linguistic (in the form of a measured application of discourse analysis). By means of this dual approach it is proposed that a better understanding can be obtained not only of how systematic review methods may be usefully developed, but also of the substantive impact that the way in which those methods are discussed and debated (through discourse) can have upon the development. In this way, the process of conducting a systematic review for social policy is critically located within an understanding of both policy making and methodological development as discursive processes. This is important for the way that it allows evidence for policy and practice (both in the sense of the framing of the evidence and the methods used to synthesize it) to be discussed in terms that prioritize respectful debate rather than the promotion of particular methods as superior for the production and synthesis of knowledge. Furthermore, it enables a critical understanding of how dominant discourses can not only frame policy issues, but also the production of evidence-bases that are subsequently used in the policy making process.

This thesis focuses on interagency coordination and collaboration in the management of child sexual abuse in Australia and in England. The impetus for the research arose from the experience of the author as manager and practitioner in the area of child sexual abuse, while working in these two countries. Problems regarding the management of interagency cooperation had become apparent in child protection practice and were also recognized in the literature. Personal experience, as well as a review of the literature, revealed that there was a need for the identification and validation of the key mechanisms and processes underlying effective interagency coordination and collaboration. This review of the literature also indicated that although existing models of operation had been identified, their value to practitioners had not been evaluated. The research underpinning the thesis set out to identify and validate key components contributing to effective interagency cooperation in the management of child sexual abuse that could be of international significance. This research is placed in the context of the evolving social construction of child abuse and child sexual abuse that is reflected in the rise in the incidence of the phenomena as well as in its expanding definitions. The nature of adult/child relationships are explored in terms of the sociological constructions of childhood and their periodisation. Specific attention is given to the rights of children and the professional regulation of child abuse and child sexual abuse in relation to the periodisation of modernity and postmodernity. Child abuse management operated mainly within the medical paradigm between the 1960s and the late 1980s. In England, child abuse tragedies occurred during the 1980s that resulted in official inquiries and culminated in various governmental reports that made recommendations for the improvement in services. The child sexual abuse scandal that occurred in Cleveland in 1986 was accompanied by a moral panic and a backlash in society against social workers and existing methods of professional regulation. As a consequence of Governmental efforts to remedy this situation, the medical paradigm that had dominated child abuse management' was shifted towards a socio-legal paradigm accompanied by the emergence of the discourse of `child protectionism'. However, challenges to the child protection discourse continued and these appear to be centred mainly upon the need for the adoption of a more subjectivist paradigm in the management of these phenomena. The debates and issues arising from these shifts in paradigm, particularly in relation to the operation of the interagency, multidisciplinary approach to the management of the problem, are discussed in the context of the self-referential, closed social systems involved in child protection network. Amidst these changes to service delivery paradigms concerning child welfare, the underlying multiagency interagency method of operation continued to be advocated. Existing research had pointed to the central role of this method of working in the management of child sexual abuse. An eclectically designed study was undertaken to validate the key mechanisms and processes underlying interagency coordination and collaboration. After their identification, it was found that they could be categorised into coordinating mechanisms, collaborative procedures and personal perspectives. These key components were then operationalised to form a questionnaire that was administered to a random sample of four-hundred and seven social worker practitioners and managers in both Australia and England. This was followed up with twenty in-depth interviews with a randomly selected sample of social work managers and practitioners from Australia and England chosen from those who had participated in the original survey. The major finding from a statistical analysis of the results of the survey, and discourse analysis of the in-depth interviews, indicated that the operationalised components were key mechanisms and procedures in the management of child sexual abuse in both Australia and England. A significant outcome from these findings has been the development and integration of the key mechanisms into a model of interagency coordination and collaboration. The model has been termed, the Interagency Model for the Management of Child Sexual Abuse (IAAC). The Model's functions are outlined, together with recommendations for its practical application for the planning of child protection services as well as the training of child protection teams. The final chapter contains specific recommendations for child protection practice, in the light of the research findings, together with their possible implications for the contemporary child protection discourse. Suggestions are made regarding future directions for child protection practice, also based on the research results, together with proposals for future research.

No description available.

No description available.

No description available.

No description available.