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“In what ways does the experience of caregiving for a terminally ill family member affect the experience and process of bereavement?” The identity of family caregivers in palliative care has been ambiguous: caregivers are often unaware they fit the description of ‘carer’. Previous research describes two contrasting constructs that shape the identity of the caregiver: burden and privilege. Research, including this study, suggests that the emergence of identity as a carer impacts on the course and experience of bereavement. Two semi – structured interviews were conducted with a small number of caregiving family members: during the caregiving role and in their subsequent bereavement. This exploratory study used phenomenological research to examine the experiences of those caregivers interviewed. The data were examined using the existential themes uncovered in analysis. This paper reports on those themes.

How support workers enable, regulate or constrain the sexual expression of intellectually disabled people who live in service agency group homes is the subject of this thesis. A general literature search of what intellectually disabled people currently experience in their lives, including their experiences in the area of sexuality and intimacy, begins this investigation. Secondly, an extensive literature review of the support role, incorporating an appraisal of past and current issues related to the support position in general and to the area of sexuality support in particular, was completed. What intellectually disabled people themselves would like in relation to sexuality and intimacy support was included in this section. Thirdly, a review of research studies focussing on the operation of the support position within service agency systems was undertaken. These explorations revealed a high degree of reluctance on the part of workers to provide assistance in the sexuality area, despite a proven necessity for support to be made available to the intellectually disabled people they worked with. Review research studies suggested a variety of causal factors in explanation of this reluctance. These suggestions link to two meta-reason positions. Failure to prove support either stemmed from individual worker’s inactions due to ignorance and/or incompetence, or from wider systemic failures on the part of agency services to positively value and support this key service role in this area. However, little if any analysis of the possible influence of the broader social, emotional and cultural contexts, in which the concepts ‘sexuality’ and ‘(intellectual) disability’ are located, could be found in the studies reviewed. Eleven in-depth interviews were conducted with front-line support workers about their sexuality support practice. Preliminary readings of the interview texts revealed a similar reluctance on the part of the workers concerned to assist those they worked with in this area. Interview texts were then subjected to a post-modernist inspired, interpretive discursive analysis. This analysis uncovered and tracked how key power/knowledge effects inherent in the terms ‘(intellectual) disability’, ‘sexuality’, ‘gender’ and ‘desire’ inhering in the concept of an ‘ideal (sexual) couple’ interweave to shape the ‘no support necessary’ practice responses held in worker’s interview talk. From this exploration it is suggested that research studies of workers’ practices as an aspect of the promotion of change in support outcomes in the sexuality support area need to go beyond the parameters of recommendations that stem from considerations of either individual or systemic limitation alone. It remains a convincing point to suggest that poorly performing workers need retraining in this area and the overall value of the support role within service organizations needs reshaping. However, future research recommendations also need to engage more directly and effectively with the effects of the wider social and emotional “ideal (sexual) couple” ambiguities that also influence worker’s lack of assistance in this complex and sensitive support area. The use of a post-modern perspective as a helpful conceptual tool in unpacking the power these ambiguities hold within the support position is offered as a productive way forward for future research and practice development.

Family Meetings occur frequently in the Paediatric Intensive Care Unit (PICU) yet little data existed to guide clinicians in the conduct of these meetings. The medical team is required to deliver complex medical information and navigate complex decision-making with a traumatised family during a meeting. The objectives of this study were to describe the content and process of 15 whanau/family meetings in the PICU, identify family meeting characteristics and patient and family attributes that influence family satisfaction and recommend guidelines for health professionals working in the PICU. The study was conducted in a PICU in a university-affiliated children’s hospital in New Zealand (NZ). The process and content of 15 family meetings were analysed using a coding framework previously developed through a qualitative study of family meetings in the adult intensive care unit (Curtis, 2002a). A questionnaire providing a quantitative assessment of family satisfaction drawn from the same study was administered to 30 family members. Demographic data for the study were collected from the patient’s hospital record and these were combined with data relating to the meeting recording and transcript to identify family meeting characteristics and attributes that might influence family satisfaction. The content and process of family meetings in the PICU were described using a framework detailing 28 codes from the six domains: introductions, informational exchange, discussions of the future, decisions, discussions about death and dying, and closings. A comparison of family meeting characteristics and patient and family attributes revealed that longer meetings (40 minutes plus) were associated with lower family satisfaction and should therefore prompt clinicians to consider whether there are unresolved conflicts, difficulties or misunderstandings between the medical team and the family. Recommendations are proposed to guide health professionals in family meetings in the PICU. This is the first study to record and code the content of family meetings in the PICU. The findings from this study will assist clinicians in their meetings with families. The description of the family meeting content will also provide a foundation for future communication training and research in the health environment.

This qualitative research enquiry sought to develop an understanding from forty-four women, comprising twenty-two couples in committed lesbian partnerships, of how they managed the long-term impacts of child sexual abuse, both on themselves and on their relationships. This is an area that is under- theorised in the literature. A number of key findings emerged from the analysis. The sexual abuse that women had experienced had impacted their adult lives in various ways. Of these the personal aspect featured most highly, with feelings of self-blame, shame and low self esteem commonly reported. Those women who reported physically invasive sexual abuse also reported a wider variety of effects, and in proportionately greater numbers, than women whose abusive experience had not encompassed that particular dimension. Just as the survivors were impacted in a variety of ways by their abuse, so too were their partners, although the effects upon the partner varied over time and in intensity depending on the length of the relationship and the degree of resolution experienced by the survivor. Despite challenges the over all view of couple relationships was positive, and couples were able to articulate coping strategies they felt would be useful to others in similar circumstances. Partners were able to identify with many of the relationship issues outlined by heterosexual male partners of female survivors, although lesbian partners had more a positive view of counselling. The emotional support and commitment of a caring partner was clearly valued although in these partnerships both women wanted their relationship to be based on more than the reparative needs of one member. Finally, being lesbian was no barrier to seeking counselling assistance. A large proportion of the participants had used counselling as a way of working through their experiences of child sexual abuse and had found this to be valuable. These findings have implications for social work practice with child and adult female survivors. They emphasise the long term impacts of sexual abuse, the important contributions made by partners and counsellors in supporting women sexually abused as children and the levels of inter-sibling sexual abuse perpetrated by brothers. The research findings also contain information from the women themselves on what facilitated their ability to cope with the effects of child sexual abuse from the varying perspectives of survivor, partner and couple. This will be essential information for counsellors and social workers wishing to employ strengths and evidence-based approaches in their work with this client group and others, particularly heterosexual women and heterosexual couples.

Servicemen returning from two World Wars were granted assistance in finding work, retraining and other benefits in recognition of the sacrifices they had made. Yet mothers' returning to work after time out bearing and raising children are reliant on a booming economy to obtain even limited entry to the labour market, and the work obtained is very often inferior to the jobs held by women before becoming mothers. Currently due to lower fertility rates and the ageing populations of the world's richer nations, a shortage of working-age people is predicted to continue into at least the middle of the twenty-first century. To overcome this shortfall, the Organisation for Economic Cooperation and Development (OECD) advises its member states to assist mothers to return to paid work sooner. Most OECD nations are complying, with varying degrees of success. Some policy frameworks make this goal more easily attainable than others. Mothers in liberal welfare states often return to paid work later than they might otherwise prefer. Many returners are overqualified for the work they are doing. While there appears to be relatively few barriers to re-entry, the choice of re-entry occupations are limited and returners are predominantly offered low status jobs with no career opportunities at the back of the job queue and gender queue. Mothers who interrupt their careers by taking a career break for childbearing and rearing generally face downward occupational mobility and loss of lifetime incomes. This thesis assesses the experiences of mothers who return to employment in one liberal nation, New Zealand. It applies Esping-Andersen's three models of welfare states and Reskin and Roos' gender queues model to the situation of returners. The study investigates the precise nature of the obstacles and processes encountered by a number of mothers attempting to resume a career. It argues that social policies matter: returners in countries where state intervention is more widespread and where there is universal, extensive and generous social provision and support for working mothers are economically better off. The research methods include in-depth interviews and a focus group with mothers, a mail questionnaire and interviews with employers, and a study of recent and current New Zealand and overseas government policies to assist working parents. The findings of this thesis are that regardless of skill levels, New Zealand returners are consigned to low status occupations where they are not fully integrated into the 'normal' full-time workforce with career opportunities. These mothers generally suffer more than one episode of returning to the back of the queue. They also earn less (weekly and annually) than mothers who do not take career breaks. The study identifies social policy frameworks and employers' policies and practices as factors contributing to the processes whereby returners are relegated to the back of the queue. Although New Zealand has recently brought in policies to assist mothers to return to paid work these initiatives have not addressed the processes that currently confine returners in low status, part-time employment. Policies similar to those created to specifically target the needs of ex-servicemen would go a long toward assisting mothers to access higher status and better-paid jobs at the head of the queue. The thesis concludes with policy recommendations to facilitate mothers' integration into such jobs.

Since becoming the first English speaking country to legislate against the physical discipline of children in 2007, there has been much debate in New Zealand for and against the parental practice of smacking. For some it has meant a welcome amendment to legislation that protects the human rights of children, for others it raises fears that parents can be criminalised for smacking their children and that the rights of parents to discipline their child, as they see fit, are being eroded. Working for an organisation that fully supports the Amendment to Section 59 of the Crimes Act, 1961 and that promotes the human rights of children; the motivating factors that encourage a parent to stop the practice of physically disciplining their child became of interest to the researcher for this thesis. Ten participants, who had used physical discipline and who had made a decision to stop the practice, were recruited to take part in a qualitative study. The data collected was analysed through a thematic analysis process using five motivational contexts found in previous research on the topic. The five contexts were experiential, relational, biographical, regulatory and ideological (Davis, 1999). The findings of the research for this thesis concur with the previous research and add further information about the motivating factors. The findings also identify the strategies that parents have found useful to achieve success in their endeavour to change their disciplinary practice. Furthermore the importance of and the distinction between the human rights of the child and parental rights have been highlighted.

This thesis examines the rapport building that occurs between rangatahi Māori whaiora (adolescent Māori who use mental health services) and Māori social workers in the field of community mental health. Six Māori social workers were interviewed to explore how they view and practice rapport building with rangatahi Māori whaiora. The Māori social workers were able to provide valuable perspectives based on years of personal and professional experience. The research was conducted using a social constructionist perspective, informed and guided by Māori-centred research principles. A qualitative research method was used and both Massey University and Māori ethical considerations thoroughly explored. Face to face interviews guided by an integrated practice framework, enabled the voices of the Māori social workers to be heard, eliciting in detail where their views have come from. The findings from the research showed that Māori social workers view rapport as essential in their practice and therefore they practice in a way that facilitates this with rangatahi. The social workers utilise their values and beliefs in their practice, according to their worldview; how they were raised; what they have experienced, and what they have learned. Specifically, Māori social workers identified the importance of practicing with a Māori worldview, therefore enabling physical connection, spiritual connection, and cultural connection with the rangatahi. These all contributed towards rapport building with the rangatahi and also their whānau. The importance of action reflection processes were also highlighted. This is due to the balance required from Māori social workers to fulfil the needs of the rangatahi as aligned with their values and beliefs, while meeting the requirements of the organisation, profession and wider community. This thesis explores these key findings.