Jill Wilson

Supervision practices in allied mental health : relationships of supervision characteristics to perceived impact and job satisfaction

This study examined whether supervision characteristics impacted on mental health practice and morale, and developed a new Supervision Attitude Scale (SAS). Telephone surveys were conducted with a representative sample of 272 staff from public mental health services across Queensland. Although supervision was widely received and positively rated, it had low average intensity, and assessment and training of skills was rarely incorporated. Perceived impact on practice was associated with acquisition of skills and positive attitudes to supervisors, but extent of supervision was related to impact only if it was from within the profession. Intention to resign was unrelated to extent of supervision, but was associated with positive attitudes to supervisors, accessibility, high impact, and empathy or praise in supervision sessions. The SAS had high internal consistency, and its intercorrelations were consistent with it being a measure of relationship positivity. The study supported the role of supervision in retention and in improving practice. It also highlighted supervision characteristics that might be targeted in training, and provided preliminary data on a new measure.

Older people and their assets: A range of roles and issues for social workers

Abstract Following a 10-year research program around assets and ageing, the present paper summarises the work done, and outlines the major findings from the perspectives of older people, carers, and service providers. The research has explored the roles and practices of family caregivers in managing older peoples assets, the experiences of older people who receive such assistance, the factors associated with the financial abuse of older people with and without cognitive capacity, and the concerns of aged care practitioners when the mismanagement of assets is suspected. The experiences of older people and their carers are characterised by a range of responses that generate a number of issues for social work practitioners. Taking a critical perspective, the article discusses practice responses in relation to financial abuse, the assessment of the capacity of the older person to make decisions, and assisted and substitute decision making around asset management.

Prevalence and predictors of advance directives in Australia

Advance care planning is regarded as integral to better patient outcomes, yet little is known about the prevalence of advance directives (AD) in Australia.

Outcomes of training in supervision: randomised controlled trial

There is little controlled research on the impact of supervisor training on supervision. The current study examined the effects of supervision training in a sample of 46 supervisor-supervisee pairs of mental health practitioners. It compared Immediate 2-day workshop training of the pair, a wait-list control in which workshop training was delayed 3 months, and a condition in which supervisors were trained 3 months before their partners (Split). Benefits of Immediate training were restricted to supervisors reporting fully specified agreements, and to reduction of some perceived problems. Self-efficacy in providing effective supervision fell in the Split condition, relative to the other conditions. Across conditions in general there was a fall from baseline to post-test assessment in the proportion of sessions where recommended supervision strategies were used, perhaps partly because the controlled trial extended across the summer vacation period. Results are consistent with other observations of the limited impact of workshop training on practice.

Supervision practice for allied health professionals within a large mental health service: exploring the phenomenon

Abstract This paper reports on an exploration of the concept of ‘supervision’ as applied to allied health professionals within a large mental health service in one Australian State. A two-part methodology was used, with focus group interviews conducted with allied health professionals, and semi-structured telephone interviews with service managers. Fifty-eight allied health professionals participated in a series of seven focus groups. Semi-structured interviews were conducted with the Directors or Managers of mental health services in all 21 regions in the state. Allied health professionals and service managers both considered supervision to be an important mechanism for ensuring staff competence and best practice outcomes for consumers and carers. There was strong endorsement of the need for clarification and articulation of supervision policies within the organization, and the provision of appropriate resourcing to enable supervision to occur. Current practice in supervision was seen as ad hoc and of variable standard; the need for training in supervision was seen as critical. The supervision needs of newly graduated allied health professionals and those working in rural and regional areas were also seen as important. The need for a flexible and accessible model of supervision was clearly demonstrated.

Evaluating communication for resident participation in an aged care facility

Speech pathologists who work in aged care facilities are often challenged to find appropriate measures of communication that consider the frailty of residents and the policy environment that speech pathologists are required to work within. This article describes a process for evaluating resident participation in an aged care facility (ACF) using the framework of the World Health Organizations International Classification of Functioning, Disability and Health (ICF). It also presents the findings of this process from one ACF, a 60-bed high care facility. Assessments of individual residents communication impairments, activity limitations and participation restrictions were conducted initially, followed by evaluations of the physical and social communication environment of the facility. At the individual level, residents were found to have a high prevalence of communication impairments and reported activity limitations and participation restrictions associated with these. The environmental assessments identified that residents had few opportunities to communicate, and that the physical and social environment was not conducive to communication. This study supports many others that have found a high prevalence of communication disabilities in residents of ACFs. It also confirms that the communication environment is not conducive to participation and recommends assessments for identifying both resident and facility-wide communication problems.

MENSTRUAL MANAGEMENT AND WOMEN WHO HAVE INTELLECTUAL DISABILITIES: SERVICE PROVIDERS AND DECISION-MAKING

As part of a study about menstrual management decision-making for women who have an intellectual disability and high support needs, 63 service providers were interviewed using a semi-structured interview schedule. The interview participants included school staff, residential staff, ”resource” staff, managers, and medical practitioners. The interview schedule sought information about decision-making bases, such as relevant personal experiences and observations, attitudes to menstruation, knowledge of management approaches, and practical support networks accessed by the participants. In addition, participants were asked their opinions about decision-making processes such as what choices they perceive as practicable and preferable, who should be involved in decision-making processes and criteria upon which decisions should be made. Participants were also asked for their suggestions about how to access information and enhance practical support for the young women and their families. This paper summarises the ...

Sterilisation, drugs which suppress sexual drive, and young men who have intellectual disability

In 1992, the High Court of Australia ruled that all procedures involving the sterilisation of children (other than to treat some malfunction or disease) should be referred to the Family Court of Australia. There has been recent public debate about the sterilisation of young women who have intellectual disability. However, there appears to be very little known about the sterilisation of young men who have intellectual disability. Health Insurance Commission figures indicate that vasectomies and perhaps bilateral orchidectomies are occurring for some young Australian males under 19 years of age, some of whom are under nine years of age. In addition, the use of drugs to alter sexual behaviour in young men with intellectual disability remains controversial. Concerns include sexual behaviour, aggression and other aspects of human relationships of young men with intellectual disabilities. This paper reports on 51 responses to a request for information about sterilisation, drugs and young men who have intellectual disability in Australia. Several issues, including the influence of attitudes and the need for informed decision making are raised.

Access to assets: older people with impaired capacity and financial abuse

This paper draws upon findings from a secondary analysis of suspected financial abuse cases in files of the Guardianship and Administration Tribunal in Queensland, Australia. The paper explores the association between formal and semi‐formal asset management arrangements and suspected financial abuse cases. The role of families as formal asset managers is also considered.

Financial Capacity in Older Adults: A Review of Clinical Assessment Approaches and Considerations

Financial capacity is a critical issue of autonomy for older people. However, determining the point at which a cognitively impaired older adult is no longer capable of independent financial management poses an onerous task for family members, and health and legal professionals. At present, there is no agreed-upon standard for evaluating financial capacity, and issues pertaining to the level of impairment that constitutes incapacity remain largely unresolved. In the absence of validated assessment guidelines, determinations of capacity are frequently based on neuropsychological measures and clinical judgment, although there is limited evidence to support the validity of these methods in capacity determinations. In this paper, various cognitive, psychiatric, social, and cultural factors that potentially contribute to financial incapacity in older adults are described. The strengths and weaknesses of clinical approaches and instruments currently used in capacity determinations are evaluated, and specific recommendations are made regarding broader assessment approaches. Finally, directions for future research and instrument development are offered.