Sexuality, Sexual and Gender Identities and Intimacy Research in Social Work and Social Care
Until now, sexuality has been treated as a specialist topic or area of specialist social work practice. This book cuts across all areas of the discipline. It examines the relationship between sexuality, sexual identities and intimacies and the life course, and showcases a range of issues pertinent to social work through these lenses. It opens up new possibilities for better understanding sexuality in social work, and contains empirical work and theorising about sexuality, intimacy and gender not currently found in a traditional course on life course theory and practice.
The chapters position new areas of scholarship in sexuality including trans perspectives, masculinities, bisexuality and the voices of other gender and sexual minority populations within a life course trajectory. Empirical research picks up on the broader public health and well-being agenda with a strong focus on challenging normative theories to promote human rights and justice for marginalised individuals and groups.
Sexuality, Sexual and Gender Identities and Intimacy Research in Social Work and Social Care will significantly enhance any core texts on life course theory and practice, anti-oppression and anti-discriminatory theories for professionals. It should be considered essential reading for academics, practitioners and undergraduate and postgraduate students.
Professor Jan CzesÅ‚aw CzabaÅ‚a’s Anniversary of Science and Research Work
On the 24th of November 2017, we celebrated the 50th Anniversary of Prof. CzesÅ‚aw CzabaÅ‚a’s Science and Research Work. Prof. CzesÅ‚aw CzabaÅ‚a is a clinical psychologist, psychotherapist and psychotherapy supervisor. For last 50 years, he has been working with patients with mental health problems as well as with other specialists on many research projects. His main fields of scientific research are in the area of psychotherapy and mental health promotion. Professor CzabaÅ‚a has been also engaged in the activities of the ENTER Mental Health Network from the very beginning. He was present on the first meeting of ENTER members in 2000 and has been involved in many projects over the last 17 years.
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Working with Czesław Czabała is an honor as well as a great pleasure.
Now Prof Czesław Czabała works in in Warsaw at the Maria Grzegorzewska Pegadogical University. He lectures in the Department of Psychology and coordinates numerous research projects.
On the 24th of November 2017, many of CzesÅ‚aw CzabaÅ‚a’s students, colleagues and friends came to celebrate his 50th anniversary working as a psychologist. The Steering Group of the ENTER Mental Health European Network were also present. A Polish Professor of Psychiatry, Dr Jacek Wciórka, made a speech on “Understanding and solving mental health crises: Are we looking for the ‘philosophical stone?” Prof. CzesÅ‚aw CzabaÅ‚a received an Anniversary Book written by his co-workers. One of the chapters was prepared by Prof. Peter Ryan, Dr. Tim Greacen, Ian Dawson and the Enter Mental Health European Network: “Professor CzesÅ‚aw CzabaÅ‚a: An Encomium from the Perspective of ENTER Mental Health”. During the celebration, there was also time for music, food and friendly exchanges with Professor CzesÅ‚aw CzabaÅ‚a and all his colleagues and friends from over the years.
Congratulations Czesław!
ENTER Mental Health Members
ENTER's 20th Anniversary
ENTER held it's 20th meeting this year at Nordland Hospital in Bodø Norway.
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Invited guests heard a short presentation on the history of ENTER by Ian Dawson, addresses from previous chair Tim Grecen and the present chair Marja Kaunonen and a greeting from Czeslaw Czabala a long standing member from Poland read by his college Lidia Zablocka-Zytka.
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So to the next 20 years.
Education intervention as a part of mental health service users’ rehabilitation: A practice theory
MScN Irja Nieminen defended her doctoral dissertation at University of Tampere on 20th of January 2017. Irja’s dissertation is important for ENTER Mental Health when the data for it were collected as part of the EMILIA Project. The dissertation includes an overview written in Finnish and four scientific articles:
1. Nieminen, I. & Kaunonen, M. 2011. Mielenterveyskuntoutujien osallistuminen EMILIA-
projektin koulutusinterventioihin –kuntoutujien ja henkilökunnan kokemukset 10 kk:n seurannan jälkeen (In Finnish). Hoitotiede 23, 57-71.
2. Nieminen, I., Ramon, S., Dawson, I., Flores, P., Leahy, E., Pedersen, ML. & Kaunonen, M. 2012. Experiences of social inclusion and employment of mental health service users in a European Union project. International Journal of Mental Health 41, 3-23.
3. Nieminen, I., Kylmä, J., Åstedt-Kurki, P., Kulmala, A. & Kaunonen, M. 2016. Mental health service users’ experiences of training focused on empowerment: Training environment and the benefits of training. Archives of Psychiatric Nursing 30, 309-315.
4. Nieminen, I. & Kaunonen, M. 2017. Professionals’ views on mental health service users’ education: challenges and support. Journal of Psychiatric and Mental Health Nursing, 24(1),
57–68.
The dissertation can be read from: http://urn.fi/URN:ISBN:978-952-03-0316-7.
In the Abstract of the thesis Irja Nieminen writes: Due to their mental illness, mental health service users often face difficulties when it comes to educating themselves, whether it is elementary, vocational, higher level or non-vocational training. However, education improves their employability and integration to society. Understanding mental health service users’ experiences on education will help identify factors, which can be used to help them achieve their educational goals. In her research mental health service users’ education was observed by focusing on the participation in an education intervention in the context of mental health rehabilitation. The purpose was to develop a practice theory on the education intervention as a part of mental health service users’ rehabilitation. The aim was to obtain data on what factors have to be taken into account when organizing the education intervention so that they would support mental health service users’ coping in the education. Another goal was to find out ways for the mental health service users to cope in the education intervention by using means of mental health rehabilitation.
The education intervention used in the study was developed in the international research project called EMILIA, which was funded by the European Union. The goal of the education intervention was to enhance the rehabilitation and social integration of mental health service users. The participants of the study were mental health service users (n=47) and staff members of mental health service units (n=59) from nine European countries. The countries participated in the research were Bosnia-Herzegovina, Denmark, Finland, France, Great Britain, Greece, Norway, Poland and Spain. The data were collected from the mental health service users by one-by-one interviews before the education intervention and 10 and 20 months after the beginning of the intervention. Data collection from the staff was conducted by observations and focus group interviews. The observations were carried out 10 months after the beginning of the intervention by observing staff meetings where the education intervention was discussed. The observations were carried out in all countries except for Finland, where the data from the staff members were collected by the focus group interviews. All data were analyzed by inductive content analysis. Metasynthesis was used as an analysis method to conclude the results of the original studies (Nieminen 2017).
The results showed that the education intervention as a part of mental health service users’ rehabilitation is a multidimensional process. It consisted of factors which are associated with the educational preparedness of the mental health service users, dimensions of the education event, consequences of the education and the forms of support of mental health rehabilitation that contribute to the mental health service users’ education. Factors that made the mental health service users’ education easier included taking into account the rehabilitation level when starting the education, treatment balance, goal-orientation of the education, motivation of the learner and intentional commitment to the education. Factors that hindered the mental health service users’ education included isolation, dominance of the illness and the values and attitudes of society. The education event was described by the research participants through its dimensions, which were social interaction, inner resources of the learner, the pedagogical implementation and student-based cooperation between the mental health service user, rehabilitation organization and education organization. The education was experienced to support theme mental health service users’ personal growth and to prepare them for social integration. Nevertheless, there were experiences of failed education. Forms of support of mental health rehabilitation that contribute to the mental health service users’ education were strengthening the mental health service users’ inner resources and creation of an environment that provides support and professional expertise.
As the outcome of the research a practice theory was developed, which produced new knowledge and reinforced previous knowledge of the education intervention as a part of mental health rehabilitation. With the help of the practice theory, education interventions for mental health service users can be developed further to correspond to their needs and develop the education so that it supports better service users’ participation and follow-through in the education. The practice theory has yet to be tested and developed so that it can be used in different environments.
Engagement and Barriers in Help-seeking of Dually-diagnosed Mothers: Grasping life or letting go?
MSc Minna Sorsa defended her doctoral thesis at University of Tampere, Finland May 9th 2018
The opponent was professor Lena Wiklund Gustin from Arctic University, Norway.
In the acknowledgements section of her thesis, Minna writes: ”The ENTER Mental Health Network inspired me to pursue the subject of care in complex life situations, and I am deeply grateful to the ISADORA project, which opened my eyes to the problems of addiction and dual diagnosis.”
The aim of Minna’s study is to describe and explore help-seeking and connecting with different services by mothers suffering from both mental health and substance-abuse problems at the same time, the dual diagnosis syndrome. She seeks answers to the following questions: 1) What kinds of barriers exist with regard to help-seeking in the service delivery system for a dually-diagnosed mother seeking help? 2) What creates engagement in the service delivery system when a dually-diagnosed mother seeks help? 3) How can researchers influence data in open-ended qualitative interviews? 4) What is the theoretical structure of engagement and the barriers in help-seeking for dually-diagnosed mothers?
The background of the study is the complex life situations of persons with dual diagnosis. Mothers with a dual diagnosis may decide not to seek professional help, which is controversial from the service delivery standpoint, as a fundamental goal of the service delivery system is to ensure the well-being of children. A history of adversity reveals many reasons why barriers may emerge and why services designed to assist clients may actually result in additional barriers to care. The context and the theoretical lens utilised: the mental health model and the cultural determinants of help-seeking. Help-seeking and engagement have not been sufficiently conceptualised in psychiatric and mental health nursing. The tools within mental health care could be further developed to eliminate barriers and promote inclusion as the goal of equitable service provision.
The study materials: a case study (n=1), staff interviews (n=104) in a specific geographical area and an ethnographic field study at a low threshold service, including observations, field notes and interviews with staff (n=12) and clients (n=2). The methods utilised are Giorgis’s phenomenology, conventional content analysis and Leininger’s ethnographic analysis. The studies were synthesised using Noblit and Hare’s meta-ethnography. Additionally, a literature review was conducted on bracketing in open-ended qualitative interviews.
The result is a situation-specific model of engagement and the barriers to help-seeking faced by dually-diagnosed mothers. The results show that the vulnerable background of clients creates barriers from the standpoint of the client, staff and the service delivery system.
Help-seeking may be a long-term process. It requires action on behalf of the client, when not all clients have verbalisable wishes and needs. Engagement is formed at the experiential level for mothers, and it requires specific sensitivity to the interfaces and micro-moments and different interfaces where clients connect with services. The mother’s experiential and emotional level of engagement differs from her practical level of engagement. The inner experiential level of engagement is described via the metaphor of a seed recognising the client experience being valued and the importance of the environment. Barriers and engagement are co-created between the mothers and staff and the staff’s potential to approve of their client’s past. Barriers may operate in such a way that connections cannot be formed.
Engagement is the phase when a therapeutic alliance does not yet exist, and it can occur repeatedly. Interfaces consist of all types of boundaries or settings where the client encounters service delivery. It consists also of interfaces other than just verbal communication, such as the availability of staff. The tool suggested for mental health care is an individualised, family-oriented, knowledge-based and humane approach within a wide variety of interfaces and micro-moments in time. Sufficient time resources and perseverance are needed. Special attention was given to bracketing, since researchers themselves also affect the research process. Bracketing, disclosing the past or using pre-understanding intentionally are implemented not to influence the participant’s understanding of the phenomenon.
Finding solutions at policy and service delivery levels to help these mothers is a priority, and the study demonstrates a core process within the services: the clients cannot be helped without their own engagement and motivation. One reason for the presence of barriers may be that the staff can only partly make use of their knowledge and expertise obtained from training, since organisational functioning and the time pressures placed on practitioners may build walls rather than eliminate them. Staff should revisit their ethical requirements as a prerequisite to helping each client. On a policy level, while the tools for enhancing the inclusion and participation of dually-diagnosed mothers as well as their positive mental health do exist, a key issue is to decide who bears the ultimate responsibility.
The thesis can be found at: http://urn.fi/URN:ISBN:978-952-03-0725-7
Professor Peter Ryan, co-founder of ENTER, retires
One of the founders of the ENTER Network retired in September 2017. Peter has been one of the driving forces of the network and has amongst other things secured funding to several of the ENTER projects.
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Peter has a long standing interest in mental health case management (assertive outreach) in which he has published widely and also trained extensively. He have also researched occupational stress in mental health services.
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In 2000 he invited interested parties to form the ENTER network, holding the position of chair for many years and has been one of the driving forces in many of the projects ENTER has initiated, for example OSCAR, EMILIA and PROMISE. He has also been involved leading a Middlesex team, Professor Ryan developed a programme of training materials for use with Turkish university and community mental health centre (CMHC) staff, based on agreed training priorities, and using blended learning approaches including face to face teaching and online web-based material.
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Congratulations Peter!
ENTER Mental Health Members