Browsing by Author "Wulff, Daniel"

Now showing 1 - 3 of 3
  • Thumbnail Image
    ItemOpen Access
    Are We Failing FAmILy?: A Situational Analysis of Family Perspectives on Functioning While in Out-of-home Care
    (2022-07-19) Westelmajer, Chloe; St. George, Sally; Wulff, Daniel; Ewashen, Carol; Archer-Kuhn, Beth; Raffin Bouchal, Shelley
    Despite Canada having the highest rate of children living in out-of-home care throughout the world (Brownell & McMurtry, 2015; Gilbert et al., 2012; Thoburn, 2007) there is scant Canadian data or research pertaining to these children and their families. Research has shown that a child’s family functioning level is highly correlated with successful out-of-home mental health care treatment outcomes, discharge, behavioural improvement, and stability (Sunseri, 2004, 2019). Family functioning models and assessments that have not been normed upon Canadian families, or that organise family functioning related to task accomplishment, are being utilised to make life-changing decisions within out-of-home care settings. Harnessing my experiences as a front-line counsellor, family therapist, manager, administrator, and passionate out-of-home care advocate I set about asking the research question “What aspects of functioning as a family unit are most important and most immediate to families with a child in out-of-home mental health care?” in order to create theory that could provide better comprehension of what functioning means for these families. I utilised Adele Clarke’s (Clarke, 2005, 2007, 2009; Clarke et al., 2015, 2018) methodological extension of Situational Analysis, Kathy Charmaz’s (2014) Constructivist Grounded Theory Coding structure, and Nora Bateson’s (2016) concept of “warm” and contextualised data to get as close as possible to the situated knowledge of family functioning with a child in out-of-home care. Following maximum variation theoretical sampling, 13 semi-structured interviews were conducted with 12 families and 42 individual family members engaging in out-of-home mental health care. Through my analysis 72 family functioning tasks, or core competencies, practiced by families arose and were categorised within five core areas: coping with disconnected systems, managing stigma and blame, attending to the emotional needs of the whole family, living through and living with mental health issues, and creating togetherness through separation. The resulting theory is that families, as the unacknowledged and silenced front-line workers, have to function with, and within, the many elements that surround the reality of living with a family member in out-of-home mental health care.
  • Thumbnail Image
    ItemOpen Access
    Get out! A Narrative Inquiry with Four Therapist who Practice Walk and Talk Therapy
    (2016) Charbonneau, Tyla; Lysack, Mishka; Estefan, Andrew; Arthur, Nancy; Wulff, Daniel; Huber, Janice
    There is a traditional idea that therapeutic conversations are best suited for office environments. Therapists are reconsidering this practice by taking clients outside into nature to reconnect with the world around them, get some exercise, and reflect on life problems in natural spaces. This study is a narrative inquiry into the experiences of four therapists who participate in walk and talk therapy as part of their therapeutic practice. Narrative inquirers attend to a three dimensional narrative inquiry space that includes temporality, sociality, and place located within stories of experience. Over a period of ten months, the therapists and I participated in conversations about their experiences with walk and talk therapy. This fieldwork resulted in four co-composed narrative accounts that represent each of their individual experiences. Across these four narrative accounts four narrative threads emerged: social complexities, connecting to a greater sense of the world, acknowledging the therapist, and innovation and creativity. Implications for practice, further conversations that are needed in the counselling profession about walk and talk therapy, and ideas for future research are also presented.
  • Thumbnail Image
    ItemOpen Access
    Inpatient Pediatric Oncology Nursing Adolescent Relational Care: It is Different, the Difference, and Making a Difference
    (2017) Toner, Nicole; Moules, Nancy; Tapp, Dianne; Wulff, Daniel
    Adolescents diagnosed with cancer confront a unique set of psychosocial challenges related to their particular developmental stage. Adolescents have high rates of psychosocial distress at diagnosis and their distress rates remain high well into survivorship. A nurse’s knowledge and sensitivity to the unique intersection between adolescent development and having cancer is foundational to effective psychosocial care. Responsive relationships between adolescents and nurses may well ease the distress of being hospitalized for cancer treatment and mitigate the various unique psychosocial sequela that cancer has on the adolescent developing self. Very little research has been done to understand the experience and meaning of the relationships developed between inpatient pediatric oncology nurses and their adolescent cancer patients. My purpose in this philosophical hermeneutic inquiry was to better understand the experience of relationship between adolescents with cancer and pediatric oncology nurses on pediatric oncology inpatient units, from both nurse and patient perspectives. Eight participants who have or had cancer during adolescence (14-18 years of age) and four pediatric oncology nurses were interviewed with an intent to expand the meaning of this relationship as it applies to practice. These data were then analyzed according to hermeneutic tradition as guided by the philosophical hermeneutics of Hans-Georg Gadamer. Findings from this research revealed that adolescent needs are distinctive and important just because of their difference. Friendship-like adolescent-pediatric oncology nurse relationships on inpatient units are pivotal to a positive and developmentally constructive hospital experience. Developmentally appropriate relational nursing care includes: humor, social connection, “real speak,” being “rounded up” or treated older than chronological age, and friendship. The findings support the idea that friend-like relationships developed between nurses and adolescents are developmentally beneficial to the developing self and facilitate the integration of an adolescents pre-and-post cancer identity. Developmentally appropriate relational care of adolescents hospitalized for cancer on pediatric oncology units, I conclude, should be thought of as a psychosocial intervention in and of itself. Nurse-adolescent relationships are key to positive adolescent development in pediatric oncology inpatient care. The findings of this study underscore the need for future research that further understands the ways in which the inpatient pediatric oncology nurse-adolescent relationship may be therapeutic and the ways in which it is not.