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Since 1994, many survivors of the Rwandan genocide against Tutsi have migrated to Canada to re-build their lives. The literature has established that a large proportion of the Rwandan population suffers from post-traumatic stress and depression. However, there is also a large body of ‘psycho-social’ and ‘anti-colonial’ literature that problematizes ‘Western’ mental health constructs such as post-traumatic stress and depression. Similarly, anti-oppressive social work theories argue that social workers need to recognize the politics of suffering and helping in order to practice effectively. Some have argued that ‘Western’ approaches (namely: bio-medical), that are harmful, continue to dominate work with survivors of mass violence, whose own views are rarely heard. To address the lack of Rwandan voices in the discourse about the genocide, I conducted 1-on-1 interviews with 9 members of Rwandan-Canadian survivor communities to find out what they have to tell us about their perspectives on genocide survival and healing in the Canadian context. My findings identified a total of eleven interrelated themes re: how Rwandan-Canadian survivors are affected by, deal with and make sense of the 1994 genocide. Ultimately my research supported the findings of psycho-social and anti-colonial frameworks that link individual mental health ‘healing’ to political resistance. My research, integrating literature reviews with the interviews and critical discourse analysis concluded that trauma among Rwandan-Canadian genocide survivors is an individual and collective process rooted in a history of anti-Tutsi systemic discrimination borne out of colonialism. Thus, I argue that supporting survivors requires collective politicized processes of recovery. For Rwandan-Canadians, these collective processes of recovery would include addressing ruptures within Rwandan communities and supporting survivor communities in processes of remembering and authoring Rwandan histories in resistance to ongoing structural and epistemic violence, including genocide denial.

2020-11-19 00:00:00

Advisors/Committee Members: Williams, Charmaine, Social Work.

▼ This grounded theory study sets out to explore identity development and lived experiences among Chinese immigrant young gay men, with a focus on their migration journey and intersectional social locations. Eighteen Chinese gay men who were aged 18-28 and had moved from Mainland China, Hong Kong, or Taiwan to Canada participated in semi-structured individual interviews conducted in either Mandarin or English. Findings indicate that these gay men migrated to Canada for an array of reasons, citing “living in a LGBT-friendly country” as only one of many factors. Recent socioeconomic and cultural changes in Chinese societies have led many participants to revise their original perception of “the West is better.” On the other hand, the increasing acceptance of homosexuality in Chinese societies is noted throughout the interviews. Situated in this socio-cultural context, the participants’ current state of ethnocultural identity is found to be in-between, consisting of constant transitions between Canadian culture and Chinese culture over time and across contexts. Their sexual identity generally followed a linear progression and achieved a uniform and settled state with selective, pragmatic disclosure. Yet, various interpersonal and environmental factors were highlighted to bear upon their process of self-identifying as gay. Several themes regarding intersectionality emerged from the data. First, study participants do not experience conflicts between their sexual and cultural identities. Second, the intersectionality is context-specific. While rejecting the ubiquitous existence of intersectional oppression, study participants have experienced a certain form of marginalization that occurs in the context of disclosing their gay identity to their Chinese friends/families and finding a dating partner within a gay community. Third, participants consider the label of “double minority” oversimplified and derogatory, indicating that their intersectional identities can serve as a source of social support. Based on the research findings, implications for social work theory, research, and practice are discussed. Advisors/Committee Members: Fang, Lin, Social Work.

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The objective of this study was to generate a deeper understanding of the influence of pre- and post-migration traumatic experiences on refugees’ psychological distress, including historical, political and social factors. This dissertation used a multi-method design to examine the impact of trauma on the psychological well-being of refugees. Further, the design included a qualitative component to provide a contextual framework for understanding refugee psychological distress that is not limited to an analysis of a disease model alone but by also making connections to important historical, social and political events. Post-Colonial, Refugee, Trauma and Feminist theories are used as analytic lenses to explain the social structures and events contributing to refugees’ pre- and post-migration traumatic events, and psychological distress. This was an international study that spanned two continents. Sampling included 50 Sri Lankan Tamil refugee participants who lived in Chennai, India and 50 Sri Lankan refugees in Toronto, Canada. Inclusion criteria included a residency period of the last 12 months in either of the sampling sites, and participants 18 years of age or older. Participants from Toronto were recruited through social service agencies and associations, and participants from Chennai were recruited from refugee camps, and the Organization for Elam Refugee Rehabilitation. Tamil versions of the Harvard Trauma Questionnaire, the Post-Migration Living Difficulties Questionnaire, and the Symptoms Check List – 90R were utilized to measure participants’ pre- and post-migration traumatic events and psychological distress. The Harvard Trauma Questionnaire contained qualitative open-ended questions to triangulate the quantitative data in identifying and exploring the impact of contextual influences. Results showed that post-migration traumatic event scores positively predicted psychological distress, and refugee claimants living in Canada had the highest scores on pre-migration and post-migration scores. The qualitative analysis revealed themes related to civil war and resettlement as significant issues. Implications of these findings support the development of a multi-level approach within social work practice which emphasizes contextual issues, focuses on individuals, and promotes social advocacy. Recommendations for future research point to conducting longitudinal studies to assess the cumulative effects of historical, social and political factors on refugees and identify resiliencies that mobilize their capacity to survive.

PhD

Advisors/Committee Members: Alaggia, Ramona, Social Work.

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The present study explored the experiences of victimization and immigration among immigrant youth in the Peel region in Ontario, Canada. Victimization included the experiences of bullying and ethnic discrimination in the school environment. The study utilized a phenomenological approach to investigate how immigrant youth interpreted their experiences and whether they identified victimization as bullying, ethnic discrimination or both. The effects of victimization on adaptation and acculturation were also explored. Results from individual interviews of six youth (ages 16 or 17) indicated that immigrant youth viewed bullying and discrimination as separate constructs. Themes that emerged from the interviews included the importance of language proficiency; the role of peer affiliations; and factors associated with resiliency. It was evident through their descriptions that immigrant youth face unique challenges, which include adjusting to a new culture and country of residence, establishing a new social circle, and gaining comfort in utilizing the English language.

MAST

Advisors/Committee Members: Mishna, Faye, Social Work.

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The concepts of risk and safety are central to social work practice with survivors of violence against women, especially within the child protection system. Recent studies have highlighted how discrepancies between client and worker perceptions may create problematic conditions for developing effective intervention strategies (Dumbrill, 2006; Jenney, Alaggia, Mazzuca, & Redmond, 2005). In addition, tensions exist between movement toward improving worker-client interactions through collaboration and the use of standardized risk and safety assessments as a means of improving practice. The purpose of this research study was to explore how women’s narratives of domestic violence (DV), expressed within the context of child protection services (CPS), become translated into CPS workers’ assessments of risk and need for safety planning. Using Grounded Theory Methodology (GTM), this qualitative study used focus group and interview data to explore how both workers and clients’ experiences of the process of risk assessment and safety planning influenced the course of the intervention. What emerged is that workers and clients held similar representations about the social construction/collective representation of woman abuse and the work of CPS. For both worker and client participants the concept of ‘doing the right thing’ presented itself as an over-arching theme. This theme implies that there is a perceived ‘right way’ of addressing DV cases within CPS work and enhances understanding about the ways in which social workers and clients interact. These findings illustrate how narrative structures shape interactions that take place within the context of care and prevention, manifesting themselves in complex ways that can lead to misunderstanding the impact on children, the (un) conscious subjugation of women victims, and the absence of dialogue about the role of men in addressing DV at a system level.

PhD

Advisors/Committee Members: Mishna, Faye, Social Work.

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This qualitative study examined three areas of social service provision through the experiences of non-English speaking older Hispanic immigrants. These three areas included availability and accessibility of services and culturally competent practices of service providers. The qualitative approach of phenomenology was used to interview ten participants in order to explore their experiences with service provision. An analysis of the interviews pointed to the following themes: (a) experiences with services were deeply connected to issues of immigration and adaptation; (b) language barriers were especially difficult to overcome in services; (c) the role of families as primary supports needed to be reconsidered in order to offer better quality of services; and (d) culturally competent practices needed to be reinforced at the organizational level of workers, agencies and government in order to become more effective. From these themes, recommendations and implications for social work and services for non-English speaking elderly Hispanics are detailed.

MAST

Advisors/Committee Members: McDonald, Lynn, Social Work.

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This dissertation contests the ontological social work interpretations addressing issues of societal inclusion and exclusion for migrant populations. Outcomes of societal advantage and disadvantage, of privilege and oppression, as the colloquial social work jargon designates, resulting from distributive inclusionary-exclusionary processes, are generally abstracted on identitarian categorical markers (i.e., gender, class, race) and subsequently interpreted through intersectional matrices of analysis. Categorical whiteness, taken as a fixed classification to denote fair skin colour possessed by those originating from Caucasian racial ancestries, particularly from European ethnic backgrounds, has grown to represent the universal marker grounding analyses of privilege. Yet the assumption that whiteness is the same (i.e., European, biologically marked by skin colour and privileged) across the globe, in every social circumstance, and universally traversing national communities of value, is highly problematic, since interpretations of categorical markers depend on particular geo-political and national referential frames. In comparing and contrasting the inclusionary and exclusionary logic determining aspects of societal marginalization for two populations, skilled migrants to Canada, and Romanian and Bulgarian migrants to United Kingdom (UK), this dissertation demonstrates that: 1) a universal taxonomy of whiteness as explanatory for outcomes of inclusion and exclusion does not hold within transnational contexts; 2) current understandings of ontological whiteness are constructed on a false epistemological presumption of equivalence that synonymizes colonialism with Europeanness, Europeanness with whiteness, and whiteness with colonialism; 3) the theory of intersectionality, generally used to contextualize particular outcomes of privilege and oppression, is limited in analyzing inclusionary-exclusionary processes; and it proposes, in turn: 4) the adoption of a sameness-difference dialectical reasoning to guide inclusionary/exclusionary analyses for transnational migrant populations.

2020-11-16 00:00:00

Advisors/Committee Members: Tsang, A. Ka Tat, Social Work.

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Background: Trans women living with HIV (WLWH) have lower access to HIV care compared to cisgender (cis) people living with HIV. US-based research describes barriers (e.g., trans stigma) and facilitators (e.g., integration of gender-affirming and HIV care) to HIV care engagement among trans WLWH. Scant research has explored factors associated with HIV or gender-affirming care access among trans WLWH in Canada. This three-paper dissertation aims to expand an intersectional and social ecological understanding of the experiences of trans WLWH in Canada accessing HIV, gender-affirming, and other types of healthcare. Methods: A transformative, convergent parallel, mixed methods design was used whereby quantitative and qualitative data were rigorously collected and analyzed, then purposefully merged. Quantitative data was drawn from baseline cross-sectional survey data collected 2013-2015 from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) (n=54 trans WLWH/n=1422 participants) and analyzed using descriptive statistics and bivariate analyses. In-depth semi-structured individual interviews (25-100 minutes) were conducted with a purposive sub-set of trans WLWH (n=11) 2017-2018 who completed the baseline CHIWOS survey, analyzed using framework analysis. Qualitative and quantitative results were merged by comparing data and considering how results converged, diverged, or expanded understanding. Inequities were highlighted and recommendations made, consistent with a transformative design. Results: Three empirically-based chapters report on: (1) the HIV care cascade and factors associated with HIV care cascade outcomes (ever accessed HIV care, received any HIV care in the past year, currently use antiretroviral treatment (ART), ART adherence, and virological suppression); (2) transition and gender-affirming healthcare experiences of trans WLWH; and (3) resilience and empowerment exhibited by trans WLWH as they navigate intersecting stigmas in healthcare settings. Conclusions: Findings suggest a need for multi-level interventions to address barriers to accessing care. Intersecting stigmas were a pervasive barrier to accessing multiple types of healthcare. Trans WLWH resist and reduce stigma in healthcare settings; however, widespread stigma-reduction training for providers, administrators, and students is recommended. These findings inform a trajectory of social work research, theory development, and practice at policy, organizational, and individual levels, all of which may further contribute to health equity for trans WLWH in Canada.

2020-11-19 00:00:00

Advisors/Committee Members: Newman, Peter A, Social Work.

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Children made the subjects of sexual abuse images online have been abused offline and in addition, images of their abuse have been distributed online - images that cannot be retrieved and that circulate on the Internet indefinitely. There is a lack of knowledge regarding practitioners’ understanding of child sexual abuse images online and the effects of such images on the child victims. This study represents one of the first explorations of how practitioners working in child sexual abuse (CSA) understand online CSA images and the effects of these images, and how practitioners integrate their understanding into assessment and treatment approaches. Employing a Grounded Theory methodology, 14 practitioners from Ontario, Canada were recruited using theoretical sampling to participate in in-depth interviews to explore their understanding of online CSA images and how this understanding influenced their clinical practice. Themes that emerged indicated that the participants differed in how they conceptualized what constituted online CSA images, and that they held varying levels or degrees of concern regarding the effects on the child. Factors identified as influencing practitioners’ conceptualizations included whether practitioners viewed online CSA images as: 1) the same as conventional CSA; 2) different from conventional CSA and not as serious; 3) different from conventional CSA and as serious. The core category ‘Out of Focus’ signifies that most practitioners did not have a clear understanding of CSA images online nor were they sure about how to respond to online CSA images particularly the therapeutic issues associated with the permanence of the online images. The phenomenon of CSA images online presents new daunting challenges for practitioners working in this area. The study findings affirmed the high priority need for training that addresses factors which influence how practitioners understand and respond to CSA images online. Awareness and understanding of the phenomenon of CSA images online is essential for the development of accurate assessments and effective approaches to treatment. Findings of this study affirmed that further research exploring the potential effects of the images on the child is of vital importance. These findings are discussed as they relate to critical considerations for social work practice concerning children made the subjects of CSA images online.

PhD

Advisors/Committee Members: Alaggia, Ramona, Social Work.

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This three-paper dissertation seeks to advance the conceptual understanding of resilience among lesbian, gay, bisexual, trans, and queer (LGBTQ) youth. Interviews with service-providers (n = 16) and LGBTQ youth (n = 19) were conducted and analyzed, using Grounded Theory (GT) methodologies. The first paper conceptualizes how participants understand the construct of resilience and the associated concepts (i.e., adversity, positive adaptation). Three relevant categories are reported: (1) facing adversities across contexts, (2) growing up in the age of marriage equality, and (3) “doing well” while still in pain. Provided extensive adversities LGBTQ youth experience, participants endorsed a context-dependent understanding of “doing well” (e.g., “battling through”) rather than using normative criteria of health and wellbeing (e.g., absence of psychopathologies, presence of socially desirable outcomes). The second paper reports a substantive theory of resilience emerged in the GT study. The core category, paving pathways through the pain, suggests that youth build on their experiences of marginalization and the concomitant emotional pain to carve out personalized pathways to resilience. All youth employed the following five processes: (1) navigating safety across contexts, (2) asserting personal agency, (3) seeking and cultivating meaningful relationships, (4) un-silencing social identities, and (5) engaging in collective healing and action. While the degree of which and the ways in which youth made use of these resilience processes varied, youth focused their attention to the areas of their individual life circumstances that inflicted emotional pain and engaged more deliberately in one or more of the resilience processes related to the origins of pain. In the third paper, results of the GT study, along with other relevant literature, inform the application of a social ecological framework of resilience in working with LGBTQ youth. This framework conceptualizes that the role of social workers is to promote not only the internal capacity of LGBTQ youth but also the capacity of their social ecologies to better support them. A youth case is discussed to inform interventions across the micro, mezzo, and macro levels of practice. Discussion sections for each paper and the dissertation conclusion summarize study results, limitations, and implications for social work and further research.

2018-02-05 00:00:00

Advisors/Committee Members: Newman, Peter A, Social Work.

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This three-paper dissertation seeks to advance the conceptual understanding of resilience among lesbian, gay, bisexual, trans, and queer (LGBTQ) youth. Interviews with service-providers (n = 16) and LGBTQ youth (n = 19) were conducted and analyzed, using Grounded Theory (GT) methodologies. The first paper conceptualizes how participants understand the construct of resilience and the associated concepts (i.e., adversity, positive adaptation). Three relevant categories are reported: (1) facing adversities across contexts, (2) growing up in the age of marriage equality, and (3) “doing well” while still in pain. Provided extensive adversities LGBTQ youth experience, participants endorsed a context-dependent understanding of “doing well” (e.g., “battling through”) rather than using normative criteria of health and wellbeing (e.g., absence of psychopathologies, presence of socially desirable outcomes). The second paper reports a substantive theory of resilience emerged in the GT study. The core category, paving pathways through the pain, suggests that youth build on their experiences of marginalization and the concomitant emotional pain to carve out personalized pathways to resilience. All youth employed the following five processes: (1) navigating safety across contexts, (2) asserting personal agency, (3) seeking and cultivating meaningful relationships, (4) un-silencing social identities, and (5) engaging in collective healing and action. While the degree of which and the ways in which youth made use of these resilience processes varied, youth focused their attention to the areas of their individual life circumstances that inflicted emotional pain and engaged more deliberately in one or more of the resilience processes related to the origins of pain. In the third paper, results of the GT study, along with other relevant literature, inform the application of a social ecological framework of resilience in working with LGBTQ youth. This framework conceptualizes that the role of social workers is to promote not only the internal capacity of LGBTQ youth but also the capacity of their social ecologies to better support them. A youth case is discussed to inform interventions across the micro, mezzo, and macro levels of practice. Discussion sections for each paper and the dissertation conclusion summarize study results, limitations, and implications for social work and further research.

2018-02-05 00:00:00

Advisors/Committee Members: Newman, Peter A, Social Work.

▼ This institutional ethnographic study explores the coordinated processes that organize Black female child protection workers’ (re)construction of their role as carers in the Ontario child protection system. This examination occurs within the backdrop of colonialism and shifting and unequal power relations in Canada. Absent from social work research is an understanding of the complex sequences of actions in every day child protection activities that authorize colonial ideologies and practices and the impact of Black female child protection workers’ negotiation of this context on their well-being. This study’s informant sample includes 9 Black female child protection workers currently employed at a child protection institution in Ontario. Data was collected from semi-structured interviews and textual analysis. The findings revealed colonialism in the child protection system is maintained through institutional patterns of exclusion and acts of dissimulation in the institutional discourse and practice. In response, Black female child protection workers resist colonial practices through their injection of acts of caring into their work. At the same time, their constant experiences of structural violence lead to institutional trauma. This research highlights a contradiction within the social work framework; the overt espousal of human rights and social justice as ethical priorities, while covertly maintaining colonialism in the child protection system, specifically towards Black female child protection workers and their communities. The findings advance social work knowledge by offering a way to identify the existence and the impact of the colonial context on Black female child protection workers as well as map out the sequences of actions or inactions that embed colonial ideologies and practices in the child protection system. Advisors/Committee Members: Williams, Charmaine C, Social Work.

▼ Maya Angelou (1993) has famously noted, â History, despite its wrenching pain cannot be unlived, but if faced with courage, need not be lived againâ (para. 26). This dissertation joined the ongoing conversation about generational trauma, also known as historical trauma. It argues that to understand parenting within the Black Caribbean population, consideration has to be given to their experiences with past trauma, including forced migration, physical and sexual assault suffered in slavery, segregation, and ongoing racial discrimination. Through a recognition that undesirable trajectories that have emerged in some Black parenting practices find their origin in transmitted generational unresolved traumas, those traumas can be addressed and disrupted. Using frameworks that employ an analysis of anti-Black racism, Black feminism and anti-colonialism as analytic tools, combined with literary exploration, this dissertation examines the impact of generational trauma on parenting practices among the Black Caribbean population. It contends that generational trauma exists, and has profound implications on parenting within this population, and that current routine assessments are not inclusive and considerate of historical racial experiences and the consequences of racism when they assess Black families. It reveals that the consequences of not doing so support the continuation of experiences that stemmed from the complication of racism and unresolved historical trauma, layering another burden of trauma on each successive generation. These findings recommend a critical pedagogy that educates, empowers, and mobilizes parents, professionals, and communities to recognize historical trauma as significantly present within the Black population, and to understand how this can be problematic in the functioning of Black parents and their families. Advisors/Committee Members: Wane, Njoki N, Social Justice Education.

▼ This study retrospectively explores the experiences of separation and reunification of African Caribbean immigrant families and how they rebuild their families in the context of immigration and oppression in Canada. Experiences of multiple separations and prolonged reunification have been expected and commonplace for many Caribbean families who have immigrated to Canada since the 1960s. There is a gap in social work knowledge about the experiences of African Caribbean immigrant families in Canada, and this lack is particularly important in light of the frequency of these families’ contact and conflict with institutions such as child welfare agencies, the educational system, and the criminal justice system; these are social institutions where social work has an instrumental role. The study sample consisted of 27 participants, including 25 who identified as African Caribbean women and men, and two who were not African Caribbean-identified. This qualitative study used a decolonizing critical constructionist grounded theory methodology, with data collected through semi-structured individual interviews and focus groups. The major themes that emerged from the study include “Cast Out,” “Keeping Up,” and “Child Rearing.” Together, these themes point to the specific realities and complexities involved in the impact of multiple separations and extended reunification on African Caribbean immigrant families. For social work, the findings offer important contextual knowledge about African Caribbean immigrant families that may help to inform transformative policies and practices. Additionally, the findings aim to contribute towards depathologizing and decolonizing understandings of the historical and contemporary social conditions and subsequent life choices and chances of African Caribbean immigrant families in Canada. Advisors/Committee Members: Williams, Charmaine C., Social Work.

▼ This study explored the experiences, interpretations and cultural beliefs of older Italian immigrants who were receiving culturally specific formal homecare services through an assisted living facility in Ontario, to examine how their identity and life history influenced their experiences of receiving care.The current study builds on the existing body of knowledge about Canada's older Italian immigrants, in particular their caregiving traditions and current need for formal care. This research study employed phenomenology to explore the subjective experiences of Canadian Italian older immigrants who were receiving formal homecare services to capture the personal meanings and interpretations of their immigration experiences, as they related to their need for formal homecare services. Interviews were conducted with 25 older Italian immigrants over the age of 75 that were receiving culturally specific homecare services. The participants shared their immigration stories, fears, work history, healthcare challenges and descriptions of arrival, family, losses, and life in Canada. The Life Course Framework was selected to guide this research study, to represent the process of aging and human development that continuously occurs across the life span. The Social Identity Theory was also used to provide additional guidance in understanding the social, cultural and historical influences of their life histories, as they related to their living arrangements in an assisted-living facility in Ontario and need for caregiving services. Three major themes emerged: 1. the importance of communication and relationship building in the provision of care and the barriers in accessing health care services, 2. retaining identity and control, and 3. facing an uncertain future. These themes reveal the importance of language, cultural practices and residential location. At the micro level, these findings demonstrate the importance individuals assign to their immigration history and cultural traditions. At a macro level, the findings reveal the need to provide cost-effective care that enhances the physical and mental well-being of individuals. These findings also reflect the importance assigned to the home environment and the need for workers to develop relationships with clients that are reflective of their cultural needs. Social workers have the ability to appreciate the historical context of Canada's immigrants; to develop policies in support of their cultural practices, traditions and acculturative interests, and the ability to appreciate the aging process and the associated need for formal services. As Canada's multicultural population continues to grow, social workers will be increasingly challenged to deliver culturally competent healthcare services. The findings are intended to offer additional guidance into the meaning of culture and its importance in furtherance of these goals. Advisors/Committee Members: Faye, Mishna, Social Work.

▼ Homophobic name-calling abounds in schools, especially at the high school level. Driving much of this research is the negative impact of anti-gay language and epithets on lesbian, gay, bisexual and trans (LGBT) identified students, students with LGBT parents and guardians, and students overall. Studies in the US, UK, and Canada report regular use of phrases such as ‘that’s so gay’, ‘faggot’, and the word “gay” itself to denote something or someone with little to no value. However, a dearth of research looking at the prevalence of homophobic language at the middle school level exists. Furthermore, there is even less research looking at the relationship between homophobic and sexist language use. Using a mixed methods explanatory sequential design, this three-paper dissertation explored homophobic and sexist language use in middle school, specifically investigating, among other things, how often and under what conditions grade seven and eight students use these types of language. A stratified random sample of middle school students (n=488) completed a survey that included the Homophobic Content Agent Target Scale (HCAT). The newly developed Sexist Content Agent Target Scale (S-CAT) explored sexist language. Students reported their frequency of homophobic and sexist language use in five relationship domains including friends, strangers, and antagonists. As well, five focus groups explored more deeply students’ perceptions and understandings of homophobic and sexist language use at school. A number of important findings were produced including the prevalence of homophobic name-calling prior to high schools as well as the strong association between homophobic and sexist language use. These empirical findings join the literature that has long conceptually linked sexism and homophobia, whereby their interlocking nature manifests in name-calling experiences of middle school students. Students (boys in particular) as either agents or targets of sexist language had increased likelihood of being agents or targets of homophobic language. Given the often contentious nature of anti-homophobia education, the hesitancy of school staff to intervene regularly (even in the presence of this language), the findings presented here suggest anti-sexist education as another means to address homophobic language, thereby contributing to creating and maintaining more positive learning environment for all students. Advisors/Committee Members: Mishna, Faye, Social Work.

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It is estimated that 50% of the 75,500 people living with HIV/AIDS in Canada will be affected by at least an asymptomatic form of HIV-Associated Neurocognitive Disorder (HAND). As the number of HIV-positive people over age 50 increases, social workers and other helping professionals need to adapt to meet people’s changing needs. Using a Participatory Action Research (PAR) framework, an explanatory sequential mixed-methods study was conducted to understand: a) concerns about living with HIV and changes in cognition; b) client knowledge and experience of social work; and c) gaps in current HIV-related programs and services related to cognitive health. Through a quantitative survey (n=108) and qualitative interviews (n=20), five key themes emerged regarding the duality of people’s perceptions and experiences, confusion about whether health issues were attributable to HIV or to aging, social work’s role as a necessary support service, and how knowledge and supports decrease stress and anxiety.

M.S.W.

Advisors/Committee Members: Craig, Shelley L, Watchorn, Jocelyn, Social Work.

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Using a phenomenological design, eight (8) children from a paediatric rehabilitation hospital, between the ages of 6 and 12, were interviewed to understand their medical experiences and issues of resilience. All children were exposed to what has been defined in the literature as paediatric medical trauma, or the overwhelming experiences that can occur in medical settings. Through an iterative hermeneutic based analysis, themes emerged about their medical trauma, understanding of resilience, and ways in which they viewed themselves and their environment. Children reported their most challenging symptoms in acute care, and experiences in rehabilitation that maintained difficulties. Though children did not understand the formal term resilience, they understood the concept in simpler terms. All children identified themselves as resilient, describing and giving examples of their resilience, which are discussed throughout the thesis. This study importantly amplifies childrenâ s voices within their own care. Implications for future practice and research are discussed.

M.S.W.

Advisors/Committee Members: Alaggia, Ramona, Social Work.

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Child welfare workers are the conduit between child welfare systems and children and their families. Required qualifications for practice include certain educational and practice experiences, skills, and knowledge. The overall goal of this dissertation is to increase understanding of the child welfare workforce. To meet this goal, the objectives of this dissertation are: 1) to assess the evidence for the necessary education and training qualifications required for child welfare practice; 2) to examine how worker qualifications have shifted in response to changes in child welfare system mandates and child and family needs; and 3) to contribute to the understanding of the role worker characteristics play in the ongoing services provision. Three studies were undertaken to meet the goal of this dissertation. The first paper is a synthesis of a portion of the child welfare workforce literature and reveals a lack of evidence regarding the specific educational background, skills, and experience that best equip child welfare workers for the demands of practice. Paper two is the first provincial study in Canada to examine how the profile of workers who conduct child maltreatment investigations has changed alongside shifts in child welfare legislation and mandate. Ontario data over the past 20 years illustrate changes in caseload size, training attendance, pre-service education, ethnicity, and years of child welfare worker experience. Paper three, the final study of this dissertation, uses multilevel analyses to examine the decision to transfer a family for ongoing services. Findings reveal that clinical and organizational characteristics predict this service provision, whereas worker characteristics (i.e., education, training attendance, experience, age, position, caseload size) did not. Overall findings suggest that there is little empirical evidence to suggest that valued qualifications actually equip workers with the skills and knowledge for effective child welfare practice and that the efficacy of these qualifications are based primarily on assumptions. Recommendations for future research and practice are provided.

2020-07-10 00:00:00

Advisors/Committee Members: Mishna, Faye, Fluke, John, Social Work.

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Background: Intimate partner violence (IPV) is a prevalent worldwide problem with devastating outcomes. Trauma is one particularly concerning outcome of IPV that requires further understanding. Despite a growing recognition of the traumatic impacts of IPV, there is scant research investigating how women who have experienced IPV understand and experience trauma, from an intersectional perspective. In response, this dissertation explores women’s views of IPV-related trauma in connection to other experiences in their lives. Methods: This dissertation employed an intersectional, qualitative design, using a constructivist grounded theory approach to address the following over-arching research questions: 1) How is trauma conceptualized and experienced among women who have experienced IPV; and 2) From the perspectives of women who have experienced IPV, how do counselling services respond to IPV and IPV-related trauma? Fifteen women who experienced IPV and had attended one or more related counselling session at social service and/or counselling settings in southern Ontario, Canada participated in in-depth individual interviews. Theoretical sampling ensured a diverse sample (range of IPV experiences, geographic/service locations, social locations, identities). Interviewing continued until the identification of theoretical saturation, when no new themes were identified. Memoing, reflexive journaling, and iterative stages of coding (line by line, initial, focused) formed the basis of data analysis. Results: The results of the study produced this three paper dissertation: 1) constructing theory on women’s intersectional experiences of trauma and IPV; 2) developing knowledge on how service providers can better meet the needs of IPV survivors and respond to trauma; and 3) providing implications for future intersectional and trauma-related research. Implications: This dissertation provides important practice, policy, and research implications. First, this dissertation provides an in-depth understanding of IPV-related trauma from an intersectional lens. Second, it provides guidance to service providers on responding to IPV and trauma in ways that address the complexity of women’s lives. Third, it demonstrates that an intersectional lens is long overdue in trauma-related and other social work research. From the perspectives of women affected by IPV, this dissertation illustrates the complexity of experiences of IPV-related trauma, and the next steps needed to address this trauma in more comprehensive ways.

2020-11-16 00:00:00

Advisors/Committee Members: Alaggia, Ramona, Social Work.

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First Nations children are chronically overrepresented in the child welfare system in Canada. This is largely a result of the effect that colonization has on Aboriginal peoples, but also evidence of colonialism being reproduced through current discriminatory legislation and practices. This three-paper dissertation employed a secondary analysis of data to examine the extent of the overrepresentation of First Nations children involved with child welfare in Ontario. Moreover, this study critically examines investigations of reported maltreatment to understand what is driving the overrepresentation of First Nations children. The results show that overrepresentation is a predictable outcome in a system predicated on assimilative objectives. In Ontario, First Nations children represent 2.5% of the child population; they represent 7.4% of child maltreatment-related investigations. For every 1,000 First Nations children in Ontario, 160.3 were involved in investigations compared to 54.4 per 1,000 White children. Overrepresentation was most pronounced for investigations of neglect. Rates of substantiation (3.4 times), ongoing services (4.2 times), child welfare court (5.7 times), and child welfare placement (7.5 times) were higher for the First Nations child population and disparities increased as children moved further into the child welfare system. Caregiver concerns were the main drivers of transfers to ongoing services for both First Nations and White children. For investigations involving White children, after controlling for caregiver concerns, workers were more likely to transfer a case for ongoing services when child psychological harm was present. While the proportion of children identified with psychological harm was similar across both groups, workers placed more weight on a White child experiencing psychological harm. The notion that workers might have different standards for decision-making for First Nations children compared to White children is concerning. Overall, the findings indicate that structural risks have not been addressed, putting First Nations families at risk for child welfare involvement. Structural issues such as chronic poverty and systemic racism are indicative of the legacy of the residential school system and produce the conditions that result in children coming to the attention of child protection services. Overrepresentation will continue unabated if the immense social inequities for First Nations children are not addressed.

2020-11-19 00:00:00

Advisors/Committee Members: Alaggia, Ramona, Social Work.

▼ This dissertation examines Arab Iraqi refugee women's experiences of the "war on terror" from a gendered historical perspective within the contemporary structural violence of state policies and practices in the Canadian context. Drawing on critical anti-racist and anti-colonial feminist theoretical frameworks, I argue that Iraqi refugee women experience the "war on terror" as both a historical and contemporary phenomenon. Historical ideological constructions of Arab Muslim women as terrorists, unsuitable for integration into Canadian society, facilitate their current social exclusion and eviction from civil society. Examining the trauma of the "war on terror" and Iraqi women's everyday experiences in this light shifts the focus away from disease focused psychiatric conceptualizations of trauma while centering the participants' experiences and varied responses to their circumstances in the Canadian context. Using a historically-based multi-level trauma framework of the "war on terror" enables us to move away from artificial binaries of "us" and "them" and facilitate a better understanding of the structural dynamics of our interconnected world in order to foster alliances across transnational borders and boundaries aimed at developing multi-level transformative interventions. Advisors/Committee Members: Williams, C Charmaine, Social Work.

▼ Empirical evidence and practice wisdom indicates women simultaneously endure and resist intimate partner violence (IPV) in an effort to protect themselves - to be safe. But what does it mean to be safe? Contemporary discourses and interventions often position physical safety, and reducing the threat of future harm, to be the primary goal of women's help-seeking behaviour, and by extension, the primary feature of what it means to be safe. However, there is no evidence indicating the elimination or minimization of direct physical harm is the primary feature of feeling safe. The purpose of this study was to examine 1) women's conceptualizations of safety and 2) how safety was achieved, in order to theorize about the broader construct of safety. Underpinned by intersectional and feminist theories, and guided by grounded theory methodology, 14 semi-structured interviews were conducted with women who self-identified as experiencing IPV. Analysis revealed women who experience IPV conceptualized safety in complicated, complex, and conditional ways. A key finding of this study revealed the notion of safety goes beyond the direct, embodied harms inherent in many abusive relationships. A broader formulation of safety emerged suggesting the concept spans economic, physical, emotional, psychological, and social domains. Building conditional safety across these various domains contributed to a variety of possible safety dispositions ranging from provisional safety to considerable safety. Data suggested women feel safest when they have power to make decisions; access to information about IPV; time and space to heal; housing and economic self-sufficiency; access to unconditional support; and most importantly no ongoing experience of IPV. While working to eliminate the impacts and consequences of IPV should certainly remain at the core of social work prevention and intervention strategies, the dynamic and ever-changing sense of safety women experience over the course of an abusive relationship must be more fully considered in future practice with survivors. Advisors/Committee Members: Ramona, Alaggia, Social Work.

▼ Living with Uncertainty: The Experiences of Parents and Children When a Parent is Living with and Dying from, Advanced cancer Gabrielle Erica Pitt Doctor of Philosophy, 2017 Factor-Inwentash Faculty of Social Work University of Toronto Abstract Advanced cancer and its progression and treatment deeply affect members of a family, especially the children. The limited research contends that the complexities of advanced cancer and the anticipated loss of a parent result in greater psychosocial vulnerability for children, compromising their well-being (Beale et al., 2004; Bugge et al., 2008; Christ, 2000). Conducted at the Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, the purpose of this interpretive research was to investigate the experiences of parents and children six to eighteen years coping with a parent living with, and dying from, advanced cancer. This study focused on the meaning children and parents ascribe to this time of uncertainty, in addition to aspects such as emotional security, and the role of parents in understanding, and ameliorating, potential effects to children. Seven families participated in the study (seven parents with advanced cancer, four children, and four well parents). A review of the existent literature was presented thematically, and demonstrated critical gaps and meagreness of the research. The theoretical framework encompassed social constructivism and sociocultural theory, in addition to the relational theories of attachment and intersubjectivity. Aspects of neurobiology underpinned the framework. Each facet of the framework was situated within the context of children and parents coping with advanced cancer and anticipatory loss. A theoretical model depicts this framework. Hermeneutic interpretive phenomenology was the methodology incorporated in this study. The primary method of data collection was semi-structured interviews with children and parents separately. Interpretative Phenomenological Analysis (Smith et al., 2009) guided the data analysis and interpretation. Results of the study are presented as a discussion of the themes, illustrated in an accompanying map. A review of the findings in relation to the research questions, the empirical literature, and theoretical framework reveals potential contributions of this research. This study concludes with implications for scholarly knowledge, social policy, social work education and practice, and recommendations for future research. Results of this research will advance the understanding of the experiences of parents and children, inform social work education and practice, and facilitate the development of interventions promoting positive outcomes for children and families. Advisors/Committee Members: Mishna, Faye, Social Work.

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Families who are dissatisfied with the nursing home care of their family member may supplement their care by hiring a private companion. Families who have the financial resources pay for extra care, while families who cannot afford a private companion receive the current standard of care. Anecdotal evidence suggests that private companion use has increased over time. However, there is no research that examines private companions. The goal of this mixed methods study was to provide empirical evidence about who private companions are, what they do, and why they are needed. Andersen and Newman’s Health Service Utilization Model was used to understand private companion use. This study used both survey research and grounded theory. A mailed survey was completed by 280 of 432 family members of nursing home residents in a Toronto nursing home, yielding a response rate of 65 percent. Grounded theory principles were used to conduct interviews with 10 family members to understand why private companions were hired. Almost two-thirds of nursing home residents had a private companion. Family members reported that they paid about $475 per week for private companions who provided about 40 hours of care per week. Private companions were mostly women and immigrants. Private companions performed many activities including assisting with activities of daily living, toileting, feeding, escorting to activities, and providing social support. In the survey, family members reported hiring a private companion for reasons related to families’ needs (e.g. quality of care concerns), residents’ needs (e.g. deteriorating health); and staff recommendations. The family members reiterated these reasons in the interviews. Quality of care was the overarching theme that captured the reason for private companion use, which encompassed the following themes: inadequate staffing, unmet residents’ needs, overburdened family members, and suboptimal nursing home environment. The qualitative data emphasized the importance of building relationships with nursing home residents. The predictors of private companion use in the multivariate analysis were longer duration of nursing home stay, higher resident dependency, and family members’ concerns with quality of care. This research is among the first to study private companions, and has implications for research, policy, and practice.

PhD

Advisors/Committee Members: McDonald, Lynn, Social Work.

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The optimal model to support adolescent sexual health is the concurrent use of hormonal birth control and condoms. This dual protection approach prioritizes protection against unplanned pregnancy as well as sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV). In order to explore individual, interpersonal and structural factors that influence adolescent protection use, multivariate Chi-squared Automatic Interaction Detector (CHAID) analysis was completed with a national sample of adolescents (n=2320) from the 2002 Canadian Youth, Sexual Health, and HIV/AIDS Study. CHAID is a decision tree method which assesses interactions between significant independent variables to optimize prediction of the dependent variable (i.e. safer-sex protection method). Among adolescent females, the following factors were associated with dual protection use: high condom intentions; having lived with both biological parents; having accessed a medical professional or media as the primary source of HIV/AIDS information; having utilized a medical professional as the primary source of sexual health information; having never had unwanted sex; having not consumed alcohol and/or drugs before sex; frequent sexual activity; having identified a medical professional as the primary source of STD advice; having been tested for STDs; and having supported the importance of talking about condoms with a partner. Among adolescent males, dual protection was associated with: high condom intentions; frequent sexual activity; the belief that both partners are responsible for condom use; having been born in Canada; having noted uncertain or high levels of religiosity; having been older than 14 at first sexual intercourse; having been able to speak with their father about sex; having accessed a medical professional or media as the primary source of HIV/AIDS information; and having reported a peer group that did not use tobacco. The results indicate that structural factors, in concert with individual and interpersonal factors, play a vital role in understanding adolescent safer-sex practices. Policy and practice implications include revisions to sexual health curricula, sexual health service accessibility for all adolescents, and targeted prevention programming for adolescents at highest risk. Further research into the sexual health of male adolescents and the influence of structural factors on sexual health among diverse samples should be prioritized.

PhD

Advisors/Committee Members: Fuller-Thomson, Esme, Social Work.

▼ This dissertation reports and discusses the findings of an online survey of 339 sex workers in Canada and the United States concerning their experiences of traumatic stress, burnout, and violence by clients, their working conditions and environment, and their perceptions and experiences of their clients. The survey was designed to collect data on the prevalence of harm and distress among sex workers across the various contexts and locations in which sex work is bought, as well as on how harm and distress in sex work relate to client behaviours and characteristics, structural factors such as sex work stigma and racial or ethnic identity, and protective factors such as working conditions and social cohesion. The 339 sex workers surveyed reported very high levels of traumatic stress, with at least half the respondents reporting levels of traumatic stress consistent with a post-traumatic stress disorder (PTSD) diagnosis. Respondents also reported a very high prevalence of violent clients, as nearly half of the clients were reported to be violent. The prevalence of violence by clients was somewhat lower, with half of respondents experiencing violence occasionally and 25% of respondents reporting violence as a rare occurrence. Burnout levels among the surveyed workers were also high; half the sample reported levels of burnout above the accepted threshold for detecting burnt-out workers. A higher prevalence of clients perceived as adhering to hegemonic masculinity norms significantly predicted higher levels of traumatic stress as well as a higher prevalence of violent clients. Also, a higher prevalence of clients motivated by their inability to access non-commercial sex due to a physical or mental disability or lack of social skills significantly predicted higher levels of violence by clients and higher prevalence of violent clients. More control over working conditions significantly predicted lower levels of traumatic stress, and higher levels of social cohesion significantly predicted lower levels of burnout. Sex work stigma significantly predicted variation in the prevalence of violence by clients, prevalence of violent clients, levels of traumatic stress, and levels of burnout in the surveyed sex workers. Advisors/Committee Members: Regehr, Cheryl, Social Work.

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The objective of this dissertation was to contribute to the understanding of child welfare organizations by testing the hypothesis that the characteristics of organizations influence decisions made by child protection staff for vulnerable children. Two aspects of organizational structure were examined: 1) role specialization, or the division of tasks to accomplish the mandate of the organization; and 2) service integration, or whether child welfare organizations and other services such as childrenâ s mental health are integrated. Other organizational factors proposed by the theoretical and empirical literature as salient to understanding child welfare decisions were included in the analyses (e.g., the location of the organization, service availability, etc.). The dissertation tests a theoretical framework that integrated the Decision-Making Ecology Framework (Baumann, Dalgleish, Fluke, Kern, 2011) and Yoo, Brooks, and Pattiâ s (2007) conceptual framework of organizational constructs as predictors of service effectiveness. Three decisions along the child protective services Decision-Making Continuum (Fluke, Baumann, Dalgleish, Kern, 2014) were examined: service referrals, provision of ongoing services, and placement in out-of-home care. Secondary data analysis of the Ontario Incidence Study of Reported Child Abuse and Neglect 2013 (OIS-2013) was conducted. A subsample of 4,949 investigations from 16 agencies was included in the multi-level models. The results confirm the importance of clinical factors to child welfare decisions. Organizational factors also influence decisions; specifically, investigations conducted at agencies with a specialist structure were less likely to include a service referral. Although structure did not influence the ongoing service decision, urban agencies were less likely than rural agencies to keep a case open following an investigation. Structure had no effect on the decision to place a child in out-of-home care, and there was no variance at the organizational level. The utility of the theoretical framework was demonstrated and should be applied to future studies. This dissertation contributes to the limited empirical evidence regarding the association between organizational structure and decisions.

2020-03-01 00:00:00

Advisors/Committee Members: Mishna, Faye, Fluke, John D., Social Work.

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The overarching objectives of this three-paper dissertation are to: (1) build upon and extend the minimal knowledge base with respect to infants in a Canadian child welfare context; and, (2) identify opportunities and challenges for promoting the optimal development of infants through an exploration of child welfare practice and policy responses in Ontario. A developmentally-informed framework guided this research. The first two papers utilized data from the 2013 cycle of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS-2013) to create a clinical portrait of infants and families involved with the child welfare system. The first paper explored the most influential clinical factors associated with the decision to transfer a case to ongoing services (i.e., characteristics of the infant, primary caregiver, household, case and of the short term services provided). The second paper examined the clinical factors predictive of the decision to refer families to services and age-specific differences in the clinical portrait and types of services referred to. The third paper explored how the science of early childhood development could inform and enhance child welfare policies and practices with infants and their families. The findings indicated that the most influential predictor of the provision of ongoing services was having a primary caregiver with few social supports; whereas, being a victim of intimate violence (IPV) and younger caregiver age were the caregiver risk factors that were significantly associated with a referral. There were age-specific differences in both the clinical profiles and the services referred to, suggesting that infants are a distinctly vulnerable subpopulation of children. The findings converge on the importance of developing policies and practices that target the unique needs and experiences of infants and their families. Key findings, themes, implications for social work, and recommendations for future research, policy, practice and advocacy efforts are proposed.

2018-07-06 00:00:00

Advisors/Committee Members: Fuller-Thomson, Esme, Social Work.

▼ Background: Assisted reproductive technologies (ARTs) have facilitated novel family structures and, in turn, have yielded new opportunities to parent for gay men. Recently, Canada has witnessed an increased number of same-sex parent families and a growth of gay father-headed households. ARTs continue to be only ascribed as biomedical interventions to resolve infertility. With the progress of ARTs and the increasing prevalence of gay fathers, the aim of this dissertation is to explore gestational surrogacy for gay men in Canada. Methods: From January 2015 to January 2016, gay fathers (n=16) and gestational surrogates (n= 6) were recruited through advertisements distributed across same-sex parenting groups, surrogacy consulting services and social media. Using non-probability purposive sampling, three populations were targeted: (1) single or partnered gay fathers who completed gestational surrogacy; (2) gestational surrogates who bore a child for gay men; and (3) gay fathers and their paired surrogate. All participants had to be living in Canada at the time surrogacy was practiced. In-depth semi-structured interviews (~60-90 min) were conducted either in-person or over the phone; informed consent was reviewed and obtained prior to the interview. Textual analysis was conducted by the researcher; emerging patterns were organized from the data manually to generate findings. Triangulation, member-checking and peer-debriefing supported validity. Results: The three empirically-based chapters will report on: (1) the motivations of gay intended fathers and gestational surrogates to pursue surrogacy; (2) the interpersonal relationships between gay intended fathers and gestational surrogates before, during and post pregnancy; and (3) institutional supports and barriers encountered during surrogacy and post-birth, with respect to both the practice of surrogacy and gay fatherhood. Implications: This dissertation has implications for social work practice, research and education, as well as policy, law and bioethics. The aim of this dissertation is to advance an understanding of non-normative families, resisting and challenging heteronormative discourses that have framed parenting and reproduction practice and scholarship. Encouraging dialogues with stakeholders, such as surrogates, intended parents, lawyers, fertility specialists and allied health professionals, is critical. Advisors/Committee Members: Newman, Peter A., Social Work.