Doctor of Philosophy in Social Work (PhD)
Understanding resistance in adult-adolescent interactions
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Strengths-based practice has been widely promoted as a preferred approach for statutory child protection work, but its complexity and inconsistent implementation suggest that it may be hard to do. This pragmatic mixed methods study asked frontline workers whether and how they applied strengths-based and solution-focussed ideas in their daily child protection practice and what supported and impeded their efforts. Via 26 semi-structured interviews and an online survey, 225 child protection workers from the Ministry of Family Development in British Columbia, Canada, gave their views. The study found nearly all workers to be positive about strengths-based practice but 70% had implicit rules about the clients and situations for which strengths-based solution-focussed work was not appropriate or possible. Five definitions of strengths-based practice were identified from their descriptions of the approach, each linked to particular challenges and supports. The most applicable definition, 'Enacting firm, fair and friendly practice', illustrates a way for practitioners to navigate the strengths-based child protection relationship while managing the risk and authority inherent to their role. It involves maintaining a shifting balance between inviting maximum client collaboration and using authority purposefully and suggests the importance of judging impartially, being transparent, attending to the worker-client interaction and seeing clients as fellow human beings. It may support workers to navigate a developmental progression from occasionally doing strengths-based practice to identifying as strengths-based practitioners. The study highlights the importance of developing organisational capacity to provide the time, resources and culture necessary for strengths-based practice. It suggests that 'fearlessness', emotional self-regulation and comfort with mandated authority support strengths-based practice and recommends greater emphasis be placed on these qualities in child welfare education. Other recommendations include adopting a system-wide child protection-applicable definition of strengths-based practice like 'Enacting firm, fair and friendly practice', implementing 'strengths-based management' and providing ongoing opportunities for practitioner reflection and education.
Often, international engagement efforts are set in vulnerable communities where there is great potential to do good, but a significant potential to do harm, and there has been a call for higher attention to the many effects of volunteer presence and efforts when engaging with such communities. Recent attempts have been made to have honest discussions about the ethical implications for service abroad, but rarely are these discussions and resulting policy decisions directly informed by the nuanced, contextual perspectives of host communities themselves. When they do, often the conception of “community” does not adequately represent the diversity of stakeholders that form the community in question.This mixed methodological work explores how various stakeholders in one such community in Eldoret, Kenya respond to the question of what it is like to host young international volunteers. These perspectives were gathered over a three month period through interviews and a focus group.Findings 1) A need exists for a broader conception of “host”; 2) The voices of hosts and host communities are underrepresented throughout the literature and the volunteering process; 3) Current language used to describe the role of volunteers is the product of inequitable historical relationships, has adverse effects on process and outcomes, and needs to be adjusted; 4) Host fatigue is a significant factor in adversely affecting outcomes of volunteer placements; 5) Resistance and dissent in volunteer encounters present differently than volunteers might expect; in Kenya, they often present as withdrawal, silence, slowness to respond, bearing the hardship, and much less commonly as direct confrontation, and; 6) Volunteer activity must be factored into what constitutes the social determinants of health of a host community when we try to learn about that community and the issues it faces. Suggestions are made for improving outcomes for volunteers, hosts, and sending organizations.
Background:While the health system in Canada recognizes the need for comprehensive cancer care, barriersmust be overcome to achieve this goal. One is improving how professionals work together. Thisstudy explores social workers’ and counsellors’ experiences offering psychosocial cancer care aspart of a cancer system that prioritizes medically related cancer care. My study objective is toincrease understanding on how the health care system can better support team-basedapproaches in providing psychosocial cancer care for families faced with cancer.Methods:I explored, through a generic qualitative research methodology, the experiences of eight socialworkers or counsellors who utilize team-based approaches in psychosocial cancer care. Using asemi-structured interview approach, I asked each participant to describe their experiences withteam-based approaches in cancer care.Findings:Findings are presented using the ecological systems perspective, with the themes representingmicro, mezzo, and macro level facilitators and barriers to psychosocial cancer care within ateam-based approach. The overarching theme identified by participants was the need forbuilding authentic and close working relationships with their colleagues. At a micro level,relationships between cancer care providers was identified as an asset when working in anoncology setting facing larger system influences that detract from offering psychosocial cancer care. Within this overarching theme participants described the following mezzo and macrofactors in facilitating or detracting from team-based approaches in offering psychosocial care:flexible infrastructure and resources, space, staff availability, medical dominance, and limitedtime and resources.Implications:Exploring team-based approaches in psychosocial cancer care is understudied in oncologyand health system research. This study may fill some of this knowledge gap, specifically byhighlighting the need for authentic and close relationships with colleagues especially in times of high and demanding workloads within an emotionally fatiguing work environment such asoncology. The participants’ experiences mirror the challenges identified in psychosocialoncology in Canada and future research may expand this study by developing theoreticalframeworks for team-based approaches within a psychosocial oncology context, and bytranslating theory into cancer care practice that addresses the needs of mind, body, and soul.
Background: Unsafe injection practices remain a significant source of morbidity and mortality among people who inject drugs (IDU), this thesis sought to: review the literature outlining the ways in which people inject unsafely, the health consequences associated with unsafe practices, the factors that influence injection practices, and the interventions that have been designed to address these problems; describe a drug user-led safer injecting education campaign; and finally, examine the facilitators’ and participants’ perceptions of a unique user-led intervention.Methods: Qualitative data was derived from semi-structured qualitative interviews conducted with eight members of the Injection Support (IS) Team who developed and facilitated a series of safer injecting education workshops and 20 individuals who participated in these workshops. Interviews were transcribed verbatim and a thematic analysis was conducted.Results: A literature review identified numerous specific unsafe injection practices, which are associated with negative health outcomes, including HIV, hepatitis C, bacterial infections, and venous damage. Research demonstrates that various individual, physical, social, and structural factors influence injection practices, and has identified a number of interventions (e.g. syringe distribution, education) that reduce negative health consequences. Results indicate that IDU typically learn about injecting by watching or sharing experiences with other IDU and that significant gaps in knowledge regarding safer injecting practices persist. Accounts of IDU suggest that the unique process and structure of IS Team workshops enabled effective communication of information about safer injecting practices, while targeting the unsafe practices of workshop participants. Facilitators’ identity as IDU enhanced their ability to relate to workshop participants, most of whom expressed that they prefer user-led interventions to other approaches. Facilitators reported gaining knowledge, skills, and positive feelings about themselves from their involvement in the campaign, while many participants reported that they acquired new knowledge that would alter their future injecting practices.Discussion: The IS Team education campaign focuses on health issues relevant to IDU that are not being adequately addressed by existing public health programs. This study demonstrates the feasibility and benefits of involving IDU in educational initiatives targeting unsafe injecting. Increased involvement of IDU in interventions designed to address unsafe injecting is urgently required.
No abstract available.