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.

This study was focused on exploring the relationship between victimization history, attachment to parents, pornography exposure/use, and characteristics of the sexual offences committed by male adolescents. It was hypothesized that, the poorer the attachment to parents, the greater number of abuses experienced, and the more exposure to pornography, the more likely an adolescent would be to have had more victims, have offended against more age groups, have both male and female victims, have committed penetration in his sexual offences, and have been forceful or violent in his sexual offences. The study involved secondary analysis of a large data set that was based on prior administration of an extensive survey which also included a number of psychological measures and questionnaires. A total of 308 male participants ranging in age from 13 to 20 at the time of completing the survey were included in this study. Participants were 12-17 years of age at the time of their sexual offending. A series of regressions were used to examine if attachment to parents, history of abuse/neglect, and pornography use could predict the number of victims, age group of victims, gender of victims, sexual intrusiveness, and level of force in the sexual offences that had been committed by the participants. Predictor variables that emerged as important in this study were the duration of the sexual offending, having experienced three or more types of abuse, and exposure to live sex. In general, it was suggested that treatment efforts should focus on intervening promptly and reducing the duration of an adolescent’s sexual offending and that intervention for all types of abuse be prioritized. Additionally, it was recommended that future research seek to identify characteristics that might predispose certain victimized individuals to develop sexual offending behaviours in the future. In general, it was noted that further explorations are needed regarding applicable theoretical approaches, as well as the various factors, and interactions among factors, that contribute to the characteristics of sexual offences committed by male adolescents.

The objectives of this study are two-fold: (a) to delineate the factors that guide Ontario social workers’ decision-making when rendering judgments on the mandatory reporting of child maltreatment and (b) to understand how social workers maintain the therapeutic alliance with children and families following the decision to report suspected child maltreatment. The study is informed by two distinct bodies of literature: the decision-making theoretical literature within the fields of medicine, psychology, social work, and marriage and family therapy and the therapeutic alliance theoretical literature. Harnessing the advantages of online survey technology, the study surveyed registered members (n = 480) of the Ontario Association of Social Workers who provide direct service to children and families. Participants responded to prepared vignettes of suspected child maltreatment followed by Likert-scale questions (strongly agree to strongly disagree) and open-ended questions on strategies to maintain the alliance. Open-ended questions allowed respondents to offer further commentary regarding their opinions on mandatory reporting and on maintaining the therapeutic alliance. These comments added a rich source of information to the quantitative data. Multiple logistic regression analyses showed that social workers’ ethical responsibility to the College of Social Workers and Social Service Workers, their legal responsibility to the provincial mandatory reporting laws of Ontario, and consultation with peers or eliciting direction from a supervisor comprised the main factors in their decision-making around reporting suspected child maltreatment to the Children’s Aid Society. Qualitative analyses showed that social workers employ a plethora of strategies to repair the alliance following a disclosure of child maltreatment including reporting strategies, information strategies, affect regulation strategies, advocacy strategies, and resource strategies. The major limitation of the research design was the use of vignette research, which in proscribed circumstances may not reflect what the social worker does in actual practice. Design features that compensate for this limitation include (1) use of a 5-point Likert-item response of strongly agree to strongly disagree to allow respondents a range of responses; and (2) use of open-ended questions to allow respondents the opportunity to express their opinions on the issues.

This dissertation’s analyses examined the association of caregiver, child, abuse and investigation characteristics with maternal response and emotional harm among families for whom child sexual abuse (CSA) was suspected or substantiated. Method This study was based on secondary analysis of data collected in the Canadian Incidence Study of Report Child Abuse and Neglect 1998. The current analysis was limited to 373 CSA investigations for which there was a female non-offending caregiver and complete data on maternal response. Bivariate and hierarchical logistic regression analysis was conducted for two outcomes; maternal response and emotional harm. Results According to social worker assessment, the majority of female non-offending caregivers (87.1%) of children investigated for suspected or substantiated child sexual abuse responded with belief of the abuse disclosure, emotional support and protection of the child victim. The overall maternal response model was significant and accounted for 40.8% of the variance (Nagelkerke R2). Factors significantly associated with maternal response in the multivariate model included maternal mental health, age of the child, child’s manifestation of sexualized behavior, child’s relationship to the perpetrator, duration of abuse and co-occurring maltreatment. The overall emotional harm model was significant and accounted for 18.3% of the variance (Nagelkerke R2). Age of the child at the time of investigation, inappropriate sexualized behavior and substantiation level were significant predictors in the final block of the emotional harm regression equation. Maternal response was no longer significantly associated with emotional harm when the analysis adjusted for child characteristics. Conclusion Consistent with previous research, the majority of non-offending mothers investigated as part of the CIS-98 responded to CSA disclosure with belief, emotional support and protection as determined by the social worker’s assessment. The current study supports the cumulative evidence that caregiver mental health, age of the child and the child’s relationship with the offender are significant predictors of negative maternal response and emotional harm. Although negative maternal response failed to predict emotional harm among children investigated for CSA, continued examination of the risk factors associated with maternal response is warranted to ensure the safety of a small, yet vulnerable segment of children.

Objective: While child welfare policy and legislation in Canada and other regions has increasingly defined children who are exposed to intimate partner violence (IPV) as maltreated, little is known about the response of the child welfare system to children exposed to IPV. This dissertation seeks to determine the response of child protection services to reports about IPV; the outcomes of child protection investigations referred for children exposed to IPV; and what factors predict decisions made by child protection workers (e.g., court involvement, child welfare placement, closing the case, substantiation, and making a referral to other supportive services) for investigations involving children exposed to IPV. Methods: This study is based on a secondary analysis of data collected in the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003). Bivariate analyses and multiple multinomial regression were conducted to study the substantiation of maltreatment, and logistic regression was conducted to predict child protection workers’ decisions to keep the case open, make a child welfare placement, take the family to court, and make a referral for investigations involving children’s exposure to IPV. Results: Seventy-eight percent of the investigations involving only IPV were substantiated. The multinomial regression could not accurately classify the suspected and unfounded cases. Substantiated investigations involving co-occurring IPV were three times more likely to stay open for ongoing child protection services compared to IPV only cases (adjusted odds ratio = 2.93, p < .001). Child protection service outcomes for substantiated investigations involving co-occurring IPV were ten times more likely (adjusted odds ratio = 10.61, p < .001) to involve a child welfare placement compared to IPV only cases. The factors driving child protection worker decisions were primarily the co-occurrence of maltreatment, younger children, and emotional harm. Conclusions: Due to the expansion in what constitutes a child in need of protection, there has been an overwhelming increase in the number of referrals about children being exposed to IPV in Canada. Future analyses should explore whether policies that direct IPV cases to child welfare services is both an effective way of protecting children and a reasonable use of limited child welfare resources.

Despite the establishment of heart transplantation as a life-saving therapy for children and adolescents, little research has focused on the biopsychosocial impact of the transplant process. Few studies have captured the subjective experiences of young heart transplant recipients. This program of research examined how pediatric heart transplant recipients construct their worlds and the meanings they ascribe to their transplant experience. A grounded theory approach was implemented which guided data collection and analysis. A total of twenty-seven adolescents participated in semi-structured qualitative interviews. Findings illuminate pediatric heart transplantation to be a pervasive experience, with consequent impact on physical, psychological and social well-being. Participants described various biopsychosocial processes and experiences that occurred over the course of their transplant journey. Data analysis yielded themes of quality of life reflecting notions of temporality including: 1) the pre-transplant experience – a struggle to survive, 2) the transplant surgery and hospitalization – a difficult transition and 3) the post-transplant experience – an awakening and transformation. This research identifies that heart transplantation, which may contain elements of suffering and loss, may ultimately enhance young recipients’ overall quality of life. Results reveal the possibility that adolescent heart transplant recipients not only adapt to transplantation, but also potentially experience associated growth-enhancing experiences. An emergent theoretical model is presented, with implications for practice and research.

This thesis explores Korean-Chinese migrant workers’ local experiences of the global phenomenon of international migration of care labour, focusing on how the care labour of migrant workers is being constructed through the intertwined social and political processes in South Korea’s shifting long-term care sector for the elderly. The thesis uses a qualitative case study method and relies on data collected through participant observation, interviews, and textual analysis during field research between November 2009 and May 2010. The analysis is based on a global economy of care framework, which understands care work as being made of products that are socially and politically constructed in the global processes. My study findings illuminate the roles and relations of the state, the employers, and the workers in producing a huge migrant workforce in South Korea’s segregated elder care labour market. The policy analysis at the intersection of elder care, labour market, and immigration policies shows that, over the last decade, the South Korean government has significantly reconstructed the boundaries of elder care work through the expansion of publicly-funded programmes for the elderly and the institutionalisation of care work in those programmes. In the institutionalisation process, the government’s ignorance about the care work performed in the private care sector has resulted in different regulations and working conditions for care workers in the publicly-funded versus the private sector. My empirical findings highlight how employers’ search for ‘cheap’ and ‘flexible’ labour and older female migrants’ disadvantageous status in the labour market have placed these workers in the less regulated private sector and their pay and working conditions at the bottom of hierarchical elder care workforce. In advocating for migrant care workers’ labour rights, this thesis challenges the current discriminative employment practices and the government’s lack of protection and regulation of care work in the private sector.

This thesis explores Korean-Chinese migrant workers’ local experiences of the global phenomenon of international migration of care labour, focusing on how the care labour of migrant workers is being constructed through the intertwined social and political processes in South Korea’s shifting long-term care sector for the elderly. The thesis uses a qualitative case study method and relies on data collected through participant observation, interviews, and textual analysis during field research between November 2009 and May 2010. The analysis is based on a global economy of care framework, which understands care work as being made of products that are socially and politically constructed in the global processes. My study findings illuminate the roles and relations of the state, the employers, and the workers in producing a huge migrant workforce in South Korea’s segregated elder care labour market. The policy analysis at the intersection of elder care, labour market, and immigration policies shows that, over the last decade, the South Korean government has significantly reconstructed the boundaries of elder care work through the expansion of publicly-funded programmes for the elderly and the institutionalisation of care work in those programmes. In the institutionalisation process, the government’s ignorance about the care work performed in the private care sector has resulted in different regulations and working conditions for care workers in the publicly-funded versus the private sector. My empirical findings highlight how employers’ search for ‘cheap’ and ‘flexible’ labour and older female migrants’ disadvantageous status in the labour market have placed these workers in the less regulated private sector and their pay and working conditions at the bottom of hierarchical elder care workforce. In advocating for migrant care workers’ labour rights, this thesis challenges the current discriminative employment practices and the government’s lack of protection and regulation of care work in the private sector.

The decrease in hospital recovery time created a transition to more care being performed in the home. There is a need to balance care needs from both demand and supply characteristics. This research sets out to address how the presence or absence of informal caregiver(s) impacts on resource allocation decisions made by home and community care case managers. This research used a mixed methodologies approach employing both semi-structured interviews with frontline workers and secondary data analysis of the Central and Toronto Central LIHN Resident Assessment Instrument for Home Care (RAI-HC). Overall total average hours of formal services did not differ between care recipients depending on the presence or absence of a caregiver. It is evident from the responses provided by the participants that street-level bureaucracy plays a large role in service allocation decisions. That is, decisions are being made based on diverse idiosyncratic observations, opinions and feelings.

This phenomenological study explores the needs of community dwelling Holocaust survivors and proposes a framework for social work practice with this population. Data from qualitative interviews with Holocaust survivors and family caregivers of Holocaust survivors suggest that there are at least two different cohorts of Holocaust survivors in this study. These cohorts, referred to as classic and contemporary survivors in this dissertation, differ with regard to their age as well as the extent to which they are affected by numerous barriers relating to their health and physical ability as well as to language, education, and work background. A small number of respondents demonstrated characteristics belonging to both of the cohorts. A continuum, with classic survivors on one end of the scale and contemporary survivors on the other is therefore suggested as the best way to understand the differences between the two cohorts of Holocaust survivors in this study. Research findings compare and contrast these two ends of the continuum, as well as the cases which fit somewhere in the middle, and suggest the following five themes: 1. There are important similarities and differences between classic and contemporary survivors, 2. Individual Holocaust survivors, their family members and the larger community have all been affected by the Holocaust, 3. Identities and values have been impacted by the trauma associated with the Holocaust, 4. Survivor characteristics can be classified as characteristics of resiliency and/or vulnerability, (The sub-themes uncovered in this study relating to resiliency include fierce independence, a “never give up” mentality and a strong social conscience. The sub-themes relating to vulnerability include guarded trust, a “going without” mentality, increased vulnerability to loss, and loss of secure identity), and 5. The needs of the study population can be better understood by considering resiliency and vulnerability characteristics. The life course framework and individual and community trauma theories are applied to understand these research findings which inform the proposed framework for social work practice.