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.

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 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.

Demystifying the Commodification of Social Relations in the Ontario Child Protection System: A Marxist Approach to Textual Analysis Susan Elizabeth Preston Doctor of Philosophy Faculty of Social Work University of Toronto 2013 In the space of quiet and disquiet, another read is possible. Abstract Capitalism invades all aspects of society, including the welfare state. Capitalist notions of the market appear to be encroaching into social services, wherein we see the “businessology” of social work; however, little empirical attention has been given to how capitalism appears to be replicated within social services. This research aims to make the invisible visible in order to agitate for radical change in the organization and practice of social service provision. In this inquiry, focusing on the child protection system in Ontario I examine some of the documentary actualities of the ruling apparatus of regulated parenthood and childhood by exploring the textualities of the state. Specifically, through the critical lens of Marxism and feminism, and drawing on my own experience of a classed and gendered world, I critically deconstruct the regulatory texts closest to the state, the legislation of the Child and Family Services and the regulations that expand the legislative intent. I also explore the procedural document of the Ontario Risk Assessment Model as an enacted text that operationalizes the legislation and regulation. By reading and re-reading these texts, at the surface but also above and below the surface, positioning the documents in context and recalling my social work practice, I seek answers to questions of how texts replicate capital, and commodify social relations through the ruling apparatus of the state. This work queries how the text itself in its active use of language has implications for social work, in practice, in research and in education.

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.

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.

Demystifying the Commodification of Social Relations in the Ontario Child Protection System: A Marxist Approach to Textual Analysis Susan Elizabeth Preston Doctor of Philosophy Faculty of Social Work University of Toronto 2013 In the space of quiet and disquiet, another read is possible. Abstract Capitalism invades all aspects of society, including the welfare state. Capitalist notions of the market appear to be encroaching into social services, wherein we see the “businessology” of social work; however, little empirical attention has been given to how capitalism appears to be replicated within social services. This research aims to make the invisible visible in order to agitate for radical change in the organization and practice of social service provision. In this inquiry, focusing on the child protection system in Ontario I examine some of the documentary actualities of the ruling apparatus of regulated parenthood and childhood by exploring the textualities of the state. Specifically, through the critical lens of Marxism and feminism, and drawing on my own experience of a classed and gendered world, I critically deconstruct the regulatory texts closest to the state, the legislation of the Child and Family Services and the regulations that expand the legislative intent. I also explore the procedural document of the Ontario Risk Assessment Model as an enacted text that operationalizes the legislation and regulation. By reading and re-reading these texts, at the surface but also above and below the surface, positioning the documents in context and recalling my social work practice, I seek answers to questions of how texts replicate capital, and commodify social relations through the ruling apparatus of the state. This work queries how the text itself in its active use of language has implications for social work, in practice, in research and in education.