published_or_final_version / Social Work / Master / Master of Social Work

The purpose of this study was to gain a deep phenomenological understanding of how young adults living in a detoxification centre for people with no fixed abode made the life changing decision to free themselves from substance use and provide insights that could be helpful for counselling psychologists working therapeutically with this client group. An exploratory study was conducted using Interpretative Phenomenological Analysis (IPA). The participants were between the ages of 25 and 29 years old (1 female and 5 males). All participants had spent 6 weeks in the detoxification centre at the time the interview took place. Two specific areas were pinpointed for exploration during the semi-structured interviews: (1) self-concept before entering the project and after having entered the project and been abstinent for at least 6 weeks, and (2) possible links between homelessness and substance use. Emerging themes were clustered in terms of polarities and existential dimensions. Four superordinate themes comprising of eight existential polarities were extrapolated: control-chaos; connectedness-disconnection; meaning-meaninglessness; responsibility-guilt. The data analysis revealed participants’ struggle to resolve the conflict between these polarities. Identity issues seemed to be crucial, as well as a sense of having lost touch with or possibly never developed an authentic self and a struggle to live and accept emotions in the present moment. Another aspect that emerged was difficulties in grieving losses as well as death anxiety. Connecting with others and caring about oneself seemed to be closely linked and conducive to wellbeing in participants’ experience of abstinence from substance use. On the basis of this study recommendations are made for professionals working therapeutically with this group of clients. These include taking an existential approach and using mindfulness techniques to support clients to accept the polarities we experience in life and to develop the capacity to embrace the contradictions of our existence.

<p>HIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. There are still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners&rsquo / behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and<br /> confidentiality addressed / they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place / they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of &lsquo / mass testing&rsquo / used by the NGO did not fulfil learners&rsquo / expressed need for privacy with regards to HCT. Service providers were friendly and non-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of leaners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for providing youth friendly schoolbased HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.</p>

Sexually Explicit Internet Movies (SEIM) have emerged as a frequently accessed sexual resource by youth; however, SEIM’s potential influences on youth’s sexual health remains an understudied area. This study aimed to develop crucial insight into what youth perceive to be SEIM consumption’s sexual health influences. Employing an exploratory, constructivist grounded-theory approach, data were collected through semi-structured interviews. Three main findings emerged from the data analysis: 1) Youth experienced SEIM consumption as having interconnected negative and positive sexual health influences; 2) SEIM were utilized by youth as a means to explore both their individual sexual self and the subject of sexuality; 3) Youth perceived SEIM consumption differently in the contexts of individual sexual health versus sexual health promotion. Youth’s perceptions suggest that it would be beneficial to enact more holistic, sex-positive approaches to sexual health promotion, and support the utility of creating alternative, lived experience-based discourses about youth sexual health.

<p>HIV counselling and testing (HCT) is an essential element in the response to the HIV epidemic. There are still major gaps in research about the best ways to provide HCT, especially to young people. School-based HCT is a model which has been suggested for providing HCT to young people in a youth friendly manner. This study was aimed at producing recommendations for providing a youth friendly school-based HCT service using the World Health Organisation (WHO) framework for youth friendly health services. It was conducted in six secondary schools in Cape Town, where a mobile HCT service is provided by a nongovernmental organisation (NGO). It was an exploratory descriptive study, using a mixed-methods approach. Twelve focus group discussions (FGDs) were held with learners to explore their needs with regards to school-based HCT. An evaluation (which consisted of observation of the HCT site, service provider interviews and direct observation of the HCT counselling process) was done to determine whether the mobile school-based HCT service was youth friendly. A learner survey was conducted with 529 learners to investigate the factors that influence the uptake of HCT and to explore learners&rsquo / behaviours and experiences under test conditions. In the FGDs, learners said that they wanted HCT to be provided in schools on condition that their fears and expressed needs were taken into account. They wanted their concerns regarding privacy and<br /> confidentiality addressed / they wanted to be provided with information regarding the benefits and procedure of HCT before testing took place / they wanted service providers to be competent to work with young people, and they wanted to be assured that those who tested positive were followed up and supported. On evaluation of the mobile school-based HCT service, it was evident that the service did not meet all the needs of the learners nor did it have all the characteristics of a youth friendly health service. The model of &lsquo / mass testing&rsquo / used by the NGO did not fulfil learners&rsquo / expressed need for privacy with regards to HCT. Service providers were friendly and non-judgemental but had not been trained to work with young people (especially marginalised groups e.g. young men who have sex with men). The information needs of learners were not addressed, and learners were not involved in the provision of the HCT service. Learners who tested positive were not assisted in accessing care and support. The learner survey revealed a high uptake of HCT (71% of learners) at schools with learners who do not identify themselves as Black, with female learners and older learners being more likely to have had an HIV test. Factors that influenced uptake of HCT were complex, with learners reporting many different motivators and barriers to testing. Of concern was the low risk perception of leaners with regards to HIV infection and the fact that learners who tested HIV positive were not being linked up with treatment and care. Based on the findings of the study, recommendations were made for providing youth friendly schoolbased HCT. A multisectoral approach, with learner and community involvement, was suggested in order to provide a service which is equitable, accessible, acceptable, appropriate and effective.</p>

Background Mental health stigma-reducing and awareness trainings encourage trainees to talk about mental health with the hope that increased discussions will lead to reduced stigma and increased access to mental health services. This survey study aimed to examine the current levels of confidence among participants, or “first aiders” who completed the Youth Mental Health First Aid (YMHFA) training in their ability to demonstrate the skills that were taught in the training. Additionally, this study examined the difference in levels of confidence between the YMHFA instructors and first aiders in the ability of the first aiders to demonstrate the skills that were taught in the training. We examined differences in levels of confidence among first aiders according to their socio-demographic and personal characteristics. Finally, we explored the ways in which first aiders who completed the course used their knowledge and skills after the training. Methods Seven hundred fifty-seven first aider participants were surveyed post-training and 129 first aider participants were surveyed at follow-up. Fourteen YMHFA instructors were surveyed. Results The data indicated that there was a significant decrease in confidence among first aiders between post-training and follow-up. With the exception of age, there were no statistically significant differences in levels of confidence among first aiders according to the following sociodemographic and personal characteristics: a.) gender; b.) race; c.) reason for attendance; d.) role of use. Survey data also indicated the various ways in which first aiders are currently using their training. Conclusions First aiders’ confidence declined after follow-up even though they reported various ways in which they are using their training. Instructors reported positive perceptions of the training and reported a high level of confidence in the ability of their trained first aiders to demonstrate the taught skills.

abstract: American Indian youth are experiencing a mental health crisis fueled by the lingering ramifications of experiencing a near cultural genocide. Scholarly literature indicates that American Indians have used their cultural values to survive the atrocities associated with colonization. The purpose of this Indigenous based mixed-methods action research project was to examine how Blackfoot elders perceive the transfer of values through ceremonies, cultural activities and traditional stories; and to what degree a Blackfoot way of knowing paradigm informs cultural connectedness, and school connectedness for students attending school on the Blackfeet Indian Reservation. The study was conducted through a Blackfoot way of knowing paradigm and consisted of two distinct but related data collection efforts. The first sample consisted of formal and informal interviews with 26 American Indian elders as well as observation notes from attending and participating in American Indian ceremonies in order to discover the traditional values believed transferred during ceremonies, cultural activities, and traditional stories. The elder interviews resulted in identifying ten traditional values encasing spirituality displayed in the Hoop of Traditional Blackfoot Values. The second sample consisted of 41 American Indian youth attending school on the Blackfeet Indian Reservation. The youth learned the values identified in the Blackfeet Education Standards “Hoops of Values” through a Blackfoot way of knowing paradigm and completed measures to assess cultural connectedness and school connectedness. In addition, all students were interviewed to develop a more robust understanding of the role culture plays in cultural connectedness and school connectedness and to lend a Blackfoot youth perspective to a Blackfoot way of knowing. Quantitative data analysis showed that a Blackfoot way of knowing paradigm significantly influences cultural connectedness but does not significantly influence school connectedness. In addition, analysis of the student interviews provided a Blackfeet youth perspective on cultural connectedness and school connectedness. / Dissertation/Thesis / Doctoral Dissertation Educational Leadership and Policy Studies 2020

International migration flows and patterns shaped by the determinants, processes and outcomes of social, political, and economic conditions have led to important transformation of society and human geographies. As Canada continues to effectively manage its immigration system and uphold its commitment to international refugee protection and resettlement, it is critical for Canada to do so with an understanding of the changing context of immigration, which are reinforced by shifting policies and their impact, in our contemporary society. In this thesis, the migration trajectory of three groups of newcomers to Canada; international students, Syrian refugees, and refugee youth, are explored by examining policies and conditions that can create group risks and vulnerabilities in immigration, settlement, and integration as groups transition to life in Canada after arrival. As suggested by Castle (2010) migration researchers can advance the field by embedding their work in broader theories of social change to facilitate understanding of the complexity, interconnectedness, variability, contextuality, and multi-mediation of migratory process in the context of rapid change. This thesis employs a geographical lens of place to deepen understanding of processes and outcomes in our contemporary society, while responding to these evolving contexts in one mid-size, post-industrial Canadian city. In three separate research, this thesis examines: 1) economic immigration flow under Express Entry in 2015 and 2016; 2) the role of the voluntary sector during the Syrian Refugee Resettlement Initiative in Hamilton, Ontario in 2016; and 3) the place of school-based settlement in bridging and brokering school-based mental health for newcomer youth. / Thesis / Doctor of Science (PhD) / As Canada continues to effectively manage its immigration system and uphold its commitment to international refugee protection and resettlement, it is critical for Canada to do so with an understanding of the changing context of immigration in our contemporary society. In this thesis, I examine the migration trajectory of three groups of newcomers to Canada; international students, Syrian refugees, and refugee youth, by asking two overarching research questions that explores policies and conditions that can create group risks and vulnerabilities in immigration, settlement, and integration. This thesis seeks to understand how policies could be addressed to improve successful outcome for newcomers. This thesis employs a geographical lens of place to deepen understanding of processes and outcomes in our contemporary society, while responding to these evolving contexts in one mid-size, post-industrial Canadian city.

Studies have shown a concerning and disproportionate amount of treatment failure and premature termination in youth populations. Routine measurement feedback has been proposed as a means to prevent treatment failure and premature termination for adults and may also improve youth mental health services. However, studies examining helpfulness of measurement feedback systems in youth populations have demonstrated a lack of effects more likely due to poor measurement implementation than to the measurement feedback system itself. Because contexts within the service settings are such crucial factors in whether an innovation is successfully implemented, examining barriers and facilitators in said contexts is a necessary step towards improving implementation for the ultimate purpose of improving youth mental health services. The present study explored barriers and facilitators to the implementation of the Youth Outcome Questionnaire (Y-OQ) and Treatment Support Measure (TSM) in youth routine clinical care. Thirteen staff of varying job titles, experiences, education and opinions towards measures were interviewed using consensual qualitative research (CQR) methods. Results were similar to previous studies, indicating multilevel barriers and facilitators to measurement implementation such as at the organization, staff, client and measure level. Using CQR data analysis, domains, categories and subcategories along with level of frequency are displayed and discussed in further detail. In addition to barriers and facilitators, interviewees provided recommendations for how to improve implementation of measures within their organization. Researchers provide recommendations of continued communication, re-assessment of barriers and facilitators over time and shared responsibility between stakeholders and professionals invested in improving youth mental health services.

published_or_final_version / Social Work / Master / Master of Social Work