Social Work School Theses and Dissertations

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Rural Hospice Caregivers and the Social Workers Who Support Them: A Mixed Methods Study
(2024-12) Curd, Jessica Lind Ann; Pierce, Barbara; Hong, Michin; Lee, Jessica; Nguyen, Thu Suong Thi
This study aimed to explore the experiences of rural caregivers for dying individuals and the hospice social workers who support them, with a focus on the Covid- 19 pandemic and its recovery phases. This study also investigated stress, secondary trauma, anticipatory grief, social support, and health disparities among home informal caregivers of dying persons, as well as stress and secondary trauma among hospice social workers. This study employed a mixed method approach to explore the factors affecting rural caregivers and hospice social workers. This allowed for a comprehensive understanding of their experiences. Initial analysis of means revealed moderate to high levels of anticipatory grief, secondary trauma, and caregiver stress among end-of-life caregivers. To explore the interactions between these variables, a multiple linear regression analysis was conducted using data from 107 caregivers. Each regression model (Caregiver Stress, Secondary Trauma, and Anticipatory Grief) was statistically significant. Results indicated that anticipatory grief, secondary traumatic stress, and caregiver stress co-vary and are influenced by perceived social support. Qualitative findings from caregiver interviews supported the quantitative results. Seven themes emerged: "no time to grieve but I am grieving," "feeling alone," "structure and routine help," "meaning making," "building a 'new normal'," "going into their world," and "impact ofCovid-19 pandemic." Interviews with 19 hospice social workers revealed moderate to high levels of anticipatory grief and secondary traumatic stress. Six themes emerged: "feeling disconnected and less effective," "grief regarding loss of no1malcy," "no longer 'heroes'," "false sense of security," "closer with peers and distanced from leaders," and "systemic barriers." Overall, this study sheds light on the specific stressors and emotional challenges faced by rural end-of-life caregivers and social workers. It highlights their resilience and adaptability in the face of adversity. The findings underscore the need for targeted support systems and interventions to address the mental health and well-being of these essential yet often overlooked members of the healthcare community. Additionally, the research contributes valuable insights to the broader discourse on the importance of social support in mitigating the effects of stress and trauma in caregiving professions.
Bennett Expansion to the International Trauma Questionnaire: Results of Thematic Analysis and Psychometric Testing
(2024-08) Bennett, Lindsay Michelle; Pierce, Barbara J.; Adamek, Margaret E.; Fukui, Sadaaki; Bigatti, Silvia M.
Complex Post Traumatic Stress Disorder (C-PTSD) is distinct from Post Traumatic Stress Disorder based on genesis of trauma type leading to disorder and resulting symptomatology. Currently, C-PTSD is not included as an official diagnosis in American mental healthcare systems but is recognized worldwide by the International Classification of Diseases. Lack of awareness and recognition of this disorder has resulted in few behavioral health scales available to evaluate symptoms experienced by survivors of complex trauma. This study is a mixed methods approach to scale development and builds on the International Trauma Questionnaire (ITQ). This ITQ is currently available to the public as a brief diagnostic tool for C-PTSD. In this study, thematic analysis was used following qualitative interviews to generate items for the Bennett-Expansion to the International Trauma Questionnaire. Themes emerged from qualitative analysis of affect regulation, physical symptoms, self-concept, interpersonal relationships, systemic influence and injustice and contextual triggers. These themes and codes provided language to capture C-PTSD symptoms more robustly. Results of exploratory factor analysis show six subscales named “Self-concept and interpersonal relationships,” “PTSD symptoms,” “Self-awareness,” “Physical symptoms,” “Affect regulation,” and “Conflict avoidance”. Internal consistency ranged from “acceptable” to “very good” in the subscales, with the total scale being “very good”. The BE-ITQ could be used in therapeutic practice to evaluate the efficacy of interventions with populations experiencing C-PTSD.
Enhancing the Sexual Health of Youth in Systems of Care: Factors Affecting Risky Sexual Behaviors and Implications for Pregnancy Prevention Programs
(2024-05) Armstrong Richardson, Eprise AJ; Adamek, Margaret E.; Ott, Mary A.; Mariscal, Susana; Glassburn, Susan
This study investigates factors contributing to risky sexual behaviors and teenage pregnancies among youth in systems of care (YSC). Secondary analyses were conducted on quality improvement data from two sexual education programs in the urban Midwest. Descriptive analyses uncovered disparities in risky sexual behaviors between the study samples; moreover, both groups exhibited higher rates compared to those reported in existing literature and the general population. In the Indiana Proud and Connected Teens (IN-PACT) study (N = 1916, mean age = 16.1 years), multivariate analysis showed that, when controlling for age, adverse childhood experiences (ACEs), and system involvement, pregnancy risk scores—a measure of participants' engagement in risky sexual behaviors—were positively associated with decision-making capacity and negatively associated with perceptions of pregnancy as undesirable. Furthermore, among a population of youth currently involved, or at risk of future involvement, in systems of care, those within juvenile justice (JJ) systems reported higher pregnancy risk scores, while youth in child welfare (CW) systems reported lower scores. In the Healthy Teen Connection (HTC) study (N = 603, mean age = 15.7 years), descriptive analyses revealed that 6.3% of participants scheduled appointments post-intervention, indicating limited success in linking participants to reproductive health clinics. The analyses also highlighted patterns regarding participants’ sociodemographic and sexual health characteristics, including an increased proportion of youth reporting sex under the influence during the pandemic. Thematic analysis of coordinators’ reflections links the intervention’s limited success to multifaceted barriers hindering participants’ access to sexual and reproductive health (SRH) services, resources, and education. However, coordinators suggested that, by fostering a safe and supportive environment and engaging caregivers in the intervention, HTC was successful in empowering participants in their sexual health. Acknowledging limitations such as reliance on self-reported data, the findings lay the groundwork for comprehensive policy and practice recommendations. Collaborative efforts are needed to provide YSC with tailored sexual health programming, including comprehensive and developmentally appropriate sexual health education, and accessible SRH resources and services. Future research should prioritize comprehensive needs assessments and explore disparities in sexual health behaviors and outcomes to enhance program development and implementation efforts.
Teaching Race and Racism in Social Work Education: A Thematic Analysis of Social Work Educators' Experiences and Attitudes
(2023-09) Miller, Natasha Wine; Kim, Hea-Won; Adamek, Margaret; Khaja, Khadija; Hayes, Cleveland
Race and racism are central ideas in the conceptualization of social justice in the US and thus topics of fundamental importance within the social work discipline. Accredited social work schools must include race and racism education in their curricula. Social work pedagogical literature has historically lacked critical, consistent attention to these issues. This exploratory study applied a cluster sampling strategy to distribute study invitations across 10% of randomly selected accredited US social work schools to access the study’s target population of social work educators. Reflexive thematic analysis was used to interpret educators’ written responses to six qualitative survey questions on their perspectives teaching race and racism-centered themes to social work students. The study was guided by three research questions: how educators conceptualize race and racism pedagogy; how confidence and doubt are contrasted in their experiences; and the consequence of educators’ own racial identity. Critical Race Theory (CRT) and oppression theory were guiding theoretical frameworks. Each question generated 31 to 48 responses. In total, 10 themes were developed in response to the research questions. Highlighted findings illustrate a variation in how educators conceptualize race and racism pedagogy: ethics training, antiracist praxis development, and through a CRT framework. Educators also experience doubt in their teaching abilities, such as in managing students’ responses to race and racism-centered learning. Educators’ racial identity also shapes their perspectives on race and racism pedagogical experiences. Further research is indicated, such as how educators understand antiracist practice; their pedagogical training on teaching these subjects; evaluative studies on social work schools’ support to educators; and the influence of racial identity on teaching and learning these complex topics.
Reconceptualizing the Role of Identity in Social Work Education Through Liberation Pedagogy
(2023-08) Fultz, Andrew James; Gentle-Gennitty, Carolyn; Kyere, Eric; McCarthy, Katherine; Treff, Marjorie
In response to social developments and the civil rights movement in the 1960s, the social work profession began to develop a formal identity which included a commitment to social justice. Today, that concept of social justice includes diversity, equity, inclusion, and anti-racism in education and practice. Teachers and researchers have rarely assessed the use of teaching pedagogy and student experiences in diversity courses via the social work education curriculum from the lens of White students developing an understanding of social justice. A mixed method study was designed and implemented to reconceptualize the role of White identity in social work education with social work undergraduate students. Hypothesizing that identity is influenced by both pedagogy and life experiences, social work students took part in a classroom intervention to understand how White racial identity development occurs and the role that emotional regulation has in difficult conversations which shapes behavior and action. Findings: quantitative analysis using both linear mixed models and analysis of covariance (ANCOVA) revealed a lack of statistical significance between groups due to unexpected sampling issues and possible social desirability bias. Surprising findings from the qualitative portion of the study, a phenomenology, provided surprising support of the intervention and the utility of the teaching model. Modifications to the study design and broader intervention application for future replication are explored. The full findings of this study are presented in three manuscripts, the first theoretical, exploring the early conceptualizations of identity in social work with particular attention to social justice and White Racial Identity Development theory. The second manuscript explores using liberation pedagogy in the classroom to quantitatively assess for change in White racial identity status and frequency of anti-racist behavior with 17 undergraduate students. The third manuscript shares results of a hermetical phenomenology to understand student's life experiences and how those experiences contributed to their overall development as social workers. In sum, the role of values, dissonance, relationships, and curiosity emerged as important to understanding the overall development of students. Implications for education and practice are provided.
Youth Experiences of Organized Activities and Violence: Trends and Interrelationships
(2023-08) Khan, Mohammad Mostafizur Rahman; Reza, Hasan; Adamek, Margaret E.; Pierce, Barbara; Wu, Wei
Organized youth activities contribute to positive development by engaging with a favorable and supervised social environment. This dissertation research explored the influence of organized youth activities such as school-based, community-based, and faith-based activities on youth violence such as fighting, group-fighting, and attacking someone with the intent to seriously hurt them. It also emphasizes the effect of socio-economic characteristics such as age, gender, level of education, and family income on organized youth activities and youth violence. There are studies as well as a general assumption that organized youth activities contribute to reduce youth violence. However, the literature lacks evidence on what types of activities, or which particular activity is more effective in preventing youth violence. Also, many times it depends on intensity, duration, and supervision of these activities. Examining trends in organized youth activities and youth violence may provide a better picture of various activities and the effectiveness of current youth programs and policies. Therefore, it is important to understand the trends and interrelationships between organized youth activities and violence. This study revealed some interesting facts and revealed some gaps to conduct further research. Findings revealed an inverse association between organized youth activities and youth violence. The study documented a significant association between respondents’ socio-economic characteristics and participation in organized youth activities. The analysis also showed a significant association between respondents’ socio-economic characteristics and youth violence. The study analyzed the trends in organized youth activities and youth violence over the last decade and revealed that the more youth participated in organized youth activities, the less they participated in violence. The present dissertation provides preliminary evidence of the interrelationships between organized youth activities and violence that impact and affect the overall development and well-being of young people in our society. Researchers, practitioners, and policymakers can use the findings to advance the social work grand challenge of ensuring healthy development of all youth.
How Public Libraries Respond to Crises Involving Patrons Experiencing Homelessness: Multiple Perspectives of the Role of the Public Library Social Worker
(2023-05) Provence, Mary Anita; Starnino, Vincent; Adamek, Margaret; Copeland, Andrea; Kyere, Eric; Wahler, Elizabeth
Due to a shortage of affordable housing, gaps in social welfare infrastructure, and the criminalization of homelessness, public libraries find themselves providing daytime shelter to patrons experiencing homelessness. Their needs and crises have created demands on staff and security that exceed their training and role. Sometimes police are involved, exposing patrons to possible arrest. To fill this knowledge and service gap, libraries have begun hiring social workers. Early research on the broad role of social workers suggests they are changing how libraries respond to crises with patrons experiencing homelessness in four keyways: by providing an option to calling 911; influencing code of conduct implementation, serving patrons, and equipping staff. However, no study has given an in-depth explanation of how social workers are changing libraries’ responses to crises with patrons experiencing homelessness. The purpose of this study is to explain how the role of the social worker influences how libraries respond when patrons experiencing homelessness are in crises. Considered through lenses of role theory, social cognitive theory, and the humanization framework, this embedded multiple-case study of three U.S. urban libraries collected 91 surveys and conducted 46 Zoom interviews. It includes the perspectives of 107 participants across six roles: patrons experiencing homelessness, social workers, front-facing staff, security, location managers, and CEOs. The social workers’ influence was perceived to reduce behavior incidents, exclusions, and arrests around three themes: (1) being an option, with subthemes of in-house referrals and de-escalation; (2) running interference, with subthemes of low barrier access and barrier-busting services; and (3) buffering, with subthemes of equipping, influencing code of conduct implementation, and advocating and being present during security and police interactions. Three models of library social work and their impact on the social worker’s role of de-escalation were identified and described: The Sign Up and Summon Model, the Outreach and Summon Model, and the Social Work Center Model. In addition, a commingled rival was found: the impact of the Black Lives Matter movement. The implications of the findings include recommendations for structuring library social work practice to reduce exclusions and arrests of patrons experiencing homelessness.
American Muslim Well-Being in the Era of Rising Islamophobia: Mediation Analysis of Muslim American Social Capital and Health
(2023-04) Miller, Keith Matthew; Kondrat, David; Khaja, Khadija; Fukui, Sadaaki; Latham-Mintus, Kenzie
This study aims to examine American Muslim well-being and social capital in the face of Islamophobia. Ecological frameworks and social capital theory were synthesized to provide an approach for research, analysis, and social work practice. A mediation analysis was conducted to test the mediating effect of cognitive social capital on the relationship between structural social capital and distress. The paths of structural social capital, cognitive social capital, and distress were conceptualized using the ecological framework of Berkman and colleagues. Special attention was paid to how experiences of Islamophobic discrimination affect cognitive social capital and distress. Structural social capital was operationalized as the number of active memberships in civic organizations; Cognitive social capital was operationalized as trust in major institutions such as schools and the local police and Distress was operationalized using the Kessler Distress Scale. It was hypothesized that an increase in structural social capital would show a decrease in distress with cognitive social capital mediating the path. Results showed that cognitive social capital mediates the relationship between structural social capital and distress. However, an inconsistent mediation was found where an increase in cognitive social capital shows a decrease in distress, but higher levels of structural social capital show an increase in distress. Lastly, the results of the analysis were interpreted to inform current interventions with the American Muslim community through a social work lens.
The e-OSCE and Social Work Education: Creating Authentic, High-Impact Practice Learning Opportunities for Students
(2023-01) Wolfe-Taylor, Samantha N.; Khaja, Khadija; Wilkerson, David; Brown, James; Price, Jeremy
Advances in technology, non-traditional students, and a new generation of elearners all challenge institutions of higher learning to support innovations that create relevant distance education opportunities for their students. Due to the COVID-19 pandemic dramatic shifts to education occurred, requiring schools of social work to consider new ways to prepare students for the field and new evaluation methods of students’ practice skills. Smoyer and colleagues explored this further in their study on BSW students’ experiences in distance education during the pandemic and found when students were unexpectedly thrust into online learning platforms most were able to learn online; however, substantive interactivity and synchronous engagement were factors that were necessary to maintain student overall satisfaction in the distance learning environment. In addition, they point out the need for interactive technology in online social work classrooms to simulate the human interaction that is essential to student learning and practice. The online objective, structured clinical examination (e-OSCE) is one form of online simulation-based learning that offers highly interactive and engaging HIP learning opportunities for social work students. The OSCE is a standardized, valid, and reliable assessment method that social work education programs use to ensure successful practice skills development. This study used a qualitative, exploratory embedded single-case method to investigate online MSW students’ experiences participating in an e-OSCE, their perspectives on the use of an e-OSCE in online social work education, and future practice considerations students identify upon completing the e-OSCE.
Secondary Traumatic Stress: Pervasiveness and Contributing Factors in School Personnel
(2022-11) Klemme, Paige M.; Pierce, Barbara; Turman, Jack E.; Fukui, Sadaaki; Brown, James R.
The study aim is to identify pervasiveness and factors leading to secondary traumatic stress (STS) in school personnel to increase awareness of the need for support and help for school personnel who are affected by STS. School personnel is defined in this study as all personnel employed by schools and includes, teachers, administrators, staff, resource officers, custodians, lunch aids, bus drivers, nurses, social workers, etc. School personnel work together to support students and ensure that they learn not only educational material, but also social and emotional skills. They also provide a sense of safety for students. School personnel are tasked with providing seven hours of daily support to their students; however, lack of supports, constant stressors, and exposure to secondhand accounts of trauma, put school personnel at risk for STS. This dissertation includes a review of STS in school personnel, theory used to inform and understand STS, a systematic review of STS in school personnel, a cross-sectional study of STS in school personnel from a Midwestern County, and integration of findings including practical implications and need for future research.

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