Social Work School Theses and Dissertations

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Leaving Hate: Social Work and the Journey out of Far-Right Extremism
(2022-09) Carroll, Danny W., II; Khaja, Khadija; Boys, Stephanie; Hostetter, Carol; Vogt, Wendy
Over the last 20 years, domestic far-right extremism has risen to become the greatest threat to peace and safety in the United States. In the last few years alone, racialized, minoritized, and marginalized individuals and communities have been increasingly forced to feel the pain and experience the consequences of domestic far-right terrorism. Supposing academics, community leaders, and elected officials seek to combat the rising threat of far-right extremism in the United States, a greater focus must be paid to the lived experiences of men and women seeking to exit extremist groups. This study aimed to better understand the psychosocial processes involved in the disengagement and/or de-radicalization journey of former far-right extremists. Additionally, this study sought to understand better the potential role social work could play in the disengagement and de-radicalization of far-right extremists seeking to exit a life of hate and extremism. Charmaz’s (2014) grounded theory approach provided the framework for this qualitative study. Semi-structured interviews with 18 former white nationalist extremists recruited through community informants and snowball sampling were used to answer the research question; What are the psychosocial processes involved in the disengagement and de-radicalization journey of former far-right extremists, and how do they develop in society? To date, there has not been a study located utilizing grounded theory in disengagement and de-radicalization studies. Additionally, a theory of disengagement and de-radicalization has yet to be explored. This study sought to explore and conceptualize latent social patterns and structures within the disengagement and de-radicalization journey as a means to construct a theoretical frame to better understand one’s journey from a life of hate. Study findings emerged from over 3,500 coded items from 18 transcripts. Eight themes emerged from the data, and a proposed model conceptualizing the psychosocial processes involved in the journey out of far-right extremism is introduced.
Oppression in Social Work Education: How Do Oppression and Privilege Impact Social Work Educators' Pedagogy?
(2022-09) Rudd, Stephanie Ellen; Hostetter, Carol; Kyere, Eric; Burns, Debra; Khaja, Khadija
Social work has deep roots in and a commitment to social justice and eliminating and addressing the oppression of people of diverse backgrounds. This commitment is based on the National Association of Social Work 2021 Code of Ethics. In order for social workers to learn how to ethically challenge social injustice with cultural humility, they need to develop a high level of self-awareness, or critical consciousness (Freire, 2003) and commitment to marginalized groups. This makes the role of a social work educator a critical one. Social work educators have their own biases and experiences of oppression and privilege. In order to support and prepare social work students with the skills of self-awareness and cultural humility, the educator must analyze their pedagogy, such as the inclusion of Black, Indigenous, and People of color (BIPOC) authors, the use of open dialogue, and engagement in creating and supporting brave spaces, while accurately describing social work history. Specifically, social work educators need to be aware of their social positioning in which oppression and/or privilege shape their realities, since this impacts their sense of self and teaching practices. This proposal seeks to apply qualitative research methods to investigate whether social work educators' social positioning and the associated privilege or oppressive experiences are important to understand their pedagogical and instructional practices/strategies relative to antiracism.
The Experience of Burmese Refugee Students in Higher Education: Blooming out of Concrete
(2022-09) Lim, Minyoung; Adamek, Margaret E.; Pierce, Barbara; Lee, Jessica E.; Huber, Lesa
The United States is the world’s top resettlement country for refugees and the third largest community of Burmese refugees lives in the state of Indiana. Many refugee families look to their college-age youth to enhance their well-being. This study explored the lived experiences of Burmese refugee college students’ resettlement and the role that social support plays in that approach. In order to explore the refugee students’ resettlement experiences and the role of social support, social support theory and conservation of resources theory were used to explain the importance of social support for refugee students’ successful resettlement. A qualitative study using thematic analysis was conducted using 32 in-depth individual interviews with Burmese refugee students in higher education. Through an indepth examination of the lived experiences of Burmese refugee college students’ resettlement, four main themes were identified: challenges of resettlement, resettlement needs, the resources of social support, and resettlement experiences. Refugee students actively cultivated their life and showed aspirations of being successful members of this new environment. Even though they faced many challenges and needs identified through interviews, the participants overcame these barriers including a different culture and language and prosper in their lives in the host country. The social support from the coethnic community and people in the host country both affected the participants’ successful resettlement. Co-ethnic community also plays an important role to pursue higher education. The study findings will be used by social work practice, programs, and policies to improve the success of Burmese refugee students' resettlement. This study would serve as a foundation for enhancing refugee students’ resettlement and understanding the critical role of social support resources during the resettlement period. Burmese refugee students would be an important avenue to develop international relations and achieve social justice. In spite of a variety of barriers and prejudices, Burmese refugee students bloom and flourish in their new environment in the United States. They are beneficiaries but also currently benefactors. The perspectives on refugees need to change and move from victims to the citizens of the world.
The Influence of Social Isolation and Other Risk Factors on Older African Immigrants' Emotional Well-Being
(2022-08) Adeniji, Dolapo Omolola; Adamek, Margaret; Hong, Michin; Gentle-Genitty, Carolyn; Huber, Lesa
Social isolation has been documented as a significant challenge for older adults, including those who are immigrants. The conventional wisdom blames social isolation among older immigrant adults on language barriers, living arrangements, and age at migration, however, this does not allow for analytical clarity on how social isolation interacts with other important risk factors to influence emotional well-being among older African immigrants. This study offers an important contribution to the existing knowledge by examining how social isolation and other risk factors interact to impact emotional well-being among older African immigrants. It uses life course theory, acculturation theory, resilience theory, and cumulative risk theory to identify the relevant stressors or risk factors such as living arrangements, financial satisfaction, acculturation predictors, transportation, and grandchild care. A mixed-methods approach integrating quantitative and qualitative research methods was used in the study. For the collection of quantitative data, 163 participants aged 60 and over completed an online or mailed survey. Hierarchical regression was used to analyze the quantitative data. Findings showed that ethnic social relations and living arrangements had a unique contribution to the social isolation of the participants. Also, social isolation, ethnic social relations, and financial satisfaction significantly influenced the emotional well-being of study participants. For the study’s qualitative data, the researcher conducted in-depth interviews with 11 participants, age 63-79, by telephone. Five major themes were generated from the data using a thematic analysis approach, which included (a) minimal social engagement outside of the home, (b) barriers to social engagement, (c) satisfaction with finances, (d) fewer socialization consequences, and (e) coping strategies. The overall finding showed that the participants lacked social engagement outside of the home, which negatively affected their emotional well-being. Implications for social work practice and policy as well as recommendations were emphasized in the study.
Predictors of Acceptance: Exploring Healthcare-Related Master's-Level Social Workers' Attitudes on Alcohol Use Disorder, Opioid Use Disorder, and Medication-Assisted Treatment
(2022-08) Bartholomew, Joseph Brooks; Carlson, Joan M.; Lay, Kathy; Agley, Jon; Crabb, David; Kim, Hea-Won
Heavy alcohol consumption and opioid overdose rates continue to increase in the United States (U.S.). Social workers provide approximately 70% of the behavioral healthcare in the U.S. Medication-assisted treatment (MAT) combines FDA-approved medications with psychosocial interventions to provide a comprehensive approach to recovery for alcohol use disorder (AUD) and opioid use disorder (OUD). However, stigmatized attitudes toward individuals with AUD, OUD, and MAT limit MAT’s use. Guided by critical social theory, this study explores factors that predict master’s-level social workers’ (MSWs) attitudes toward AUD and OUD and, by extension, factors that predict their acceptance of MAT. A repeated measures analysis of variance (ANOVA) identified MSWs from Indiana, Kentucky, and Ohio (N = 140) having more favorable statistically significant (p < 0.001) attitudes toward individuals with AUD than those with OUD. Multiple regression models used age, gender identity, political ideology, years working in addiction (tenure), social work licensure, and 12-step facilitation beliefs to predict AUD and OUD attitudes, with AUD and OUD attitudes included in the regression models for MAT acceptance. Increased years working in addiction (tenure) was a statistically significant predictor in elevating attitudes toward individuals with AUD (p < 0.05) and OUD (p < 0.01). A more liberal political ideology (p < 0.001), increased years working in addiction (tenure) (p < 0.05), and more favorable attitudes toward individuals with AUD and OUD (p < 0.001) were statistically significant predictors in MAT acceptance. These results warrant increasing MSWs’ education on addiction and research on factors that impact their acceptance of MAT. Increasing MSWs’ education on addiction may lower stigmatized attitudes toward individuals with AUD and OUD and increase MAT acceptance. MSWs’ increased acceptance of MAT could improve patient health outcomes.
Post Liver Transplant Patient Outcomes and Survival: Impact of Demographics and Psychosocial Factors
(2022-08) French, Marcia Mount; Kim, Hea-Won; Adamek, Margaret E.; Glassburn, Susan; Mangus, Richard S.
Many persons with cirrhosis and eventually end stage liver disease (ESLD) are unable to meet the eligibility criteria for becoming a candidate for a liver transplant (LT). Currently, approximately 17,000 persons in the United States (U.S.) need a LT to survive, though only about 8,000 LT’s are performed each year; a LT is the only option for survival. The genesis of ESLD is most typically attributed to alcohol abuse, chronic hepatitis B or C, non-alcoholic fatty liver disease, autoimmune hepatitis, biliary atresia (new-born liver disease), or metabolic disorders. The etiology of adult LT recipients in 2017 for the U.S. were non-alcoholic fatty liver disease (31%) and alcoholic liver disease (25.1%). This study is guided by the Critical Social and Stress Coping Theories to assist in exploring potential health disparities prevalent in LT recipients. The aim of this study is to explore the psychological and demographic characteristics of 1297 LT recipients between 2010-2020 in an Indiana transplant center and identify potential disparities impacting 10-year survival rates. This exploratory, cross-sectional secondary analysis found that race/ethnicity, histories of mental illness, substance use/abuse, social support networks, education, marital status, and insurance sources held no statistical significance for 10-year survival rates. To date the screening process for each of those demographics appears to be effective and efficient. A Cox regression analysis revealed having a history of criminality significantly impacts 10-year survival rates. To address these findings the consideration for increased support and follow-up for patients with a history of criminality may positively impact 10-year survival rates.
Living with Serious Mental Illness, Police Encounters, and Relationships of Power: A Critical Phenomenological Study
(2021-12) Quiring, Stephanie Q.; Kim, Hea-Won; Starnino, Vincent; Sullivan, Patrick; Kennedy, Sheila
The criminalization of mental illness has drawn and kept a disproportionate number of people living with mental illness in jails and prisons across the United States. The criminal legal system is ill-equipped or unequipped to provide meaningful mental health care. Police often serve as gatekeepers to the criminal legal system in the midst of encounters involving people living with serious mental illness. The literature that examines police decision-making amid these highly discretionary encounters has been primarily situated in post-positivist, quantitative methodologies focused on police perspectives. There is a dearth of research with the direct involvement of people living with serious mental illness that employs more advanced qualitative methodologies. The purpose of this study was to understand the lived experience of police encounters from the perspective of people living with serious mental illness through multi-level analysis of the interpersonal and structural contexts which underpin these encounters. This critical phenomenological study used interpretative phenomenological analysis as process. A sample of 16 adults were recruited using purposive and snowball sampling and completed semi-structured interviews. The findings reported two descriptive areas for participants—aspects of serious mental illness and contemplations of power. The findings also included the interpretive analysis organized around six themes that emerged regarding the lived experience of police encounters: (a) significant context, to include serious mental illness, was made invisible, (b) the carceral response to serious mental illness and interpersonal issues, (c) law enforcement’s power to force submission, (d) facets of escalation, (e) law enforcement encounters lacked essential care, and (f) law enforcement encounters served as a microcosm of the criminal legal system. The implications of the study’s findings on police encounters as they are currently framed in the largely post-positivist, quantitative body of research are discussed. In addition, the current wave of national police response models and reform are considered and connected to implications for social work practice. Finally, culminating in the findings’ implications for a growing edge of critical phenomenology that incorporates intersectionality and disciplinary power and the central role of an abolition feminist praxis at the nexus of mental health, crisis response, and collective care.
Learning to Thrive in a Binary World: Understanding the Gendered Experiences of Nonbinary Individuals and Ways to Bolster Wellbeing
(2021-08) Kinney, M. Killian; Victor, Bryan G.; Fortenberry, J. Dennis; Thigpen, Jeffry W.; Wahler, Elizabeth A.
Traditionally, gender has been viewed through an essentialist lens with fixed biology-based traits or polarized gender norms between women and men. As awareness of gender diversity grows, increasingly more people identify as nonbinary – or not exclusively a man or woman. Despite a growing literature on the experiences of binary transgender individuals, little has been explored regarding experiences unique to nonbinary individuals. The research that does include nonbinary individuals focuses primarily on adverse risks and outcomes. As such, a dearth of empirical research exists to understand the unique experiences of nonbinary people and how they relate to wellbeing. A qualitative participatory action study using PhotoVoice was conducted virtually to address the identified gaps in the literature on nonbinary individuals concerning gendered experiences and wellbeing. Prevailing theories of wellbeing informed the study along with minority stress theory and the resilience literature to account for environmental factors of oppression and individual and community resilience. A sample of 17 nonbinary adults in the Midwestern United States was recruited using convenience sampling and participated in online group discussions and individual interviews. The findings were reported in sections corresponding with the three study aims: 1) Explore core dimensions of wellbeing as defined by nonbinary individuals, 2) Identify promotive and corrosive factors of that wellbeing, and 3) Provide recommendations to bolster nonbinary wellbeing. The findings provided a thorough description of how nonbinary individuals perceive their wellbeing concerning their gender and as part of a marginalized population. Thematic analysis identified nine wellbeing themes for how participants conceptualized their wellbeing (e.g., Exploring gender identity and expression, Being connected to community, etc.), seven themes of promotive and corrosive factors of wellbeing (e.g., Positive, accurate, and nuanced representation, Coping skills to manage minority stressors, etc.), and three themes of recommendations (e.g., personal, interpersonal, and professional) with eighteen strategies to bolster wellbeing among nonbinary individuals and communities. The significance of the findings to social work was discussed, including practice application and advocacy. This study contributes to PhotoVoice methodology, wellbeing literature, and trans literature.
Using Technology to Enhance the Well-Being of Caregivers of Persons with Dementia: Implications for Social Work Practice and Policy
(2020-12) Yi, Eun-Hye; Adamek, Margaret E.; Hong, Michin; Wilkerson, David; Lu, Yvonne
Difficulties caring for people living with dementia (PWD) contribute to their family caregivers’ diverse unmet needs and adverse outcomes in health and well-being. This dissertation research explored the influence of macro systems on individual caregivers' well-being reflecting on the prevalence of online use among caregivers. Caregivers have migrated to online platforms to seek support. However, there is limited understanding of how online social support [OnSS] compares to offline support [OffSS] in terms of caregivers’ well-being. The first study examined the associations of OnSS and OffSS with the psychological well-being [MH] of caregivers. A subsample of the Health Information National Trends Survey (HINTS) from 2017 to 2018 (n=264) was analyzed. The data indicate that OnSS supplemented rather than replaced OffSS. Emotional support delivered offline had a positive direct association with MH, while OnSS did not. OffSS interacted with caregiving stressors while OnSS interacted with life stressors. Caregivers who are in less favorable situations, such as working part-time while caring for a PWD, living with economic hardship, and being unhealthy, tended to be significantly affected by OnSS. The results suggest that practitioners need to incorporate caregivers’ OffSS into OnSS to maximize the available support resources, specifically for those who are in less favorable conditions. There is limited understanding of caregivers’ experiences within the complex health care system, especially after the significant policy changes brought about by the Affordable Care Act (ACA). The second study analyzed caregivers’ perceptions of and experiences with the ACA using national online forum data posted in 2011-2017 (n=514 posts). Text-mining thematic analysis method was used to analyze the posts. Three overall themes emerged: (a) concern about cost implications of placement decisions for care recipients, (b) skepticism about government and healthcare system support of their caregiving roles, and (c) caregivers’ own well-being and concerns about health insurance. Efforts are needed to enhance clear and effective communication among policymakers and health professionals serving service users, including caregivers of PWD. The present dissertation provides preliminary evidence to increase understanding of the complex contexts that affect the overall well-being of caregivers. Implications and suggestions for practitioners, policymakers, and researchers are discussed.
Women's Perspectives on Social Change in Saudi Arabia
(2020-08) Alhajri, Wafa; Khaja, Khadija; Pierce, Barbara; Adamek, Margaret E.; Seybold, Peter
There are significant social and policy changes that have been made in Saudi Arabia. Some of these changes are relevant to women’s lives. The changes related to the male guardianship system are crucial. Saudi women are restricted by the male dominant culture and face obstacles that hold them accountable to their male guardians. The male guardianship system is tied to heritage, culture, and traditionally ingrained mindsets. This exploratory qualitative study provided a more comprehensive understanding of women’s narratives by focusing on the deep meaning about the effects of the male guardianship system on women’s lives in Saudi Arabia. Sixteen women were interviewed. The finding found that the majority of Saudi women did not perceive the guardianship system as protective or helping women by any means and many had questions about its purpose and relevance. Regarding the legal concept, most women were ambivalent because of recent policy reforms that the government had promised, yet had not implemented it when the data was collected. The religious beliefs surrounding the male guardianship system also varied according to which religious interpretation women and their families followed. The traditional beliefs of the male guardianship system differed among women due to social values which differed from one family to another. This study showed the persistent need to raise awareness among women and men to deconstruct the Saudi culture and reshape the values and norms where women can be respected as individuals so that they could govern their own lives. The findings also showed that the new younger generation in Saudi Arabia are more willing to challenge the Saudi culture and tradition for a better future. They are inspired by the Saudi vision 2030 and the social changes that took place a few years ago to benefit women, extending work opportunities, education, enabling women to do government paperwork themselves, and allowing women to drive and travel without male permission. All these reforms are promising for a better future, but more work, more women voices, and more discussion is needed.

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