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An editorial is presented on the role of critical feminist leadership in social work academia and its impact. Topics include the practice of feminist leadership in academic settings, the challenges and rewards of navigating leadership roles as feminists, and the importance of self-care and community-building among feminist scholars.

AbstractPurposeMaterial and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONThe need for specialized rehabilitation considerations to address racial health disparities and optimize functional outcomes such as participation in daily life for Black people with traumatic brain injury (TBI) has been acknowledged. This study uses anti-racism as an entry point for addressing institutional racism by examining what the experiences of Black survivors of TBI, rehabilitation providers, and family caregivers tell us about imagined possibilities for rehabilitation to promote Black futures.A constructivist-informed narrative inquiry using critical race theory and in-depth narrative interviewing was applied across ten women and four men. Reflexive thematic analysis within and across groups of participants led to conceptualizing two main themes and five sub-themes.Conceptualized themes captured requirements for TBI rehabilitations’ investments in Black futures: (1) the need for critical information and specialized educational supports and particular requirements for supporting participation in meaningful life situations, and (2) responsibilities of delivering rehabilitation care for Black service users.TBI rehabilitation must be tailored to the realities of living while being Black, integrate personal values, beliefs, interests, and equitable supports to maximize optimal functioning and participation if the goal of rehabilitation is community integration for all persons living with the impacts of TBI.Rehabilitation care that challenges institutional racism is fundamental to meeting the unmet functional and participation goals of Black people living with traumatic brain injury.At the individual-level, investments in anti-racist rehabilitation for Black traumatic brain injury service users require attention to clinical encounters between providers and patients and specifically the importance of the therapeutic relationship.Organizational level changes include critical information and education about intersections of race and traumatic brain injury, supporting participation in meaningful life situations, and particular responsibilities for Black and non-Black rehabilitation providers to inspire recovery.Knowledge of the rehabilitation professions requires racial consciousness of the practices, protocols, and guidelines underpinning care and how these bodies of documents reinforce racial health disparities which have implications for training and practice.Rehabilitation care that challenges institutional racism is fundamental to meeting the unmet functional and participation goals of Black people living with traumatic brain injury.At the individual-level, investments in anti-racist rehabilitation for Black traumatic brain injury service users require attention to clinical encounters between providers and patients and specifically the importance of the therapeutic relationship.Organizational level changes include critical information and education about intersections of race and traumatic brain injury, supporting participation in meaningful life situations, and particular responsibilities for Black and non-Black rehabilitation providers to inspire recovery.Knowledge of the rehabilitation professions requires racial consciousness of the practices, protocols, and guidelines underpinning care and how these bodies of documents reinforce racial health disparities which have implications for training and practice. [ABSTRACT FROM AUTHOR]

Social work is a practice-based profession with social justice as a core value and ethical principle. Social work programs incorporate social justice into both the explicit and implicit curricula. However, there has been a longstanding divide in how to address social justice at systemic levels while fostering socially just and competent practice. The aim of this qualitative study was to examine how MSW students describe their learning about social justice and social work practice. To explore this area of inquiry, we conducted three focus groups (N = 16) with current MSW students or recent MSW graduates from Canadian social work programs. Participants described the following five themes that either facilitated or created barriers in their learning about social justice and social work practice: 1) reflection on practice, 2) negotiating discomfort, uncertainty, and safety, 3) learning from lived experiences, 4) learning how to embody social justice in practice, and 5) receiving support, supervision, and coaching. We discuss the implications for social work education and practice. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterial and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONTraumatic brain injury (TBI) is a chronic disease process and a public health concern that disproportionately impacts Black populations. While there is an abundance of literature on race and TBI outcomes, there is a lack of scholarship that addresses racism within rehabilitation care, and it remains untheorized. This article aims to illuminate how racism becomes institutionalized in the scientific scholarship that can potentially inform rehabilitation care for persons with TBI and what the implications are, particularly for Black populations.Applying Bacchi’s What’s the Problem Represented to be approach, the writings of critical race theory (CRT) are used to examine the research about race and TBI rehabilitation comparable to CRT in other disciplines, including education and legal scholarship.A CRT examination illustrates that racism is institutionalized in the research about race and TBI rehabilitation through colourblind ideologies, meritocracy, reinforcement of a deficit perspective, and intersections of race and the property functions of whiteness. A conceptual framework for understanding institutional racism in TBI rehabilitation scholarship is presented.The findings from this article speak to the future of TBI rehabilitation research for Black populations, the potential for an anti-racist agenda, and implications for research and practice.Critical race theory contributes to a comprehensive understanding of racism in the literature about race and traumatic brain injury (TBI) rehabilitation by asking how racism operates in the scholarship, including methods, analyses, interpretations, and conclusions.Applying a critical race theory lens in TBI rehabilitation has the potential to inform antiracist scholarship that holds important implications for critical rehabilitation research, practice, professional training, and policy.Implications for rehabilitation practice include opening up opportunities to address how race and racism shape rehabilitation outcomes to imagine different possibilities, programs, and futures for Black people with TBI with various communities of practice.Critical race theory contributes to a comprehensive understanding of racism in the literature about race and traumatic brain injury (TBI) rehabilitation by asking how racism operates in the scholarship, including methods, analyses, interpretations, and conclusions.Applying a critical race theory lens in TBI rehabilitation has the potential to inform antiracist scholarship that holds important implications for critical rehabilitation research, practice, professional training, and policy.Implications for rehabilitation practice include opening up opportunities to address how race and racism shape rehabilitation outcomes to imagine different possibilities, programs, and futures for Black people with TBI with various communities of practice. [ABSTRACT FROM AUTHOR]

Purpose: Sexual and gender minority and racialized populations experienced heightened vulnerability during the Covid-19 pandemic. Marginalization due to structural homophobia, transphobia and racism, and resulting adverse social determinants of health that contribute to health disparities among these populations, were exacerbated by the Covid-19 pandemic and public health measures to control it. We developed and tested a tailored online intervention (#SafeHandsSafeHearts) to support racialized lesbian, gay, bisexual, transgender, queer, and other persons outside of heteronormative and cisgender identities (LGBTQ+) in Toronto, Canada during the pandemic. Methods: We used a quasi-experimental pre-test post-test design to evaluate the effectiveness of a 3-session, peer-delivered eHealth intervention in reducing psychological distress and increasing Covid-19 knowledge and protective behaviors. Individuals ≥18-years-old, resident in Toronto, and self-identified as sexual or gender minority were recruited online. Depressive and anxiety symptoms, and Covid-19 knowledge and protective behaviors were assessed at baseline, 2-weeks postintervention, and 2-months follow-up. We used generalized estimating equations and zero-truncated Poisson models to evaluate the effectiveness of the intervention on the four primary outcomes. Results: From March to November 2021, 202 participants (median age, 27 years [Interquartile range: 23–32]) were enrolled in #SafeHandsSafeHearts. Over half (54.5%, n = 110) identified as cisgender lesbian or bisexual women or women who have sex with women, 26.2% (n = 53) cisgender gay or bisexual men or men who have sex with men, and 19.3% (n = 39) transgender or nonbinary individuals. The majority (75.7%, n = 143) were Black and other racialized individuals. The intervention led to statistically significant reductions in the prevalence of clinically significant depressive (25.4% reduction, p <.01) and anxiety symptoms (16.6% reduction, p <.05), and increases in Covid-19 protective behaviors (4.9% increase, p <.05), from baseline to postintervention. Conclusion: We demonstrated the effectiveness of a brief, peer-delivered eHealth intervention for racialized LGBTQ+ communities in reducing psychological distress and increasing protective behaviors amid the Covid-19 pandemic. Implementation through community-based organizations by trained peer counselors supports feasibility, acceptability, and the importance of engaging racialized LGBTQ+ communities in pandemic response preparedness. This trial is registered with ClinicalTrials.gov, number NCT04870723. [ABSTRACT FROM AUTHOR]

This qualitative study used the long interview method with Canadian mothers of African and Caribbean descent to understand the underresearched experience of raising a child with sickle cell disease (SCD). Mothers' realities were explored through three levels of social organization: daily caregiver coping (micro level); community views of SCD, such as stigma (meso level); and systemic SCD health care provision (macro level). Through the use of population health and structural social work perspectives, mothers' experiences were examined in the context of perceived gender and racial oppression. Saturation was achieved after initial interviews with 10 participants and a four-month postinterview with half of the participants. Mothers commonly reported several daily coping challenges: fear of their children's death, separation anxiety, loss of control over life, helplessness, and loneliness/isolation. SCD stigma interacted with racism, contributed to social isolation, and prevented families from organizing as a group. All mothers perceived racism as a salient factor behind inadequate mainstream SCD health care. Recommendations to improve SCD health care and implications for social work practice and research are discussed. This is the first known Canadian psychosocial study of SCD and investigation into SCD stigma outside of rural Nigeria.

OBJECTIVES: Black women in Canada are at disproportionately high risk for HIV. We assessed HIV vaccine acceptability and correlates of acceptability among Black women from African and Caribbean communities in Toronto. METHODS: 'Sisters, Daughters, Mothers, and Aunties' was a community-based research project. Black women of African and Caribbean descent were recruited using venue-based sampling across diverse community organizations in Toronto. We used a structured questionnaire to collect data on sociodemographic characteristics and acceptability of 8 future HIV vaccines, each defined by a set of 7 dichotomous attributes. Conjoint analysis was used to quantify the relative impact of vaccine attributes on acceptability, with multiple regression to adjust for socio-demographic characteristics associated with overall acceptability. RESULTS: Mean vaccine acceptability was 58.8 (SD = 17.2) on the 100-point scale. Efficacy had the greatest impact on acceptability, followed by side effects, cost, duration of protection, and number of doses. Acceptability of a high (99%) efficacy vaccine (70.1/100) was significantly greater than for a 50% efficacy vaccine (47.6/100). Vaccine acceptability was significantly higher among women of Caribbean versus African descent, ever married versus single women, and women with full-time versus part-time employment. CONCLUSIONS: Black women in Toronto indicated a modest level of acceptability for future HIV vaccines. Educational interventions that address the benefits of partially efficacious vaccines and clearly explain potential side effects, as well as vaccine cost subsidies may promote HIV vaccine uptake. Differences in acceptability within Black communities suggest that tailored multi-level interventions may mitigate barriers to uptake. KEY WORDS: AIDS vaccines; acceptability of healthcare; conjoint analysis; African, Caribbean and other Black women; Canada OBJECTIFS : Le risque de contracter le VIH est demesurement plus eleve chez les femmes noires au Canada. Nous avons evalue l'acceptabilite des vaccins anti-VIH et les correlats de cette acceptabilite chez les femmes noires des communautes africaines et caribeennes de Toronto. METHODE : [much less than] Sisters, Daughters, Mothers, and Aunties >> est le nom d'un projet de recherche communautaire. Des femmes noires d'ascendance africaine et caribeenne ont ete recrutees par echantillonnage dans les lieux de rencontre de divers organismes communautaires de Toronto. Nous avons utilise un questionnaire structure pour recueillir des donnees sur les caracteristiques sociodemographiques et l'acceptabilite de huit futurs vaccins anti-VIH, chacun etant defini par un ensemble de sept attributs dichotomiques. Une analyse conjointe a servi a chiffrer l'impact relatif des attributs des vaccins sur leur acceptabilite, et nous avons fait appel a la regression multiple pour tenir compte des caracteristiques sociodemographiques associees a leur acceptabilite globale. RESULTATS : L'acceptabilite moyenne des vaccins etait de 58,8 (ecarttype de 17,2) sur une echelle de 100 points. L'efficacite potentielle du vaccin avait le plus grand impact sur son acceptabilite, suivie par ses effets secondaires, son cout, sa duree de la protection et son nombre de doses. L'acceptabilite d'un vaccin a haute (99%) efficacite potentielle etait significativement plus elevee (70,1/100) que celle d'un vaccin a l'efficacite potentielle de 50% (47,6/100). L'acceptabilite des vaccins etait significativement plus elevee chez les femmes d'origine caribeenne que chez celles d'origine africaine, chez les femmes ayant ete mariees que chez les celibataires, et chez les femmes ayant un emploi a plein temps plutot qu'un emploi a temps partiel. CONCLUSIONS : Le niveau d'acceptation des futurs vaccins anti-VIH par les femmes noires de Toronto est modeste. Des interventions educatives qui portent sur les avantages des vaccins partiellement efficaces et qui expliquent clairement leurs effets secondaires potentiels, ainsi que des subventions au cout des vaccins, pourraient favoriser le recours aux vaccins anti-VIH. Les ecarts dans les niveaux d'acceptabilite au sein de la communaute noire montrent que des interventions multiniveaux adaptees pourraient attenuer les obstacles a l'acceptation de ces vaccins. MOTS CLES : vaccins contre le SIDA; acceptation des soins; analyse conjointe; femmes africaines, caribeennes et autres femmes noires; Canada, HIV vaccine development is well underway with a recent large-scale clinical trial indicating efficacy for the first time, although insufficient for public licensure. (1) Although current HIV preventive interventions and [...]

This paper examines insight into mental illness, particularly as it applies to people diagnosed with schizophrenia. The paper argues that insight should be reconceptualized as a component of post-diagnosis identities that are defined in relation to other social identities, and under conditions of stigma against mental illness. The proposed conceptualization suggests there are at least four possibilities for post-diagnosis identities in schizophrenia: engulfed, resistant, detached, and empowered. Revising the insight concept to integrate the influence of social context and the potential for multiple post-diagnosis identities could be the basis for therapeutic dialogues with individuals about the implications that diagnosis has for their lives.

This qualitative study used the long interview method with Canadian mothers of African and Caribbean descent to understand the underresearched experience of raising a child with sickle cell disease (SCD). Mothers' realities were explored through three levels of social organization: daily caregiver coping (micro level); community views of SCD, such as stigma (meso level); and systemic SCD health care provision (macro level). Through the use of population health and structural social work perspectives, mothers' experiences were examined in the context of perceived gender and racial oppression. Saturation was achieved after initial interviews with 10 participants and a four-month postinterview with half of the participants. Mothers commonly reported several daily coping challenges: fear of their children's death, separation anxiety, loss of control over life, helplessness, and loneliness/isolation. SCD stigma interacted with racism, contributed to social isolation, and prevented families from organizing as a group. All mothers perceived racism as a salient factor behind inadequate mainstream SCD health care. Recommendations to improve SCD health care and implications for social work practice and research are discussed. This is the first known Canadian psychosocial study of SCD and investigation into SCD stigma outside of rural Nigeria. KEY WORDS: coping; illness stigma; mothers; sickle cell disease; social inequality, Sickle cell disease (SCD) is the most prevalent genetic hematological disorder worldwide (Baskin et al., 2000), predominantly affecting populations of West African and African Caribbean descent, as well as populations [...]

An organization of cultural competence strategies into epistemologically defined paradigms for multicultural practice is presented. They are presented as potential tools for developing a better understanding of what constitutes effective multicultural practice and what contributes to cultural impasses.

Understanding the dynamics of caregiving is essential to providing effective support to individuals and families living with serious mental illnesses. Yet, research in this area has typically explored caregiving without consulting mentally ill people. This paper adds this overlooked viewpoint by exploring the experience of care relationships by people diagnosed with schizophrenia. A secondary analysis of interview data from 21 individuals reveals that relevant dimensions of care relationships include: providers of care; types of care received; self-care; contested practices in care; negotiating practices; recipients of care; and types of care provided to other people. Addressing care within this broader conceptualization can contribute to developing interventions for individuals and families that more fully recognize the potential for people with mental illnesses to be active participants in care relationships.

This paper reviews the experience of evaluating a cultural competence workshop series for social workers practicing in a mental health care setting. The study used a pretest-posttest nonequivalent comparison group design, and evaluation was based on both quantitative and qualitative data collections. Between subjects analyses suggested that there were no differences between the intervention and comparison group alter the intervention was completed, but within-subjects analyses revealed that the intervention group had made superior gains in their scores on the Awareness subscale of the Multicultural Counseling Inventory. Qualitative data contributed additional information about important individual and group processes that affected the experience of training and contributed to self-reported outcomes from training. The study suggests that evaluating process and outcomes of training at both the individual and group levels may be particularly important to understanding how cultural competence develops for social work practitioners in interdisciplinary settings. KEYWORDS. Cultural competence, workshops, mental health care, interdisciplinary settings, racial and ethnic diversity

Ce papier examine la violence faite aux femmes dans le contexte de la sante mentale en etudiant les cas d'aide apportee au malade par les membres de la famille. L'histoire [...]

The International Pilot Study of Schizophrenia has had a major influence on mental health and research practice since its inception in the 1960s. It is most famous for demonstrating superior outcomes for people living with schizophrenia in developing countries over those living with schizophrenia in developed countries. Like other international research initiatives, it has been shaped by social, political and economic circumstances that contribute to positive and negative outcomes for participating nations. This paper evaluates the contribution of the pilot study by analyzing the discourse surrounding the dissemination of its results. The discussion of long-term outcomes across cultures is used to scrutinize the process of long-term research collaborations across nations. Discourse analysis of the research records indicates that, in various ways, the discourse was constructed to preserve an image of Western superiority and Third World inferiority. As the international research context shifts in psychiatry, it is hoped that inequitable practices that affect this and other studies will be challenged to benefit knowledge-building and mental health care across the world. Keywords: International research; Schizophrenia; IPSS; Postcolonialism; Discourse analysis

This paper presents my reflections on the use of critical oral history method for a participatory, community-based international LGBT human rights research project. Although critical oral history method has been promoted as an empowering research method particularly suited to advocacy work, I describe emerging dilemmas around naming the work, assuming risks and understanding the method as a medium with potential for reifying existing power imbalances. I advocate for more complicated understandings of how critical research is not defined by the method, but instead, by the processes surrounding it. [ABSTRACT FROM AUTHOR]