CLINICAL SOCIAL WORK WITH INDIGENOUS CHILDREN AND YOUTH

by

Rebecca Carr
B.A. (Honours) Psychology, Memorial University of Newfoundland, 2016
B.S.W, Memorial University of Newfoundland, 2018

PRACTICUM REPORT SUBMITTED IN PARTIAL FULFILMENT OF
THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF SOCIAL WORK
IN
SOCIAL WORK

UNIVERSITY OF NORTHERN BRITISH COLUMBIA
November 2021

© Rebecca Carr, 2021

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Table of Contents
ABSTRACT ....................................................................................................................... 4
ACKNOWLEDGEMENTS ............................................................................................. 5
DEDICATION................................................................................................................... 6
CHAPTER 1: INTRODUCTION.................................................................................... 7
PLACEMENT AGENCY ..................................................................................................... 7
SERVICES PROVIDED ....................................................................................................... 9
CARRIER SEKANI FAMILY SERVICES MISSION .............................................................. 10
LEARNING GOALS ......................................................................................................... 10
CHAPTER 2: PERSONAL POSITIONING & THEORETICAL ORIENTATION.13
PERSONAL POSITION .................................................................................................... ..13
THEORETICAL ORIENTATION ......................................................................................... 15
CHAPTER 3: LITERATURE REVIEW .................................................................... 18
CHILD AND YOUTH MENTAL HEALTH IN CANADA ....................................................... 18
INDIGENOUS CHILD AND YOUTH MENTAL HEALTH ....................................................... 19
THE IMPORTANCE OF PROVIDING SERVICES TO CHILDREN AND YOUTH ....................... 21
PRACTICE CONSIDERATIONS FOR CLINICAL SOCIAL WORK WITH INDIGENOUS PEOPLES 22
CHAPTER 4: LEARNING EXPERIENCE FROM PRACTICUM .......................... 32
PROFESSIONAL IDENTITY AS A CLINICAL SOCIAL WORKER ............................................. 32
PRACTICE ENVIRONMENT ................................................................................................ 36

THE PEOPLE SERVED ....................................................................................................... 38

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CLINICAL SOCIAL WORK LEARNING .............................................................................. 45
CHAPTER 5: IMPLICATIONS FOR PERSONAL PRACTICE ............................ 57
INTERDISCIPLINARY PRACTICE ....................................................................................... 57
HOLISTIC CARE ............................................................................................................... 58
SELF-CARE ..................................................................................................................... 58
CHAPTER 6: CONCLUSION ...................................................................................... 60
REFERENCES ............................................................................................................... 63
APPENDIX ..................................................................................................................... 75

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Abstract
In this report I discuss my practicum experience at Carrier Sekani Family Services and my work
with the Child and Youth Mental Health Team during the summer of 2021. I review the agency I
worked with, including an overview of the services they offer and its mission. My personal
positioning and theoretical orientation are outlined, with a specific focus on how social location
impacts my work, social constructivism, and strength-based framework. A literature review is
provided in which four topics related to my practicum are reviewed: child and youth mental
health, Indigenous child and youth mental health, the importance of providing services to
children and youth, and practice considerations. I discuss my practicum learning experience and
focus on the theme of holistic practice. Finally, I review how my practicum experience will
impact my future practice and how my learning will benefit me and my future clients.

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Acknowledgements
Thank you to my academic supervisor, Dr. Si Transken, for your encouragement,
kindness, and support. I appreciate you most for your perspectives on learning and for always
encouraging me to find joy in the process. Thank you to my committee member, Dr. Susan
Burke, for your knowledge and for encouraging me to always strive for excellence. Your
structured guidance and attention to detail have been very much appreciated.
Thank you to my practicum supervisor, Catherine Weilmeier, for your support, guidance,
and outstanding clinical knowledge. Your mentorship has made me a better clinical social
worker, and I will always be grateful to you. Thank you to Dr. Christina Dobson for playing a
key role in arranging my practicum at Carrier Sekani Family Services. Thank you to the Child
and Youth Mental Health Program for welcoming me to your team and allowing me to learn
from you during my practicum. Thank you to Carrier Sekani Family Services and the clients I
had the opportunity to work with during my time there; it has truly been a privilege.
Thank you to local artist Carla Joseph of Hummingbear Cree-ations for granting me
permission to include her beautiful artwork, We are Found, in this report.
Thank you to my husband, Alex Carr, who has cheered me on throughout my academic
journey and has been my biggest supporter. Your willingness to sit with me in the difficult
moments, celebrate with me during the wonderful moments, and remind me that I am capable
through it all has been such an incredible gift. A final acknowledgement to the people who raised
me; who always instilled in me that I could conquer whatever I put my mind to and to always
“keep the faith”. Thank you to my late mother, Tammy Vokey-Austin, my late grandfather, Roy
Vokey, and my grandmother, Vera Vokey-Andrews; I will forever be grateful for your
unconditional love and support.

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Dedication
To the Indigenous children of Turtle Island, past and present. May the world honour you,
stand with you, and see you for the gifts you are.

We are Found by Carla Joseph (2021)

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Chapter 1: Introduction
This report outlines my learning from my practicum experience with Carrier Sekani
Family Services in the Child and Youth Health and Wellness Counselling Program. The
practicum occurred between May and August 2021 in Prince George, BC. The practicum
focused on clinical social work practice with Indigenous children and youth. This report
discusses the agency with which I was placed and the learning goals I developed for my
practicum experience. This report also reviews my theoretical framework and personal
positioning. A literature review focuses on child and youth mental health, Indigenous child and
youth mental health, the importance of providing services to children and youth, and practice
considerations for working with this population. Lastly, I discuss the learning I gathered from my
practicum experience and its implication for my practice.
Placement Agency
The Carrier and Sekani people are located in north-central British Columbia (Brown,
2002). Their territory spans over 76,000 square kilometers, and there are approximately 22 First
Nations communities who identify as Carrier or Sekani on the terrority (Carrier Sekani Family
Services, 2015). There are 10,000 individuals represented by the Carrier Sekani First Nation
(Carrier Sekani Family Services, 2015). Like many Indigenous communities, the Carrier and
Sekani peoples have experienced hardship due to colonization, such as discrimination, loss of
human rights, oppression, abuse, mistreatment, forced assimilation, and land displacement, all of
which will be discussed in detail in the literature review (Blackstock & Trocmé, 2005; Kirmayer
et al., 2009; McCormick, 2009). Although there has been much devastation, the immense
strength and resiliency of the Carrier and Sekani peoples are evident in their continued efforts to
tackle the negative impacts of colonization (Brown, 2002).

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Figure 1: Carrier Region of British Columbia (Brown, 2002, p. 26)

9
Carrier Sekani Family Services, originally known as Northern Native Family Services,
was created in 1990 (Carrier Sekani Family Services, 2015). Elders and leaders of the Carrier
Sekani Tribal Council recognized that there were numerous issues in Carrier and Sekani
communities resulting from the adverse effects of colonization that made support services
needed. The organization has grown substantially in the last three decades and has expanded its
services. The organization has and continues to create programs that met the Carrier and Sekani
people’s unique needs to provide healing and empowerment. The organization has and continues
to build programs and services that are rooted in Carrier and Sekani knowledge, values, and
culture.
Services Provided
Carrier Sekani Family Services offers a wide range of services and has three primary
offices located in Prince George, Vanderhoof, and Burns Lake (Carrier Sekani Family Services,
2020). These offices also arrange services for surrounding rural and remote communities (Carrier
Sekani Family Services, 2020). Carrier Sekani Family Services offerings include Aboriginal
Patient Liaison Program, Addictions Recovery Program, Aboriginal Supported Child
Development, Best Beginnings Outreach Program, Bridging to Employment, Canadian Prenatal
Nutrition Program, Community Linkages Program, Early Years Centre, Family Empowerment
Supported Visit Program, Family Preservation and Maternal Child Health, Family Support
Program, First Nations Health Benefits and Patient Travel Program, Foster Family Resources,
Guardianship and Voluntary Delegated Child Welfare Services, Health and Wellness
Counselling Program, Home Care, Intensive Family Therapeutic Services, LGBTQ2+ Health
and Wellness, Mediation and Family Justice Services, Mobile Diabetes Program, Primary Care,

10
Safe House Dzee Bayugh, Vanderhoof Indigenous Head Start, Wrap Around Parental Guidance
and Support Program, and Youth Services (Carrier Sekani Family Services, 2021a).
My practicum was completed with the Health and Wellness Counselling Program in
Prince George, and I worked with the Child and Youth Mental Health Team. This team provides
counseling services to children and youth who are experiencing “difficult situations and
emotions” (Carrier Sekani Family Services, 2020, paragraph 1). The program focuses on
providing services and supports that are unique to clients’ needs and do so through culturally
relevant mental health consultations, assessments, and interventions (Carrier Sekani Family
Services, 2020).
Carrier Sekani Family Services Mission
Culture is the core of the programming at Carrier Sekani Family Services, and the
programming aims to provide holistic wellness through the Carrier Life Cycle Model (Carrier
Sekani Family Services, 2021b). The Carrier Sekani Family Services mission statement is as
follows: “With the guidance of our Elders, Carrier Sekani Family Services is committed to the
healing and empowerment of First Nations Families by taking direct responsibility for: health,
social, and legal services for First Nations people residing in Carrier and Sekani territory”
(Carrier Sekani Family Services, 2021b, paragraph 3). Carrier Sekani Family Services asserts
that it provides services that meet high standards and are culturally relevant to serve the Carrier
and Sekani peoples of Northern British Columbia to “create wellness together” (Carrier Sekani
Family Services, 2021b, paragraph 1).
Learning Goals
Practical learning experience is an essential part of becoming a skilled and competent
clinical social worker. As part of my practical learning, I planned my practicum to focus on

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clinical work with children, youth, and their families to enhance my clinical social work skills.
The following goals structured my learning journey during my practicum. My first goal was to
continue to develop my professional identity as a clinical social worker. Second, I sought to gain
familiarity with the practice environment and agency structure. I planned to continue to develop
my clinical social work skills and knowledge of clinical social work, particularly with
Indigenous populations. Last, I wanted to increase my knowledge of various counseling
techniques used specifically with the child and youth populations. These goals guided my
learning during my practicum experience.
The aim to develop my professional identity as a clinical social worker guided me to
ensure I adhered to professional guidelines while also continuing to develop my own identity as
a social worker. This was cultivated by engaging in reflexivity in dedicated periods of reflection,
personal journaling, and planned time for reflective conversations with supervisors and mentors.
Further, I maintained my professional self-care regimen, including taking scheduled breaks,
having firm boundaries with respect to workplace hours, and maintaining a manageable
workload. Last, I maintained ethical standards of practice using the Canadian Association of
Social Workers (2005) Ethical Guidelines and Standards of Practice Guidelines when providing
services to clients.
Growing my familiarity with the practice environment and my placement agency’s
structure helped me understand the nature and forms of community mental health services in a
Delegated Aboriginal Agency. I reviewed the agency’s mandates, policies, and practice manuals.
I also observed and worked collaboratively with mentors, supervisors, and other professionals.
Continuing to develop my clinical social work skills was one central focus of this
practicum. I was able to review theories, frameworks, and knowledge used in clinical social

12
work practice at the agency. I was also able to engage in workplace tasks such as intakes and
clinical interventions to practice skills. Individual and group clinical supervision guided my
practice and allowed me opportunities to review and enhance my application of skills.
Improving my clinical skills and knowledge of clinical social work with Indigenous
populations, in order to provide the most effective and useful services, was an important aspect
of my practicum learning. I sought to gain knowledge and understanding of the Carrier and
Sekani peoples by focusing on their history and culture by acquiring and reviewing historical
documents. Providing culturally safe services was a central pillar of this learning goal which was
defined as “recognizes, respects and nurtures the unique cultural identity of Indigenous peoples
and safely meets their needs, expectations, and rights” (Whanau Kawa Whakaruruhau, 1991, p.
7).
Lastly, I hoped to increase my knowledge of counseling techniques when working with
Indigenous children and youth, both from a Western lens and an Indigenous lens. To achieve this
goal, I was fortune to be able to participate in numerous trainings and events that focused on
counselling techniques for this population. I was also able to complete personal research that
assisted me to engage productively with this goal.

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Chapter 2: Personal Positioning & Theoretical Orientation
Personal Position
Personal positioning is a valuable tool that enables helping professionals to engage in
critical self-reflection to improve their work (Probst, 2015). Using this tool, clinical social
workers can recognize and reflect on how their personal experiences shape their values,
assumptions, and beliefs. It is understood within the profession of social work that the self is a
critical part of our work as social workers because the self can never be removed entirely from
practice (Lynch, 2000; Probst, 2015). Hence, personal positioning creates opportunities to
challenge ourselves and improve our clinical practice.
Some positions I hold include being a clinical social worker who identifies as a
Caucasian and cis-gendered woman who is heterosexual, able-bodied, and Christian. I am also a
feminist, a mental health advocate, a child and youth counselor, happily married, and currently
live a comfortable middle-class life. I currently live in Northern British Columbia. However, I
am from a tiny rural community in Newfoundland, characterised by a strong Christian and
conservative worldview, which is where I lived most of my life. Though my family was very
low-income and struggled significantly economically, particularly during my childhood, I was
raised in a loving and safe home that I will forever be grateful for. I was born in Canada in the
1990s. My ancestors are of Northern European descent and emigrated from England in the 1800s
during what is commonly known as The Great Migration of Canada.
These positions impact how I see the world and live my life. Further, I humbly
acknowledge that my upbringing, culture, and worldviews play a role in my work. When
working with Indigenous peoples or any individuals from a different culture from my own, I
have come to understand the importance of acknowledging my personal positions and taking

14
time, as Baskin (2016) suggests, to reflect on how my respective positioning will be present in
my work. My culture and worldview often differ from those of clients I work with.
Consequently, to work successfully and support Indigenous clients, I must be comfortable with
acknowledging my positions with clients, taking time to understand why these elements may be
of interest to (or be problematic for) clients, and being open to having candid conversations
about how this may influence our therapeutic work.
My interest in clinical social work and mental health was sparked by my own experiences
with mental health in my family. When I was a child, many of my relatives struggled with
mental illness and addiction. However, these issues were never explicitly discussed or addressed.
It was not until adulthood that I became fully aware of the reality and nature of the struggles my
relatives lived with, the tremendous efforts made by my relatives to conceal their struggles, and
their avoidance of professional help and treatment. My culture significantly impacted my
family’s actions; mental illness and addiction were viewed as personal failures and were
considered shameful.
While my interest in the field was grounded in a desire to understand how mental illness
and addictions impacted my family, my focus has evolved into a passion for the field. I have
come to believe in the importance of openly addressing mental health concerns and speaking
about mental health openly. Further, I believe everyone has the right to access supportive and
high-quality mental health and addiction services. I have particular empathy for children and
youth who are experiencing mental health struggles or are indirectly impacted by mental health
and addiction. I consider my work a privilege and hope to spend my career in the mental health
field. I plan to continue to develop my knowledge and expertise to effectively support children,
youth, and families who have similar experiences as my own.

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Theoretical Orientation
In thinking about the overarching theoretical framework through which I interpret my
professional practice, I identify most closely with social constructivism. In the broadest sense,
this framework is built upon the idea that human beings can be understood through relationships
(Witkin, 2012). The beliefs and values that are integral to social constructivism, and that guide
my practice, are as follows: practitioners seek to understand their world, there are multiple
perspectives from which to understand reality, and it is through work with others that reality is
constructed by means of interactions and lived personal experiences (Creswell & Poth, 2017).
Additionally, within this framework the relationship between the client and the practitioner takes
precedence in any intervention (Witkin, 2012).
Practitioners who adhere to this framework often exercise a pragmatic approach to their
work (Witkin, 2012). Social constructivism is an adaptable framework that focuses on how one
can best serve clients in each unique case. Care providers focus on selecting specific approaches
that address the social landscape of the client’s life, they consider existing issues that confront
the client, and they acknowledge context of life stage and time within the client’s life. This
framework is in contrast to other frameworks that are more rigid in their approach and selecting
interventions when working with clients. Witkin (2012) states that the social constructivism
framework operates as an “ever-evolving, co-constructed character of the relationship, not
particular methods or techniques, guides the practitioners’ actions” (p. 3).
Further, my direct clinical practice is heavily influenced by a strength-based framework.
This framework originated in the 1980s and has been considered an overarching framework in
social work practice for decades (Howe, 2009; Saleebey, 2011). The strength-based framework

16
is broadly defined as an approach that focuses on a client’s natural strengths and emphasizes the
client’s self-determination while they work toward self-actualization (Cummins et al., 2012).
The defining features of strength-based framework include a focus on the value of
resilience and resourcefulness that clients have within themselves by virtue of being human
(Howe, 2009). Recognizing that all clients have inherent strengths and then focusing on those
qualities, rather than the client’s limitations, is most productive for promoting healing (Howe,
2009). Social workers must help empower clients to move toward their goals by using a
strengths-driven perspective—recognizing that therapeutic relationships that are collaborative in
nature serve clients best (Howe, 2009). When using this framework, clinicians must ensure
clients take the lead in their own therapeutic work so they can create sustainable change through
problem-solving experiences that foster personal growth and learning (Howe, 2009).
A key aspect of using a strength-based framework in clinical practice is recognition that
the strength-based framework does not encourage clinical social workers to dismiss problems
(Saleebey, 2011). The framework recognizes that exploring issues and problems identified by
clients is essential to conducting successful therapeutic work (Saleebey, 2011). While tackling
problems that clients bring to us, the strength-based framework encourages clinical social
workers to first acknowledge client’s inherent strengths and capabilities that will help them
manage their issues (Saleebey, 2001).
Additionally, this framework is characterized by a pragmatic approach: it recognizes that
clinical social work practice includes multiple interventions, modalities, and therapies. Rapp et
al. (2008) provide guiding principles to identify whether an intervention can be applied
effectively in a strength-based framework. These principles include the idea that intervention
must assess the client’s strengths, capabilities, and resources. The goal of practice is to assist the

17
client in using the knowledge of their strengths to address issues. Intervention focuses on the
client’s self-determination in their therapeutic work. The clinical social worker is primarily a
supporter; ultimately, the decision-making responsibility lies with the client, and it is the role of
the clinical social worker to help the client cultivate that ability. Finally, interventions should
focus on relationship-building because relationships are a source of support, hope, and empathy
for the client.
Both social constructivism and the strength-based framework guide my practice. Social
constructivism is the overarching framework that helps me understand the world and how to
approach work with clients. At the same time, the strength-based framework provides more
specific guidance that directs my clinical practice. Both approaches have similar underpinning
values: focusing on the client and acknowledging them as the expert in their own life while the
clinical social worker maintains a supportive role. These frameworks complement each other and
enhance my practice.

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Chapter 3: Literature Review
Children and youth are a community’s most cherished gifts, and they must be supported
to grow and thrive. This literature review explores child and youth mental health in Canada and
why this population is crucial to address in conversations about mental health. Indigenous child
and youth mental health in Canada is also explored in connection with colonialism and its
impacts on the mental health of contemporary Indigenous children. Finally, practice
considerations relevant to clinical social work with Indigenous peoples will be reviewed.
Child and Youth Mental Health in Canada
It is important to first review definitions and understandings of mental health. In
traditional Carrier society, the concept of mental illness did not exist (Dobson & Schmidt, 2015).
Carrier oral history does reflect that individuals did develop struggles related to wellness, and the
causes of these struggles were related to being out of balance, the loss of spirit, or bad medicine
(Mann & Adam, 2016). Currently, mental illness is recognized by Carrier peoples, but it is
acknowledged that this concept was introduced through colonization (Dobson & Schmidt, 2015).
The mind, body, spirit, and self are understood as interdependent in the Carrier worldview
(Dobson & Schmidt, 2015; Mann & Adam, 2016). Consequently, Carrier peoples view “the
whole person, family, community, natural environment, ancestors, and the spirit world are
involved in maintaining mental health and treating mental illness” (Dobson & Schmidt, 2015,
p. 33). The World Health Organization (2018) provides another definition of mental health,
which is “a state of wellbeing in which an individual realizes his or her own abilities, can cope
with the normal stresses of life, can work productively and is able to make contributions to his or
her community” (paragraph 2).

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Conceptualizations and definitions of mental health vary across cultures, geographical
regions, and generations. Nevertheless, common among various definitions and understandings,
a shared theme is that mental health is an integral part of wellness throughout a person’s life. The
development of mental wellness starts as soon as a person is born and continues to fluctuate
throughout the lifetime as a fluid state (Kostouros & Thompson, 2018). Positive long-term
mental health is associated with increased positive life outcomes for children and youth, such as
positive social relationships, increased self-confidence, increased overall happiness, higher
likelihood of finishing high school, and, eventually, increased income potential (Bulter & Pang,
2014). When a child’s or youth’s mental health is suboptimal for extended periods of time, this
condition is associated with less desirable outcomes such as lower life-satisfaction rates, a
greater risk of physical health problems, reduced likelihood of finishing high school, and
decreased income potential (Bulter & Pang, 2014).
Mental health issues are the leading health problem for children and youth (Waddel et al.,
2005). It is estimated that in Canada 1.2 million children and youth are affected by mental illness
(Mental Health Commission of Canada, 2019). Seventy percent of mental health problems arise
during childhood and adolescence (Mental Health Commission of Canada, 2019). However, less
than 20 percent of the children and youth impacted by mental health struggles receive the
supports and services they need (Mental Health Commission of Canada, 2019). The vast number
of children and youth who experience mental health struggles is a significant cause for concern
in Canada and remains an important issue to be aware of and attend to.
Indigenous Child and Youth Mental Health
In 2016, Indigenous children represented 7% of Canada’s child population (Statistics
Canada, 2017). Among children and youth experiencing mental health struggles in Canada,

20
Indigenous children and youth experience a higher occurrence of mental health struggles than
their non-Indigenous counterparts (Atkinson, 2017; Kirmayer et al., 2009). Indigenous children
are also at significantly higher risk of mental health issues, in both quantity and severity, than
their non-Indigenous counterparts (Adelson, 2005; Ning & Wilson, 2012; Young, 2003).
In discussing the mental health of Indigenous children and youth in Canada, it is
impossible to understand the landscape of the issue without discussing intergenerational trauma.
Indigenous peoples have had a unique experience among ethnic groups in Canada. Through
colonization, Indigenous peoples have endured remarkable hardship, loss, and pain (Blackstock
& Trocmé, 2005). For example, Indigenous people have experienced losses of land and culture
and human rights; the break-up of families caused by the residential school system; and
discrimination, racism, oppression, abuse, and mistreatment (Blackstock & Trocmé, 2005;
Kirmayer et al., 2009; McCormick, 2009). Colonization in Canada attempted to dismantle
Indigenous culture, displace Indigenous people from the lands they occupied, and assimilate
Indigenous peoples entirely into Western culture (Woroniak & Camfield, 2013). Canada as we
know it would not exist without stolen access to Indigenous peoples’ lands and resources, and
the unjust actions taken against Indigenous peoples as part of the colonization process (Woroniak
& Camfield, 2013). The trauma and ongoing problems that colonization engendered continue to
have significant impacts on Indigenous families today, including the most recent generation of
Indigenous children and youth (Brady, 2015; Quinn, 2007).
Few Indigenous children today have had the opportunity to learn their culture or to be
part of a strong, healthy family, or, for that matter, a strong community system, and these deficits
are due to the impacts of colonization (Menzies, 2010). Understanding intergenerational trauma
helps us understand why Indigenous children and youth experience more mental health struggles

21
than their non-Indigenous counterparts (Menzies, 2010). In addition, such knowledge assists our
understanding of how to provide support to Indigenous children and youth struggling with
mental health challenges (Menzies, 2010).
The Importance of Providing Services to Children and Youth
The onset of mental illness in Canada typically occurs before the age of 25 (Malla et al.,
2018). Most mental health difficulties start to become apparent in childhood and early
adolescence (Ellis et al., 2014). A period of opportunity exists during childhood and
adolescence—between the ages of 4 and 17—to promote mental health and provide critical
interventions that might prevent the onset of mental illness or could potentially reduce the
severity of mental illness if it occurs (McGorry et al., 2007). For example, Malla et al. (2018)
reported that when children and youth have access to assessment, diagnosis, intervention, and
support services by the age of 12, there is a significant increase in positive outcomes associated
with mental health. Research indicates the Canadian government should make Indigenous child
and youth mental health a priority in the development of health care services and policy (Malla et
al., 2018). Given the unique experiences of Indigenous children and youth associated with
colonization and other risk factors such as high rates of poverty, geographical challenges, and
restricted access to health care services among Indigenous populations, the importance of
providing timely strength-based high-quality mental health supports and services for Indigenous
children and youth in Canada should clearly be a national priority (Walker et al., 2018).
A thorough understanding of Indigenous history, colonization, and intergenerational
trauma can help clinical social workers better understand the immense difficulties confronting
Indigenous children, youth, and their caretakers (Cook et al., 2005; Fox et al., 2015). However, it
is also vital to recognize Indigenous peoples’ resilience and strength when asked to provide

22
support. Despite challenging and tragic circumstances, Indigenous peoples continue to push
forward, fight for their rights, maintain as much of their culture as possible, and rebuild their
communities (Blackstock, 2009). Blackstock (2009) quotes many Indigenous elders who state, in
essence, “we did not get here alone, and we are not leaving alone” (p. 34). Non-Indigenous
professionals in the mental health field need to consider our roles as supporters and allies of
Indigenous peoples and look to Indigenous leaders, Elders, and knowledge holders to guide how
we can best support Indigenous children and youth (Blackstock, 2009).
Practice Considerations for Clinical Social Work with Indigenous Peoples
Clinical social work practice plays an important role in providing mental health support
to Indigenous peoples and can be broadly defined as “the application of social work principles to
the broad scope of mental health treatment” (Groshong, 2009, p. 7). Practice in this area of social
work focuses on building therapeutic relationships as the foundation upon which supporting
clients is grounded (Groshong, 2009). Clinical social work practice identifies clients in both their
environmental contexts and as individuals; this occurs in conjunction with the use of robust
ethical frameworks to guide practice (Groshong, 2009).
In conversations about clinical social work, it is essential to acknowledge that mental
health services have not been, historically, a context in which Indigenous voices or needs have
been valued and validated as they ought to have been (Lavallee & Poole, 2010). Literature also
demonstrates that many Indigenous people have had negative experiences when accessing
mental health support, especially from non-Indigenous professionals (Nuttgens & Campbell,
2010). Further, Indigenous peoples have, in some cases, avoided seeking support because
services have not provided in a culturally safe and respectful manner (Dion Stout et al. 2001;
Nuttgens & Campbell, 2010). Hence, for any clinical social worker—especially those who are

23
non-Indigenous, such as myself—it is vital to consider how clinical social work can be improved
to more effectively support Indigenous clients and ensure ethically sound services are provided.
Such an objective starts with reflection on one’s personal practice.
Cultural safety is a helpful concept when working with Indigenous peoples. The notion
was created in New Zealand by Indigenous nursing leaders, and it functions as a critical lens
through which to analyze how helping professions—specifically professionals who are nonIndigenous—provide services for Indigenous peoples (Ramsden, 2000). The purpose of this lens
is to aid professionals’ critical evaluation of their practice and improve it (Ramsden, 2000).
Cultural safety is meant to improve services and support for Indigenous peoples and other clients
with cultural backgrounds that differ from the helping professional (Ramsden, 2000).
Cultural safety has been adopted as a tool around the world and particularly in Canada. It
is a versatile approach that is applicable across many professions, environments, and geographic
regions (Brascoupé & Walters, 2009). Current literature is available to guide how clinical social
workers can implement the concept in their work; it focuses primarily on guiding nonIndigenous helping professionals in using the cultural safety lens when supporting Indigenous
people.
A significant part of applying cultural safety to practice includes reflexivity in practice.
Reflexivity has long been recognized as a useful tool in social work contexts for improving
practice and helping practitioners provide ethical support to clients (Probst, 2015). When using
reflexivity within a cultural safety lens, there are two elements to consider. The first is that the
clinical social worker must take the time to identify and acknowledge their assumptions, beliefs,
and values (Syme & Browne, 2002). In the context of clinical work, the worker should focus on
their own understanding of mental health, particularly the definitions and origins of their

24
understandings (Syme & Brown, 2006). The goal is to help the worker recognize that their
understanding of mental health is based on their unique experience and is not an ultimate,
objective truth (Syme & Browne, 2006). Second, the clinical social worker must come to
understand how each individual client views mental health, what is important to them in their
relationship with their mental health, and how the clinical social worker can support the client’s
needs (Syme & Browne, 2006). The goal is to use reflexivity to address cultural differences that
may be present between the clinical social worker and the client (Ball, 2008; Syme & Browne,
2006).
Another significant aspect of applying cultural safety to practice includes addressing
internalized racism and bias among clinical social workers (Gray & Hetherington, 2016;
Ramsden, 2000). This process can be very labour-intensive and emotionally challenging (Gray &
Hetherington, 2016). However, it is a critical therapeutic component that helps workers avoid
unintentionally continuing oppression in their practice. Further, this process is particularly
important for non-Indigenous clinical social workers who work with Indigenous populations. In
this process, social workers take time to analyze themselves, their work, and their practice
environment for oppressive or harmful practices that continue structural racism (Ramsden,
2000). Consciously and consistently addressing internalized racism and bias can begin to
challenge and change oppressive practices and attitudes and dismantle harmful ideas that might
otherwise be perpetuated (Ramsden, 2000).
A second valuable consideration in clinical social work with Indigenous people is TwoEyed Seeing. Elder Dr. Albert Marshall introduced Two-Eyed Seeing approach in 2004 (Reid et
al., 2020). Two-Eyed Seeing (Etuaptmumk in MiKmaq) “embraces learning to see from one eye
with the strengths of Indigenous knowledge and ways of knowing, and from the other eye with

25
the strengths of mainstream knowledge and ways of knowing, and to use both these eyes together
for the benefit of all” (Reid et al., 2020, p. 1). This approach offers valuable knowledge to
clinical social workers, particularly when working in environments with multiple cultural
backgrounds and experiences.
The Two-Eyed Seeing approach offers an alternative to traditional clinical social work
practice. In Canada, many mainstream approaches to mental health in clinical social work
practice and training are rooted in Western culture (Stewart et al., 2016). While Western
approaches have value and can help support Indigenous peoples, it is recognized by the social
work profession that using only Western approaches in clinical social work is very limiting.
Indigenous peoples had employed their knowledge and understanding of how to maintain
wellness for generations before contact with European settlers; that knowledge and historical
practice can offer social work professionals much insight into Indigenous approaches to mental
health (Baskin, 2016, McCormick, 2009). Indigenous approaches to mental health have also been
incorporated into practice such as land-based healing programs and have generated many
positive outcomes (Baskin, 2016). Utilizing the strengths and benefits of both Indigenous and
Western approaches when working in mental health, as the Two-Eyed Seeing approach suggests,
creates more effective supports and better outcomes when working with both Indigenous and
non-Indigenous clients (Baskin, 2016; McCormick, 2009).
A third valuable consideration for clinical social work with Indigenous children and
youth—in particular—is trauma-informed practice. As discussed, many Indigenous children and
youth have experienced trauma in some form because of colonialism’s values, practices, and
impacts. Hence, it is essential to incorporate trauma-informed practice in therapeutic work with
this population. Trauma-informed practice is a strength-based lens that is used to understand and

26
recognize how trauma impacts clients and to then create therapeutic environments that are safe
and supportive for those who have experienced trauma (Poole et al., 2017). An essential aspect
of trauma-informed practice is understanding that trauma impacts people in unique and complex
ways, and can impose adverse impacts on individuals’ functioning in daily life (Poole et al.,
2017).
There are four guiding principles in trauma-informed practice. The first is that the
practitioner must be aware of the nature of trauma (Poole et al., 2017). This principle implies that
the practitioner knows what trauma is, the commonness of trauma experiences, how trauma can
impact a person’s brain and daily functioning ability, and the relationship between trauma and
physical and mental health concerns. Further, the practitioner acknowledges that trauma creates
survival instincts that were critical during those periods when trauma events occurred, and that
that knowledge should be honored (Zingaro, 2012).
The second guiding principle in trauma-informed practice is the importance of creating
an environment that cultivates safety and trust (Poole et al., 2017). By its very nature, trauma
creates an environment in which a client was once deprived of safety, a condition that often
trains the brain to be hypervigilant to threats in the environment to maximize protection and
safety (Steele & Malchiodi, 2012). Hence, to support a client, practitioners must first start by
creating physical, emotional, spiritual, and cultural safety in the environments where we serve
clients who have experienced trauma. The practitioner should be aware of how they present
themself and ensure they do their best to prevent causing distress accidentally (Crisis and
Trauma Resource Institute, 2019). For example, ensuring there is always a clear path to an exit,
asking the client clearly and directly about their preferences regarding seating or lighting, being

27
mindful of tone and volume when speaking, and being aware of facial expression (Crisis and
Trauma Resource Institute, 2019).
Third, cultivating collaboration and connection while providing services is a guiding
principle of trauma-informed practice (Poole et al., 2017). Trauma-informed practice is a
strength-based framework. Hence, clients are always recognized as the experts in their respective
healing journeys. Within trauma-informed practice services, the practitioner works
collaboratively with children, youth, and their families. It is important that clients feel connected
and secure within the therapeutic relationship to create a safe space for healing in which the
client’s choices are prioritized.
The fourth guiding principle of trauma-informed practice is competency in professional
practice (Poole et al., 2017). This guideline is accomplished by ensuring the use of evidencebased interventions in practice. When working with clients who have experienced trauma,
practitioners must take great care to ensure they do not cause additional harm to the client, such
as retraumatizing. Hence, practitioners must ensure they have the knowledge and skills to serve
clients effectively and safely when doing trauma work. In addition, practitioners must adhere to
professional guidelines of practicing within their individual scope.
Allyship is a fourth valuable consideration for clinical social work when working with
Indigenous peoples. Allyship refers to the relationship that is built when non-Indigenous people
support Indigenous people in their efforts to claim their rights (Baskin, 2016). How to be an ally
as a non-Indigenous clinical social worker—in particular, identifying the actions, thoughts, and
values that define an ally, is complex. However, striving to be an ally as a person and as a
professional is important in the pursuit of social justice and in efforts to improve society as a
whole (Baskin, 2016).

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In examining allyship, it is vital to acknowledge the roles that of privilege, power, and
social location play. Non-Indigenous people must be willing to explore and acknowledge their
position in relation to colonization and oppression—that is, specifically, how they have benefited
from colonization within Canada (Baskin, 2016). This process is often emotionally distressing,
but it is a vital step in the process of becoming an ally. This process needs to be ongoing.
Critically, it is a process that must be conducted authentically (Baskin, 2016). It should not be
undertaken with the aim to either avoid feelings of guilt or to gain praise from peers or clients
(Baskin, 2016). Clinical social workers must reflect on and acknowledge the power and
privileges they benefit from in their personal and professional lives.
Baskin (2016) suggests that non-Indigenous people should adopt several objectives as
they strive to be allies to Indigenous people. First, they should adopt a learning stance: Allies
must grow their knowledge of Indigenous cultures, history, and current issues. As they do so, it
is important to recognize that this process is the sole responsibility of the learner, who must
actively seek out knowledge; it is not the responsibility of Indigenous peoples to educate others.
Second, allies should always be mindful that the aim is to be supportive. Allies recognize that
Indigenous peoples are experts of their experiences, and the role of allies is to support
Indigenous agendas in ways that Indigenous peoples see fit. Third, allies must recognize that
action is required to sustain allyship. Being an ally is not a passive role, and allies must take
concrete actions to support Indigenous people and their work in addressing colonization, racism,
and oppression.
A final consideration for clinical practice is telehealth practice. At the time of writing this
report, the Coronavirus (COVID-19) continues to cause a global pandemic (Government of
Canada, 2020). In Canada, governments and health officials continue to guide the public in

29
navigating day-to-day life while living with the threat of COVID-19. Like many other care
professions, the landscape of mental health services has been greatly impacted by COVID-19.
Many mental health professionals are utilizing telehealth, which is defined as “any health-related
service that is provided remotely via technology-assisted media such as the telephone, computer,
or internet” (Campos, 2009, p. 27). While this method of providing services is not new and has
been practiced for decades, it has only become broadly prevalent among Canada’s mental health
professionals due to the pandemic’s imposition of limits on in-person services.
Similar to in-person services, telehealth mental health services provide assessments,
referrals, intervention, treatment, and crisis management services (Grady et al., 2011). Although
this means of service delivery is not necessarily equivalent to in-person services and can provide
unique challenges, telehealth providers strive to deliver comparable high-quality services. There
is also a growing body of literature that focuses on the benefits of telehealth services.
Advantages include, for example, the ability to provide services to more clients across long
distances, provision of services to clients in remote and rural areas, greater flexibility in delivery
of services to clients-particularly with some populations, such as youth, may feel more
comfortable using a telehealth service in contrast to in-person service (Biggerstaff & Short,
2017; Campos, 2009; Edwards et al., 2015; Grady et al., 2011; Myers et al., 2017).
Research has demonstrated that telehealth technology can be used successfully to support
a wide variety of mental health and addiction issues (Mahmoud & Vogt, 2019: Myers, 2019;
Swinton et al., 2009). Zhou et al. (2020) found that telehealth is also beneficial in efforts to
combat ongoing distress and social isolation due to the ongoing COVID-19 pandemic. Further,
this approach creates a framework in which clients can continue to receive mental health support
in the safety of their homes during the pandemic.

30
Of course, it must be acknowledged that there are also pitfalls in telehealth, as there are
with any health delivery service. By nature, telehealth alters the dynamic of mental health
services, particularly the counseling process, because it is a dramatic change from conventional
in-person services (Nickelson, 1998; Weinzimmer, 2021). For example, providing meaningful
human connection through physical presence cannot be replicated in telehealth services. There
are also concerns about maintaining patient privacy and confidentiality while using telehealth
services (Doshi et al., 2020). If a client is using telehealth from their home, the clinical social
worker cannot control the environment and guarantee confidentiality as they could do in an
office setting. For example, another person in the home may overhear the session, or the client
may not have a private room from which to access service in a home setting. Another deficit
common to telehealth is access to technology and the ability to use technology effectively
(Weinzimmer, 2021). For example, clients may not have the ability to access the electronic
devices they need or may not have the knowhow to use electronic devices to engage with service
via telehealth. A final difficulty that arises across most health and support services is that clients
often prefer in-person services and frequently decline telehealth services when they are offered
(Woo & Dowding, 2018). It is recognized that this finding would likely be influenced by the
current COVID-19 crisis and may be diminished. However, it is still important to recognize that
research indicates many clients often prefer in-person services when it is an option.
Given the commonality of telehealth services currently, ethical considerations associated
with telehealth services in clinical social work will be reviewed briefly. The British Columbia
College of Social Workers (2015) has outlined standards of practice for social workers who
provide telehealth services. First, the college recommended that social workers are competent in
the use of electronic devices and software used to provide services, and that they are compliant

31
with the ethical standards of using technology for services. Second, social workers must take
additional measures to obtain informed consent such as assessing a client’s capacity to provide
consent, taking reasonable steps to verify the client’s identity, and providing the client with
additional policies pertinent to engaging in telehealth services. Third, social workers must take
additional steps to ensure privacy and confidentiality are maintained in telehealth services, such
as using safeguards when sharing information electronically, discussing the risks of using
telehealth services, and informing clients of additional policies related to engaging in telehealth
services. Lastly, as with all social work services, when using telehealth the social worker must
maintain professional boundaries and avoid dual relationships and conflicts of interests. When
using telehealth services, it is imperative to discuss expectations regarding the use of telehealth,
and the social worker’s availability to the client when using this service. For example, what type
of communication can be transmitted via what type of technology and when the worker will
respond to communications. While telehealth is not a new service, as noted earlier, it was not
used widely in clinical social work practice prior to the pandemic. Hence, familiarity with
current ethical standards for the use of technology for telehealth services is vital for clinical
social workers.

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Chapter 4: Learning Experience from Practicum
During my practicum at Carrier Sekani Family Services, I had many opportunities to
learn about clinical social work practice, and these have helped me achieve my learning goals.
This chapter will summarize the learning that pertains to my goals. Specifically, learning about
my professional identity, the practice environment, the people served by the agency, and clinical
social work practice. A significant portion of my practicum focussed on learning clinical skills
while working with Indigenous peoples and the child and youth population; this learning will be
discussed as relevant to specific learning experiences.

Professional Identity as a Clinical Social Worker
As part of my goal to develop my identity as a social worker, I wanted to maintain my
professional self-care regime and maintain professional boundaries. I believe I was successful in
this effort. I was able to take scheduled breaks, take screen breaks, maintain workplace
boundaries, maintain ethical standards, and keep work at work. As someone who worked in the
child and youth mental health field before my practicum, I felt I understood self-care and aimed
to maintain the habits and practices I had used in my self-care regime. However, in receiving
clinical supervision, I realized my understanding of professional self-care was limited.
As part of an individual supervision session, a discussion about balance and self-care
within professional practice became a central topic. In my professional role, I had always thought
about self-care in terms of how I could ensure I got enough rest and had time to recharge while
not at work so that I could better face the challenges that come with clinical social work practice.
I learned, however, that I have neglected being intentional during my workday and thus ensure I
could effectively serve clients. We discussed balance it in terms of balance within the workday
instead of the traditional way I had thought about it as work-life balance. I was asked various

33
questions about my practice experience: Do you know when you work best? Do you know when
you write best? Are you planning tasks based on when you can do them best? Are you booking
your lower-needs and higher-needs clients in strategic ways when possible? Are you intentional
in thinking about using your time best while also maintaining your wellness during the
workweek and workday?
I realized many of the answers to those questions was “No”. It had not occurred to me to
think about balancing self-care within work hours and not merely work-life balance. Of course, I
do not discount the value of work-life balance and do not plan to abandon my exiting practices.
However, what this learning has made apparent is the opportunity to enhance my self-care plan.
For example, I know I have more energy during the middle of the workweek than on Mondays
and Fridays; hence, it would likely be best to book higher-needs clients during the mid-week
days whenever possible. I also know I tend to write best directly after appointments: working on
documentation helps me process, organize what took place, and make a flexible plan for the next
session. Ideally, I should always leave time between sessions to ensure I can complete this task
instead of booking client appointments back to back to fit in as many appointments as possible.
Going forward, I will be asking myself the questions raised in clinical supervision and use them
to guide me in being intentional in creating balance in my workday.
Allyship and Professional Identity
During my practicum, I had the opportunity to attend webinars on cultural safety hosted
by the Indigenous Cultural Safety Collaborative Learning Series. During one of the webinars, Dr.
Karina Walters shared an analogy that an Elder had shared with her. The story, which I
paraphrase here, is if you ever put crabs in a bucket you will notice they behave strangely: the
crabs try to get out, but in the process they pull each other down in their attempt to escape,

34
making it impossible for any of them to get out successfully. One might ponder, why would the
crabs not just work together to get out of the bucket? However, a more interesting question might
be, why are the crabs in the bucket in the first place? Crabs on the coastline, on rocks, and in the
sea do not pull each other down; they live well together (K. Walters, personal communication,
June 4, 2021).
Dr. Walters talked about how this analogy is a metaphor for issues caused by
colonization that arise among Indigenous peoples. She referred, specifically, to how colonization
has caused so much harm in Indigenous communities such as high rates of violence, crime, and
child apprehension. Dr. Walters posited that as helping professionals we can sometimes get so
caught up in trying to help people “in the bucket” that we forget about the bucket itself. This
analogy was powerful for me and made me think immediately about what allyship means for a
helping professional in direct practice.
I have struggled with the term “ally” in a professional context. I have struggled
particularly with learning how to engage in allyship in my role as a clinical social worker who
works primarily in direct practice with children and youth. I have pondered what actions I can
take within my role that would provide allyship. Being an ally is an active role, and I have often
framed allyship as an advocate role in a political context. However, Dr. Walters’ story and
knowledge gave me a valuable insight: as a clinical social worker, as I see it, much of my role
will always be about “being in the bucket” with clients so I can provide direct services. However,
I can deliver direct service and still be constantly aware of the existence of the bucket we are
standing in—that is, colonization and its effects. I support clients and families in their
understanding of and experiences with colonization’s effects in their lives: specifically, by being
informed about how colonization is ever-present in the lives of Indigenous peoples, by being

35
sensitive to the approaches I use in my work with Indigenous clients, and reflecting consistently
on my practice to ensure it is culturally safe. Further, I can assess the policies and procedures of
the organizations I work with to ensure cultural safety is prioritized and use my voice to advocate
for changes when needed. While striving for allyship may look different than the conventional
version of allyship I had imagined, it is nonetheless allyship and an essential part of my role
when working with Indigenous peoples. A critical part of my professional identity is striving to
be anti-oppressive in my work. Hence, allyship must always be a part of my practice as a clinical
social work.
Personal and Professional Identity
During my practicum, 215 bodies of Indigenous children were found buried at the site of
the former Kamloops Indian Residential School in British Columbia. More Indigenous child
remains were found at other residential school sites across Canada in the weeks that followed.
The number of remains found at former residential school sites continues to increase as I have
written this report. While it has been well known that large numbers of Indigenous children died
at residential schools, confirmation of this knowledge is a tragic and heart-wrenching reminder
of the harms done to Indigenous peoples by settlers in this country.
I am a descendant of European colonizers. News of the discoveries is a reminder of the
shame and injustice that coincides with that fact, because settlers have traumatized Indigenous
children and families for decades. My social location as a non-Indigenous clinical social worker
who works with Indigenous peoples is complex. This is a component of identity that I carry into
every aspect of my work and continually evaluate in daily practice. As the news unfolded, I
found myself reflecting on my motivations to take part in social work. I believe my primary
motivation for working with Indigenous peoples is that I feel compelled to contribute to this

36
work. Indigenous peoples have endured horrendous hardships and abuse because of the actions
of my ancestors, regardless of whether there are direct familial connections. In my work, I see
the impacts and continuation of these harms every day. I am hopeful that I can be a part of the
generation of Northern European descendants that will genuinely recognize and take ownership
of the wrongdoings that Indigenous peoples have endured. I am hopeful that I can serve and
support Indigenous peoples fighting to move forward in reconciliation to make meaningful,
positive change. As a social worker and a Canadian citizen, I am responsible for doing my part
and taking action to actively be involved in the reconciliation process. This responsibility will
always remain foundational in my identity as a clinical social worker.
Practice Environment
I completed my practicum at the Prince George Carrier Sekani Families Services office
with the Child and Youth Mental Health Team as a part of the Mental Health Wellness
counseling program. Although I was based in Prince George, the majority of the practicum was
completed at home via telehealth technology. Although I had done some telehealth work before
my practicum, this was the first time I had been completely immersed in a telehealth
environment. Consequently, a lot of my practicum focused on learning how to manage working
from home. Managing confidentially and maintaining workplace boundaries while working from
home were two significant challenges and areas of learning.
In managing confidentiality, my biggest struggle was physical space. Due to COVID-19,
my husband was also working from home in our tiny one-bedroom apartment. I set up a small
office space in my bedroom so that I could shut a door between our workspaces. Unfortunately,
due to the size of the apartment, it was impossible to block out noise completely. To solve this
issue, we both got noise-canceling headphones to minimize background noise and prevent each

37
other from overhearing our respective work conversations. I also coordinated my appointments,
whenever possible, with periods when my husband was likely to have few phone calls or
meetings. When this was not possible, I had the option of booking space at the office or
explaining my situation to whomever I was meeting, and I did my best to ensure they knew their
confidentiality was protected. Because my “office” space was a shared living space, I was also
very mindful of anything I wrote down. Put another way, I did not write down any personal
information. Any scratch notes I did take to aid my memory were then converted to electronic
records and the paper copy was destroyed immediately after a conversation or meeting. Hence,
throughout the practicum, I was especially mindful that my workspace did not reveal confidential
information.
Another struggle I managed while working from home was that of workplace boundaries.
While working from home I had access to the technology I needed to do practicum tasks all the
time; it was sometimes challenging to keep practicum work to scheduled times only, especially
learning tasks that were interesting to me. On the other hand, because I was in my home, it was
also easy to get distracted by things at home, such as chores I needed to complete or hearing my
cat misbehaving in another room. To establish boundaries, I set alarms and timers to remind
myself to maintain regular work hours and complete workplace tasks within those hours. I also
planned my days, even on days when I did not have appointments or meetings, so that my time
was organized. These steps helped ensure I always had practicum tasks and daily goals to focus
on so that I did not become distracted by my environment. I also eliminated distractions by
moving distracting household objects out of my immediate view and shutting the “office” door
as a visual reminder that I was engaged in practicum time. These strategies helped me mirror an

38
in-person work environment so that I was mentally at my practicum during appropriate hours,
and, during off-hours, I was at home.
The People Served
During my practicum at Carrier Sekani Family Services, it was crucial that I learn about
the population the agency serves. Due to the COVID-19 pandemic, this learning was conducted
through independent research and reading. Although I recognized that my personal research
could not capture the richness or complexity of any group’s history or culture, my research did
provide me with a lot of valuable knowledge that contributed to my learning. My research
consisted of reviewing the Member Nations serviced by the agency, their locations, and
information about the communities. Carrier Sekani Family services provides services to 11
Member Nations (Mann & Adam, 2017). These nations include: Saik’uz First Nation, Nadleh
Whut'en, Stellat'en First Nation, Burns Lake Band, Wet'suwet'en, Lake Babine Nation, Nee Tahi
Buhn, Skin Tyee Band, Cheslatta Carrier Nation, Takla Lake First Nation, and Yekooche First
Nation. In the following paragraphs I will briefly review each nation.
Saik’uz First Nation is located 9 kilometers southwest of Vanderhoof. Saik'uz is also
known as Stoney Creek for the creek that runs through the community (Mann & Adam, 2017).
The name Saik’uz means “sandy bottom,” which also refers to the creek. Many people who live
in the community are descendants of the communities of Chinlac, Clucluz Lake, and Tatluk
Lake. Saik'uz First Nation has more than 1,000 members and, in 2015, it was estimated that
approximately 450 members lived in the community (Saik'uz First Nation, 2019). Saik'uz First
Nation members form two clans, the Nulkiwhot'en (Lasilyu or Frog) and the Ta'chek Whut'en
clan (grouse), and follow the Bah'lats system of clans.

39
Nadleh Whut'en means “the place where the salmon return every year” (Mann & Adam,
2017, p. 13). This community is located at the eastern section of Fraser Lake in north-central BC.
In 2015, there were approximately 540 band members (Aboriginal Affairs and Northern
Development Canada, 2015b). The Nadleh Whut'en comprise five clans: Lhtseh yoo (Frog) clan,
Dumdehm yoo (Bear), Luk sil yoo (Caribou), Ulstah mus yoo (Owl, Grouse), and Tsah yoo
(Beaver), and follow the Bah'lats system of clans. It should also be noted that the Lejac
residential school site, which operated from 1922 to 1978, is located on Nadleh Whut'en terrority
on the south side of Fraser Lake.
Stellat'en First Nation means “people of Stella.” Stella is a point of land at Fraser Lake
(Mann & Adam, 2017). The members of this nation live primarily in the community of Stellako
(Stellat'en First Nation, 2021). This community is located 160 kilometres from Prince George
between the Stellaquo and Endako rivers. In 2015, there were more than 500 band members
(Aboriginal Affairs and Northern Development Canada, 2015c). The Stellat'en First nation clans
include: Luksilyoo (Caribou/Little Man), Tsa yoo (Beaver), Lhtsumus (grouse), and Lhtsehyoo
(frog/crane).
The Burns Lake Band is located in the community of Burns Lake (Mann & Adam, 2017).
In 2011, there were approximately 130 members (Carrier Sekani Tribal Council, 2011). Burns
Lake Band is also known as Ts il Kax Kah, which means “Creek that runs through the area” and
is a Carrier-derived name.
Wet'suwet'en is located on the Bulkley River (Mann & Adam, 2017). The name
Wet'suwet'en means “People of Wa Dzun Kwuh River (Bulkley River)” (Mann & Adam, 2017,
p. 16). In 2015, there was 234 members of the Wet'suwet'en (Aboriginal Affairs and Northern
Development Canada, 2015h).

40
The Lake Babine Nation is one of the largest bands in northern British Colombia, with
2400 members recorded in 2015 (Aboriginal Affairs and Northern Development Canada, 2015a;
Mann & Adam, 2017). The name Babine refers to “big or drooping lip,” as French fur traders
noticed that high-ranking Babine women wore labrets in their lips at the time of early contact.
Five communities represented by Lake Babine Nation, including Fort Babine, Old Fort, Tachet,
Donald’s Landing, and Woyenne. Old Fort is a seasonal community where families go to gather
berries, and fish and hunt. Donald’s Landing is also a seasonal community that is occupied only
during the summer. The other communities are occupied year-round and have municipal
services, the largest of which is Woyenne. The Babine terrority is known for an abundance of
rich food resources, particularly salmon. The Lake Babine Nation clans include Caribou, Bear,
Frog, and Beaver, and they follow the Bah'lats system of clans.
The Nee Tahi Buhn Indian Band has five reserves that are located on Francois Lake and
Urcha Lake. In 2015, 140 members constituted the band (Aboriginal Affairs and Northern
Development Canada, 2015f; Mann & Adam, 2017). The name Nee Tahi Buhn means “It fills at
one end and empties at the other,” and is the Indigenous name of Francois Lake. The Nee Tahi
Buhn Indian Band clans include Gilseyhu (Big Frog), Laksilyu (Small Frog), Gitdumden (Wolf,
Bear), Laksamashu (Fireweed), and Tsayu (Beaver). The Nee Tahi Buhn Indian band follows the
Bah’lats system of clans.
The Skin Tyee Band is located near Francois Lake, which is the second longest natural
lake in British Columbia (Mann & Adam, 2017). The band has six reserves that are located on
the Skins Lake and the Uncha Lake area. In 2015, there were approximately 187 members of the
band (Aboriginal Affairs and Northern Development Canada, 2015g). The name Skin originated
with a member of the band who traded with the Hudson Bay store in Old Fort during initial

41
contact; settlers referred to him as “Skin” because he was an excellent trapper who brought in the
most furs for trade.
The Cheslatta Carrier Nation is located near the Nechako River (Mann & Adam, 2017).
The nation name Cheslatta means “people who go upon the water” (Mann & Adam, 2017, p. 20).
In 2015, there were approximately 330 band members. Preserving traditional language has been
very important to this nation. As Mann & Adam (2016) explain “The Cheslatta language is a
dialect of Nedgut'en of Dene, which is part of the Athabasca language family” (p. 20). In 2015,
there were 8 fluent speakers and over 100 people learning to speak the language.
Takla Lake First Nations identifies as Sekani and Carrier, because this nation is
considered to have Dene, Carrier, Bear Lake, Gitzsan, and Yse Kay Nay heritage (Mann &
Adam, 2017). This Nation was taught the Bah'lats systems because of marriages between their
people and the Gitxsan people. There are four clans in Takla Lake: Lux Gibuu (Wolf/Bear clan) ,
Jilh Ts'e Yu (Frog clan), Likh Ts'a Mis Yu (Beaver clan), and Gil Lan T’en (Caribou clan). In
2015, there was 700–800 band members and the majority were living on the reserve with others
in various communities (Aboriginal Affairs and Northern Development Canada, 2015d).
Yekooche First Nation has approximately 230 members (Aboriginal Affairs and Northern
Development Canada, 2015e; Mann & Adam, 2017). The name of the community in Carrier
translates the location of the community, as “Ye Koo”, which is Cunningham Lake. The “-che”
component of the nation name refers to the end of Nankut Creek.
When discussing the Indigenous peoples of this land, it is always important to
acknowledge that colonization had significant and horrific impacts on their lives. Great numbers
of Carrier and Sekani Nations people died due to exposure to foreign diseases carried by
European settlers. The devastation during colonization included the loss of entire villages within

42
Carrier territory (Mann & Adam, 2017). The Lejac Residential school was attended primarily by
children on Carrier territory due to its central location, near Fraser Lake. However, some Sekani
and Gitxsan children also attended. The school operated from 1922 to 1976. The school’s land
was transferred to the Nadleh Indian Band, who destroyed the school building and created a
memorial site on the property. Carrier peoples also experienced the Sixties Scoop, racist
segregation in hospitals, government discrimination, and oppression, and inevitably, the horrific,
long-term impacts of these wrongful actions and practices.
As stated in my goals, during this practicum I hoped to learn more about the culture of
the people served by Carrier Sekani Family Services. Culture can be defined in many ways, but I
most like the definition that “culture is an umbrella term which encompasses the social behavior
and norms found in human societies, as well as the knowledge, beliefs, arts, laws, customs,
capabilities, and habits of the individuals in these groups” (Tylor, 1871, p. 124). Culture is a
moving, living, and ever-changing force among humans; consequently, recognizing culture as an
umbrella term that encompasses many aspects of people’s lives seems most fitting. Culture is a
social concept that teaches us how the world should be understood and how we ought to operate
within it (Mann & Adam, 2017). In learning about Carrier culture, it was clear to me that I would
never come to fully understand Carrier culture in my short time at practicum. Indeed, I do not
think I could fully understand the complexities of Carrier culture if I were to spend a lifetime at
Carrier Sekani Family Services. I chose to narrow my focus and learn what I could about Carrier
worldviews and values, the Bah'lats system, and the Carrier Life Cycle Model.
There are many traditional Carrier views of the world, some of which are described
below (Mann & Adam, 2017). The northern interior of British Columbia is a homeland in which
every physical feature—lakes and mountains, for example— is valued and named. The physical

43
environment is also home to many plants and animals that are respected. The land has sustained
Carrier peoples for thousands of years and requires protection. In Carrier society, everyone
within a given clan is related. The sharing of wealth is considered very important because what
one gives will eventually come back in some form. The Bah'lats system plays a key role in
determining the sharing of wealth among clans.
The potlatch system is called Bah'lats in Carrier tradition (Mann & Adam, 2017). It
began as a means to manage conflict by bringing people together, according to Stellat'en oral
history (Mann & Adam, 2017). These meetings evolved into a formal governing system that is
now the core of political, economic, social, spiritual, and legal institutions for Carrier people.
Moreover, “it represents a holistic, evolving approach to relationships within the Nation and with
other Nations and always required decision-making protocols for conduct, as well as countless
other aspects” (Mann & Adam, 2017, p. 87). All Bah'lats are conducted in an open environment
in which clan members witness what occurs during the meeting. There are many different
reasons for a Bah'lats, and many different events are conducted at these meetings such as
witnessing the assigning of Chief names or conducting ceremonies. Most Member Nations still
hold Bah'lats regularly, though others do not. As Mann & Adam (2016) note, “for most people,
there is an understanding that the Bah'lats is the ‘proper’ way to deal with life events and interclan relationships” (p. 88).
Bah’lats are large meetings, and, as such, require a significant amount of coordination
(Mann & Adam, 2017). These meetings are often planned a year in advance by the hosting clan
and take a considerable amount of preparation and represent considerable expense. Some
Bah'lats are attended only by invited community members, while other meetings are open to any
community member to attend. The hosting clan also ensures that protocols for the meeting are

44
followed, which vary for each Member Nation. When attending a Bah'lat, respect, responsibility,
obligation, compassion, balance, wisdom, caring, sharing, and love govern individual conduct at
the meeting. All individuals are witnesses to what occurs at the Bah'lats and are expected to take
great care to remember the details of what takes place. Hereditary Chiefs are responsible for
recounting oral histories at Bah'lats when relevant. These events often involve feasts, prayer,
performances, songs, dance, stories, gifts, and formal business.
The Life Cycle Model, which also forms the core of Carrier Sekani Services
programming, is an approach that acknowledges that a lifetime has multiple stages and that each
stage has its own needs for wellbeing and distinct determinants of holistic health (Mann &
Adam, 2017). Within the interconnected worldview, it is understood that each individual’s health
and wellness impacts the health and wellness of everyone in the community. During each life
stage, four principles are acknowledged: "We are all bound together by blood, land, and spirit[;]
life is a continuum beginning and ending with the Creator[;] healing occurs for the whole person
and impacts all people in that person’s life[;] and lastly, historical impacts affect who we are
today as Indigenous people” (Mann & Adam, 2017, p. 69).
In the Life Cycle Model, numerous states of life are recognized and, throughout each, the
balance of mental, emotional, spiritual, and physical health is sought to maintain wellness (Mann
& Adam, 2017). Each life stage is valued because everyone acknowledges that each life stage
has wisdom to share. Some life stages include pregnancy, the birth of a baby, Ny nee Nyhudel
Tsut (getting your mind back), menstruation, marriage, nearing death, and after death. There are
various cultural practices among each Member Nation that are associated with life-cycle events.
The Life Cycle Model “utilizes a restorative approach to healing which ensures that everyone has

45
a place and role in society and those gifts of the Creator are used and shared with the
community” (Mann & Adam, 2017, p. 69).
Clinical Social Work Learning
During my practicum, I had the opportunity to attend a Case-Based Learning group that
Compass Mental Health led in partnership with Carrier Sekani Family Services. The purpose of
these meetings was to have multiple disciplines from across Carrier Sekani Family Services
come together to perform case consultations and support clients with complex mental health
needs. While participating in the group, a theme began to emerge: holistic care. Specifically, the
focus was on effectively working collaboratively within a circle of care to provide holistic
service for clients. While this way of practicing may seem to be an obvious approach to social
work, in my experience, across multiple workplaces and in several provinces, it has not been the
norm. This sparked my interest in understanding holistic care and it became a central theme of
learning in my practicum experience.
In the Western worldview, aspects of the world are often dealt with as parts, in contrast to
considering them as part of a whole. Generally, aspects of life, knowledge, understanding, and
perception are broken down to enhance understanding. This approach to understanding the world
in health and support services is often evident. For example, physical and mental health are
organized into separate disciplines, which are then subdivided further into specializations of
practice. Throughout my work with Indigenous peoples, I have learned about a contrasting way
of understanding the world from a holistic worldview. Unlike the Western worldview, holistic
worldviews recognize aspects of the world in the context of relationships (Baskins, 2015). For
example, a person’s wellness is considered in light of the spiritual, emotional, physical, and
psychological aspects of their life, and these aspects are seen in the context of relationships with

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family, community, nature, and creator (Baskin, 2015). There is much wisdom in a holistic
health approach, especially when one considers how mental health and wellness can be
promoted, understood, and supported in our society.
In previous work contexts, I attempted to incorporate a holistic approach to providing
services. For example, I sought to consider the varied aspects of a client’s life, to assess how
those aspects intersected with mental health, and to help clients get support in other life areas to
support wellness. Most often, I supported clients in this way through referral services. However,
I wanted to ensure I stayed in my lane, so to speak: I was the mental health clinician, and that
was the area of my expertise. Others would have knowledge better suited to assist clients in other
areas. For example, if a client had physical health issues, I referred them to a doctor
knowledgeable in that field and left care to that doctor to support the client’s particular issue.
mental health, I did not actively support those different aspects. I did not see that as my
responsibility.
As I read Braiding Sweetgrass by Robin Wall Kimmerer (2013), during practicum, it
occurred to me with particular clarity that I had not let the wisdom of holistic worldviews,
particularly in practice, become a part of my approach and work process. This book recounts the
author’s honouring of Indigenous knowledge while becoming a trained botanist using the
Western approach to science. Kimmerer writes about how worldview, values, and cultural
understandings shape how we understand the world. I recognized and welcomed her approach.
What interested me especially was Kimmerer’s account of trying to simultaneously navigate
Western and Indigenous understandings of the world. For example, she discusses how plants are
conceptualized in the Western thought as parts to be explained and understood for their
functional purposes only, while from an Indigenous worldview, she had come to understand

47
plants as whole beings that offer gifts and lessons. Kimmerer observed that the university valued
Western understandings but did not value Indigenous understandings. For example, Kimmerer
notes how university academics asserted that her non-scientific questions—which were
underpinned by Indigenous knowledge—did not belong in academia or professional work.
While reading Braiding Sweetgrass, I realized that I had unintentionally neglected to
make space for the practical application of Indigenous knowledge in my practice. While I
understood the value of holistic service and valued the idea, I was not fully embracing the
practical application of these ideas in my work. I have been primarily trained in Western
ideologies of mental health and clinical social work. I had held to the idea that focussing only on
mental health was my role, and I should not provide help or suggestions that were not in keeping
with the traditional conception of clinical social work. For example, by referring a client for
other services without working and collaborating, myself, with those services to best serve the
client, I was not incorporating my knowledge of holistic care. While referring services will
continue to be a vital part of my role, I observed a better way to provide service while attending
the learning group. I therefore took steps to learn how to apply holistic views of health and apply
them practically with clients. Which ultimately served the overarching purpose I pursued a
practicum with an Indigenous organization—to learn a better way to serve Indigenous peoples by
blending Indigenous and Western knowledge in a respectful and meaningful way.
The evaluation of my practice continued while visiting the community of Saik'uz with a
colleague. Throughout the trip, we discussed her work in the community. Most interesting to me
was her commentary about how clinical work happened in the community without designated
office space. She noted that she often met clients at their schools or home, or she took clients into

48
nature on walks, playing in the park, or in picnic areas. I was most curious about work in public
settings, often referred to as “walk and talk” counseling.
I was immediately filled with questions. How does confidentially apply in public
settings? Specifically, what about working with children who need parental consent? How can
we ensure children understand the risk to privacy and confidentially in public? How would a
clinician manage a crisis in a public outdoor setting? How do you manage general safety in a
public outdoor setting? While many of these questions arose from curiosity, I am sure many
questions were also fueled by my ideas about how clinical work “should look” and my anxiety
about changing traditional practice settings. My previous counseling work had taken place in an
office with safeguards and controllable clinical settings, especially work with children when I
was responsible for their safety during our sessions. The added layer of complexity of needing to
build and keep trust with Indigenous parents as a white clinical social worker engaging with their
children was a genuine concern. Keeping children safe and providing high-quality services—
particularly in light of the long history of white social workers causing harm to Indigenous
families and their children—is a responsibility I take very seriously.
While I thought about these questions, my colleague mused about how clinical social
work “is only as limited as we make it” (K. Gable, personal communication, May 17, 2021).
This is true because there is no single, uniform way to do clinical social work. Being in nature
can be very therapeutic for clients. Both Indigenous knowledge and Western research have
communicated the benefits of connection with nature for wellness and mental health (Baskin,
2016). This experience was another moment when I realized I was allowing my preconceptions
about clinical work and fear of challenging how I was educated limit how I conduct clinical
work.

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The experiences I have discussed thus far reveal that during the practicum I had many
occasions when I was challenged to evaluate why I conducted work in the way I did, and to
examine and question the ways in which I constrain my work practices. These events led me to
explore how I could enhance my practice in ways that added richness to my work with clients. In
work with Indigenous children and youth, I thought about how I could improve how I engage
with the client, their caregivers, and other members of the care team to support clients with a
more holistic approach. I will discuss this in the following pages.
The change in how I thought about client care and social work began with the example of
walk-and-talk services. I realized it was more helpful to discuss how my colleague manages
potential issues associated with clinical work in an outdoor public setting instead of just focusing
on potential issues with different approaches and methods. For example, we discussed having a
conversation with a child about confidentially in terms they would understand. We focused on
what it would be like to meet outside and whether they would be comfortable being seen in
public with a counselor. We talked about the potential privacy risks and how protecting
confidentially during services outside would occur so that the client could make an informed
decision. Before conducting counseling in a public setting, the counsellor would need to ensure
there is sufficient time during sessions to make plans with the child to establish expectations,
boundaries, and safety. Last, it would be wise to ensure a colleague or manager was available
who could assist if a crisis were to occur. Our conversation focused on how doing clinical work
in non-conventional settings could be done in ways that adhered to ethical guidelines and
maintained standards of practice.
In counseling with children and youth, it is understood that parents and caregivers play a
vital role in children’s lives. In clinical social work, the importance of involving caregivers in

50
mental health services is discussed at length in the literature (Brady, 2015; Landreth, 2012;
Siegel & Bryson, 2012; Vanfleet et al., 2010). However, in my previous work experience,
involving caregivers in meaningful therapeutic ways had been difficult to achieve and I realized
this had been a deficit in my practice. I began to search for resources and therapy models that
offered guidelines and practice interventions that involved caregivers in meaningful ways.
I considered why involving caregivers in the counselling process had been difficult in
previous practice. The detail that stood out the most for me when I struggled to involve
caregivers was time. First, my lack of time. The child and youth mental health field makes many
demands, and often there are not enough resources to meet the demand for services. Hence, I
often found myself working at a pace that did not leave me with enough time to actively involve
caregivers beyond the necessary check-ins and progress meetings. The second issue was
caregivers’ lack of time to participate in service. In my practice, I often worked with families
who were struggling in a multitude of ways; caregivers were focused on meeting survival needs
such as shelter, food, heat, income, and, or, trying to manage in a high-stress environment. In
short, they had more pressing needs and concerns than returning my calls.
Upon reflection in clinical supervision, I believe that struggling to provide support to
caregivers is another example of struggling to find balance in my practice. Of course, I cannot
control a family’s ability to engage; however, I can control making time in my practice to
attempt to engage with caregivers. One means to do so is to adjust my expectations. I realized I
had been focused on the quantity of services I provided instead of quality of service. For
example, I saw as many clients as possible rather than maintaining a manageable caseload. I
have come to realize that my practice, in future, will require me to create more boundaries so that
I can provide higher quality services. I can do this, for example, by maintaining a manageable

51
workload by saying no to extra work tasks or client files. It will be important that I book time
throughout the week to connect with caregivers by providing caregiver support sessions as I have
done during practicum. While doing this would be difficult, since it might feel like I was serving
fewer clients (while waitlists continue to grow) to have time to provide direct caregiver support.
It is a necessary change.
During practicum, I had the opportunity to complete trauma-focused cognitive
behavioural therapy training, which promotes involvement of caregivers in my practice. The
trauma-focused cognitive behavioural therapy model is an evidence-based treatment model
designed to support the child or youth who has experienced a traumatic event and supports the
caregiver to help with their child’s healing (Cohen et al., 2016). The model’s components
include psychoeducation, parenting skills, relaxation techniques, affect identification and
regulation, cognitive coping, trauma narration and processing, in-vivo mastery, conjoint childparent sessions, and last, enhancing safety and future development. The training provided
concrete and practical guidelines to support caregivers when using the model and for involving
caregivers in the therapeutic process. Specifically, mention was made of how to prepare parents
for joint sessions so that sessions can be as therapeutically productive as possible. While we
cannot perfectly predict or fully prepare for a given session, practical guidelines that help prepare
caregivers for joint sessions is very valuable. For example, arranging preparation sessions that
outline what to expect, providing information to help caregivers manage their emotions before
the joint session, how they can prepare for the joint session, how to manage if the session is
distressing for them, and what the goals of the sessions are—this preparation would help
tremendously to ensure the joint session is maximally therapeutic.

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Another important aspect of involving caregivers in child and youth mental health is
helping them support their child. During the practicum, I completed a learning webinar series
called “Rolling with ADHD,” produced by Compass Mental Health, about supporting children
with attention deficit hyperactivity disorder (ADHD). The webinars explored how ADHD
impacts children, the importance of diagnosis and treatments, medications, and nonpharmacological interventions. When discussing non-pharmacological intervention, the speaker
stated that the first thing they offer to caregivers is an education group about ADHD. The
presenter recommended that clinicians look for caregiver education that educates on what ADHD
is, how it will impact their child, how to support their child, advocating for their child, and
managing ADHD in the family. The speaker stated that studies have shown that interventions
that provide caregiver education are just as effective as medication for children with ADHD. For
me, this finding highlighted that there are practical interventions I can provide to support parents
to support their child, and that these will generate significant impacts for the child and the family
overall.
Often, caregivers come to me because they feel they do not know what to do. They are
struggling and hoping I can support their child who is struggling with a mental health concern to
improve the situation. Of course, I support children directly, and this is an integral part of my
role. However, it is also vital to support the caregiver in becoming well equipped with
knowledge and skills to help them feel confident in their abilities to support their child. This can
be accomplished by providing accessible, practical, and realistic interventions. Caregiver
interventions can empower the caregiver to better support their child and help improve overall
family wellness.

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Direct parenting skills support is a caregiver intervention that can be helpful. During
practicum, I read The Whole-Brain Child by Daniel Siegel and Tina Bryson (2011), and I was
involved with a Circle of Security parenting group. Both of these models, based on attachmenttheory research, were designed to develop parenting skills and offer support. These practicum
activities provided me with valuable learning about parenting skills that are useful and evidence
based. For example, The Whole-Brain Child, identifies 12 parenting skills designed to help
caregivers and families thrive (Siegel & Bryson, 2011). The book and the group discussed the
positive impacts that strong caregiving skills can have on the child, the child-parent relationship,
and the family as a whole. The group also helped me understand how to provide direct parenting
skills support to caregivers. Specifically, the importance of creating safe relationships with
caregivers by taking a gentle and nonjudgement approach underpinned by empathy and
connection. Caregiving is a very personal experience and can often be linked to guilt and shame.
Struggles with guilt and shame regarding parenting can be even more difficult for vulnerable
families and families that have been involved with institutions, such as child protection. In this
context, creating strong therapeutic alliances is critical to providing direct parenting skills that
successfully support caregivers.
It is important to be cognizant of the cultural context in which caregiving is provided.
Caregiving is value-based work. Upbringing, culture, personal values, family values, and family
structure all impact how a person provides childcare. In my work with Indigenous families, my
social location is important to acknowledge. Firstly, I am a non-Indigenous person. My Western
values, culture, and training shape my ideas about parenting. Secondly, I am not a parent;
therefore, I do not have lived experience of parenting that I can share when working with
caregivers. In reflecting on my social location, one of my key learnings has been to ensure I am

54
open to having candid conversations regarding my social location while supporting caregivers.
This ensures I am creating therapeutic alliances that are trusting and supportive.
A second area of importance to discuss when providing holistic practice in child and
youth mental health is the professional circle of care. For this discussion, the professional circle
of care is defined as any other professional, service, or support involved in a child or youth’s life
such as cultural supports, health professionals, and care providers. As mentioned above, I had the
opportunity during my practicum to be part of the case-based learning group. At one meeting,
there was discussion about supporting a client in a remote community. A staff member from the
community was able to provide a significant amount of information on what needed to be
considered when providing support in this area. This experience highlighted the importance of
including community voices in the design of practical, achievable treatment plans. In the
example discussed above, the community staff member’s contributions provided valuable
knowledge to ensure a support plan could successfully be developed. The group could explore
how to ensure the plan was culturally safe, achievable and practical in a remote practice context,
and how the team could work together to ensure the plan was followed by all professionals
involved.
The second learning I experienced was how this example demonstrated the importance of
collaboration across professionals in the field. We talk about collaboration often and its
importance. However, the mental health field is demanding. There are often many needs and
much work to be done. Hence, the basics of collaboration, which are listening and understanding,
can be missed in the busyness of the work. While in the field, taking time to slow down to fully
understand the context and knowledge of everyone involved will be far more productive than

55
attempting to move to the problem-solving phase as quickly as possible during collaboration, as
demonstrated by the practice example.
Interdisciplinary collaboration can create a wealth of knowledge within a professional
circle of care. This was demonstrated very clearly when I attended the Compass Case Learning
meetings. For example, when we discussed support for a client with complex needs served by the
mental health team, I expected the conversation to focus on mental health concerns. Instead, the
topic focused on a physical health issue: specifically, primary care professionals providing
information about impacts on daily function, what extra supports are needed, and how the
physical health concern may play a role in a client’s mental health struggles. This was a moment
when medical staff communicated valuable and helpful knowledge to mental health staff. In turn,
the mental health team provided information about the client’s day-to-day functioning, and this
helped inform the medical team’s treatment plan for the client from their service program. This
example demonstrated how collaboration can benefit all involved in the circle of care and
improve services for clients.
At the end of the discussion, I asked myself how I would shape my practice to foster
interdisciplinary consultation and collaboration. Through clinical supervision and reflection, I
have learned about various practical strategies such as writing a letter of introduction to a client’s
care team members, outlining my involvement with the client, and providing contact
information. A second approach is to call other care team members periodically to consult on
client care. This would help to develop rapport with care providers and share information, when
appropriate, to better support the client. Last, I might take responsibility for arranging care team
meetings periodically or ensure I attend scheduled community meetings to support the client. In

56
practice, these strategies support the same goal: to build working relationships with others within
the client’s circle of care to provide holistic service.
A final element relevant to providing holistic practice in child and youth mental health is
that of engaging Elders and Cultural Knowledge Holders. The importance of these leaders in the
community is immense. Their time, knowledge, and teachings provide incredible healing for
children, youth, and families. In thinking about engaging with Elders and Cultural Knowledge
Holders, I was uncertain what my role would be during this type of work. During group clinical
supervision, we discussed how to promote Elder engagement with clients and agreed that Elders
and Cultural Knowledge Holders are the experts on how they can support Indigenous children,
youth, and families. It was agreed that being mindful and recognizing their role as leaders and
the work they do to support the community is vital. My role is to contribute to a collaborative
environment in which I follow the guidance of Elders and Cultural Knowledge Holders as they
support members of the community.

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Chapter 5: Implications for Personal Practice
My time at Carrier Sekani Family Services gave me many opportunities to identify
implications for my future practice. I came to the agency with experience as a child and youth
clinician and hoped to improve my clinical knowledge and skills. The experience I gained, along
with reflection on my approach to practice, will improve my future practice. Values that I will
cultivate and incorporate in future include interdisciplinary practice, holistic care, and self-care.
Interdisciplinary Practice
Interdisciplinary practice can be defined as a “complex process in which a variety of
different experts collaborate together” (Nancarrow et al., 2013, p. 1). During my time at Carrier
Sekani Family Services, I attended several meetings in which doctors, nurses, community
support workers, clinicians, and management participated in interdisciplinary practice. By sitting
(virtually) with many interdisciplinary professionals, the deep value of collaborating across
disciplines became clear, as I discussed earlier in this report.
While most professionals understand the value of interdisciplinary practice in their daily
work, it can nevertheless be difficult to coordinate this practice due to work demands. In the past,
I accepted that this difficulty was a part of the practice landscape and made do with limited
interdisciplinary collaboration. However, my experience at Carrier Sekani Family Services
taught me that the value of interdisciplinary practice far outweighs the difficulties associated
with cultivating and coordinating opportunities for collaboration across disciplines. In future, I
am committed to cultivating environments and relationships that promote interdisciplinary
practice in my work and treatment strategies. I am confident that incorporating interdisciplinary
practice in my work will enhance the quality of services I provide.

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Holistic Care
Holistic care has been a learning theme throughout my practicum. One of my most
valuable insights when learning about holistic care is the importance to strive for excellence in
professional practice. As discussed earlier, I had foundational knowledge about holistic care
before beginning my practicum; however, I have learned that I had not fully embraced holistic
care within my practice. This realization underscores the need to constantly evaluate and be
reflective in practice to ensure you are reaching your expectations for your own standards of
practice. In this case, I know I need to deepen my knowledge and skills in this practice area.
Holistic care is an element I value and believe is important to incorporate in mental health
service. However, I recognize that I still have a lot to learn in regards to applying holistic care in
my work. In future, I will continue to evaluate my practice through the lens of holistic care to
continue to improve my practice.
Self-Care
The social work profession has long understood the benefits of self-care. In their study,
Green and Thomas (2007) found that most social workers value maintaining a self-care plan. The
subject is also a regular part of university courses when training to become a social worker,
which was also true in my education.
Personally, before practicum, I believed I had successfully incorporated self-care into my
practice. However, during practicum, my ideas and practices were challenged. I learned I could
significantly improve my self-care practices by incorporating them within my workday habits.
These learnings will benefit me, my practice, and the clients I serve. My most significant
epiphany is that self-care is a journey, not a destination, as I had thought it to be. As I continue in
my journey as a clinical social worker, my self-care plan will need to change and evolve with
me. I am a firm believer in the idea that we never stop learning and growing in social work

59
practice; it is one of the reasons I love this profession. While my time is often spent focusing on
growth in skills and knowledge of clinical practice, I plan to actively work on refining my selfcare journey as part of my learning as a clinical social worker.

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Chapter 6: Conclusion
In conclusion, this report has outlined my learning during my practicum experience with
Carrier Sekani Family Services that focused clinical social work with Indigenous children and
youth. This organization was created to serve the Carrier and Sekani peoples in north-central
British Columbia. The organization provides services rooted in Carrier and Sekani knowledge,
values, and culture to heal and empower Carrier and Sekani peoples. I was grateful to be able to
complete my practicum with the Child and Youth Mental Health Team. During my time at
Carrier Sekani services, my goals were to develop my professional identity, gain familiarity with
the practice environment, continue to develop clinical social work skills, increase my knowledge
of clinical practice with Indigenous peoples, and increase my knowledge of counseling
approaches when working with Indigenous children and youth.
In preparing to achieve these goals I began by engaging in critical self-reflection to
explore my personal positioning. I explored my social locations, identity, and interest in the
mental health field. Special attention was given to acknowledging that my personal positions
play a role in my clinical work. Further, I explored my theoretical orientations, which anchor my
practice in clinical social work. Social constructivism is the overarching framework that guides
my practice, and strength-based practice guides my direct clinical practice.
In preparing for practicum, relevant literature was reviewed relevant to clinical social
work. The literature review firstly explored child and youth mental health in Canada, with
particular attention to definitions of mental health and context of mental health issues among
children in Canada. Secondly, Indigenous child and youth mental health was explored. The
literature highlighted the higher prevalence of mental health issues among Indigenous children
and youth, and the impacts of colonial trauma within the context of Indigenous mental health.

61
Thirdly, the literature review explored the importance of providing services to children and
youth, emphasizing that mental health difficulties are often present during childhood and
adolescence, the importance of early intervention, and the importance of non-Indigenous
professionals looking to Indigenous leaders for guidance while supporting Indigenous child and
youth. Lastly, the literature review explored practice considerations for clinical social work with
Indigenous peoples, with particular attention to the role of clinical social work with Indigenous
populations, cultural safety, the Two-Eyed Seeing approach, trauma-informed practice, allyship,
and telehealth practice. These practice considerations guided my practice throughout my
practicum.
My time at Carrier Sekani Family services provided many incredible learning
experiences. I had the opportunity to learn about my professional identity, which focused on selfcare, allyship, and how my personal and professional identities intersect. I learned more about
my practice environment which focused on providing telehealth services and working from
home. I also learned about the people served by the agency, which included 11 member nations.
Each member nation was explored, including aspects of culture such as worldview and values,
the Bah'lats system, and the Carrier Life Cycle Model.
My clinical social work knowledge was also expanded through my learning experiences
at Carrier Sekani Family Services. Holistic care was the central theme of this learning. Learnings
that were discussed included Indigenous and Western knowledge in a professional context.
Further, I learned about how to engage with caregivers, the professional circle of care, and Elders
and Cultural Knowledge Holders as part of integrating holistic care approaches into personal
practice.

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Lastly, the implications of my learning for personal practice were explored. Implications
focused on what I wanted to bring forward when I returned to practice. These included a
commitment to integrating interdisciplinary practice and holistic care into my practice. Finally,
to recommit to an ever-evolving self-care journey in my professional practice.
I look forward to returning to my practice with Indigenous children, youth, and their
families with my new knowledge and growth. In 1995, Nelson Mandela observed, “Our children
are the rock on which our future is built” (Nelson Mandela Children’s Fund, 2015). Children and
youth are a community’s most valued gift and we must support them to grow and thrive. My goal
is to spend my career supporting children, youth, and their families; I am grateful that the
practicum experience has better prepared me to fulfill this goal.

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Appendix
Appendix A: Summary of Learning Goals Grid

Learning Goals

Intentions to Help Achieve Goals

Continue to develop my - Adhere to ethical guidelines of practice
professional identity as a
- Keep a reflective journal
clinical social worker
- Engage in peer consultation
- Maintain professional self-care
- Maintain professional boundaries
Gain familiarity with the - Review the agency’s mandates, policies, and practice manuals
practice environment
- Collaborate with colleagues to achieve workplace goals and provide
services
- Visit various agency sites
- Visit various communities that the agency serves
- Become familiar with the services provided by the agency and learn how
these services are combined to meet client needs
Develop my clinical
social work skills

- Review theories, frameworks, and knowledge used by the agency
- Engage in workplace tasks if possible. For example, intake, assessment,
treatment planning, and clinical intervention.
- Work directly with clients, if possible.
- Engage in individual and group clinical supervision.

Improve my clinical
skills and knowledge of
clinical social work with
Indigenous populations
to provide the best
services

- Gain knowledge and understanding of the Carrier and Sekani peoples by
reading available resources
- Participate in cultural competency training offered by the agency, if
possible
- Engaging with leaders and cultural knowledge holders, if possible
- Engaging in conversations with collages regarding providing cultural
relevant and safe services

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Increase my knowledge
of various counseling
techniques used
specifically with the
Indigenous child and
youth population

- Learn and assess new counselling techniques while using both Western
and Indigenous lenses
- Engage with colleagues on the Child and Youth Mental Health team to
learn about the techniques used in their practice
- Engage in training on counselling techniques employed with children, if
possible