EMERGING PRACTICE, MAP-IN-PROGRESS:
A SOCIAL WORK PRACTICE MODEL

by
Jessica K. Leavens
B.A., University of Victoria, 2009
Diploma, University of Victoria, 2009
Post-degree Diploma, Camosun College, 2017

PRACTICUM REPORT SUBMITTED IN PARTIAL FULFILLMENT OF
REQUIREMENTS FOR THE DEGREE OF
MASTER OF SOCIAL WORK
UNIVERSITY OF NORTHERN BRITISH COLUMBIA

December 2022
ãJessica Leavens, 2022

Abstract
As social workers, we develop our own integrated social work theory and practice model
to guide an ethical, accountable, and evidence-based approach to professional practice. This
report describes my emerging model, a map-in-progress, developed over the course of my
Master of Social Work degree and final practicum. My practice takes place in the territories of
the Tla’amin Nation. In this report, I focus on social work in primary health care, grounded in a
theoretical orientation of Just Practice, queer theory, and abolitionist theory. I describe four
landmarks generated in the context of my practicum: i) interprofessional practice, ii) the clientpractitioner relational continuum, iii) equity-oriented health care, and iv) abolitionist social work.
I present a series of process-oriented collages rooted in the tradition of arts-based inquiry as selfreflexive practice. This report serves as a tangible touchstone for my emerging practice and I
offer it as a humble addition to social work scholarship and practice.

Table of Contents
Abstract .......................................................................................................................................... ii
Table of Contents .......................................................................................................................... iii
List of Figures ................................................................................... Error! Bookmark not defined.
Acknowledgements ........................................................................................................................ vi
Land Acknowledgement ........................................................................................................................ vi
Dedication ............................................................................................................................................... vi
Gratitude ................................................................................................................................................. vi

Introduction .................................................................................................................................... 1
Chapter 1: Bedrock ......................................................................................................................... 3
Practice Ground ...................................................................................................................................... 3
Practice Location ..................................................................................................................................... 4
Practicum Learning Goals and Activities ............................................................................................. 5
Arts-based Inquiry as Self-Reflexive Practice ...................................................................................... 5

Chapter 2: Foundations ................................................................................................................. 8
Positionality and Social Location ........................................................................................................... 8
Theoretical Orientation ........................................................................................................................ 10
Just Practice ........................................................................................................................................................ 10
Queer Theory ...................................................................................................................................................... 11
Abolitionist Social Work .................................................................................................................................... 12

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Chapter 3: Landscape ................................................................................................................... 15
Social Work in Primary Health Care .................................................................................................. 15
Ethical Practice in Primary Health Care ............................................................................................................. 19

The Client-Practitioner Relational Continuum.................................................................................. 22
The Unique Approach of Social Work ............................................................................................................... 23
Engagement ........................................................................................................................................................ 24
Teaching-Learning .............................................................................................................................................. 25
Accompaniment and Action ............................................................................................................................... 26
Evaluation ........................................................................................................................................................... 27
Critical Reflection............................................................................................................................................... 27
Celebration.......................................................................................................................................................... 28

Equity-Oriented Health Care ............................................................................................................... 29
Culturally Safe Care ........................................................................................................................................... 30
Trauma-and-Violence Informed Care (TVIC).................................................................................................... 31
Harm Reduction .................................................................................................................................................. 32
EQUIP in Practice .............................................................................................................................................. 33

Abolition in Practice.............................................................................................................................. 34
Moral Courage .................................................................................................................................................... 36
Abolition as Decolonization ............................................................................................................................... 37
Abolition Within the Client-Practitioner Relationship ....................................................................................... 38

Chapter 4: Constellations ............................................................................................................. 40
Chapter 5: Emergence .................................................................................................................. 49
References ..................................................................................................................................... 51

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List of Figures
Figure 1

Celebration of transition

40

Figure 2

Self-reflexivity: A series

41

Figure 3

What makes a brilliant social worker?

42

Figure 2

What makes a brilliant social worker?

43

Figure 3

Abolitionist inquiry

44

Figure 4

Emerging practice map

45

Figure 7

Heart to hand, hand to earth, earth to sky

46

Figure 5

Abolition in practice, practice, practice

47

Figure 6

Process, care, and liberation

48

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Acknowledgements
Land Acknowledgement
Land acknowledgements are one aspect of broader actions of truth and reconciliation. My
work and studies take place on the traditional territory of the Tla’amin Nation, within the qathet
Regional District. The name qathet means ‘working together’ in ʔayʔaǰuθəm.
The Tla’amin Nation have been the stewards of this land since time immemorial and it is
through their good stewardship that we all have a place to call home. I acknowledge Indigenous
sovereignty, land and food rights, and human rights. As a white 4th generation settler of
European descent and an emerging social work practitioner, I am part of a culture and profession
with historical and contemporary complicity in the state’s colonial project to perpetuate unequal
access to resources, supports, and human rights; this comes with responsibilities to address and
take action toward truth, reconciliation, and decolonization at the individual, community, and
state level. As a guest in this territory (and in any territory that I live within), I commit to my
responsibilities that include learning about history, protocols, treaty rights and responsibilities,
listening, cultivating right relationships, and taking action from a place of thoughtful reflection
and cultural humility (Koleszar-Green, 2018).
A note: In 2021, the Tla’amin Nation requested the City currently known as Pxwell River
complete a name change process as the current name represents the history of cultural genocide;
this request is in process. In solidarity, I use the following terms throughout this report: qathet
Regional District or qRD to indicate the region, City when referring to the City currently known
as City of Pxwell River and ‘Pxwll’ instead of ‘Powell’.
Dedication
My degree is dedicated to my grandfather, RTP.
Gratitude
To the sacred ones, the land, sky, water, beach and forest, creatures and kin
To my mom, Kathy, for her constant encouragement and love
To my sister, Abby, who is one of my greatest teachers and friends
To my anchor partner, Fred, for their devotion and care of me and our shared life together
To my committee: Melanie Johnson, Dr. Pierce, and Dr. Margolin
To my dear and darling friends who walk and talk, dance and karaoke, and babe it up with me
To my extended family and friends-as-family for your care and love
To the queers that have come before me and shine the way behind me
To my professors, supervisors, and colleagues who have guided and supported my efforts
To all the generous humans, particularly within my community development work, who have
shared their dreams, expertise, experiences, and care with me
To the activists, theorists, and scholars whose work guides, challenges and inspires me
To the kindness of strangers
Your names are important… and would fill pages… you know who you are.
I am eternally grateful for the interdependent, soft and generous container of love
we co-create together
May I be of skillful service and uplift and co-generate safety, belonging, dignity and liberation.
Note: As a genderqueer person, I use the term Magisteriate of Social Work (MSW).

1
Introduction
The final Magisteriate of Social Work practicum takes on a weight of significance,
aspiration, and import; it is a potent time of embodied challenge, learning and integration. The
overarching purpose of my practicum was to centre the creation of a personalized integrated
theory and practice model to guide my emerging social work practice. This report is the result of
my learning gleaned through relationship tending and practicum experiences. It serves as the
culmination of research conducted throughout my MSW at the University of Northern British
Columbia. As I visioned this report, I was inspired by the work of arts-based researcher Leavy
(2020) who uses the word shape to help us visualize how scholars may experiment with form,
format, and knowledge exchange in innovative, accessible, and creative ways. With this in mind,
I present my model as a map-in-progress, exploring the topography of chosen theories,
frameworks and models, practices, and processes. I consider the shape of terrain that is emerging
- what can be shared, what must be hidden, and what is still to be discovered. I anticipate this
map will be re-worked, dismantled, and built upon throughout my social work career; the snail
and the bird’s eye view, next steps, and cohesive whole continues to form.
My emerging practice model consists of foundational layers, landscape, landmarks and
pathways, and constellations; these elements were researched, refined and experimented with
during the practicum. The foundational layer of bedrock, Chapter 1, is rooted in
acknowledgement, gratitude, dedication, and intention. I explain the practice ground, including
geography and context, my practicum learning goals, and provide the rationale for the inclusion
of arts-based inquiry as a generative source of self-reflexive practice. I focus on primary health
care (PHC) as my favoured practice setting and incorporate practice examples from PHC and
mental health, with attention paid to rural practice. Chapter 2 begins to build up the topography

2
of my map-in-progress through the presentation of my positionality, social location, and
theoretical orientation, which includes the Just Practice model (Finn, 2016, 2021; Finn &
Molloy, 2021), queer theory, and abolitionist social work. Chapter 3 explores central elements of
the landscape, pathways and landmarks central to primary health care social work, that emerged
throughout my practicum, including i) social work in primary health care, ii) the clientpractitioner relational continuum within social work, as defined primarily by the Just Practice
model, iii) equity-oriented health care (EOHC), and iv) abolitionist social work. Chapter 4:
Constellations consists of practice wisdom as poems and collage as arts-based self-reflexive
practice. Chapter 5 provides a conclusion of this report.
Social work’s contribution to primary health care is unique, requires specialized skill and
knowledge, and must centre transformative social justice rooted in equity, cultural humility, and
visions and practices towards shared liberation. Based in ethical practice, we must tend to
context, meaning, history, power and structural inequities, and possibility (Finn, 2016; 2021)
throughout the relational and care continuum. We must be collaborative, creative, courageous,
and meet ourselves and others where we and they are at, while centering love and compassion.
The process of creating this map-in-progress has rooted me more deeply in my values. It is a
commitment to queering social work within a framework of anti-colonial and anti-racist theory
and practice: “a queer social work recognises that queerness is more than a problem requiring
intervention, a queer social work seeks to challenge and disrupt hegemonic ideas about identity
and normalcy, a queer social work centres social justice and social transformation” (Kaighen,
2020, p. 342). This report serves as a tangible touchstone for my emerging practice – words and
images of vulnerability, remembrance, and aspiration – and I offer it as a humble addition to
social work scholarship and practice.

3
Chapter 1: Bedrock
Practice Ground
Broadly, the completion of my MSW and practica takes place in the midst of worsening
climate change, global wars, human rights uprisings, and two concurrent public health
emergencies (the COVID-19 pandemic and the opioid overdose poisoning crisis) that impact all
areas of community life, government policies, and social work practice. This is a time of great
distress and fear alongside great hope and possibility. Finn (2021) invites social workers to
contemplate how “our practice plays out in (these) multiple and mutually influencing contexts,
which are embedded in and further shaped by the broader social, political, cultural, and
economic logics and forces” (p. 25). In this current context, social workers have very real
constraints, particularly within rural and remote practice. We are facing significant challenges in
providing responsive services to diverse populations with less specialized services, inconsistent
access to internet and online services, reduced staff, reduced services due to restrictions (Mental
Health Commission of Canada, 2021) and reverberations of the COVID-19 pandemic. It
continues to be challenging for supply to keep pace with demand, particularly in rural and remote
communities (Bodor, 2009; Mental Health Commission of Canada, 2021); this was discussed
regularly within my practicum context, including challenges with recruiting staff due to working
conditions, housing availability, and wage disparities between public and private sectors.
Social workers have a responsibility to approach context and presented issues with
resilience and collective action: “a critical clinical approach does not medicalize or pathologize
people’s struggles but situates them within the social contexts and inequities in which they
emerge” (Brown, 2021, p. 645). Broadly, there are a multitude of complex current issues to be
aware of. This includes higher rates of suicide, suicidal ideation, and substance use connected to

4
suicide attempts (Mental Health Commission of Canada, 2021). High costs of medication and
precarious employment (Schibli, 2019), perceived and actual stigma leading to challenges in
accessing support, intensified impacts of the opioid poisoning crisis leading to trauma, illness,
and death, lack of adequate housing and homeless shelters, and lack of access to primary care
(Mental Health Commission of Canada, 2021) impact us all. This multilayered context has
significant impacts on the health and well-being of individuals and groups in our community.
Indigenous individuals, people experiencing gender-based violence, immigrants and newcomers,
people who use drugs, and 2SLGBTQIA+ youth are inequitably and disproportionately impacted
by these marginalizing conditions (Mental Health Commission of Canada, 2021). Within my
context of rural primary health care, these conditions are compounded by the lack of equitable
access to consistent well-informed, well-funded, and local basic and specialized services and
supports, such as abortion services, gender-affirming care, and adult autism diagnosis services.
Practice Location
The practice ground for my final practicum was in primary health care (PHC) within the
qathet Regional District. qathet Regional District is within the traditional territories of the
Tla’amin, shíshálh, Klahoose, Homalco, and K’ómoks First Nations (qathet Regional District,
2020a). This geographically isolated region is accessible only by ferry or air, encompasses the
Tla’amin Nation village and territorial areas, several islands, the City of Pxwell River, and rural
areas and is home to approximately 20,000 people (qathet Regional District, 2020a, 2020b). This
region is within the Vancouver Coastal Health (VCH) authority. VCH was created in 2001 when
the Province of British Columbia created regional health authorities; it covers from Vancouver to
Bella Coola, encompassing urban, rural, and remote areas and including fourteen Indigenous
communities (VCH, 2015). At my practicum site, I was part of an interdisciplinary team,

5
supervised by a skilled and compassionate MSW clinician with extensive clinical skills and
experience in both individual and group therapy. The location and details of the organization will
be kept confidential (further discussed below).
Practicum Learning Goals and Activities
My practicum learning goals were: a) develop and apply an integrated practice model
rooted in theory, practice approaches, and practice wisdom, b) develop critical clinical social
work skills, c) develop and apply conflict resolution and advocacy skills, and d) develop skills,
knowledge, and values of working in an interprofessional team. Over the course of the
practicum, I focused my learning on the creation of my practice model, new learnings, and
integration of goals described above, as appropriate and relevant.
Throughout my practicum, I engaged in research, discussion, and application of theories
and practices in order to synthesize, refine, and create the practice model presented in this report.
To develop my critical clinical social work skills, I took part in individual sessions, conducted
biopsychosocial assessments, and co-facilitated two therapeutic groups. I participated in two
conflict management courses and experimented with conflict management and advocacy skills
alongside clients and colleagues. The area of primary health care is fraught with ethical
considerations and dilemmas; these were explored in supervision sessions. I explored the role of
social worker in interprofessional practice by shadowing colleagues, attending case conferences,
and participating in team meetings in diverse settings. These activities allowed me to explore the
breadth and depth of the continuum of care within primary health care.
Arts-based Inquiry as Self-Reflexive Practice
Given the small scale of the qRD, the importance of confidentiality, the primacy of
ethical practice within social work practice (British Columbia College of Social Workers

6
[BCCSW], 2009), and to remain focused on the purpose of the report, which is to present my
emerging practice model, I made the deliberate decision to eliminate as many identifying
characteristics of the practicum site as possible. This decision impacts the degree of specificity
offered, the level of personalized reflection, and reduces examples of direct application.
However, I investigate vulnerable and challenging concerns and questions that arose throughout
the practicum through arts-based inquiry as self-reflexive practice in Chapter 4.
Arts-based research, or arts-based inquiry (ABI) as it is referred to within this report, is
rooted in feminist theory and practice and the disruption of hegemonic forms of knowledge,
experience, and power (Butler-Kisber, 2007; Leavy, 2020; Margolin et al., 2017). The
presentation of these materials is intended to shift the relational dynamic of researcher and
viewer to make available the inner world of the researcher, illuminating points of resonance,
understanding, and divergence (Leavy, 2020) while creating space for multiple interpretations
(Butler-Kisber, 2007). The potent potentiality of ABI enhances our capacity to investigate
nuance and context (Margolin, 2014), provides space for exploration of inequity and oppressions
through lived experience and representation (Margolin et al., 2017), and cultivates and deepens
imagination, intuition, and holistic embodied self-reflexivity.
ABI is a method I have utilized throughout my MSW, weaving together video clips,
collage, photography, poetry, and narrative writing in various assignments to create my own
“holistic, integrative perspective” (Leavy, 2020, Chapter 1, para. 5); in this way, I am
particularly interested in queering the reflection process. To visualize my map-in-progress, I
superimposed words, images, and objects onto a map of so-called British Columbia covered with
layers of transparent and opaque paint and pencil; I present a series of photographs of this piece
from a snail’s eye and bird’s eye view. I played with disparate images, words, and textures to

7
create collages, as this medium is “particularly suited as a liberatory research method to express
developing internal awareness in a concrete form” (Margolin, 2014, p. 260). Collage has a
particular quality of juxtaposition that makes it particularly compelling for exploration of self
and other, personal, professional, and political (Butler-Kisber, 2007; Leavy, 2020; Margolin et
al. 2017). I present poetic renderings of practice wisdom collected from esteemed colleagues in
dialogue with three questions: What makes a brilliant social worker? What are essential skills?
What is essential knowledge? For me, this dialogue between art-making, research, and self,
forms a space for the unearthing of emotion, unconscious thoughts and associations, and the felt
sense of experiences that seek to be integrated and given shape. This form of self-reflexive
practice is an embodied conduit for meaning making.

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Chapter 2: Foundations
Positionality and Social Location
A foundational element of my integrated practice map is personal positionality and social
location. Positionality is a self-reflexive practice that requires me to consider and be transparent
about my worldview, social location, context, and relationships as connected to the setting
(Holms, 2020). This process, undertaken individually and in groups, helps us to better
understand and respond to roles, responsibilities, and power dynamics within relationships and
structural contexts. I centre the words of Baskin (2016): “What is it about the helper that may act
as a challenge or as a route of connection with the service user?” (p. 38). Within the
interprofessional sphere of social work in primary health care, I consider this to be a useful
inquiry for not only service users but also colleagues and community partners. Social work is not
neutral (Brown, 2020). The intersections of my social location, biases and behavioural patterns
with the historical and contemporary reputation of my chosen profession impact and intersect
with the identities and lived experiences of those I work alongside. For me, Baskin’s (2016)
query affirms my personal and professional responsibility to engage in careful and consistent
inquiry. It is foundational to generative, ethical, and respectful relationships, critical reflection,
accountability practices, and integration.
My intersecting identities create particular power, dis/advantage, and privilege to be
explored through inquiry, dialogue, and self-reflexive practice. While some pieces of my identity
may change, at present I am a genderqueer queer femme with post-graduate education, working
class status, and access to familial resources and supports. My familial ancestral lineages are
English, Scottish, German, French and unknown due to disconnection and adoptions; my
ancestors immigrated and settled in the traditional territories of the Anishinaabe, Huron-Wendat

9
and Haudenosaunee in the early 1800’s and many have remained there to this day. As described
in the Land Acknowledgment section of this report, I am a white settler and a guest (KoleszarGreen, 2018), now living within the traditional territories of the Tla’amin Nation, that comes
with particular roles and responsibilities. I choose to not share other elements of my identity in
this public document due to my own personal and professional boundaries, particularly relevant
to living and working in a rural and remote environment.
As part of my practice model, I centre these questions around positionality and social
location: What do I sacrifice, what keeps me safe, and what am I complicit in when I hold space
for others without acknowledging that I often walk alongside them in particular struggles and
joyful camaraderie? What internalized oppressions am I holding onto that prevent me from
claiming and sharing my own identities? How might my perceived and internal social location
comply with and/or disrupt dominant paradigms? And, given my social location, how might I
navigate self-disclosure, self-advocacy, and self-care with clients and colleagues? Finn (2021)
invites us to consider the role of history in our social work relationships – our own, those of our
clients, and the intersections of the micro-mezzo-macro levels. What will I gain when I situate
myself in these histories, claim my own stories, and honour those rich and complex narratives
that are not my own? In this context, I was also interested in what the development of a
professional identity meant to me, my shifting status from non-professional to the professional
ranks of social worker, and the placement of myself as MSW student within the hierarchal and
complex systems of power within primary health care. I enter into dialogue with these questions
through the format of arts-based inquiry (see Chapter 4).

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Theoretical Orientation
As I continue to conceptualize my integrated practice map, I come to the theories that
weave together to form my social work theoretical orientation; the geological term for this layer
is parent materials and I queer this term by using the term chosen family materials; particularly
fitting as a way to recognize and honour the theorist practitioners that have come before me. My
chosen family materials are made up of the Just Practice model (Finn, 2016, 2021, 2022; Finn &
Molloy, 2021), queer theory, and abolitionist social work. I appreciate the range of theoretical
perspectives that Finn (2016, 2021) draws from to create the Just Practice model, including queer
theory. As a queer person, I resonate with the flow of inquiry and invitation set out by queer
theory and dedicate a section to it alone. For me, abolitionist theory is an essential aspect of
contemporary social work, responsive to the needs of our communities and intimately linked to
the pressing issues of decolonization, reconciliation and the dismantling of intersectional
oppressions, including white supremacist ideologies; thus, I include it here. It is beyond the
scope of this report to fulsomely explore each theoretical framework.
Just Practice
The Just Practice theoretical and practice framework is developed primarily by American
social worker, Janet Finn (2016, 2021). I briefly touch on the theoretical aspects here and
describe specific practice elements in Chapter 3. Just Practice is an integrative, meaning it
combines various theoretical frameworks, including but not limited to social constructivism,
feminism, critical race theory, intersectionality, queer theory, anti-oppressive practice, and
practice theory, to create a “model for critical inquiry that enables us to disrupt assumed truths,
explore context, and appreciate ways in which social location may shape interpretation” (Finn,

11
2016, p. 178). The unique integration of theoretical orientations provides fertile ground for
experimentation and application for my emerging social work practice.
This theoretical orientation is rooted in social justice and seeks to address the impacts of
globalization and neoliberalism while integrating micro, mezzo and macro levels in diverse
practice settings. It prioritizes a critical approach to social work history, practice, and theory,
centres critical reflection, social work values and ethics, and offers a clearly defined approach to
working alongside diverse clients in diverse settings (Finn, 2016, 2021; Finn & Molloy, 2021).
Just Practice envisions the social work relational continuum to move through seven processes:
engagement, teaching-learning, action, accompaniment, evaluation, critical reflection, and
celebration (Finn, 2016, 2021) and are used to frame the upcoming discussion on the clientpractitioner relationship in Chapter 3. Five theoretical concepts of meaning, context, power,
history, and possibility, are overlaid into the seven processes to invite and encourage a depth of
critical and collaborative reflection within the relational continuum (Finn, 2016, 2021). Inspired
by the integrative approach outlined in this model, it is my intention that my map-in-progress
interweaves theory and practice.
Queer Theory
Queer theory “operates as a set of intellectual claims, practices and political actions”
(Rumens et al., 2019, p.597). I centre this theoretical framework in my map-in-progress because
it centres social justice (Kaighan, 2020) and invites creativity and curiosity while “being playful
with ideas and turning knowledge inside out and backward” (MacKinnon, 2011, p. 140). By
aligning with this theoretical lens, I consciously choose to actively trouble the cisheteronormative paradigm and question cultural messages, stereotypes, and institutional policies
and practices around gender, sexuality, and binaries of all forms. Within the primary health care

12
setting, I am particularly interested in the invitation to question assumptions, identities, and
relationships in order to explore and expand our ideas about ab/normality and diversity (Hardy &
Monypenny, 2019; Rumens et al., 2019). Queer theory, as a foundational aspect of my practice,
invites me to embody an approach that “does not focus on integration into dominant structures
but instead seeks to transform the basic fabric and hierarchies that allow systems of oppression to
persist and operate efficiently” (Cohen, 1997, p. 437). Within the tensions of a primary health
care system that simultaneously promotes empowerment and advocacy while being entrenched
in hierarchal and bureaucratic structures, queer theory lens is a necessarily anti-oppressive and
anti-colonial balm; there is much for me to learn about how to apply queer theory to my practice.
Abolitionist Social Work
Broadly, abolition theory and practice offer a collective vision of a world without
policing, prisons, and punishment. This theoretical and practice stance is rooted in the global
majority’s cultures, communities, and scholarship (Ben-Moshe, 2018; Kaba, 2021). Black
scholar and organizer Cullors (2019) describes abolition as a “a praxis that roots itself in the
following principles: people’s power; love, healing, and transformative justice; Black liberation;
internationalism; anti-imperialism; dismantling structures; and practice, practice, practice” (p.
1685); abolition theory and practice benefits the liberation of all. Central to the aims of abolition
is the dismantling of structural oppression while recognizing that the carceral state is inextricably
linked to white supremacy (Ben-Moshe, 2018; Richie & Martensen, 2020), colonialism (Almeida
et al., 2019), and ableism (Peña-Guzmàn & Reynolds, 2019). Indeed, “a rigorous examination of
what is considered “illegal” reveals patterns that suggest in many ways law and legal policies
serve as an instrument of social control of marginalized groups rather than some neutral
mechanism for encouraging safety and social order” (Richie & Martensen, 2020, p. 13).

13
Abolitionist social work acknowledges and works to end our profession’s participation in
and proximity to social control mechanisms, punitive practices, and colonial systems. The
profession’s proximity to the carceral state is in direct conflict with the profession’s ethics and
standards of decolonization, social justice, human rights, and liberation (Absolon, 2019;
Alberton et al., 2020; Hereth and Bouris, 2020; Jacobs et al., 2021; James, 2021; Richie &
Martensen, 2020). Social workers Hereth and Bouris (2020) describe how scholars and activists
integrate abolition theory and queer theory, supporting an intersectional analysis to “examine
how the state constructs “normative” gender and sexual identities and then uses surveillance,
policing, and punishment to enforce those norms against any group who deviates from
heteronormativity” (p. 364). Broadly, this analysis can be put into practice when we resist
collusion with the carceral systems and instead are led by those most impacted, centre selfdetermination (both individual and community), engage in advocacy (Richie & Martensen,
2020), share power, and divest from our expert status (Hereth and Bouris, 2020). A commitment
to abolition requires us to remember, learn, and share skills and knowledges around justice,
reparations, and repair practices (Cullors, 2019; Kaba, 2021). The practice of abolitionist social
work in primary health care will be explored in Chapter 3.
In this section, I provided resonant aspects of each theoretical orientation and
acknowledge the partiality of what is offered here. Social work necessarily draws on research
from other disciplines and learns from/with community to create responsive practice theories
(Payne, 2020). It consistently seeks to transform its own theories and practices to better reflect
contemporary anti-oppressive ethics, client/community priorities, and transformative social
change goals (Payne, 2020). Within my practicum experience, I incorporated my chosen
theoretical frameworks into diverse activities; broad examples are offered in Chapter 3. It is my

14
intention to continue to engage with Just Practice, queer theory, and abolitionist social work and,
at the same time, I am committed to curating the development and practice of my theoretical
orientation in an iterative and dynamic way to create a responsive, transformative, and
invigorating practice.

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Chapter 3: Landscape
The verdant landscape of my practice map is made of intersecting pathways, landmarks,
and unknown areas yet to be created, revealed, and explored. Within this chapter, I present four
landmarks that presented themselves within my practicum as essential aspects of primary health
care social work: i) the social worker in primary health care, ii) the client-practitioner relational
continuum, iii) equity-oriented health care, and iv) abolitionist social work. It is beyond the
scope of this report to provide a comprehensive literature review of each element; rather I
provide what is most relevant and inspiring to the development of my map-in-progress. I
acknowledge the material presented and my own knowledge is limited; each area is in a
continuous state of research, refinement, and expansion.
Social Work in Primary Health Care
My practicum took place at a primary health care centre; this section describes primary
care, social worker’s role in context and interprofessional practice, and ethical practice. Primary
health care (PHC) is a universal concept that was formalized in 1978 and unifies approaches to
public health worldwide (World Health Organization [WHO] & United Nations Children’s Fund
[UNICEF], 2018). It is intended to be the first point of health care contact for all community
members and includes sites such as public health units, clinics, and emergency departments
(WHO, 2018; WHO & UNICEF, 2018). In these sites, multidisciplinary teams are made up of
administration, allied and medical health professionals, traditional healers, support staff, and
community members who offer care to diverse clients throughout their lifespan and throughout
the health care continuum, from health promotion to palliative care (WHO & UNICEF, 2018).
Social workers are an integral part of such teams; Döbl et al. (2015) refer to us as “the hidden
jewel” (p. 333) of primary health care.

16
The expressed values and intentions of PHC are well-aligned with the definitions,
standards, and practices of social workers worldwide (International Federation of Social Workers
[IFSW], 2022). PHC seeks to neutralize social determinants of health, such as income, literacy
levels and social connection, while nurturing healthy communities and environments at the
individual and population level (WHO & UNICEF, 2018). Of particular interest to the
development of my map-in-progress are the key features of advocacy and empowerment, figured
prominently within primary health care (WHO & UNICEF, 2018) and social work standards and
ethics guidelines (BCCSW, 2009; IFSW, 2022). Within PHC, service users are advocates, codevelopers of services, self-carers and caregivers: “the involvement of empowered people and
communities as co-developers of services improves cultural sensitivity and increases patient
satisfaction, ultimately increasing use and improving health outcomes” (WHO, 2018, p. 6).
Within social work, advocacy and empowerment exist at the edges and intersections of the
micro-mezzo-macro levels. We work collaboratively to impact positive social change with the
values of social justice, human rights, dignity, safety, and liberation guiding our way (IFSW,
2022); inherent tensions with our collusion in colonial and punitive structures are evident.
Primary health care goals are highly aspirational and practical: i) provide access to
reliable, equitable and accurate information, knowledge, skills and resources, ii) address specific
needs and changing socio-cultural contexts, iii) provide support for interpreting complex
information and help with decision-making processes, and iv) integrate an awareness of how
social determinants of health impact a person’s access and capacity to utilize self-care
knowledge, skills, and resources, and v) address health inequities (Ford-Gilboe et al., 2018;
WHO & UNICEF, 2018). When PHC is high-performing, it is accessible, continuous,
coordinated, and comprehensive (WHO, 2018). When PHC is high-quality, it is safe, effective,

17
people-centered, equitable, efficient, timely, and integrated (WHO, 2018). The benefits are
tangible: high-quality and high-performance primary health care improves health outcomes,
health literacy, and self-knowledge, decreases unnecessary referrals, results in shorter hospital
stays, and lowers mortality (WHO & UNICEF, 2018). However, Canadian health care currently
operates within a neoliberal culture that promotes capitalist productivity as professional
responsibility, equality-over-equity approach to services, and perpetuates systemic racism and
oppressions (Blanchet Garneau et al., 2019). Reynolds (2014) calls this a time of “structural
oppression, scarce resources, and abundant need” (p. 2). One of the antidotes to this complex and
dire situation is the integration of equity-oriented health care (EOHC) into primary health care
settings (Browne et al., 2015; Ford-Gilboe et al., 2018) and will be discussed in a subsequent
section.
Social workers are embedded in all areas of primary health care, offering a unique set of
theoretical and practice frameworks to highly specialized teams working with diverse clients in
complex settings (Döbl et al., 2015; Tadic et al., 2020). Social work spans work with individuals,
leadership roles, community development (Tadic et al., 2020) and socio-political activism (Finn,
2021). Alongside the role of social worker, our roles and responsibilities are often defined by the
specific context and may include advocate (Ambrose-Miller & Ashcroft, 2016), assessor, mental
health counsellor, educator, supervisor, community development and outreach (Tadic et al.,
2020). In an age of managerialism, social work is measured, commercialized and commodified,
often resulting in poor short and long-term outcomes for clients and social workers alike (Bodor,
2009; Brown, 2021; Radian, 2017). We are required to adapt to continuous systemic change,
tensions between social work values and work tasks, and unclear or overlapping scope of
practice with other health care professionals (O’Brien & Calderwood, 2010). Antidotes to the co-

18
option of social work include but are not limited to individual and collective resistance, the
adoption and advocacy of critical social work values, ethics, and practices, and collective
collaboration to centre social justice within social work education, associations, and unions
(Brown, 2021).
Within the hierarchal yet collaborative setting of interprofessional primary health care,
researchers have identified particular issues; these issues mirror my experience within my
practicum context. At times, interprofessional teams have been shown to result in poor outcomes
for the client as space for advocacy, social justice, or client empowerment is not prioritized (Cui
et al., 2022). The role of social worker as advocate has been shown to sometime result in conflict
within interprofessional teams (Ambrose-Miller & Ashcroft, 2016). Power differentials within
decision-making processes may regulate social work perspectives to the bottom of the hierarchy
(Ambrose-Miller & Ashcroft, 2016; Cui et al., 2022). Tensions are inherent between the medical
model of symptom management and social work’s emphasis on empowerment (Cui et al., 2022)
and human rights. Role ambiguity continues to serve as a source of concern (Ambrose-Miller &
Ashcroft, 2016; Döbl et al., 2015; O’Brien & Calderwood, 2010; Tadic et al., 2020).
In an article jointly written by a social worker, physiotherapist, occupational therapist,
and speech-language pathologist, Burghardt et al. (2021) share how they (the authors) were not
just unprepared to understand and meet the realities of their clients who were disabled but were
actively working against their client’s needs, through pathologizing and harmful practices and
frameworks taught to them in their respective professional training program. In addition, I would
argue harms are perpetuated within the primary health care settings through punitive policies,
under-resourced programs, and lack of time and resources to research, update, and revise

19
programs and policies to incorporate and reflect the contemporary needs and perspectives of
diverse clientele, staff, and community members.
As a response to these concerns, I am drawn to the work of Oliver (2013) who frames
social workers as boundary spanners – professionals who “attend to the whole system in addition
to the parts of which it is comprised” (p. 777) and are “rule-benders and risk-takers (p.779). To
effectively engage in this role, social workers must learn and practice skills in negotiation,
mediation, conflict resolution, relationship tending, and non-hierarchal leadership with courage,
practicality, honesty, and complexity (Oliver, 2013); this echo skills elevated within the Just
Practice model (Finn, 2016, 2021). However, as a MSW student, I recognized my needs for
safety and support contrasted with my desire to invoke risk-taking and innovation. I require more
time to build and tend to relationships, cultivate discernment, and learn how to effectively
navigate overt and subtle power dynamics and hierarchies within the interprofessional team in
order to effectively engage in the boundary spanning role. I erred on the side of research and
learning rather than application of that specific role and strategy; this approach is aspirational
and will guide my future endeavours. The skills and approaches described above require ongoing
patience, commitment, learning, and courageous conversations with self, colleagues, and policymakers to impact positive change at the micro, mezzo, and macro levels of primary health care.
Embracing the identity of boundary spanner is one strategy that invites social workers to more
clearly define and articulate their identity, impact, and stance within interprofessional primary
health care practice.
Ethical Practice in Primary Health Care
I am particularly interested in working from an ethics of care, “a situated ethics that
places dilemmas and decisions in a broader social, political and cultural context and sees

20
responsibilities in a wider, more relational sense, beyond the isolated individual decision-maker”
(Banks, 2016, p.36). This requires an intentional approach to working alongside colleagues and
clients who may not share the same values, ethics, and worldview with humility, compassion,
and integrity. Common ethical dilemmas or concerns identified within my practicum and
corresponding to identified issues throughout social work included dual relationships, scope of
practice, advocacy, responsibility to client, record keeping and documentation, privacy and
confidentiality (BCCSW, 2009). In rural and remote practice, there may be a lack of clarity
around who the client is, what harm needs to addressed in what order, and/or working with
multiple clients with differing needs in the same situation, creating an ethical issue of “paradox”
(Weinberg, 2020, p. 59). For me, particular ethical issues in the primary health care context
include social work’s role in mandatory reporting and involuntary hospitalization; I remain in
process with how to navigate these issues with integrity and due diligence.
Within primary health care, ableism is a significant ethical and human rights issue woven
into the very fabric of care. The medical system often willfully ignores theory, evidence, and
practice from outside sites of knowledge and experience, including disabled individuals,
activists, and scholars because in doing so, it maintains hierarchal power (Peña-Guzmàn &
Reynolds, 2019). To be effective social workers, we must remember that “distrust and resistance
are often healthy responses to such systems” (Finn, 2016, p. 199). Social workers are complicit
in this oppressive system; however, it is our responsibility to learn, practice, and refine
approaches, strategies and skills to dismantle internalized, interpersonal, and structural ableism.
In order to acknowledge and address ableism and its associated intersectional ethical issues, I
found helpful guidance in the synergies of the work of Burghardt et al. (2021), the central role of
advocacy in social work, and the guiding approach of epistemic humility.

21
Disability studies and critical race theory studies (DisCrit) draws on the work of
academics and activists, “focuses on interdependence, refusing erasure (Mingus), and
recognizing enduring historical moments’ influence on present day events” (Annamma & Handy,
2020, p. 7). Founded in Black and critical race feminist scholarship and activism, DisCrit
investigates and troubles oppressive social structures, using a lens of intersectionality,
particularly around gender, race, and dis/ability (Annamma et al., 2018). Burghardt et al. (2021)
invite allied professionals work from a critical disability studies (CDS)-informed understanding
of disability as socially constructed and socially perpetuated, construct the client-practitioner
relationship as partnership rather than helper-helped, and engage in explicit examination and
addressing of ableism, inequitable power dynamics, and the complex, yet at times, harmful aims
of rehabilitation and social work practice. These invitations are useful to me in order to guide
thoughtful and informed conversations around ethical dilemmas and concerns and support my
aim to centre an approach rooted in abolitionist social work values (as described throughout this
practice model). They are also linked to advocacy and epistemic humility, as described below.
Advocacy is a set of skills and strategies that supports ethical practice; it is a central tenet
of social work (BC College of Social Workers, 2009; Harms & Pierce, 2019; Maylea et al.,
2020). Effective advocacy centres a person-centred approach that emphasizes partnership
alongside personal autonomy, supported decision-making processes alongside self-advocacy, and
solidarity for human rights at the community and structural level to promote social justice change
(Maylea et al., 2020). As a student, the importance of self-advocacy emerged within my
conversations with clients – this became an important aspect of capacity-building and powersharing. The use of self-advocacy skills has been linked to increased hopefulness, better quality
of life, fewer psychiatric symptoms (Jonikas et al., 2013), timely care and better pain

22
management treatment options (Carusone et al., 2019), supportive conversations with family and
friends (Dassieu et al., 2021), and inclusion in policy and strategic actions (Mental Health
Commission of Canada, 2012).
Epistemic humility is a broad concept, but for our purposes, it requires practitioners to
address their biases, offer a sense of curiosity towards the client’s experiences, and make central
the role of the client in understanding their own health conditions so that we may offer accurate
and evidence-based decision-making and treatment recommendations; this approach nurtures
mutual trust (Buchman & Ho, 2014). There is an element of translation that may occur within the
primary health care setting. At times, I noticed that the social worker must present the client’s
perspective in a language understandable to other professions to increase its legitimacy, validity,
and inclusion into treatment planning. Ethical practice is complex; it requires ongoing
commitment, skill development, hopeful practices, concrete strategies, conversations, and a
sense of strategic optimism. To remind me of what is important, I come back to this quote: “what
is ethics, if ethics is not demonstrated care, and, dare we say, love in action?” (Sewpaul &
Henrickson, 2019, p.1473).
The Client-Practitioner Relational Continuum
The client-practitioner relationship is significant in social work and an intentional
framework to guide us through the relational continuum can be helpful, protective, and
grounding. The Just Practice (Finn, 2016, 2021, 2022; Finn & Molloy, 2021) conceptualization
of this relationship is relevant, inspiring, and congruent with my personal and professional
values, intentions, and other elements of my map-in-progress; I draw on other sources as relevant
and appropriate. While the Just Practice model was described briefly within the theoretical
orientation section of this report, it remains outside the scope and purpose of this report to

23
provide a comprehensive description and analysis of the model; please see Finn (2016, 2021,
2022) and Finn and Molloy (2021) for full description and analysis.
Briefly, the Just Practice integrated practice model invites social workers to centre the
transformational, political, and critical (Finn, 2016, 2021). Social workers are called to be in
active critical reflection and analysis of self, the profession, and socio-cultural political contexts.
To deeply consider and problematize how we may (and may not) respond with leadership,
compassion, and discernment to the complex intersections of the micro-mezzo-macro spheres of
practice and community life. To support this crucial and critical analysis, the Just Practice model
defines five intersecting key concepts, meaning, context, history, power, and possibility,
interwoven through seven processes of engagement, teaching-learning, action, accompaniment,
evaluation, critical reflection, and celebration. In this section, I explore the seven processes as the
frame for the client-practitioner relational continuum. I applied this model to my work in
individual and group settings and broadly provide my key learnings throughout this section. In
social work practice, the client may be an individual, multiple stakeholders and/or a community
(BCCSW, 2009; Finn, 2021); in this context, I primarily focus on the client as individual.
The Unique Approach of Social Work
As part of our unique approach to the client-practitioner relationship, social work is
rooted in “love, justice, community, and mutual responsibility” (Baskin, 2016, p. 34), social
justice, and advocacy (BCCSW, 2009; Finn, 2021; Towns & Schwartz, 2012; O’Brien &
Calderwood, 2010). We emphasize “client- focused, client- driven, recovery, strengths, human
rights, empowerment, (...) perspectives (O’Brien & Calderwood, 2010, p. 328); in a recent study,
the continuity of the caring relationship and whole-person empowerment approach were
attributes of social work most valued by mental health service users (Wilberforce et al., 2020).

24
These foundational features of the client-practitioner relationship are resonant with the
landmarks of EOHC and abolitionist social work described below. Broadly, the profession
considers part of its unique contribution to rest in our focus on person-in-environment and
context in order to attend to individual, structural and social issues (Ambrose-Miller & Ashcroft,
2016; Finn, 2016; Finn & Molloy, 2021; McGregor et al., 2018; O’Brien & Calderwood, 2010;
Towns & Schwartz, 2012). For example, critical clinical social work requires us to resist the
individualizing and decontextualizing of mental health and recovery. Instead, we “address
themes such as access, barriers, diversity, and equity in receiving and providing mental health
care” (Brown, 2021, p. 645). When working in primary healthcare, this holistic approach results
in positive health outcomes including improved self-management capacity and well-being, better
understanding of health conditions, empowerment, access to practical supports, and enhanced
service delivery (McGregor et al., 2018). Of course, the tensions, challenges, and possibilities of
our contemporary time and within primary health care apply; these factors create a complex
practice ground through which to navigate the client-practitioner relational continuum. As our
work can be both liberatory and oppressive, “we must search for the meaning others create and
make no assumptions regarding how others construct their worldview” (Finn, 2016, p. 149).
Engagement
Within the Just Practice framework, we are invited to consider “engagement as both an
intentional process and an ongoing commitment (…) an iterative process” (Finn, 2021 p. 183),
centred in meaningful relationship and cultural humility (Finn, 2021). Engagement is a cocreated space that centres an analysis of the ways in which meaning, context, history, power, and
possibility impact not only the client’s life but the unique relationship between the client and
practitioner (Finn, 2021). The Just Practice framework emphasizes a set of skills that are

25
necessary to continuously cultivate for a social-justice oriented engagement process; for me,
these skills are part of the blueprint for cultivating epistemic humility. These include the: i)
cultivation of empathy and anticipatory empathy, ii) noticing as a practice of “critical,
compassionate observation” (Finn, 2021, p. 202), iii) bearing witness with attention to power
differentials within the relationship, iv) developing awareness of ours, and others, patterns of
embodiment that impact attention and perception, v) attentive and radical listening that supports
self-reflexivity and deeper compassionate inquiry, and vi) dialogue skills to communicate
purpose, goals, and potential tensions in service to safety, dignity, and empowerment (Finn,
2021). Approaching engagement through the Just Practice lens has been shown to help
practitioner’s de-pathologize their perception of client behaviours (Urschel, 2022), acknowledges
the power of lived experience (Byrne, 2022), and builds trust and transparency through
appropriate practitioner self-disclosure (Hoy-Ellis, 2022).
Teaching-Learning
Within the Just Practice framework, assessment is problematized and replaced by the
process of teaching-learning, conceptualized as a collaborative reciprocal process that invites
curiosity, shared wisdom and collective action (Finn, 2021). This approach is aligned with
Indigenous teaching-learning frameworks, as described by Koleszar-Green (2019), and can
support an approach rooted in equity-oriented health care. Finn (2021) invites us to engage in
mutual learning and meaning-making, explore possibilities inspired by contexts and histories,
and to celebrate new understandings, connections, and contributions of all involved. In a
teaching-learning partnership, we are co-investigators intent on challenging inequities,
developing shared understanding of critical consciousness, and using dialogue skills that promote
honest and transparent discussion of existing and potential power dynamics (Finn, 2021). This is

26
not without its challenges. For example, mental health-focused social workers often cite
assessment as a key service provided (O’Brien & Calderwood, 2010) and it is often required to
access services and supports, including government financial assistance programs. As a point of
initial contact to primary health care, I conducted a variety of assessments; at times, this process
felt extractive and goal-oriented rather than relationship-building and empowering. In contrast,
the Just Practice Framework Assessment, presented by Brown-Manning and Tolliver (2022),
outlines specific questions about the impact of the practitioner’s positionality, aspects both
similar and different than that of the client; this supports a more effective, strengths-based,
holistic, culturally-informed, and trauma-and-violence informed assessment process. While the
Framework cannot replace required primary health care assessments, I have found that
considering these questions guides me to a more nuanced and compassionate understanding of
the client and our relationship and empowers me to take creative and divergent actions to best
serve the client’s needs.
Accompaniment and Action
As we nurture and grow our relationship with the client, we shift into accompaniment and
action (Finn, 2016, 2021). I have found resonance in the tensions and intersections between
accompaniment (Arnold, 2019; Finn, 2016, 2021) and/vs. accomplice (Arnold, 2019; Indigenous
Action Media, 2014); this is discussed within the abolitionist social work section below. Within
primary health care, we use the language of intervention, which often includes case management,
assessment, education, counselling, patient navigation support, outreach, and advocacy, as
appropriate to the issues at hand (McGregor et al., 2018). Legal responsibilities apply, such as
mandatory reporting and involuntary hospitalization, that shape the actions available to a social
worker. As a social worker within primary health care, these roles and responsibilities are a

27
reality. However, by shifting to the language of action and accompaniment, I am invited to, once
again, centre collaboration, human rights, agency, the disruption of power-over relational
dynamics, and self-determination (Finn, 2021) within complex care settings. Possibilities emerge
that include expanding the client-practitioner relational continuum to include direct political
action and community-based solidarity work (Finn, 2021) outside of the direct practice setting.
Evaluation
The evaluation of relationships, services, and systems is an essential part of social work
practice. Broadly, evaluation encourages evidence-and-research informed practice, provides
space for meaningful critical examination of the process and progress of expressed goals,
outcomes, and, importantly, the relationship itself, and centres practitioner accountability (Finn,
2021). Just Practice requires participatory forms of evaluation that centre dialogue, attention to
issues of power and decision-making, empowerment and capacity building (Finn, 2016).
Evaluation supports meaningful celebration and transition. Within PHC, evaluation of the clientpractitioner relationship has particular constraints, including the prevalence of one-time
encounters and/or abrupt endings due to circumstances beyond our control. However, within the
practicum setting, self-reflexive art-making practice and supervision sessions offered ways to
engage in reflection and evaluation, even when the client was unable to participate.
Critical Reflection
Critical reflection is an ethical approach to relationship, rooted in integrity, responsibility,
and care; it is a core process within the Just Practice model (Finn, 2021). If we are to be
responsive, anti-oppressive, and culturally humble, we must continually critique our own
practice and the profession of social work itself, individually and collectively (Finn, 2021). It
requires attention to how “we come to embody particular habits, ways of working, and patterns

28
of practice that may implicitly encode assumptions about clients, problems, and interventions
that may be faulty or problematic” (Finn, 2016, p. 166); this reflection must extend to colleagues
and systems. Reflection must turn into action: indeed, “critical clinical practice does not emerge
simply because one is grounded in anti-oppressive, decolonizing, and social justice theory. We
need to think about how these ideas are translated into intentional alternative practices” (Brown,
2020, p. 19). As an emerging social worker, I continue to experiment with methods and mediums
that will best support a simple, consistent, effective and creative process for ongoing critical
reflection; this includes professional supervision, collegial discussions, and arts-based inquiry.
This is often uncomfortable yet expansive work; Finn (2021) reminds us to be appreciative of
our efforts, aware and alert to our own contextual positionalities, and honest about our capacity
and comfort for change and transformation.
Celebration
I adore the inclusion of celebration as one of the central social work processes of the Just
Practice framework (Finn, 2016, 2021) – it is aligned with my joyful, optimistic, and lovecentred approach to practice. Social workers are invited to celebrate learning, bring celebratory
elements into everyday experience, cultivate appreciation for both challenge and success, and
practice celebration in our own ways as an antidote to burnout (Finn, 2016, 2021). I am curious
about the ways in which celebration can honour the process of the transition out of the clientpractitioner relationship, particularly within the very real constraints of time, space, and
organizational capacity and culture of primary health care. Integrating celebration in this context
requires careful forethought. In the past, I have celebrated the transition of relationship with
appreciative texts and conversations and created small collages that recognized the client’s
unique contributions to a group therapy process (see Chapter 5). I will continue to gather a list of

29
simple closing rituals (Harms & Pierce, 2019) and dialogue with clients to co-create culturally
appropriate forms of celebration and transition. I view the integration of celebration, alongside
appreciation, joy, and interdependence into my practice as “intentional alternatives” (Brown,
2020, p. 19) to strengthen the client-practitioner relationship. Aligned with this approach is the
discipline of hope (Kaba, 2021); I am reminded of the work of Reynolds et al. (2021) who states
that “it is our collective ethical obligation as practitioners to bring reasonable hope, a believe-inhope, an embodied hope to our relational work with clients, and not to steal the hope they have”
(p.5). Celebration is also a form of collective resistance (Finn, 2021).
Equity-Oriented Health Care
Equity-oriented health care (EOHC) is a central landmark within my map-in-progress. It
addresses identified issues within primary health care, is well-aligned with social work values, is
immensely practical, inspiring, and grounding. EOHC synergizes existing and new approaches to
practice through evidence-based and research-based interventions, strategies, and studies; it is an
unanticipated and very welcome addition to my practicum experience and emerging practice.
As described throughout this report, primary health care is a promising site for EOHC as
PHC’s are to address the social determinants of health throughout the lifespan and act at the
individual and population level. Those who are marginalized by the PHC systems experience
stigma and discrimination, dismissal and disbelief, and lack of appropriate fit between services
offered and identified needs (Craig et al., 2020; Ford-Gilboe et al., 2018; Wallace et al., 2021).
In response, a EOHC approach within this setting explicitly addresses power imbalances,
resource allocation, concerns of safety and respect, structural barriers, and discriminatory
attitudes (EQUIP Health Care, 2020; Ford-Gilboe et al., 2018). It addresses issues resulting from
under-resourced, fragmented, and inaccessible primary health care services (Browne et al., 2015;

30
Ford-Gilboe et al., 2018) and has been found to improve population health, increase quality
patient experiences, and reduce costs (Browne et al., 2018; EQUIP Health Care, 2020).
For the purposes of this report, I draw primarily from EQUIP Health Care: Research to
Equip Health Care for Equity (EQUIP); this body of work was developed by Canadian
researchers, health care practitioners, and community members and includes research, strategies,
and interventions for use within primary health care and other settings (EQUIP Health Care,
2022). The EQUIP framework of care is intersectional, contextual, and responsive to existing
inequities and it incorporates three key dimensions: i) culturally safe care, ii) trauma-andviolence informed care, and iii) harm reduction (Browne et al., 2018; Craig et al., 2020; EQUIP
Health Care, 2017a; Ford-Gilboe et al., 2018, Wallace et al., 2021).
Culturally Safe Care
Cultural safety is a concept that originated in New Zealand by Dr. Irihapeti Ramsden and
Mãori nurses in the 1970’s (Curtis et al., 2019). Culturally safe care is defined by those
individuals and their communities impacted by the historical and ongoing impacts of oppression,
including colonialism, racism, cis-heterosexism and discrimination; culturally safe care
acknowledges and works to redress these harms (Craig et al., 2020; Wallace et al., 2021). In this
regard, the Truth and Reconciliation Commission of Canada: Calls to Action (2015) provides
clear direction for social workers of all levels to working in health care. This includes i) skillsbased training on anti-racism, conflict resolution, and human rights, ii) integration of Indigenous
healing practices provided by Healers and Elders, iii) advocacy for equity-oriented programming
to address the disparities in health outcomes between Indigenous and non-Indigenous people,
and iv) increased funding for Indigenous-created and focused healing centres and services, v)
promotion and use Indigenous languages, including individual’s names in their own language

31
(Truth and Reconciliation Commission of Canada: Calls to Action, 2015). This is ongoing,
thoughtful, and vital work.
As a non-Indigenous social worker, my commitment to cultural safety also requires
culturally sensitive strategies and actions such as unlearning bias and active anti-racist practice,
engaging in critical self-reflection and humility, undertaking and integrating education and
training (as described above), and learning to be a good guest (Koleszar-Green, 2018, 2019). It is
important to recognize that “how the profession of social work has operated and continues to
operate as an arm of colonization” (Koleszar-Green, 2019, p. 76), and listen deeply because
“Indigenous communities are able to articulate a different path through Indigenous approaches to
social work theory, practice, and research” (Koleszar-Green, 2019, p. 71). An EOCH approach
integrates cultural safety to result in practical and sustainable changes to improve access, quality,
and service for those marginalized by social conditions (Curtis et al., 2019; Wallace et al., 2021)
and improve primary health care policies, programs, and practitioners.
Trauma-and-Violence Informed Care (TVIC)
Trauma-and-violence informed care (TVIC) recognizes the ongoing effects, impacts, and
links between health and behaviour, as related to experiences to trauma and violence, at the
individual and cultural level (Wathen & Varcoe, 2021). In this model, “trauma is both the
experience of, and a response to, an overwhelming negative event or series of events, from wars
to disasters, to accidents and loss (…), trauma can also result from what doesn’t happen, for
example when systems fail to recognize and respond to people’s experiences of violence”
(Wathen & Varcoe, 2021, p.1). As a social worker within this context, it is important to have an
understanding of the impacts of trauma, recognizing that clients, colleagues, and community
members (and ourselves) may at different times be impacted by trauma in its various forms. For

32
example, traumatized individuals regularly experience challenges with memory, attention, focus,
present-moment awareness, inability to name and respond to sensations and emotions, insight,
and inability to plan for the future (van der Kolk, 2006). TVIC is an approach particularly suited
for my emerging social work practice within primary health care as it has an explicit focus on
strengths-based practice, emotional regulation skills (Wathen & Varcoe, 2021), practitioner
humility, shared humanity, choice, collaboration, connection, and clear communication (Craig et
al., 2020). One of the key learnings of my work with clients, specifically related to emotional
regulation skills, is the requirement to commit to distilling information into accessible and simple
language that will be relevant and useful to the client’s life, as self-defined and according to their
priorities, experiences, and existing knowledge base. The implementation of EQUIP TVIC
principles and tools also results in more satisfying working conditions, better relationship with
clients (Wathen & Varcoe, 2021), and reduction of retraumatizing attitudes and practices (Craig
et al., 2020).
Harm Reduction
Harm reduction is a pragmatic approach and a set of dignity-focused policies and
practices to guide respectful, compassionate, inclusive care to reduce unnecessary harms
associated with substance use, including criminalization (Craig et al., 2020; Wallace et al., 2021;
EQUIP Health Care 2017b). Harm reduction alongside cultural safety and TVIC supports me to
offer a holistic approach to address issues brought forward by people with lived experience of
substance use and/or mental health conditions. These issues have been identified as inconsistent
care by practitioners, reluctance or denial of appropriate pain management medications or
treatment, reluctance to access health care and/or leaving and/or being discharged before proper
treatment can be conducted, and/or disempowering interactions between practitioners and

33
patients (Buchman et al., 2016; Carusone et al., 2019). Harm reduction as part of equity-oriented
care acknowledges the harms associated with substance use are worsened by social conditions,
challenges related to mental health, and stigmatizing attitudes and experiences (EQUIP Health
Care, 2017b).
EQUIP in Practice
The model of EQUIP Health Care: Research to Equip Health Care for Equity (EQUIP)
has been implemented in primary health care projects throughout Canada. It focuses on staff
education and discussion, supported organization change, and evaluation processes. This specific
research was not conducted at my practicum site, however, I find the research and accompanying
recommendations and practices to be relevant to my emerging practice and aspects to be easily
integrated into my daily activities on-site at my practicum and aspirational for the future.
The research illuminates spaces of tension and results in a number of positive impacts for
clients and health care staff alike (Browne et al., 2018). Common organizational tensions include
i) conflicts between staff’s existing beliefs and integration of new concepts (e.g. abstinence vs.
harm reduction), ii) resistance to change and comfort in status quo, iii) entrenched leadership
power dynamics and lack of support for front-line staff, and v) discrepancies between expressed
values and regular practice (e.g. cultural safety vs. lack of holistic perspective within
interprofessional team meetings) (Browne et al., 2018). However, it was also identified that
integrating concrete strategies of EQUIP resulted in i) better understanding of intersectional
conditions impacting health, the impacts of trauma on health and behaviour, iii) dentification of
areas for growth and change (e.g. power dynamics, stigmatizing attitudes), and iii) increased
capacity to address racism, trauma and violence (Browne et al., 2018).

34
The implementation of EQUIP requires explicit organization commitment, a depth of
understanding of the concepts, and leadership-supported education and policy change (Browne et
al., 2018; Ford-Gilboe et al., 2018). While strategies for implementation can be simple,
inexpensive, easy to implement, the adoption of EHOC often results in short-term disruption, for
staff and to the organization’s default practices. Research indicates staff and organizations
benefit when they connect “positive disruption to concepts such as innovation, ingenuity, and
interdependence” (Ford-Gilboe et al., 2018, p. 658). Simple yet effective strategies include but
are not limited to: i) ask permission, do not give commands, ii) recognize legitimacy of client
concerns, iii) display welcome signs in as many languages as possible, iv) ask about access to
resources and provide financially feasible recommendations (Ford-Gilboe et al., 2018).
For people living within marginalizing conditions, EQUIP has been shown to increase
trust, comfort, self-efficacy, and a sense of confidence in primary care providers (Ford-Gilboe et
al., 2018). For people living with chronic pain, it has been shown to result in less disabling pain
and reduced negative mental health impacts (Wallace et al., 2021). For those with lived
experience of substance use, improved health and mental health outcomes have been shown
(Browne et al., 2018; Craig et al., 2020; Ford-Gilboe et al., 2018). As EQUIP and EOHC
continues to be researched and responsive to changing conditions, I anticipate I will grapple with
how to integrate the principles, strategies, and actions within the client-practitioner relationship
along the social work relational continuum for years to come.
Abolition in Practice
Abolition in practice is a landmark within my map-in-progress. It is important to
acknowledge my learning in this area primarily comes from the work of Black, Indigenous, and
people of colour abolitionists, activists and scholars. I recognize the work of Cullors (2019),

35
Hassan in Haymarket Books (2021), Kaba (2021), Mingus (2019), Menakem (2021), Spade
(2020), and Piepzna-Samarasinha (2018) as particularly impactful; this is not an exhaustive list.
My positionality and social location, particularly as a white settler and guest (Koleszar-Green,
2018, 2019), necessitates a commitment to humility, ethical learning, practice, and action to
address my inherent unearned power and privilege and work in solidarity. Given this, how do I
show up as an emerging abolitionist social worker within primary health care? I arrive here with
more questions than answers; this will continue to be a life-long inquiry.
Kaba (2021) states that “prison-industrial complex abolition is a political vision, a
structural analysis, and a practical organizing strategy” (p. 2): it is an urgent imperative for
collective liberation. As mentioned in Chapter 2, abolition is both theory and practice. Broadly,
abolitionists advocate for the redistribution of funds and resources to community-building
initiatives (James, 2021) such as affordable housing, comprehensive mental health and health
care, food security, cultural safety and revitalization, early childhood education, affordable
childcare, and other community-based services and supports in service to a world without
carceral systems, including policing and prisons. Abolitionist social workers call for the
profession to align itself more explicitly with the aims and activities of abolition (Jacobs et al.,
2021; James 2021; Preston, 2021) and align ourselves with “life affirming, community-centered,
and mutual aid alternatives” (Jacobs et al., 2021, p. 2).
We are called to denounce carceral social work, “a form of social work that relies on
logics of social control and White supremacy and that uses coercive and punitive practices to
manage BIPOC and poor communities” (Jacobs et al., 2021, p. 3). Social work resides within all
types of carceral systems, including but not limited to prisons, psychiatric hospitals,
rehabilitation facilities, and long-term care homes (Ben-Moshe, 2018); this placement presents

36
both opportunity and challenge. For example, within primary health care, I have deep concerns
about being complicit with the harmful implementation of the Mental Health Act (Province of
British Columbia, 2022), mandatory treatment, mandatory reporting and the potentially negative
impacts on individuals, families, and communities. At the same time, there is legal requirement
for social workers to participate in this system as part of our employment. Indeed, “arguably, no
other discipline—besides, ironically, policing—receives the same simultaneous societal applause
while causing so much harm” (Preston, 2021, p. 151). This is a serious call to action for social
workers, one that must be investigated with care, discernment, and commitment at all levels of
education and practice (James, 2021; Preston, 2021).
As I move forward into my social work career, I will be asked and required to participate
in punitive, power-over policies and/or invited to offer and practice alternatives to this within
workplace and community-based environments. How might I resist power-over and where might
I not be able, willing, or have the agency or skills to do so? The EQUIP framework, as described
above, focused on contextual care centered in equity and cultural safety, harm reduction, traumaand-violence informed care, provides tangible strategies to support the aims and values of
abolitionist social work. Throughout this report I have offered practical strategies, learnings, and
skills to cultivate and draw on within my emerging social work practice; below are three more.
Moral Courage
Throughout my MSW program, I have been inspired by the concept of moral courage
(Blackstock, 2011). Moral courage requires social workers to fiercely locate themselves in their
integrity and engage in “courageous conversations (…) that involve the public expression of
personal or professional principles and/or values in situations where such expression is likely to
be challenged” (Blackstock, 2011, p. 36). The capacity to engage in courageous conversations

37
requires a number of skills, including but not limited to transformative justice, conflict resolution
and crisis response skills (Jacobs et al., 2021), consistent self-reflexive “radical analysis”
(Chandler, 2018, p. 6), and consistent thoughtful action infused with courage, imagination,
accountability rooted in community-building and meaningful interpersonal relationships
(Cullors, 2019).
Abolition as Decolonization
Guided by the Truth & Reconciliation Commission of Canada: Calls to Action (2015),
social workers must decolonize, decentre whiteness, and engage wholeheartedly in anti-racist
reconciliation education, theory and practice; this is the imperative work of our time (Absolon,
2019; Baskin, 2016; Hanna et al., 2021; Leon & Nadeau, 2018). We are called to address the
continuing harms of colonialism and the profession’s continued missteps around advocacy and
solidarity with Indigenous peoples in areas such as child welfare, justice, health, and education
(Absolon, 2019; Alberton et al., 2021; Blackstock, 2019; Baskin, 2016; Hendrick & Young,
2018). For example, within the Canadian penal system, the impact of racial bias is staggering:
incarceration of Indigenous peoples is increasing, Indigenous adults are recommended for
maximum security at a higher rate (35%) than non-Indigenous people, and 69% of Indigenous
youth receive longer, more punitive sentences than non-Indigenous youth (Alberton et al., 2021).
In contrast, it is well-documented that generative and culturally-safe processes and outcomes are
derived when Indigenous Nations and groups retain and reclaim their rights to self-governance,
self-determination, and community-based forms of justice (Baskin, 2016; Blackstock, 2019;
Kirmayer et al., 2011; Tait, 2007). Within the Indigenous Abolitionist Study Guide, the
Abolition Convergence collective calls for the abolition of prisons, policing, and social work in
order to reclaim sovereignty over collective experiences such as kinship care and justice

38
(Toronto Abolitionist Convergence, 2020). This goal of abolishing the conditions that require
social work is also brought forward by abolitionist social worker James (2021) in their set of
guiding questions for social work practice, provided in Chapter 4.
Abolition Within the Client-Practitioner Relationship
As described above, I find resonance in the tensions and intersections between
accompaniment (Arnold, 2019; Finn, 2016, 2021) and/vs. accomplice (Arnold, 2019; Indigenous
Action Media, 2014). Both of these relational approaches are invested in transformative social
change. Accompaniment emphasizes solidarity, coming alongside, and presence (Finn, 2016); an
accompaniment approach may “avoid even the most subtle or indirect reliance on the
punishment industry as a way to restore equilibrium to individuals or groups” (Ritchie &
Martensen, 2020, p.14). The role of accomplice is specifically directed towards those with
privilege in the situation: “it means being willing to act with and for oppressed peoples and
accepting the potential fallout from doing so” (Harden & Harden-Moore, 2019, p.32). The values
of accompaniment and accomplice are well-described in the following practical guidelines
around calling for police intervention, as described by Preston (2021): i) know the risks of
calling the police (for the person who will be engaged with the police), ii) know what you want
from the police, iii) stay engaged in the situation and be accountable for calling the police, iv) be
directive towards the police and hold the police accountable for their actions, and v) create and
practice scripts that help you stay engaged and in control of the situation. Abolition is a way for
us to heal together. It is an ongoing act of love. Abolition is not simply a theory, it is practice,
practice, practice.
In this section, I have begun to describe the landscape as it is emerging within my mapin-progress – winding pathways lead to areas yet to be revealed and landmarks of great

39
significance rise up towards the sky. The four landmarks explored above, the social worker in
primary health care, the client-practitioner relational continuum, equity-oriented health care, and
abolitionist social work, are areas rich for continued curiosity, experimentation, and refinement.
As I practice and learn alongside clients, colleagues, and other community members, within
changing contexts, I anticipate that which guides my practice may shift and change. However, I
anticipate the values of love, equity, humility, and accountability will remain constant

40
Chapter 4: Constellations
Figure 7
Celebration of transition

41
Figure 8
Self-reflexivity: A series

42
Figure 9
What makes a brilliant social worker?

43
Figure 10
What makes a brilliant social worker?

44
Figure 11
Abolitionist inquiry

45
Figure 12
Emerging practice map

46
Figure 13
Heart to hand, hand to earth, earth to sky

47
Figure 14
Abolition in practice, practice, practice

48
Figure 15
Process, care, and liberation

49
Chapter 5: Emergence
As the capstone project for my MSW program, this final report serves as synthesis and
emergence of my personalized integrated practice model. I use this space to tentatively shape a
map-in-progress. To lay down foundations and place landmarks, pathways, and constellations
with care and intention to serve my future self. To guide my emerging practice as I move into
social work within primary health care. The process leading to the creation of my map-inprogress consistently engaged me in thoughtful continuous learning and listening to deepen and
refine my skills and capacities, in service to my commitments and accountability to my
communities. This has been an ambitious internal undertaking and I recognize the external
outcome on the page is fraught with partiality and dissonance; it is also embedded with tender
and earnest heartfelt care.
This map-in-progress began by grounding myself into place and time through a land
acknowledgement, dedication, and gratitude to those who support me on this path. My
theoretical orientation integrates the Just Practice framework (Finn, 2016, 2021), queer theory,
and abolitionist theory to ground me in an intersectional approach focused on social justice,
playful disruption, and action-oriented solidarity – there is much to continue to learn here. As an
emerging social worker in primary health care, I am complicit in oppressive systems, yet must
always remember that “developing action strategies towards addressing structural and personal
barriers are central to emancipatory practice where the goals are the empowerment and liberation
of people” (IFSW, 2022). To this end, the frameworks, strategies, skills, and perspectives that I
gravitate towards and that emerge throughout the landscape of my map-in-progress centre
cultural safety, cultural and epistemic humility, harm reduction, trauma-and-violence informed

50
care, advocacy, equity, accountability, moral courage, ethical practice, and deep relational care
through a person-and-community centered lens.
In closing, this capstone project has been an opportunity to explore the science and craft
of social work, to create the map-in-progress, and experiment with intersecting theory and
practice, reflection and experience. This report is the culmination of my practicum learning and
research conducted throughout my Magisteriate of Social Work program over the last 2.5 years;
even so, it is partial, tentative, and whole. The content is drawn from research, exploration, and
relationships cultivated within my practicum experiences; I am grateful for the opportunity to
learn alongside and engage in generative reciprocity with clients, colleagues, and community
members. Arts-based inquiry allowed me to explore the embodiment of this learning and I will
continue to cultivate this form of inquiry through self-reflexive practice and as part of the clientpractitioner relational continuum. As I move forward into my emerging practice, I desire to take
informed risks, offer a sense of creativity and playfulness, cultivate a heartfelt authentic sense of
my own professional identity, and nurture confidence and competence in my skills and
capacities. I am also responsible to my community – embedded in a web of reciprocal
relationships in which we prioritize a practice of radical love (Butot, 2004; Godden, 2017). This
report serves as a reference guide to remind me of what is important and to stay connected to
what matters. This is deep work. I recognize that while I am not at the beginning, I am also not at
the end; I am in process with humble curiosity and devotion. I find resonance and hope in the
words of abolitionist scholar and activist Kaba (2021): “there are many places to start, infinite
opportunities to collaborate, and endless imaginative interventions and experiments to create”
(p.5).

51
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