MA Theses

Conduct disorder involves violations of the rights of others and/or conflict with authority figures or societal norms and may include bullying, theft, or other serious antisocial behaviours (American Psychiatric Association, 2013). Due to historic discriminatory policies and intergenerational traumas, Indigenous youth are more likely to be exposed to risk factors for conduct disorder (Bombay et al., 2014; Greenfield et al., 2017). Early intervention is the best way to prevent negative future outcomes, including future incarceration, for these children (Baskin-Sommers et al., 2016; Dodge et al., 2015). The Stop Now and Plan (SNAP) program is a well-established early intervention for children with conduct-related behaviours (Augimeri, Walsh, & Slater, 2011; Burke & Loeber, 2015; Pepler et al., 2010). Despite the increased risk of Indigenous youth, this program has rarely been evaluated with Indigenous youth and has never been adapted for First Nations families. The current study tested a culturally and contextually adapted SNAP program for First Nations youth and families. Mixed model regression analysis was used to investigate outcomes before and after SNAP program involvement. Significant improvements in parenting self-efficacy were found within the domains of Control, Discipline and Boundary Setting, and Pressures for specific age groups. Most youth age groups also showed significant decreases in externalizing symptoms, and overall reported symptoms across time points. No significant differences were found between females or males for any TOSPE or CBCL scales. Results are discussed in relation to prior research outcomes with non-Indigenous youth and families with considerations for future research.

First Nations youth are one of the fastest growing demographics in Canada, yet they are more likely to experience adverse health and life circumstances than non-Indigenous Canadians. Developing and implementing appropriate interventions for mental health is a priority area in decreasing this health gap, and requires the incorporation of First Nation models of mental wellness. Mental Wellness for First Nations’ youth is tied to interpersonal and cultural factors such as relationships with caregivers and the greater community, caregiver and/or community access to necessary resources, and cultural identities. Examining these wider sociocultural factors, in combination with youth characteristics and strengths, provides a more comprehensive understanding of how to address mental health needs in First Nation communities. Working in collaboration with a First Nation based community health provider, the Child and Adolescents Needs and Strengths (CANS) assessment was analyzed for 178 First Nation children to identify specific mental health intervention needs and explore predictors of mental health needs. The CANS is a reliable measure that assesses youth mental health needs, caregiver needs, individual strengths, environmental strengths, as well as many other factors. The most commonly reported mental health intervention needs were seen for Anxiety, Mood, Emotional Control, and Adjustment to Trauma. Hierarchical regression identified referents’ age, sex, Functioning, Individual Strengths, and Family/Caregiver Needs and Strengths domain scores as predictive of mental health intervention needs. Age and Functioning domain scores were robust individual predictors of mental health needs across most models, yet sex was not individually predictive in any model.

Organizations offering mental health services are in need of innovative solutions to address a lack of accessibility and availability in service provision. Waitlists for counselling services are long, often forcing those experiencing mental health difficulties to rely on acute care services in the interim. One option, single-session counselling, allows consumers to access services when they need it, as often as they need it. This service model can be integrated into current services to contend with difficulties related to efficiency and accessibility. The current study evaluated a new single-session counselling program offered in an outpatient community mental health clinic in Northwestern Ontario. The majority of participants rated the service favourably, and experienced a decrease in mental health difficulties and associated impairment. Single-session counselling reduced difficulties associated with the presenting problem, and allowed access to services sooner. Continued implementation of this model of care is supported by the current findings. Dissemination of information describing the nature of single-session counselling, as well as outcomes of program evaluations such as the current study, may help to increase acceptance of its integration into ongoing mental health services.

First Nations children are overrepresented in the child welfare system in Canada (Blackstock, 2003). First Nations communities are seeking to improve current service delivery models and create alternative evidence-based strategies. A First Nations child welfare organization has identified priority areas related to reunification and parenting, identify successes and barriers to reunification, and examine service needs. These priorities were addressed with a community-based, participatory model, and guided by a community Research Advisory. Results were analyzed using a blend of grounded theory and thematic analysis techniques. Participants identified the need to place children with extended family or within home communities to facilitate best child outcomes. Improving parental and community capacity was recognized to promote positive reunifications. Successes identified within communities included available supports, such as those that increased empowerment and community capacity. Identified barriers within communities were the lack of culturally appropriate parenting services, hesitancy to obtain available support due to fears of child welfare intervention, and mental health difficulties of community members. Results of this study will be disseminated to communities and used to develop a culturally appropriate parenting program.

The use of alcohol and drugs is a significant issue faced by First Nations communities in Canada, which is accentuated by high rates of mortality and morbidity resulting from opioid use. The frequency of opioid-related emergency room visits and the higher prevalence of illicit prescription drug use disorders in First Nations populations suggest challenges. Methadone maintenance therapy programs are consistently found to be the most effective treatment for opioid dependence; however, due to financial, geographic, and cultural factors, Aboriginal individuals are less likely to initiate methadone maintenance therapy. Cree Nations Treatment Haven is the first on-reserve methadone maintenance therapy program in Canada and the present study aimed to evaluate this program from clients’ perspectives. Results indicated that individuals in treatment with higher rated improvement showed greater engagement, life quality, psychological functioning, physical health, relationships with family and friends, and a more positive opinion of services and less motivation for treatment, psychological distress, problems with alcohol, criminality, employment and life difficulties, and overall risk. Individuals with a more positive opinion of services reported higher engagement and lower motivation. Finally, individuals in treatment reported a decrease in drug use, high-risk, and criminal behaviours, and improvements in housing, employment status, and family support, since admission to the program. Future evaluation would be beneficial to solidify the present findings and clarify the importance of culture in treatment effectiveness.

There is a high level of both heavy episodic drinking and related problems among Canadian undergraduates. Four personality traits and five motives for alcohol consumption place students at risk for experiencing increased levels of alcohol-related problems. Protective behavioural strategies represent a novel, harm reduction approach to ameliorating the negative consequences that individuals experience as a result of their drinking behaviour. In order to explore the relationships between personality traits, motives for drinking, protective behavioural strategies and alcohol-related problems, a 2-wave longitudinal study was conducted to examine two hypotheses: 1) Does PBS use at wave 1 moderate the relationship between personality traits at wave 1 and alcohol outcome at wave 2?, and 2) Does PBS use at wave 1 moderate the relationship between motives for alcohol use at wave 1 and alcohol outcome at wave 2? Results indicated that PBS do not moderate the relationship between any personality traits and problems, but do moderate the relationship between two motives for use (coping with anxiety and coping with depression) and alcohol-related problems, however, relationships did not emerge as predicted. For those who drink to cope with anxiety or depression, increased PBS usage was related to increased alcohol-related problems, demonstrating that PBS may not provide a protective effect at high levels of these drinking motives. Unique aspects of undergraduate lifestyle may impact the usefulness of PBS for this population, and more directive or intensive strategies to reduce related harms may be required.