Winning Articles

Cultural Diversity and Social Work: A Success Story (2007)

Lynn Dykeman

It was with some fear that I met Ahmed (name changed for purposes of confidentiality) for our first appointment. A few days earlier, he had arrived at his family doctor's office ready for physical violence. Unless someone filled out forms indicating that he was unable to work and therefore could not support his family, welfare would reduce his benefits.

I work as a social worker in a multi-disciplinary health care team and the family physician consulted me after meeting Ahmed. The work I had done with other Kurdish refugees had highlighted the importance of pondering PTSD as an explanation for Ahmed's behaviour rather than the personality disorders that are considered when this diagnosis is missed. An awareness of the sense of abandonment the Kurdish people feel by the international community was important as I began my work.

Ahmed's poignant story revealed that he and his wife secured refugee papers to Canada after a particularly traumatic time in a Turkish refugee camp. Their daughter was born immediately before their departure date. They were advised to immigrate, and that the baby would follow them shortly. The baby never came. A local church advocated on their behalf; however, they eventually received word that the baby had died.

The current situation was desperate for Ahmed and his family. One son developed an obsessive-compulsive disorder and another had a serious learning problem. When I met his pregnant wife, I could only agree that Ahmed needed to stay at home to look after his four surviving sons. His wife, almost catatonic in her depression, seemed to live in a world all her own.

A variety of assistance was needed. Culture awareness by service providers, specialized counselling and access to community resources were critical. The social service delivery system had to be used in a way that was not punitive but recognized this family's unique needs. Social workers from the maternity centre, the mood disorders clinic and from primary care would become part of the treatment team. Case conferences with a social worker as case co-ordinator were needed to ensure that all parts worked together for the benefit of the whole. Counselling, advocacy and concrete resources were secured for the family.

The treatment for Ahmed's wife and son at the mood disorder clinic was extremely helpful; Ahmed had individual social work counselling to provide time for him to express his rage and process the extreme trauma that he and his family had experienced. This helped him feel supported by the Canadian system.

When I see Ahmed and his children now, he greets me with a warm smile. His fifth child, his daughter, progresses well. The family was able to name her, something not allowed in Turkey. We are currently meeting with Kurdish refugees to plan a group for mothers and daughters designed to help them access health care and social services, a challenging task for a culture where many women are not literate. Case management, individualized counselling plans, accessing community resources and several case conferences turned a moment of potential rage into an ongoing and rewarding family/clinic relationship.

Lynn Dykeman, MSW, RSW, is a social worker at The McMaster Family Health Team.