Sherry Gill

Topic

Examining the Principles of Family Centred Care in the Pathways to Healing Partnership Initiative

Social Dimensions of Health

Date & location

• Monday, July 6, 2026
• 10:00 A.M.
• Human & Social Development Building, Room B247

Examining Committee

Supervisory Committee

• Dr. Catherine Worthington, School of Public Health and Social Policy, University of Victoria (Supervisor)
• Dr. Bernie Pauly, School of Nursing, UVic (Co-Supervisor)
• Dr. Michael Prince, School of Public Health and Social Policy, UVic (Outside Member)

External Examiner

• Dr. Rachel Birnbaum, School of Social Work, King’s University College at Western University

Chair of Oral Examination

• Dr. Lisa Reynolds, Department of Biochemistry and Microbiology, UVic

Abstract

Current programs and services intended to support children experiencing toxic stress and struggling with the impacts of developmental trauma continue to yield poor outcomes. Services remain fragmented, inadequately responsive to structural inequities, and frequently designed without the meaningful involvement of caregivers or families. Family centred care offers a promising approach for reorienting practice towards more effective, relational and developmentally appropriate services. However, noticeable gaps remain in understanding exactly how FCC principles can be leveraged alongside the principles of trauma informed care. Despite alignment in select underlying principles, intent, and approaches to service provision, empirical evidence examining the intersection of these frameworks remains limited. In addition, there is little explicit acknowledgement in the literature that such an alignment even exists. Although both frameworks share core commitments like partnership and respect, their integration into practice has been uneven and constrained, reflecting structural and operational challenges, rather than conceptual incompatibility.

Using a qualitative explanatory single case study approach, this study utilized multiple methods, including interviews with ten community partners, five guardians/caregivers, and five members of the project team; observation; document review; and reflective journalling to examine how principles of FCC were understood, interpreted and integrated by caregivers, team members and community partners during the design and early delivery of the Pathways to Healing Partnership (PTHP) initiative. PTHP is a grassroots demonstration project, aimed at supporting families navigating the impacts of complex trauma. Given the program’s objectives, the study also sought to investigate the intersection of FCC and trauma informed care (TIC). Specifically, this study sought to address three primary research questions: 1) What features of FCC were evident in the program’s design and early delivery model; 2) How did macro-level objectives of health and social care systems interact with the micro-level experiences and actions that mark FCC; and 3) How was knowledge about maltreatment constructed and legitimized. Findings from the study are organized under the superordinate theme highlighting the PTHP team’s capacity to practice with a kind of clinical freedom or level of autonomy, that distinguishes their work from other providers. The remaining interrelated themes focus on key concepts related to: the overlapping principles of FCC and TIC; a system centred approach to care; a fragmented or detached social web; the centrality of the social determinants of health when supporting families struggling with complex trauma; and finally, the ways in which expert knowledge is constructed and mobilized in practice.

Results indicate that while supporting these families differently would be welcomed, the ability to translate these principles into practice was restricted by competing structural pressures and a lack of organizational readiness. These restrictions also extended beyond those select providers who participated in trauma informed training or certification courses. Community partners, who had no formal training in trauma informed care or a fulsome understanding of what types of practice changes may be required, had also predetermined that trauma informed care was well beyond their scope of practice. Using a critical lens, the study also highlights how systemic power imbalances and organizational constraints undermined the relational and collaborative intentions of FCC and TIC. High caseloads, limited resources, and conflicting mandates continue to impede the ability of providers to deliver holistic, developmentally informed care. Finally, although the skills and advocacy role of a specialized team like PTHP were acknowledged and even praised, perceived legislative and policy barriers prevented providers, educators and even social care professionals from incorporating a similar service delivery lens.

To advance the discourse on how these frameworks can be integrated to support future iterations of PTHP or similar programs, learnings from this study put forward a set of bridged principles of family centred complex trauma informed care. Considerations for future PTHP programming in the form service model amendments are also presented to advance capacity and relationships with partner organizations.