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"Normal or...?" narratives of youth seeking online support Thiessen, Sara 2017

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   “Normal or…?” Narratives of Youth Seeking Online Support By  SARA THIESSEN BSW, University of the Fraser Valley, 2016  A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SOCIAL WORK  in THE FACULTY OF GRADUATE AND POSTDOCTORAL STUDIES (Social Work)  THE UNIVERSITY OF BRITISH COLUMBIA  (Vancouver) September 2017  © Sara Thiessen 2017   ii Abstract  As technology continues to advance, there has been an increase in youth using online forums to seek help and access emotional, relational, and mental health support; yet, very little is known about how youth are using these forums and what online intervention tools have to offer youth. Therefore, the purpose of my research is to explore what online narratives (disclosures and responses posted on support site blogs) have to teach social workers and others about the lived experiences of youth accessing online supports, including their online interactions with peers and professionals. To meet this purpose I applied a narrative ethnographic methodological approach analyzing 18 peer-to-peer disclosures and responses and 14 youth disclosures with professional responses from two online support sites: Teenline Online (teenlineonline.org) and Kids Help Phone (kidshelpphone.ca). Three primary themes were revealed. The first two themes 'Identity Formation' and 'Access to Power and Autonomy' underscores the ways in which youth used these forums to narrate their unique stories. The third theme, 'Unique Contributions of Online Support' illustrates that while there were similarities in which support was offered between the two sites, there were also some notable differences in how peers offered support compared to professionals. These findings have important implications for social workers as it demonstrates the possible motivations behind youth seeking online support, the experiences of youth using online supports and what these forums may offer youth seeking relational and/or mental health support. Further, findings have important implications for the development of online interventions, including the urgent need for professional development and training in this area. iii Lay Summary  As technology continues to advance, there has been an increase in youth using online forums to seek help and access emotional, relational, and mental health support. The purpose of my research is to explore what online narratives (disclosures and responses posted on support site blogs) have to teach about the lived experiences of youth accessing online supports, as well as interactions taking place between peers and professionals online. To do this I applied a narrative ethnography methodological approach analyzing 18 peer-to-peer disclosures and responses and 14 youth disclosures with professional responses from two specific online support sites: Teenline Online (teenlineonline.org) and Kids Help Phone (kidshelpphone.ca). Three primary findings were revealed. 1) youth using online platforms as an identity formation tool; 2) increased access to power and autonomy; and 3) unique contributions of online support sites. This research provides increased understanding about what online intervention tools have to offer youth.      iv Preface This thesis is an original, unpublished work by S. Thiessen. This project was exempt from The University of British Columbia’s Behavioural Research Ethics Board (BREB) approval due to the publically accessible nature of content, lack of interaction with content, and protection of participants’ anonymity.                     v Table of Contents Abstract	......................................................................................................................	ii	Lay Summary	............................................................................................................	iii	Preface	......................................................................................................................	iv	Table of Contents	.......................................................................................................	v	List of Tables .................................................................................................................. viii	List of Figures ................................................................................................................... ix	Acknowledgements ........................................................................................................... x	Dedication	.................................................................................................................	xii	Chapter 1.	 Introduction	.......................................................................................	1	1.1.	 Reflexivity: Locating Myself in the Research .............................................................. 3	1.2.	 Purpose of Research ...................................................................................................... 4	1.3.	 Overview of Thesis ......................................................................................................... 5	Chapter 2.	 Literature Review	..............................................................................	6	2.1.	 Power and Agency .......................................................................................................... 7	2.2.	 Relational Connection ................................................................................................... 9	2.3.	 Identity Formation ....................................................................................................... 11	2.4.	 Gaps in the Literature ................................................................................................. 14	Chapter 3.	 Methodology	....................................................................................	16	3.1.	 Conceptual Framework ............................................................................................... 16	3.2.	 Narrative Ethnography ............................................................................................... 20	3.3.	 Sample Selection ........................................................................................................... 23	3.3.1.	 Phase One: Social Media Site Selection	................................................................	24	3.3.2.	 Phase Two: Social Media Forum Topic Selection	.................................................	26	3.3.3.  Phase Three: Forum Post Selection	............................................................................	28	3.4.	 Data Analysis ................................................................................................................ 31	3.4.1.	 Analysis Process	....................................................................................................	35	3.5.	 Ethical Considerations ................................................................................................ 37	vi 3.6.	 Establishing Trustworthiness ..................................................................................... 39	Chapter 4.	 Results	..............................................................................................	42	4.1.1.	 Introduction	...........................................................................................................	42	4.2.	 Identity Formation ....................................................................................................... 43	4.2.1.	 Naming of Oneself: Online Names	........................................................................	44	4.2.2.	 Fear, Shame, Guilt and Aloneness	.........................................................................	47	4.2.3.	 Individual Pathology: Self Diagnosis	....................................................................	50	4.3.	 Power and Autonomy .................................................................................................. 52	4.3.1.	 Disempowering Interactions with Family Members	..............................................	53	4.3.2.	 Disempowering Interaction with Therapist and Counsellors	.................................	55	4.3.3.	 Opportunities for Anonymity Online: Increasing Youth Power	............................	56	4.4.	 Unique Contributions of Online Supports ................................................................. 58	4.4.1.	 Peer-to-Peer Support: Collective Strength and Solidarity	.....................................	59	4.4.2.	 Professional Support	..............................................................................................	64	Chapter 5.	 Discussion and Conclusion	...............................................................	71	5.1.	 Developmental Stage, Personal Disclosure and the Online Environments ............ 72	5.2.	 The Online Environment ............................................................................................. 75	5.2.1.	 Unique Characteristics of the Online Environment	...............................................	75	5.2.2.	 Identity Formation: The Internalization of Societal Factors	..................................	77	5.2.3.	 ‘A Safe Space:’ Freedom of Expression in Online Environments	.........................	80	5.3.	 Relational Connection in the Online Environments ................................................. 82	5.3.1.	 ‘Responsiveness’ in Online Environments	............................................................	82	5.3.2.	 Peer-to-Peer	...........................................................................................................	83	5.3.3.	 Professional	...........................................................................................................	84	5.4.	 Power and Autonomy: Youth’s Right to ‘Voice’ ...................................................... 86	5.4.1.	 Experiences of ‘Voice’ in Online Environments: A Human Rights Argument	.....	88	5.5.	 Limitations and Areas for Future Research .............................................................. 90	5.5.1.	 Researcher Bias	.....................................................................................................	91	5.5.2.	 “Accuracy” and the Narratives of Youth	...............................................................	91	5.5.3.	 Comprehensiveness and Scope of Research	..........................................................	92	5.5.4.	 Context and the Researchers Inquiry	.....................................................................	93	5.5.5.	 Efficacy: Online vs. In-Person Supports	...............................................................	94	vii 5.6.	 Moving Forward: Recommendations for Social Work Practitioners Wishing to Engage with the Online World ............................................................................................... 94	References	................................................................................................................	97	       viii List of Tables Table 1: Post Data Chart: Peer-to-Peer Monitored Website .......................................................... 28 Table 2:  Post Data Chart: Professionally Monitored Website ...................................................... 29 Table 3: Research Analysis Process .............................................................................................. 33 Table 4: Data Analysis Chart ......................................................................................................... 36 Table 5: Youth Names in Online Blog Posts ................................................................................. 44 ix List of Figures Figure 1: Interconnection between stigma, shame, fear, isolation and aloneness………………53                     x Acknowledgements To my family and friends, professors and colleagues who have journeyed with me- your presence has made this possible. For it is in the shelter of one another that we grow. A few people who left me particularly inspired to write the thesis are listed below: Dr. Deborah O’Connor, thank-you for supporting this research and encouraging me to complete a thesis. Your consistent encouragement and brilliant critical feedback has inspired me to delve deeper into the unknown in considering further aspect and elements of the stories revealed through the online narratives of youth. Dr. Gloria Puurveen, your joy in discovery, commitment to continuous exploration, creativity, critical thought, and curiosity in all things has had a tremendous impact on me. Thank-you for believing in my own research quest. I would not have been able to complete this thesis without you, nor would I have even tried.  Sterling Ray, as one of my deepest and longest standing friends I can honestly say I don’t know where I would be without your genuine friendship and consistent support. Thank-you for meeting me in my failures and choosing to see me in strength. Having a fellow sojourner as brilliant, talented, and kind as yourself is rare gift.  Granny Sue, your example of living a life full of curiosity and adventure has inspired me to seek out the wonderful. You’ve continuously challenged me to seek out all that life has to offer, whether it be traveling across the world, hiking the tallest peak, or completing my thesis. Your belief in me and my journey has meant the world.  xi  Dr. Rob Lees, your dedication to improving the lives of youth is astounding. Completing my community development practicum under your guidance has taught me to deeply and critically consider the systems impacting individuals while still valuing and honouring the inherit worth and dignity of each and every person we encounter. You’ve also taught me to be brave, for which I am sincerely grateful.              xii Dedication This project is dedicated to the thousands of resilient, strong, sacrificial, and resourceful youth I came to know through brilliant and vivid online disclosures. Your narrative accounts have taught me much about the importance of supportive, trusting, and honest relationship as well as the value of authenticity and freedom of expression. Your transparency in seeking support coupled with your genuine support for one another in spite of tremendously difficult first-hand experiences has inspired me.     1 Chapter 1. Introduction As internet and social media use amongst young people continues to reach higher peaks in frequency of usage, youth service professionals are arguably forced into a position of engagement with social media. According to the 2008 World Internet Project survey, 95% of Canadian adolescents aged 12-14 engaged in internet use, with communication applications such as instant electronic messaging, blogs, and social network sites (e.g. Instagram, Facebook) ranking most popular (Guan & Subrahmanyam, 2009, p. 353). This rise in social media use within youth culture has inevitably left parents, teachers, and helping professionals with questions surrounding its impacts. One area of online engagement that is beginning to receive particular attention is that of online support interventions that target youth in crisis and/or with mental health needs. Generally speaking, these services can be categorized into two areas. First, professionally monitored sites offer youth mental health support through online responses from adult responders who have received training in counselling, crisis intervention, or related fields. With the introduction of these kinds of online interventions, youth struggling to engage with mental health service providers in traditional long-term recovery models are provided with an opportunity to easily “link up” with professionals in an accessible way, which transforms not only the way these services are being received, but youth’s power and control over their level of engagement with these services (Alvarez-Jimenez, Gleeson, Rice, Gonzalez-Blanch, & Bendall, 2016, p. 7). Second, peer-to-peer sites offer youth peer support through a pool of volunteer peer responders and other youth registered with the online support site. Unlike professional 2 responders on professional sites, peer-to-peer responders do not necessarily have training in how to respond to and/or handle youth’s disclosures. However, these types of interventions provide an opportunity for youth to connect with their peers in ways that are unique to face-to-face relational encounters.  William and Anthony (2015) contend that, generally, peer-to-peer social support significantly increases resilience among adolescence as supportive, responsive friends enhance overall health and well-being (p. 263). However, attachment theorists strongly emphasize the importance of youth developing a consistent, trustworthy, attached relationship with an adult (in many cases, a professional) as an important step in the maturation process of a young person (Bevington, Fuggle & Fonagy, 2015, p. 158). While for both peer-to-peer and professional support, the notions of empathy and authenticity have been identified as central components of the therapeutic (professional) alliance or the supportive (peer-to-peer) relationship (Spencer, 2006), how peer-to-peer and professional support converge or diverge in the online environment has yet to be examined. In recognizing the intrinsic need for relationship held by youth (Bevington et al., 2015, p. 158), I am left questioning what, if anything, either of these online environments have to offer vulnerable and marginalized youth seeking support. Despite the fact that these types of interventions are currently being used by many (for example, over 188,000 youth between the two sites I explored in this thesis alone), little is known about why youth may be turning to online supports in times of crisis, how these services are filling a void for vulnerable youth (relationally or otherwise), or the ways in which youth represent themselves through personal narratives online. As such, more research is needed to uncover the reasons why youth are accessing online platforms, 3 as well as what online disclosure and responses have to teach us about the youth accessing them, in order to achieve a fuller understanding of whether or not online interventions for youth in need of support would be a useful and effective practice tool (Alvarez-Jimenez et al., 2016; Stanley & Temple, 2012).  Therefore, the purpose of this research is to explore how youth use online supports, including the ways in which they describe their story, as well as considering the differences (if any) between peer-to-peer responses and professional responses. 1.1. Reflexivity: Locating Myself in the Research In carrying a professional social work background, my research is influenced by a general curiosity about the relational exchanges that occur in both professional and peer-to-peer support sites. Additionally, this research was influenced by not so distant memories of personal experiences of feeling isolated and misunderstood in trying to work out my identity as a youth, as well as several years working with youth in various capacities. Working in youth leadership, clinical counselling settings, and crisis intervention with youth has taught me much about the unique struggles associated with adolescence as a developmental stage (e.g. heightened emotions), as well as barriers associated with their positionality in society (i.e. state of dependence on adults). Completing this thesis provided me the opportunity to quench my curiosity about the unique realities of youth struggling to access mental health and/or relational support through the exploration of several youth narrative accounts found online. With the challenge of capturing diverse experiences while diving into the specifics of youths experiences, as well as my core social work values rooted in “respect for the inherent dignity and worth of person” (Canadian Association of Social Workers, 2014) in mind, I 4 applied a narrative ethnography (Gubrium & Holstein, 2008) methodology utilizing thematic analysis (Braun & Clarke, 2006). In-depth exploration of these accounts using a narrative framework grounded in postmodernism and social constructionism allowed me to speak to broader societal influences that may be impacting the narratives of youth found online. Further, remaining reflexive throughout the research process allowed me to reflect on the ways in which my own social location (i.e. 27-year-old, white, upper middle-class, heterosexual, female) may have impacted my interpretation of relational interactions taking place online, as well as my ability to engage with and/or understand content. 1.2. Purpose of Research Recent research inquiry on the potential effects, impacts, and opportunities youth social media use (i.e. online forum posts) holds as a professional tool for social workers has arguably yielded more questions than answers. The purpose of my research is to offer an increased understanding of the role online supports play in the lives of vulnerable, isolated, and marginalized youth accessing these interventions in times of need. Furthermore, this research offers insight into the possible advantages and pitfalls associated with online forums as a low-barrier, participatory approach to youth engagement and support for social workers who may be considering the use of online interventions within their practice approach (i.e. recommending existing support sites, facilitating online supports). With little known about the experiences of youth and professionals using online platforms, my research aims to speak to the experience of youth using online support services through full consideration of narratives found online. Additionally, I consider the significance of youth’s personal accounts accessible through 5 public domains by exploring the reasons why youth are accessing online platforms, as well as what online disclosures have to teach us about the youth accessing them (Stanley & Temple, 2012, p. 278). Research questions are explicated in more depth throughout the following Literature Review. 1.3. Overview of Thesis This thesis has been broken up into several chapters. In Chapter 1 I have laid out the grounding for this research. Chapter 2 provides the reader with an increased understanding of the existing literature examining social media supports for youth struggling with mental health needs, as well as general ways by which youth may be using the internet to achieve increased power and autonomy and/or access to information and resources. It has been divided into the following topics: power and agency, relational connection, identity formation, and gaps in literature. Chapter 3 provides a detailed account of the methodology, including a step-by-step breakdown of data analysis processes. Chapter 4 outlines the research findings. In Chapter 5, I discuss my findings alongside my conceptual grounding and the existing literature. I also discuss the implications of this research for key stakeholders (e.g., social work practitioners, teachers, parents, support workers), and I offer suggestions for further research. 6 Chapter 2. Literature Review In an analytical review of literature, two major trends of inquiry in the area of youth internet use are apparent. The first pervasive trend in research can be conceptualized through the application of a macro-level social justice perspective. This trend considers the ways in which youth internet and social media use increases power and autonomy through increased agency, information exposure, community expansion, and political platform provision. Here, researchers ask if engaging youth in social media use enhances awareness about community, culture, social justice, and humanitarianism (Liang, Commins & Duffy, 2010, p. 14). The second trend in research applies a micro-level assessment framework and focuses more specifically on the implications of social media use in professional practice, through examination of case studies to determine whether social media should be used as a professional practice tool in support work with youth. In these cases, the researcher is concerned with best practice models for social media use as a relational service provision tool (Alvarez-Jimenz, 2016, p. 2). Both macro- (social justice) and micro- (intervention specific) level inquiry are needed to develop an in-depth understanding of the potential benefits and consequences of social media as a low-barrier, participatory approach to youth engagement for social workers seeking knowledge on the viability online forums hold as an intervention tool in youth services. The following chapter explores the existing literature relevant to understanding online support forums as an intervention for struggling youth and has been categorized in three sections: power and agency, relational connection, and identity formation. This 7 literature review represents a variety of studies that scrutinize the relational or social impacts youth internet and social media use has on end users. A wide range of research types are represented throughout this literature as a means to capture and speak to different themes. Where qualitative and ethnographic research approaches focus on the broader political implications of youth internet and social media use, participatory case studies assess social media interventions as a practice tool.  2.1. Power and Agency  The following section provides an overview of a wide variety of research studies speaking to themes of power and agency within internet and social media use. In a comprehensive ethnographic search for cultural, political, and social sequences in a wide variety of quantitative and qualitative research studies with a focus on youth social media use over the past twenty years, Sefton-Green (2006) found that social media use increases youth’s agency and power (p. 293). This is consistent with themes from Weinstein’s (2014) case study conducted with 70 U.S. based, civically engaged youth, where those engaged with online civil expression provide rationales rooted in narratives about power and agency in response to organizational mandates (p. 214). Civically engaged youth from this study utilized online platforms to promote themselves in civic arenas through alignment of personal civic ideals and purposeful use of online platforms for positive engagement with the public about politics (Weinstein, 2014, p. 214-218). Similarly, in an ethnographic inquiry searching for social relationships and communication characteristics in a remote Australian Indigenous community, Kral (2011) found contemporary media advanced youth’s agency by increasing their knowledge and literacy to levels surpassing their elders (p. 9). These studies solidify the important role that social media can play in 8 empowering marginalized and vulnerable youth, ultimately illustrating that social media interventions hold potential to impact and/or affect wider socio-political functions. For example, youth’s ability to express oneself and achieve needed resources without the presence of an adult acting on their behalf in online environments facilitates increased access to power and autonomy for the broad demographic of youth. Although the concept of internet and social media use providing youth with increased opportunity to access power and agency remains mostly uncontested, the ways and extent by which this power is transferred is largely debated. After assessing the findings from a large scale (1, 511 participants aged 9-19) national survey with UK Children Go Online, Livingstone, Bober and Helsper (2005) assert that children and youth do not have the skill-set needed to evaluate or create online content (p. 293). Likewise, Sefton-Green (2006) outlines conservative arguments against the transfer of power to youth through social media, stating that “however complex or sophisticated our analysis of the pedagogic relationship within media culture, the cultural experience remains the end of learning” (p. 29). When it comes to youth’s ability to be empowered through social media and/or web use, additional concerns rest in youth’s susceptibility to be negatively influenced within these environments. For example, in Pettigrew, Pescud, Jarvis and Webb’s (2013) research exploring Western youth’s opinions of their alcohol-related interactions with adults through screening youth-adult discussions in internet platforms, youth were considerably impacted by adults endorsing a culture of excessive drinking in online environments. To this end, youth exposed to messages from older peers and adults endorsing excessive drinking were far more likely to participate in these behaviours (Pettigrew et al., 2013, p. 32). 9 These assertions provide a foundation for further exploration of youth capacity to understand the implications of their actions on the internet, as well as the extent to which power and agency can be transferred from social media to broader community contexts. Ultimately, achieving informed understanding about the relationship between youth power and autonomy and internet use would benefit from increased research. Given the lack of literature specifically exploring the impacts of social media use as it relates to increases in power and autonomy for youth, this field would benefit from a variety of qualitative and quantitative studies, including both comprehensive, large-scale, longitudinal studies as well as participatory case studies using in-depth interview techniques. As researchers gain a more in-depth understanding of youth’s perspective on their own social media use, as well as teachers’ and health care providers’ perspectives on the benefits and drawbacks of social media use, youth practitioners and policy makers will be able to make decisions regarding the direction of services and allocation of supports (i.e. funds and resources) from an informed perspective.  2.2. Relational Connection In further scrutiny of the role social media plays in the lives of young people, the provision of a low-barrier opportunity to ‘connect’ with peers, mentors, and community at large was highlighted as meaningful for many marginalized youth. This finding was exemplified in Singh’s (2013) qualitative, phenomenological case study with 13 transgender youth of colour, aged 15-24, and their use of social media. For the youth in Singh’s study, ‘connection’ was outlined as the ability to connect with other people from the transgender community through social media platforms such as Facebook, Twitter, or Myspace, which was a significant contributor to personal resilience (p. 698). Similarly, 10 Bull, Walker and Levine’s (2014) participatory study with 201 homeless youth between the ages of 13-24 in California found that the ability to create and maintain social relationship through internet access contributed to social capital gains and importantly enhanced the lives of homeless youth (p. 243). In speaking to the ways in which youth are communicating with one another, Mitchell, Wolack and Finkelhor’s (2008) telephone survey exploring the online activity of 1,487 youth aged 10-17 that had used internet at least once in the last six months found that over half (58%) of youth interviewed did not interact with others online, however, youth posting on blog sites were far more likely to interact with others online and typically three times as likely to post personal information online (p. 288). The ‘connection’ benefits gained through social media use for youth isolated due to race, sexual orientation, or homelessness are consistent with the findings of youth marginalized due to health concerns. In Alvarez-Jimenez and colleagues’ (2016) critical assessment of user-led, online, peer-to-peer support for youth with mental health concerns, they found online social media interventions carried considerable promise in health care settings for their provision of a low-barrier opportunity for youth to easily connect socially with professionals and peers (Alvarez et al., 2016, p. 126). Similarly, findings from Henwood et al.’s (2016) research on professionally monitored social media support groups for 60 HIV/AIDS positive youth between ages 23-25 in Cape Town received positive reviews from the youth involved (p. 903). Findings from this study indicate that, “almost all of the participants wanted to use a social media platform to connect with others outside of the youth club meetings and wanted to see a virtual 11 support group continue” (Henwood et al., 2016, p. 901). This research also pointed to the accessibility and ease of connection, as one youth pointed out:  So, sometimes when they [friends] reveal their status to me, I will not know what to advise them. […] So if I have my 2go [a local mobile social networking platform] here, I would go online I will be asking people how do I consult this one. I would like some other thing outside the clinic (Henwood et al., 2016, p. 901). These research findings demonstrate that social media interventions carry considerable promise in health care settings as they provide low-barrier opportunities for youth to easily connect with professionals and peers (Alvarez et al., 2016, p. 126). Furthermore, in application of the principles of leading relational theory (Positive Youth Development (PYD) and Relational-Cultural Theory (RCT)) to the assessment of the internet’s ability to “engage youth and turn them toward community, culture and social justice” Liang, Commins and Duffy (2010) found online social justice projects (such as “GenerationPulse”) reconciliatory for their provision of a safe form of engagement that fosters empathy, connection, positivity, and action among youth involved (p. 15). 2.3. Identity Formation  An additional notable theme emerging from research in the area of youth social media use as it relates to service provision is the influential role the internet is now playing in identity formation for youth. This role is explored in Sefton-Green’s (2006) research inquiry considering youth’s written contributions on social media platforms (p. 295). The researcher (2006) claims that social media text is a form of character formation as narratives can be absorbed, internalized, and then re-written by youth, providing awareness into the process of developing meaning (p. 295). In assessing youth 12 identification formation through internet use from a social justice perspective, Kral (2011) found that social media allowed youth the opportunity to become an expert through construction of identifying one’s self as knowledgeable (p. 6). Kral (2011) demonstrates Indigenous young people’s ability to analyze and respond to modern circumstances with imagination and agency through internet use (p. 12). For example, a youth participant in Kral’s study encouraged audience members of the 2009 Symposium on Indigenous Music and Dance in Darwin to access social media in order to:  Come and listen to our stories. Spend some time to listen and we’ll work    together. We can show people of the world what Australia means. The   problems that we really need to handle in this country is that people not    really working together (Kral, 2011, p. 11). In considering the ways identification through social media use facilitated the resiliency of transgender youth of colour, Singh (2013) found the ability to connect with similar racial/ethnic and gender identities aided positive identity formation in reinforcing diverse perspectives, ultimately providing assurance and empowerment for youth through normalizing multiple identities and producing new approaches for addressing experiences of racism and discrimination in their lives (Singh, 2013, p. 697). However, it is important to note that social media can also negatively impact youth’s self-perception. In Castro and Osório’s (2013) qualitative exploratory content analysis of pro-anorexia Portuguese-speaking blogs written by teenagers between ages 13 and 19, youth blogs reflected wider pressures to achieve social acceptance through culturally prescribed body image.  This outlined shift towards an identity rooted in power and agency is most aptly pronounced through the success of IknowUshouldknow2 - a youth-driven social media campaign to promote Sexually Transmitted Infection (STI) and Human 13 Immunodeficiency Virus (HIV) testing among adolescents age 13-17 in Philadelphia (Dowshen, Lehman, Castillo & Mollen, 2015, p. 106). This campaign markedly resulted in reaching 1,500 youth through an online social network leading to their intended outcome of an increase in youth visits to medical centers where syphilis and HIV testing was conducted after exposure to the campaign (p. 109).  With Singh’s (2013), Kral’s (2011), Sefton-Green’s (2006), and Dowshen et al.’s (2015) studies in mind, it can be asserted that the autonomy afforded to youth through social media use helped facilitate a process in which youth were able to recreate an identity grounded in power and agency. Further, this research demonstrates that internet use holds particularly positive benefits for marginalized youth and their communities as it provides a platform for alleviating social isolation in its provision of connection opportunities. Although the opportunities for youth to further develop a more autonomous and powerful identity through social media use remains largely uncontested, Weinstein’s (2014) findings that almost 20% of youth participants displayed no civic expression online despite strong civic engagement and identification off line suggest the opportunity is not being taken up by all (p. 225). Importantly, Weinstein (2014) outlines a varied spectrum of youth rationales (e.g. self promoting nature of online social media, privacy concerns, prohibitory organizational policies, and misrepresentation) for not participating in social media use in spite of a strong commitment to political cause (p. 255). Weinstein’s (2014) findings caution against making universal generalizations about youth internet use by outlining differentiation between individual youth cases. Taking this into consideration, it can be asserted that the intricate nuances of the differing meanings social 14 media holds for each individual utilizing it as a communicative form must be considered. 2.4. Gaps in the Literature Although this small body of research findings appear unanimously supportive of professionally monitored social media interventions, consideration of the larger implications of these social interactions leaves room for investigation. In concluding their participatory study on online peer support Masuda, Anderson, Letourneau, Morgan and Stewart (2012) capture the researchers’ conundrum well, claiming that although “evidence for the efficacy of face-to-face peer support in youth abounds, online social support is still in its infancy” (p. 747). As it stands, one of the largest contenders against universal acceptance of online support models challenges the implicit sufficiency of ‘online’ versus relational ‘in person’ connection. In considering the effects youth internet use has on culture, Kral (2011) asserts that social media use has facilitated a shift from community to a focus on the individual stemming from Western media values occurring within online communication technologies (p. 9). While Kral’s assertion that social media perpetuates individualism merits recognition, research demonstrated throughout this literature review outlines the importance of consideration for the role social media may play in facilitating opportunities for identity formation and connection. As such, research on the benefits of relational connection through internet use and social media would benefit from additional analytical comparison studies. While Kral’s assertion points to studies that compare online to in-person supports, further research would benefit from consideration of a variety of research in the online environment itself by comparing the different online spaces (e.g. blogs, professional supports, live chats) that youth access for support.  15 With no comprehensive research comparing peer-to-peer and professionally monitored social media supports, Masuda et al. (2012) argues that there is little to no knowledge about the quality and practicability of private social networks (e.g., Facebook) compared to professionally mediated, specialized premeditated programs, designed for populations with unique needs (p. 748). To this end, Alvarez-Jimenez et al. (2016) question professionally monitored social supports as a best practice intervention, further cautioning against generalizing findings from peer-to-peer studies in professional settings, claiming that “artificially developed online networks may lack the norms and dynamics of naturally-occurring online peer-to-peer forums” (p. 126). In working to resolve these looming gaps in literature, Masuda et al. (2012) insist on more grass roots approaches to health promotion that support the creation of social media interventions, ultimately claiming that more research should be created in response to the influx of social media use among young people (p. 743). My research aims to do this through answering the following research questions: What are the experiences of youth using online support services? How are youth representing themselves through personal narratives online? And, what are online support forms, specifically, offering these youth (relationally or otherwise)?   16 Chapter 3. Methodology In order to achieve a comprehensive, holistic understanding of youth social media use as a cultural phenomenon, Sefton-Green (2006) argues for “more methodologically imaginative and complex studies of diverse young people learning across all kinds of social domains” as essential to gaining important understanding about the full meaning of media culture for youth (p. 300). Alvarez-Jimenez et al (2016) challenge researchers to consider the ways in which online social networks impact youth’s mental and social health needs. Challenging researchers to delve into the specifics, the authors suggest to break down the complexities within youth’s narratives found in online environments. In so doing, researchers will be able to identify the benefits and/or the negative effects of youth’s social media use on mental health and social outcomes.    3.1. Conceptual Framework The conceptual lens used throughout this thesis roots itself in social constructionism, therein holding undertones in postmodernism. This conceptual grounding facilitated the examination of personal narratives and interactions of youth in online environments while giving creed to larger societal factors. The postmodern framework movement was born from theorists (e.g. Kierkegaard, Nietzsche) asserting a need for critique and evaluation of Western societal understandings around established ideas such as identity and reality (Docherty, 2017, p. 36). Postmodern theorists are critical of essentialist an/or realist beliefs or claims that assert explanations as valid (or the same) for all groups (i.e. religions, cultures, races), and instead argue for relativist truth highlighting the importance of individual perspective and interpretation (Docherty, 17 2017, p. 39). In this study, the conceptual lens of postmodernism was used to explore notions and experiences of power and autonomy for youth accessing online supports. The theoretical framework applied throughout my thesis rest in social constructionism, which holds links to post modernism.  Social constructionism draws its influence from the disciplines of philosophy, sociology, and linguistics (amongst others) and appears under a variety of rubrics such as ‘critical psychology’, ‘discursive psychology’, ‘deconstruction’, and ‘poststructuralism’ and can be considered a “theoretical underpinning” of “radical and critical alternatives in psychology and social psychology” (Burr, 2015, p. 1). Generally speaking, social constructionist theory can be seen as adopting one or more of the following assumptions: (a) “a critical stance toward taken-for-granted knowledge”; (b) historic and/or cultural specificity, (c) knowledge sustained through social processes, (d) knowledge coinciding with social action (Burr., 2015, p. 1-5). This theoretical framework views language as important for constructing reality. Social constructionist theory was applied throughout my thesis in utilizing a narrative approach to consider the language youth were using to identify themselves or ‘story’ their lives online as it relates to broader societal factors and influences. Taking this approach allowed me to question the underlying factors that may be influencing youth narratives (i.e. positionality) in addition to exploring the social processes taking place online with specificity. This focus in approach amounted to considering youth interaction and cultural as an important factor influencing knowledge construction.  Breaking this down further, specific theories applied throughout my concluding discussion include: labelling theory (Becker, 1963, p.1) and attachment theory (Bowlby, 18 1979, p.13) explored throughout identity formation; and positionality (Hankivsky, 2004) explored throughout power and autonomy. These theories are essential to arguments surrounding the findings of this thesis.  Goffman’s (Scheff, 1974) notion of labelling theory is applied in order to better understand the susceptibilities and consequences of the language youth choose to describe their experiences, including the employment or use of terms commonly found within the Diagnostic Statistical Manual of Mental Disorders (DSM). Labelling theory ties in well with social constructionist theory as both theoretical frameworks consider the language someone chooses in identifying themselves to hold significant impacts on that person’s life (Becker, 1963, p.1; Stanley & Temple, 2012, p.280). For example, in considering the impact self proclaimed labels such as, “depressed” may have on youth Becker (1963) claims that the internalized blame resulting from these labels leads to potential loss in desired education, loss in employment opportunities, and low levels of self-esteem and resiliency (p.10).    Similarly, attachment theory (Bowlby, 1979) was applied to research findings for its ability to consider the manner by which the role of adult caregivers may be impacting youth narratives. According to Bowlby’s (1979) attachment theory the ‘internal working’ model in which young people acquire mental representations of themselves is based on early childhood experience (p.13). Applying attachment theory allowed me to critically consider the impacts that positive and/or negative experiences with adult caregivers may have on youth. In taking a social constructionist approach toward alleviating potential social or emotional damage caused by negative experiences with care givers, professionals working from an attachment framework attempt to integrate the experiences 19 they hear from youth into a new story with contextualized perspective rooted in a dialogue of understanding, respect, and empathy and actively avoiding the criminalization of youth (Lavie-Ajayi & Krumer-Nevo, 2013, p. 1770-1771).  Lastly, youth’s positionality (societal position in relations to others) was considered in holding to the social constructionist perspective that contends that experiences are socially constructed and therein must consider wider socio-political constructs (Seymour, 2015). Consideration of the general positionality of youth in terms of their age demographic allowed me to draw connections between youth’s societal/political position (in terms of age demographic) and the way they described their stories within online narrative disclosures (Seymour, 2015, p. 282). Exploring systemic factors inherent within the broader social and political systems that youth are a part of is essential to my research rooted in social constructionism. Understanding the interactions taking place in online environments using a theoretical lens rooted in social constructionism is essential to the process of exploring youth’s narratives in order to illuminate what they have to teach us about themselves in the context of influence from broader society.      20 3.2. Narrative Ethnography Narrative ethnography is a research approach that offers researchers the ability to scrutinize and examine the social context in all areas of epistemology, methodology, and analysis by engagement with the researcher’s personal narrative, as well as the individual stories they are studying (Goodall, 2004, p. 189; Gubrium & Holstein, 2008, p. 251). Narrative ethnography was chosen as a methodology for the important flexibility and depth it offered in capturing personal experiences outlined through narrative accounts found in online forum posts, as well as the social or cultural differences found between professionally monitored and peer-to-peer online forums (Gubrium & Holstein, 2008, p. 251, Markham & Baym, 2009, p. 15). With conceptual groundings rooted in social constructionism, an anti-essentialist critical stance towards ‘taken-for-granted truth’ (Burr, 2015, p. 10), and postmodern theory, a critical stance against objective truth or scientifically assumed certainty (Docherty, 2017, p. 36), narrative ethnography allowed me the opportunity to be both reflexive and analytical in considering the multiple dimensions and layers of social context contributing to youth’s online narrative disclosures and responses (Gubrium & Holstein, 2008, p. 251; Stanley & Temple, 2012, p. 281). Taking a narrative approach allowed me the opportunity to explore my research questions - aiming to uncover the reasons why youth are accessing online platforms, as well as what online disclosure and responses have to teach us about the youth accessing them - with analytical rigor, reflexivity, and intellectual openness (Stanley & Temple, 2012, p. 280). As a narrative ethnographer grounded in constructionism, I am situated in a place where I am given the important opportunity to think ‘outside the box’, creatively engaging with and applying interpretation to claims made throughout youth’s disclosures 21 as a means of scrutinizing the relationship between lived reality and story, as well as what is told, and untold (Stanley & Temple, 2012, p.280). This conceptual grounding allowed for critical exploration of the context in which these youth narratives were being shared and provided crucial additional information necessary for discovering why youth may be identifying and/or describing their experiences through online accounts the way they are. In addition, narrative ethnography allowed for exploration of the cultural phenomena of online environment through examination of the ways in which youth, peers, and professionals interact with one another, construct their story, and negotiate identity in a climate free from certain social factors such as snap judgments based on physical appearances, dress, demographic, or social group that may contribute to inhibitions around engagement or an unwillingness to share one’s story, social factors that are typically found in in-person settings (Keim-Malpass et al., 2014, p.1689; Markham, 2005, p.794). As a methodology, narrative ethnography, moreover, allowed me to consider youth disclosures and peer and professional responses contained within online support forums comprehensively through examination of language used throughout online narratives, as well as individual and cultural experiences that may be influencing said language. In recognition of the pertinence of narrative ethnographic methodology, it becomes important to understand its underpinnings. As a methodology, narrative ethnography holds close ties to communication research methods and feminist ‘standpoint theory,’ (Goodall, 2004, p. 188) which highlight the importance of personal experiences and background stories in the researcher’s quest for knowledge. In deep examination of the ways in which we create meaning of the world in which we live, 22 narrative ethnographers attempt to make known that which is often left in the shadows of existence, the private, hidden dimensions of our lives (Goodall, 2004, p. 190). Taking this into consideration, this research approach allowed me to hold the experiences of youth as central in unveiling the multiple layers of their self identified accounts. The need for an integration of narrative methods in the exploration of personal and subjective experiences of youth accessing online supports is further cemented by the finding that there is little to no comprehensive research or instruction as to the quality and practicability of professionally mediated, specialized premeditated programs designed for youth with unique needs (Goodall, 2004, p. 191; Masuda et al., 2012, p. 748).  My thesis speaks to the experiences of youth turning to online platforms in times of need, further exploring whether or not broader societal structures leave youth with little power and autonomy (i.e. dependency on parents and caregivers). Narrative ethnography allowed me to explore underlying social dynamics and factors that may be contributing to youth’s experiences with mental health concerns with appropriate depth. This was achieved through the examination of language throughout youth’s online disclosures and responses inherent within the narrative ethnography approach. Where using a narrative approach explicitly allowed me the opportunity to examine the ways in which youth storied their lives, ethnography provided the ability to analyze the social construction of culture. Ultimately, exploration of the personal experiences outlined by youth online, through utilization of a narrative approach allowed me the opportunity to capture necessary context surrounding interconnected complexities of human experiences, further exploring how these stories and responses relate to identity formation and experiences of receiving help. The pertinence of this study rests in the belief that in-23 depth examination of language use in disclosures and responses will add to the current body of knowledge by working to address the social work clinicians’ questions about the benefits of professionally monitored social media supports as a viable intervention tool in youth work. 3.3. Sample Selection For the purposes of this thesis I define youth broadly, containing anyone ages 12-24. As current studies in this area are limited, providing a wider demographic allowed me to prioritize studies most pertinent to the subject area. That said, websites used for data collection target a slightly narrowed age bracket focused on service provision for teens aged 13-19 years of age. The ‘seeking online support’ terminology used throughout this research encapsulates any and all individuals identifying as youth who are actively participating in the use of publically accessible online forums intended to provide emotional, relational, and mental health support. Consequently, this definition includes youth that have accessed these supports on continuous basis or only once, as well as those who have divulged complex and distressing experiences and those looking to expand their friendship network. This broad definition allows for ethnographic consideration of the online environment as a whole with important consideration of how the multi-faceted nature of these online support forums may impact those accessing them.  The sample collection process occurred in three distinct phases. In the first phase two social media sites were selected. The second phase involved the selection of forum topics. The third phase consisted of selecting the posts/responses that were explored in-depth for this analysis. 24 3.3.1. Phase One: Social Media Site Selection To select social media support sites for this analysis, I conducted two separate Google searches between September 2016 and December 2016 with the following terms: youth, mental health, blogs, peer-to-peer support, and professional support. The term ‘internet use’ encapsulates general engagement with the internet for varied purposes, whereas the term ‘social media’ references user-generated, interactive, internet-based communication. For data collection purposes, findings from ‘forum posts’ and ‘forum post comments/responses’, consisting of online narrative accounts and replies, accessible on the website forum boards were examined. Using blogrolls, webrings, and other links that are usually found on blogs (i.e. virtual snowballing) I found social media sites that offered comparable (in terms of content, purpose, and disclosure type) detailed accounts of peer-to-peer and professional monitored supports on a variety of topics such as relationships, child abuse, eating disorders, mental health issues, and suicide (O’Brien & Clark, 2012, p. 280; Pitts, 2004, p. 36). To be included in this study, social media sites needed to have the following characteristics: (a) The posts included on the sites dealt with a variety of topics impacting youth  mental health;  (b) They were well-utilized, established organizations with an online active  presence for at least 10 years; (c) Youth bloggers explicitly self-identified as struggling with an issue that they  were consequently accessing online support for; 25 (d) The professionally monitored support was administered by crisis services   responders that had training in crisis intervention and suicide prevention;  (e) The content (i.e. types of disclosure and peer or professional feedback) on  peer-to-peer and professional sites were similar/comparable in content (i.e.  disclosure types); and, (f) Posts were anonymous and accessible through public domain that did not  require a password or login.  After viewing approximately 30-35 online sites and blogs of various types (e.g. youth cancer patient, LGBTQ community, social activism) that specifically targeted the different kinds of support sought out by youth, I selected two large scale, well utilized, multi-national social media sites capturing peer-to-peer and professional supports.  The peer-to-peer online support site, teenlineonline.org, was founded by a small group of mental health professionals located in Los Angeles, California in the 1980’s. TEEN LINE operates as a confidential hotline for teenagers who “have a problem” or “just want to talk to another teen who understands”. In addition to the message board where teens post online, there is also a hotline teens can call. Teens responding to calls, emails, and texts are from Southern California and have received some training.  The professionally-monitored online support site, kidshelpphone.ca, was created by mental health professional and clinical counsellors in 1989. Kid Help Phone is funded by the provincial government of British Columbia, Canada and is captured under their suicide prevention department. Volunteer and professional responders are adults over the 26 age of 19 with a combination of training and experience in counselling and/or youth work. In addition to previously run (archived in 2013 with posts made available online) online supports, a phone line is also made available for youth seeking supports. It is important to mention that the archived nature of the blog site considered meant that only one professional response per youths’ disclosure was made available. This amounted to an inability to consider the way youth were responding to professional responses. Both sites appeared similar in scope in terms of service provision (i.e. types of posts and responses in online forums), target demographic (teens aged 13-20), and establishment (frequently used and regularly maintained/updated). These similarities made comparisons between the sites possible. Despite the fact that these two sites are located in different countries, many of the problems listed by teens appear quite similar. Furthermore, because these sites are publically accessible online it is highly unlikely that either of them are maintaining a specific sample of teens by area alone, as the post are anonymous and could be made by anyone in North America, let alone the globe, with internet access.  3.3.2. Phase Two: Social Media Forum Topic Selection In consideration of the intricacies involved in conducting online ethnography, Hine (2017) notes that “without the physical boundary defining space” online ethnographic researchers must find ways to immerse themselves in the social situation in order to understand the relevance of the interactions taking place (p. 5). With this in mind, I immersed myself in the content provided through online forums on the selected youth support websites for approximately six to eight hours a week over the course of 27 five weeks. Forum post topics found on the peer-to-peer site (Teen Line) were specific and included: abuse (child and sexual), depression, divorce, bullying, anxiety, gangs, gender identity, homelessness, pregnancy, relationships, sexuality, violence, substance abuse, and suicide. Further, this site contained a section for ‘general help’. For the most part, teens participating in these discussions committed to the designated topics and many of the posts put forth within each topic carried content consistent with topics (e.g., shame and fear after experiencing sexual abuse). Forum post topics found on the professionally monitored site were broader and contained the topics: relationship, child abuse, mental health, friendship, depression and anxiety, and general help. With broader topic platforms on professionally monitored sites, the content contained under each topic were more varied and certain topics (e.g., pregnancy) were not provided a platform specific to the topic. This could potentially have operated as a deterrent for youth already feeling uncertain about posting disclosure due to shame, stigma, and fear of judgment.   Out of the fifteen forum posts topics contained on peer-to-peer site and eight posts included in professional sites, the forum topic ‘general help’ was selected for its provision of the opportunity to explore a variety of content (i.e., self esteem issues, drug use, sexuality, bullying, and abuse) pertaining to youth accessing online forums. Unlike some of the other forum content, the ‘general topics’ section contained less graphic and detailed accounts of specific concerns related to abuse or bullying. On a personal level, ‘general topics’ was chosen to protect myself from in-depth exploration and analysis of unsettling content I was unable to intervene with directly as a passive analyst.  28 3.3.3.  Phase Three: Forum Post Selection In further breakdown of generated data, Table 1 Post Data Chart: Peer-to-Peer Monitored Website and Table 2 Post Data Chart: Professionally Monitored Website outlines the amount, types, and range of posts and topics contained on the websites used. ‘General topics’ consist of headings used to categorize online posts, whereas individual topics or ‘topics’ consist of individualized post topic names created and put forth by youth. ‘Views’ is a calculation, available on the websites, used to capture non-active participants that have either clicked on, read, or viewed online posts, but not interacted with through public response. Table 1: Post Data Chart: Peer-to-Peer Monitored Website Total posts 46,704 (length of time captured unavailable) Total topics 12,527 Total members  30,447 General Topics 19: child abuse, eating disorders, fashion and pop culture, games and contests, general, gender & sexuality, health & fitness, homework help, poems and prose, relationships, substance use & addiction, self injury, suicide, newbies, rape, sexual assault, sexual abuse, mental health issues, success stories Views (range) 29-50,000 (youth would use website to play games and have multiple responses to one post) Participants for Narrative Inquiry 18 narrative disclosures and 54 contributors (i.e. youth responders) typically ranging from 2-4 contributors per online disclosure.   29 Table 2:  Post Data Chart: Professionally Monitored Website Total posts including topics 142,637 (capturing approximately four years of posts- 2012-2015) Total members Not applicable  General Topics 11: bullying, violence and abuse, school, living on your own, friends, dating, lesbian, gay, bi, trans and questioning, family, emotional health, girl’s health, guy’s health. Views (range) 200-3,000 (posts were less interactive as only one person would be involved, they were also archived in 2015) Participants for Narrative Inquiry 14 disclosures and 14 professional responses (only one response per online disclosure available through archives).   The tables outlined above captures major distinctions between peer-to-peer and professional websites. For example, peer-to-peer websites contained only one-third of the total posts included in professionally monitored sites, possibly because professional sites were archived from 2012-2015. Additionally, the professionally monitored site reached up to 3,000 views, whereas peer-to-peer sites adopting a much more interactive approach (multiple people could post on one forum post) could reach up to 50,000 views per post. In conducting this research, I considered 18 narrative disclosures and 54 contributors (i.e. youth responders) typically ranging from 2-4 contributors per online from peer-to-peer sites, and 14 disclosures and 14 professional responses (only one response per online disclosure available through archives) from an archived professional site. The specific sample chosen was deliberate, as I chose to include posts representative of the most common themes and types of disclosures found throughout the broader scope 30 of posts I considered that were contained between the two websites. I was able to recognize common disclosure types (e.g., feelings of isolation and aloneness) after spending a significant amount of time screening the wider pool of narratives contained on both peer and professional sites. After narrowing down the forum post topics, I then limited the number of posts considered for in-depth analysis for both practical and theoretical reasons. In applying a narrative ethnography methodology, I recognized the practical importance of limiting the posts I was exploring in depth. Selecting thirty-two posts allowed me the opportunity to capture the broader demographic while not over saturating, confusing, or complicating the data interpretation process needed to conduct a narrative methodology with an over abundance of excerpts from youth accessing online supports.  In reducing the posts considered for my research I went through an analytical process to identify relevant posts and responses to be used for analysis. The process of narrowing down the number of posts considered involved skimming through approximately sixty posts and responses contained under the ‘general topics’ section of each of the two websites. Posts were chosen in part because they appeared to capture the most consistent topics found throughout my broader search of the various forum topics throughout the entire websites, as well as my readings through the first sixty posts found under the general topics section of each of the websites. This process amounted to the selection of 14 forum posts from the professionally monitored site, and 18 forum posts from the peer-to-peer site. Up to eight responses per post were included from the peer-to-peer site, while only one response per post was available online and included from the professionally monitored site. Amounting to a total of thirty-two online disclosures or 31 original posts and sixty-eight responses. Once these posts and responses were selected, they were copy and pasted into a Word processing document with their original formatting, including user names (i.e. iamaperson12345), dates, times, and images. An example of the formatting of these posts and how they were included throughout findings is outlined below. The explanation of contents of blog format are indicated in bold. The following example provides an outline of how to navigate blog excerpts included throughout the remainder of my findings.  Pinkflamingo13 (youth’s chosen name): Is this all just a part of being a teenager  or is there something wrong with me? Please help (‘Normal or?’(title of blog  post), p.18, (page number in data set) professional site (type of site explored)) 3.4. Data Analysis Utilizing a thematic analysis framework, my research was conducted in an inductive-deductive manner, in which I actively took part in the organization, description, and interpretation of themes stemming from disclosures and responses on peer-to-peer and professional sites (Braun & Clarke, 2006, p. 91). In total, thirty-two online narrative disclosure accounts and sixty-eight responses were read and reread, core concepts were identified in the field notes, and similar posts were considered, coded, clustered, themed, and analyzed in-depth to bring about my findings. Braun and Clarke’s (2006) thematic analysis was chosen as a method for its ability to incorporate both narrative elements (descriptive, personal, and specific accounts) and ethnography (cultural phenomena) in exploration of youth’s online accounts (p. 91).  Thematic analysis and narrative ethnography align well, as both approaches require active participation from the researcher in the interpretation and analysis of 32 themes found throughout data (Braun & Clarke, 2006, p. 91; Markham & Baym, 2009, p. 15). Additionally, both narrative ethnography and thematic analysis align in allowing the researcher flexibility to consider and recognize the multiple dimensions and layers of social context that may be underlying identified themes, as well as critical consideration for broader societal influence (Braun & Clarke, 2006, p. 91; Gubrium & Holstein, 2008, p. 251). However, most importantly, both approaches align themselves well with my conceptual groundings rooted in social constructionism (Burr, Taylor & Francis, 2015, p. 1).  Initial observations and reflections noted throughout the first thirty hours of content examination of websites, forums, and the topic area and captured through analytical memos influenced my data analysis and surrounding discussion. Consequently, reference to the wider body of youth can be found throughout the concluding discussion. This approach allowed me to demonstrate fidelity to ethnographic considerations of larger cultural impact, while still enabling me to conduct an in-depth narrative analysis of online narrative accounts. During this period of immersion, I made note of emerging conflicts with current notions, judgments, and assumptions about youth social media use through field notes, which I reviewed multiple times and reflectively analyzed in order to increase reflexivity and depth of understanding about the content through connecting findings to theory (Willis et al., 2016, p. 23). Finally, I categorized the different clusters according to their content and perceived attachment to broader ideological or analytical themes noted throughout the immersion phase in order to consider distinctions between peer-to-peer and professional monitored online supports (Vaismoradi, Turunen, & Bondas, 2013, p.  340).  33 When it came to structuring my analysis and break down of data, as a novice researcher, Braun & Clarke’s process (outlined in Table 3) was very helpful. Once I selected the posts that I would be exploring in my research I committed all data to the same research process. Table 3 below illustrates the process: Table 3: Research Analysis Process Phase Process Description 1. Familiarized Myself with Data  Read and re-reading the data (word document containing disclosures and responses) and recording any initial thoughts or observations about data in a separate notebook. 2. Development of Initial Codes  Coding the data using an inductive-deductive approach. Inductive codes reflected concepts emerging from the data itself (e.g., ‘asking for help’); deductive codes reflected theoretical and/or practice-based concepts (e.g., core competencies of social work professions). 3. Development of Themes Grouping similarly coded data into thematic categories. 4. Review of Themes Comparing thematic categories across all data; combing conceptually overlapping themes and examining them in relation to research questions (3.2.1. Data Analysis Code Chart) 5. Finalization of Themes Finalizing thematic interpretation of data *Variation of Braun & Clarke’s (2006, p. 87) process for a thematic analysis  34 In consideration of the above research processes it is important to note that reflexive, methodological, and analytical memos were documented in notebooks and page margins throughout the analysis and interpretation process. These memos contained links to theory (e.g. labelling theory), initial personal reactions to content themes (e.g. sadness), and associated questions (e.g. how are youth defining or labeling themselves online?) surrounding both theory and reflections. This allowed me to link content with theory, as well as reflect on the ways in which my own social location (i.e. white, upper middle-class, heterosexual, female) may have impacted my response to youth disclosures and ability to engage with and/or understand content. In maintaining an awareness of the influences my social location may have on my data analysis process I pushed myself to challenge my assumptions and dive deeper into the unique realities of youth accessing online supports by asking questions such as, ‘what narratives surround aloneness’, ‘how are therapeutic interventions understood by youth’ and ‘how are youth defining their stories’. Ultimately, this multi-step process assisted me to understand the realties of struggling youth within the context of online support environments. This enabled a more thorough examination of online support aspects, such as the way youth ‘named’ themselves, the kind of words used to describe illness, and the types of language used in peer and professional online sites. Eventually, this process led me to the final selection of themes stemming from the codes listed in Table 4 below. Codes were connected to corresponding research questions in order to provide a better understanding of how initial thoughts/questions can be transferred into codes used for analysis. 35 3.4.1. Analysis Process  As a first step to identifying codes, I first read and re-read data contained within a word document outlining disclosures and responses and recording any initial thoughts or observations about data in a separate notebook. After conducting initial reading and re- readings of online narrative disclosures for general themes, I eventually developed the following colour coded chart (table 4) based on common themes I saw reoccurring in posts that I chose to explore - in order to simplify the analysis process by allowing me to highlight sections with multiple colours and easily pick out potential overlaps, connections, and correlations in themes. Multiple colours representing different codes would often be used to highlight the same quote. Using multi-coloured highlighters allowed me to see which themes intersected and further analyze the manner in which these themes connected to one another. I had several questions in mind while contemplating the experiences of youth seeking online supports. This method allowed me to consider which themes or codes were connected or potentially correlated with one another and how these themes impacted youth overall narrative formation. The analytical questions outlined are examples of the types of questions I was asking myself throughout the analysis process, they emerged from thoughts generated after initial readings of the data.   36 Table 4: Data Analysis Chart Codes Analytical Question ‘Asking for Help’ Are youth seeking help genuinely on their own regard? Why would they be accessing this online through online forms? ‘Isolation/Loneliness’ Curious about the emotional state that youth are in when accessing online support- what narratives surround feelings of aloneness? ‘Identity Formation’ How are youth defining themselves/narrating their stories? What experiences attribute to these narratives? ‘Power/ Autonomy’ What are youth doing to obtain more power in their life? Where is power being taken away? How does power play out in relationships with parents, professionals, and counsellors? ‘Therapy/ Counselling’ How are therapeutic interventions received and understood by youth? Are current services (i.e. counselling) considered helpful by youth accessing them? ‘Parents/Families’ How are relationships with family members impacting youth? How do these relationships help or hinder youth access to help and feelings of being supported?   ‘Mental Health’ How is mental health being understood or “treated” by youth? Is there shame and stigma surrounding mental health? Are youth understanding their experiences using mental health related terms (i.e. diagnostic language) ‘Relational Aspects’ How do relationship or lack of relationships (i.e. social support) impact youth’s overall wellbeing? Do the youth accessing these supports identify as having in person friendships with peers?  Additionally, in providing a relational focus, I examined both peer-to-peer and professional posts for demonstrations of authenticity and empathy in the same way I applied codes, instead indicating demonstrations of authenticity or empathy through the letters A or E. The term ‘empathy’ refers to the level of understanding displayed for 37 another person’s affective experience, whereas the term ‘authenticity’ is used to describe the level of genuine presence and engagement in responses (Spencer, 2006, p. 289). In examining professional responses I applied the notion of ‘core competency counselling skills’ in order to achieve a better understanding of the way professionals were responding to youth. In additional to authenticity and empathy, professional responses were examined for strengths-based language, general understanding/connection, normalizing of experiences, referral to professional services and resources, and psychoeducational tools or skills. I used an inductive-deductive approach to analysis. This enabled me to stay close to the data and allow for the emergence of in-vivo themes. Simultaneously, previous research and conceptual concepts (e.g. attachment theory) were incorporated into the data analysis, which allowed for a more theoretically-based analysis. The process taken to analyze data amounted to several memos recorded throughout the research process. One example would be memos such as ‘youth feeling alone’, ‘repeat experiences of feeling misunderstood’, ‘feeling uncomfortable with family and friends’ lead to the theme Isolation/Aloneness. Another example is notes such as ‘helping one another’, ‘connected over shared struggles’, ‘shared/similar experiences’ ‘strengthening one another through shared experiences’ which lead to the theme Peer-to-Peer Support: Collective Strength and Solidarity. 3.5. Ethical Considerations Ethical concerns specific to the online narrative ethnographic methodology I used to conduct this research are found in areas of anonymity, consent, privacy, authenticity, 38 and sampling (Wilson, Kenny & Dickson-Swift, 2015, p. 3). Although all the listed ethical concerns merit consideration, validity or potential misrepresentation of young people’s experiences accessing the online supports analyzed remains my largest concern, as the anonymous nature of online forums raises questions about the legitimacy of web-based narrative (Ackland, 2013, p. 72). With a lack of in-person consultation and consent, there is no guarantee that what was being shared online accurately represents the account of a youth in crisis. Additionally, although it is argued that blog posts and online forums accessible through public internet domains are “fair game,” an ethical dilemma is presented in the fact that I am indeed accessing private content without informed consent (Ackland, 2013, p. 80; Lunnay et al. 2014, p. 103). Finally, the lack of in-person encounters removes embodiment, a major communicative component, from the research observations. A lack of embodiment could lead to ethical concerns because as a researcher I am unable to speak to the tonality of language, body language, or emphasis being projected alongside disclosures; and, consequently, may be misinterpreting the intention behind what is being written.  Because online data collection in social sciences is still evolving and there are no current standardized methods for granting ethics approval, decisions are subject to researchers’ discretion (Keim-Malpass, Steeves & Kennedy, 2014, p. 1690). With my ethical dilemmas now apparent, a brief outline of research decisions made to ensure my research process was conducted in a way that demonstrates integrity is outlined below. First, in conducting this research I was able to ensure that all the components I chose to incorporate throughout the thesis did not identify people, places, or overt descriptions that may be used as identifiers. Further, I also maintained no direct interaction (i.e. 39 commenting, posting, or altering) with any of the data. Throughout the process of conducting my research I took on the role of “passive analysis,” interrogating the ways in which information and dialogue are exchanged through the listed online forums, without any direct involvement, further maintaining confidentiality in only selecting anonymous, non-identifying forum post content. (Keim-Malpass et al., 2014, p. 1691). This project was exempt from requiring Behavioural Research Ethics Board (BREB) approval due to the publically accessible nature of content, lack of interaction with content, and protection of participants’ anonymity.  3.6. Establishing Trustworthiness Unlike quantitative methods’ concern for reliability and external generalizability, as a qualitative researcher my focus is centred on the credibility or truthfulness of my findings (Wittemore et al., 2001, p.523). Maxwell (1992) captures the importance of ensuring validity well in stating that without consistently produced valid results, qualitative research will not be relied on to inform policy, program, and practice (p. 279). There are several risks to validity related to data collection and interpretation contained within narrative ethnography that are important to address. In the next few paragraphs, I will provide a brief overview of potential threats to validity within this study, as well as strategies I used to address these threats in order to ensure trustworthiness. Validity, in a broad sense, is concerned primarily with the relationship between the thing, phenomenon, or account that is being researched and the researcher’s interpretation of said item. For this reason, it is important to recognize that I, as a researcher attempting to depict or explain an occurrence, was unable to detach myself 40 from the process (Maxwell, 1992, p. 280). With “observer-independent” accounts of experiences remaining impossible to achieve in qualitative research studies, such as a narrative ethnography, acknowledging one’s frameworks, ideals, and potential biases is essential; as just as no two individuals are exactly similar, no two interpretations can remain the same. Therein, self-biography often shapes research (Bishop & Shepherd, 2011, p. 1283; Maxwell, 1992, p. 282).  Validity measures were put in place and supported using the following five categories outlined in Maxwell’s (1992) realist approach for ensuring validity (p. 288). First, in adhering to the principle that different observers should agree on the accuracy of a narrative account in order to achieve “descriptive validity” (Maxwell, 1992, p. 288), I utilized small group, peer review sessions (3-4 peers) to consult with other researchers about interpretation of findings. Secondly, as a reflexive researcher, I adopted Maxwell’s (1992) suggestion to consider my underlying beliefs, intentions, and concepts through  reflective journaling and field notes, jotting down pertinent concepts to be discussed in peer review sessions in order to preserve “interpretive validity” (p. 292). Next, I ensured “theoretical validity” in choosing my methodology for research design (narrative ethnography) for its ability to answer current gaps in literature by providing an important foundation for in-depth, inductive-deductive analysis of the youth’s experience in seeking online supports (Maxwell, 1992, p. 292). I have displayed “internal generalizability,” Maxwell’s next suggestion, in making explicit the descriptive, interpretive, and theoretical approaches being applied to my sample of online narrative accounts of youth participants seeking support (p. 293). As the power of qualitative research rests in the in-depth analysis of a specific group of individuals in attempts to understand larger 41 phenomena (in this case the differences between peer-to-peer and professionally monitored support in online forums), I demonstrate the validity of narrative ethnographic analysis in furthering our understanding of this demographic (Maxwell, 1992, p. 294). Finally, I demonstrate “evaluative validity” in applying an inductive-deductive thematic analysis framework to organize, interpret, and guide the organization and reporting of data (Maxwell, 1992, p. 295). Furthermore, by ensuring that the demographic I studied was well defined, my methodology is congruent with questions raised by previous researchers regarding validity by including measures to ensure that I hold the key cornerstone of validity, truthfulness, central (Altheide & Johnson, 1994, p. 488). Holding to reflexivity throughout ensured that I remained sensitive to how my personal assumptions, position, and social background may have impacted my interpretations of data and therein the research process at each stage of the research process (Bishop & Shepherd, 2011, p. 1284); a process that I came to recognize as important in allowing me to remain committed to narrative inquiries’ (i.e. narrative research approaches) connection to how one stories their life on a linear (sequential), relational, emotional, and analytical level. In remaining transparent about the reflexive process, it becomes important for me to acknowledge that even in my greatest attempts toward deep reflection, analysis of diverging perspectives, and consideration of all the “factors at play” I have still fallen short in my ability to capture “with certainty” (Bishop & Shepherd, 2001, p. 1288) which parts of my personal history, assumptions, and narrative may have shaped the entirety to of my research.  42 Chapter 4. Results 4.1.1. Introduction Pinkflamingo13: Is this all just a part of being a teenager or is there something  wrong with me? Please help (‘Normal or?’, p.18, professional site) As a social work researcher spending a significant period of time immersing myself in the ethnographic context of youth accessing support through online forms, I came to a place of deep appreciation and respect for the unique struggles adolescents are facing. Simply put, the fact that over 188,000 youth turned to anonymous online supports in times of need, on the two sites explored throughout this research alone (referenced in Table 1 and Table 2 in chapter 3), speaks to the fact that these supports may be filling important gaps in youth services. Research findings evidenced through the excerpts included in this chapter below, indicate that online interventions appeared to assist youth in creatively achieving alternative avenues for support which they were previously powerless to access, despite (in some cases) several real life attempts. Furthermore, youth displayed collective resilience in empathetically supporting one another through personal struggles on peer-to-peer sites.  This chapter, I present my research findings. Findings are referenced under the larger themes of Identity Formation, Power and Autonomy and Unique Contributions of Online Supports. Findings contained within the theme Identity Formation specifically look at the way identity is being formed for youth accessing online supports in times of need, through consideration of how these youths are using online narratives to ‘story’ their lives (Gubrium & Holstein, 2008, p. 251). Identity formation is first explored 43 throughout subtheme, Naming of Oneself: Online Names, as well as, the subtheme Fear, Shame, Guilt, and Aloneness, and subtheme Individual Pathology: Self Diagnosis. The second theme, Power and Autonomy, on the other hand, explores youth’s positionality (societal position in relation to others) through considering the types of encounters youth are having with family members/caregivers and therapist and counsellors. This is explored through subthemes Opportunities for Anonymity Online: Increasing Youth Power, Disempowering Interactions with Family Members, and Disempowering Interactions with Therapist and Counsellors. Finally, with findings from both identity formation and power and autonomy in mind, the final theme Unique Contributions of Online Supports outlines the unique aspect of online supports. In this section both peer-to-peer support sites and professional support sites are explored through subthemes, Peer-to-Peer Support: Collective Strength and Solidarity and Professional Support.   4.2. Identity Formation Through exploration of identity formation within their youth narratives, I came to recognize the terms youth were using (e.g. fear, shame) and manner in which they were describing their experience (e.g. self blame) as most significant to how identity was negotiated in these online environments. Sefton-Green (2006) claim that social media text can be seen as a type of character formation, as narratives can be absorbed, internalized, and then re-written by youth, providing awareness into the process of developing meaning (p. 295). In the following sub-theme, Naming of Oneself: Online Names, I explore the types of names youth are using to identify themselves in online forums. The next subtheme, Fear, Shame, Guilt, and Aloneness, explores some of the experiences most common within online narrative disclosures shared by youth in order to assist the 44 audience to understand the ways in which youth are currently describing their struggle. Keeping in line with these findings, the final sub-theme, Individual Pathology: Self-diagnosis, considers the way youth are identifying themselves, and creating their story. This theme highlights that many youth appear to internalize struggles, blaming themselves for the negative experiences occurring in their lives.  4.2.1. Naming of Oneself: Online Names As a first step towards speaking to both the culture and identity of youth accessing online support forums, considering the types of anonymous ‘names’ youth are choosing to identify themselves under is important. Table 5 outlines a list of name choices youth used when identifying themselves on online blog posts. Table 5: Youth Names in Online Blog Posts Chosen Names in Professional Blog Posts Chosen Names in Peer-to-Peer Blog Posts ImAPerson12345 Eevees Alonelygirl2015 xFallOutGirlx iiBrokenYoshi INVISIgirl liv09 ThatOneWeirdGirl VamPirate soccermouse98 fragile_heart Leehigh777 Ashabriarwood i_am_Nicole_xo waffles55 FallingInPieces Confusedanddeaf 4ever_alive_and_lost ache8 CelestianCrow 45 Table 5: Youth Names in Online Blog Posts chairhandler1 t33nl1n34u9 Pinkflamingo13 grungekid97 Phanroar Cara_jaide  Joanna Mhae  Number2  Incognito2632  Jonasbark  Peppermelon  deaths_embrace  Xxteganrxx  lostgirl113  thatgirl6115  A brief glance through the name choices youth decided to identify themselves under has much to offer an audience seeking to better understand the experiences of youth accessing online supports. In examining the name choices youth are using in online environments, one can consider how the “self” as a socially generated phenomena may have been influenced by a variety of stories including experiences, family of origin, and “dominant cultural discourses” (Gillian & Price, 2003, p. 261). With this in mind, themes of pain (i.e. ache8, iiBrokenYoshi) and isolation (i.e. ThatOneWeirdGirl, Alonelygirl2015), alongside resilient attempts towards making oneself known (i.e. ImAPerson12345), and continued living (i.e. liv09) take on new meaning. From a narrative lens, I considered how these dominant stories under which youth are identifying 46 may create a ‘perceptual lens’ through which their future life events may be interpreted (Gillian & Price, 2003, p. 261).  Furthermore, in considering the names youth chose to identify under, I question the impacts of self-created identities. For example, for Alonelygirl2015, does identifying as lonely further perpetuate loneliness? In direct opposition to the essentialist understanding of “self” (i.e. the belief that certain categories of people (e.g. women) have an underlying reality that sets them apart as inherently distinct due to their classification), through a narrative lens “self” is a “socially generated phenomenon that occurs in language” or the internalization of interpersonal conversational encounters directly influenced by external factors such as society, power imbalances, gender, and frequency of mental health diagnosis (Adams-Westcott, Dafforn, & Sterne, 2003, p. 261). The question regarding how youth choose to identify themselves and story their lives, reflected through the names they use to identify themselves online thus needs to be understood in the context of broader socio-political context including power imbalances and diagnosis language. This will be explored in further depth throughout the remaining findings. However, before examining this at the macro-level, it is important to examine the impact of commonly used pathological medical language on youth perception of self, youth’s current state of dependence resulting in a lack of ability to access resources, as well as the general lack of acknowledgement or adherence to the ‘voice’ of youth as outlined in Article 12 of the United Nations Convention on the Rights of the Child (UNCRC).  47 4.2.2. Fear, Shame, Guilt and Aloneness Nearly all of the youth seeking support through online forums (i.e. 14 out of 18 peer-to-peer posts and 11 out of 14 professional posts) expressed feelings of severe distress, fear, shame, and consequently demonstrated significant guilt over disclosing their struggles to those closest to them (i.e. friends and family) and/or in authority over them (i.e. parents, teachers, and counsellors). Typically, these feelings were associated with a fear of disappointing others or deviating from a perceived social norm. The following excerpt displays the ways in which distressing feelings influenced iiBrokenYoshi’s deliberate decision to represent themselves falsely, iiBrokenYoshi: I feel like a disappointment, I'm depressed a lot, but I hide my  feelings. I put on a fake smile and deal with it…I just feel like a huge  disappointment and mistake (‘People just don’t understand.’, p.16, professional  site) Despite feeling depressed and like a disappointment, iiBrokenYoshi hides their feelings.  Taking the concept of hidden feelings a step further, for many youth accessing online supports, feelings of fear, stigma, and shame over unexposed struggles amounted to uncertainty and anxiety over their personal identity. This may have occurred due to the fact that the way youth presented themselves to the others, at times, sat in direct contrast to how they may be feeling internally. ImAPersona12345 describes the experiences of hiding difficult feelings and emotions while in public settings as follows:  ImAPerson12345: my voice wavers and I almost start crying, but I never cry in  public  and instinctually hide it. Often, as well, it's like I live 2 lives. (‘How do I  get help?’, p. 1, professional site) ImAPersons12345 account makes clear the manner by which the hiding of feelings can lead youth to feeling like they are living two lives; a possible conflicting internal battle 48 for many. In reflecting on experiences of hiding their feelings, youth would often connect the discomfort they held over disclosing struggles with fear of judgment and stigma from others. In the following account, Leehigh777 describes this common connection of uncertainty in self disclosing and the experiences of fear of being judged by others: Leehigh777: …I have no idea who I am or what I want to do. I don't know how to  tell anyone […] I'm afraid of going [to therapy]…and being judged by everybody.  (‘I FEEL LIKE I’M LOSING MY MIND, p. 8, peer-to-peer)  Many youth seeking support communicated feelings of disconnection, isolation, and aloneness. The following excerpt articulates youth’s general desire for relational connection in spite of feeling misunderstood and disconnected, Ache8: I feel like I'm the only one who's going through what I have been  through […] I  needed someone to talk… I want love. (‘Help’, p. 13, professional  site) Although feelings of aloneness and isolation were often connected to fear stemming from previous experiences of being penalized, judged, or shamed, there were occasions in which youth would blame themselves and personally identify themselves with these distressing emotional experiences, INVISIgirl: I have trust issues, so I don't have anyone to talk to, in real life  (‘HOW TO GET A THERAPIST’, p. 1, peer-to-peer) Additionally, self-blame presented itself in youth’s claims of feeling unable to attach, connect, and experience closeness with loved ones, JoannaMhae: I feel like that everything surrounding me means absolutely nothing  to me.  Like being around others like my family or friends I don't really feel love  towards them  (‘FEEL LIKE I HAVE NO PURPOSE IN LIFE ANYMORE.  HELP!’, p. 18, peer-to-peer) Although feelings of emotional distress were outlined by nearly every youth accessing 49 online supports, and likely many youth viewing these forums, the ways in which these emotions were conceptualized, processed, and experienced varied.  In conceptualizing the consequences that experiences of stigma and judgement may hold for youth, it is necessary to highlight feelings of isolation and aloneness as common. Although it cannot be directly asserted that these feelings are associated with one another, online disclosures demonstrate that they often went hand in hand. Connection between experiences of stigma (defined and coded as fear surrounding reputation based on others opinions) and/or judgment and feelings of isolation and/or aloneness may hold a significant impact on how youth identify themselves. An example of the evident interconnected themes is found in Leehigh777’s post,  Leehigh777: I'm afraid [fear] of going there because my friend got caught and  was sent to that place and their stories seem like nightmares to me. Besides I'm  afraid of being judged by everybody. I was afraid of what my family would think  of me [shame]. My mom made me seem like criminal [stigma]. When I went to  the ER, the whole night she gave me a huge guilt trip about it.  Is there anyway for people not to find out where you are? [Isolation and  Alonnness] (‘I FEEL LIKE I’M LOSING MY MIND’,  Peer-to-Peer, p.8, interconnected  themes in bold) In Leehigh 777’s post previous experiences of stigma and shame lead to a fear over access to support from the health care providers, in turn facilitating experiences of isolation and aloneness in attempting to overcome struggles. Negative, shameful, and/or stigmatizing experiences leading to fear that amounts to isolation and/or aloneness is an important component of youths’ narratives to consider. The interconnected nature of many of the themes found throughout youth narratives is illustrated in Figure 1 below: 50 Figure 1: Interconnection between stigma, shame, fear, isolation, and aloneness.  4.2.3. Individual Pathology: Self Diagnosis My name is… Depression Anxiety OCD Crumbs on the floor Chairs out of place Repeat Clean everyday Clean everyday Clean everyday Compulsion Controlling Psychopath Hurt  [researcher created found poem from excerpts from ‘I NEED HELP..’ I_am_Nicole_xo, p.10, peer-to-peer site] I developed this poem in attempts to vividly demonstrate common language used throughout youth’s online narrative accounts. I_am_Nicole_xo used debilitating personal experiences (i.e. compulsions to clean) to negatively define, categorize, and identify herself using words such as “psychopath.” This was a common occurrence amongst many 51 online narratives. Trends towards self-diagnosis and diagnostic language took place in many different forms: Where in some cases diagnostic terms were used casually, other cases indicate that youth would deliberately seek out diagnosis through counsellors or conduct online research in order to diagnosis themselves. The excerpt below demonstrates the way in which diagnostic terms were casually used by youth as descriptors for their experiences. Jonasbark: I am really nervous and I am going because of social anxiety and it's hard for me to talk to people I am not completely comfortable with. I want this to work but I feel like I might shut down or have panic attack. (‘Dermatillomania’, p.21, peer-to-peer) Here, Jonasbark attributes strong feelings of nervousness to ‘social anxiety’, further stating this could lead him to having a ‘panic attack’. This example highlights the way youth used mental health terms to describe their experiences in online narratives.  With little success demonstrated in seeking in-person supports, youth accessing online forums appeared to be accessing the internet for self-help information. For example, after not receiving the help and diagnosis they were anticipating, iiBrokenYoshi went online to post their rationale for thinking they were bipolar, I think I'm bipolar, I tried to get help, they brushed it off as hormones. I get  hormones, I'm not stupid. You see, I have these crazy highs and lows. One week  I'm happy, hyper, elated.. Next week I'm slow and depressed.  (‘iiBrokenYoshi’, p.16, professional site) Here we see ‘iiBrokenYoshi’ feeling upset that they were not affirmed in their attempts at achieving a diagnosis. Additionally, youth utilized online searches for symptoms they were experiencing (i.e. anxiety, depression, overwhelming feelings) and would connect their experiences with various diagnosable mental health disorders, further perpetuating 52 deficit-based language, feelings of fear, and pathology. The following excerpt portrays potential harms of utilizing ‘self diagnosis’ as an approach toward conceptualizing struggle, VamPirate: i was researching anxiety and came across OCD and other anxiety- related  problems.. […]i have most of the symptoms, but im afraid. i mean, what if  it's something else? […] i dont want to be in a straightjacket sitting in the middle  of a white room either. (‘OCD ?’, p.6, professional site) Here we see VamPirate’s search and self-diagnosis leading to fear. That youth are utilizing online supports in this way leaves me questioning the potential harms that may stem from youth engaging in self diagnosis. Although positive or negative feelings towards diagnostic terms appeared to vary from youth to youth, the access to and use of these terms merits recognition.  4.3. Power and Autonomy As a social worker, I carry with me the belief that it is important to consider systemic environmental factors inherent within broader social and political systems youth are part of in order to critically assess the way narratives and identity formation are taking place. In the following section, I will be considering the unique positionality (position in relation to others) of youth during this crucial stage of development. Although, there are undoubtedly numerous systems (i.e. political, religious, educational) that hold significant impact and influence, what was most apparent in the data was youth’s state of dependency in the context of family of origin, and professional supports (i.e. therapist, counsellor). According to youth’s online narrative accounts, experiences with adults in supportive roles carried significant ability to impact youth’s self perception and ability to access resources. 53 Youth’s lack of ability to access desired resources in-person due to potential discomfort reaching out to those on authority over them (i.e. parents and teachers), proximity or affordability provides clear support for the argument that online supports increase access to power and autonomy for youth. However, I have come to understand that increases in power and autonomy by youth accessing these supports become most pronounced through youth’s ability to access positive, non-judgemental, and supportive services that they are not exposed to otherwise. In the following section I will consider the unique role online interventions play in giving youth (typically powerless over full freedom of expression and voice) the opportunity to reach out for help anonymously and access information and resources, as well as relational support and solidarity.  4.3.1. Disempowering Interactions with Family Members For many youth accessing online supports, negative interactions with parents were a major precipitating factor for emotional pain. These experiences were especially difficult when responses from family members and friends were perceived as unsupportive, judgemental, deliberately hurtful, or threatening. This parental response appeared to foster a state of helplessness in which these youth, lacking the autonomy needed for change, found themselves. In many cases, dependency on parents and caregivers left youth powerless to achieve desired change. Furthermore, negative experiences with family members were identified as the central cause of struggles, further facilitating great distress, ThatOneWeirdGirl: [In reference to an experience with extended family visiting] 54 They all poke fun at me […] It's honestly degrading and I've been struggling a lot recently and I  genuinely don't know what to do anymore […] I'm so scared I'll end up hurting myself or worse. (‘I DON”T KNOW WHAT TO DO’, p.3, peer-to-peer) For some youth, family was identified as a major barrier to independence and autonomy in self-expression and openness. For example, Leehigh777 expressed that she or he rejected her/his identity as it did not align with the conservative values of her/his family: Leehigh777: I always reject who I think I am because I come from a conservative  family. I don't know what to do. I am still dependent on my family.  (‘I FEEL LIKE I’M LOSING MY MIND’, p.8, peer-to-peer) Where, in some cases, barriers related to the biological state of dependence were more extreme, for many youth, the implications of not feeling supported by family members held real emotional consequences, ImAPerson12345: many times, I come home from school with good news (a good  mark, a completed project, etc.) and I try to tell my mom. Often, she interrupts me  by talking to someone else, making me feel insignificant and insecure. (‘How do I get help?’, p.1, professional site) Not having support from parents and caregivers further perpetuates the disempowerment of youth as it resulted in an inability to access desired resources or supports,  ImAPerson12345: I don't know what any of this is, or how to ask for help from  my parents. I doubt either parent would listen to me…they would probably ignore  it (‘How do I get help?’, p.1, professional site)  Youth’s narratives illustrate that they appear to have little power over accessing supports or making decisions independent of authority figures (i.e., parents), and that the online environment provided a unique space for them to exercise their rights to voice and freedom of expression.  55 4.3.2. Disempowering Interaction with Therapist and Counsellors According to youth’s online disclosures, previous negative experiences with therapists and counsellors held significant impacts. Despite earnestly seeking out in-person supports, with good intentions and a readiness for change, for some youth, experiences in these settings did not appear to be empowering. Often this resulted in fractured relationships, fear, increased feelings of powerlessness, and further delegitimizing of the struggles youth were facing. In turn, these experiences created additional barriers to support. Common themes found within youth’s disclosures were a distrust of counsellors for fear they were breaking confidentiality by sharing information from sessions with parents or caregivers or experiences in which the youth felt belittled or judged by counsellors. In the following narrative account iiBrokenYoshi expresses concern over telling her counsellor that she self harms for fear that her parents would be told and become disappointed in her, iiBrokenYoshi: I think if I tell my counselor my true feelings that I self-harm and I feel like a disappointment that she'll tell my mom and she'll be disappointed and possibly not love me. I don't even know, I just feel like a huge disappointment and mistake and that I don't belong here […] She doesn't need to know, for what? So she can report back to my mom and she'll think I'm a disappointment, get me into therapy.                                                                                                             (‘People just don’t understand..’ , p.16, professional site) Along a similar vein, in the account below, CharlieTaylor outlines previous experiences of counsellors discussing meetings with parents, CharlieTaylor: The first [time they went to therapy] was when I was about 10 or 11 and she always met with my parents after our meetings, I quickly began to feel as if she told them everything I had told her - so I shut down telling her anything, (‘THERAPISTS’,p.27, peer-to-peer site) In other accounts youth expressed solidarity in feeling judged by counsellors when 56 seeking help,  Leehigh777: I'm afraid of going there [hospital for counselling support] because  my friend got caught and was sent to that place and their stories seem like  nightmares to me. Besides I'm afraid of being judged by everybody.    (‘I FEEL LIKE I’M LOSING MY MIND’, p.8, peer-to-peer)  Peer response to comment,   Peer Response to Leehigh777’s post: Colorfulgal101: I feel the same way about therapists, I've been to two different ones in my life. And neither experience was very helpful.                                                                                                                       (‘I FEEL LIKE I’M LOSING MY MIND’, p.8, peer-to-peer) Furthermore, some youth felt that their struggles were not legitimized by the professionals they were seeking help from,  Alonelygirl2015: I am 20 years old. I have been feeling unwell like throwing my  life away and have been in hospital and out of the hospital and the nurses and  doctors think that I am faking this and I am not at all faking this instead I wanted  help but I guess I'll just give up wasting time getting help. Do you have any idea  what I should do?          (‘I am not sure if I want to go to counselling any more’, p.2, professional site) Leehigh777, Colorfulgal101, and Alonelygirl2015’s narrative disclosures highlight common experiences of pain held by youth after experiences of perceived judgement or belittling from counsellors.  4.3.3. Opportunities for Anonymity Online: Increasing Youth Power Shifts in access to both power (increased access to knowledge, information, and resources) and voice (opportunities to express oneself openly) were made apparent in reading the narrative accounts of youth. In part, as online platforms are easily accessible, free, and mostly non-judgmental, it is easy to understand why these spaces offer access to increased power and voice. More significantly however, is the assumed anonymity of online environments, which provided an alternative to youth struggling to find 57 information, connection, and resources in their current environment. This anonymous environment therefore worked as a catalyst for taking an important first step in help seeking, ImAPerson12345: I don't know what any of this is, or how to ask for help from my parents. I doubt either parent would listen to me…they would probably ignore it (‘How do I get help?’, p.1, peer-to-peer)  In both their disclosure statement provided and title (i.e. ‘How do I get help?’), ImAPerson12345 is able to explore the idea of approaching an adult in their life on a completely anonymous and secure platform. Similarly, CelestianCrow demonstrates a new found ability towards seeking and achieving help provided through anonymous online platforms, CelestianCrow: I need someone I need help, this may be the first time I’ve ever  said that, even if it’s not aloud.. But I really do ( ‘I NEED HELP..’, p. 13, peer-to- peer) CelestianCrow and ImAPerson12345’s statements are representative of many of the youth’s new-found power in seeking help and expressing themselves openly through online platforms. Although the freedom youth find in taking the first steps towards seeking help and disclosure can not be attributed entirely to the anonymity these environments offer, it is an important factor to consider when trying to understand what motivations lie behind youth’s use of online platforms, the appeal of such platforms, and the kinds of disclosures that might be written in these environments.  To conclude, it is important to consider the ways in which unsupportive responses in online environments may contribute to disempowerment of youth voice, power, and agency. In studying barriers to counselling services, Yoshitaka (2014) found that when 58 marginalized youth were consulted about their personal barriers to accessing youth services, many reported that feeling disconnected, judged, and labeled by professionals they speak with as a significant contributing factor to their lack of engagement with youth services (p. 32). In honouring the voices of youth it is important to recognize the importance of both access and validation. Providing opportunities for youth to access supports without validating their experiences may work as a larger inhibitor to youth’s ability to exercise voice. The above sections on power/autonomy and identity formation highlight in-person encounters in which youth were not experiencing validation from those in which they were seeking it from. These concerns were raised on both peer-to-peer and professional platforms. However, overall the responses to youths requests for mental health and/or relational support in online environments appeared to be validating. That being said, when it came to responses containing language that validated youths’ experiences important differences emerged that distinguished the peer-to-peer site explored from the professionally-monitored site. The next theme, Unique Contributions of Online Supports unpacks these differences more fully. 4.4. Unique Contributions of Online Supports It is apparent that many of the youth turning to anonymous online supports demonstrate great strengths and self-determination in seeking support, despite feelings of powerlessness over their ability to change their situation. Many of the youth seeking online supports outlined significant barriers to their ability to seek in-person supports despite a personal desire to access help, education, and support in order to move past current struggles. These barriers were tied to resources (e.g., finances), lack of family support for counselling services, lack of knowledge about available resources, fear and 59 uncertainty around accessing services in person, and inability to physically get to services (e.g., no car, homeschooled). It is in this space of felt powerlessness that online counselling support services appear to be an effective alternative, or additional support to youth in times of need that would not be able to access services otherwise. As such, these online platforms, arguably, can increase youth’s capacity for increased perspective, support, information, and resources. Disclosures make evident that youth used online supports strategically, as a tool for collaboration, idea sharing, and mutual support which appeared to result in connection, community, and solidarity in the face of tremendous difficulty in their personal lives.  However, key differences in the interactions and responses emerged when comparing peer-to-peer and professional sites. For example, peer-to-peer sites appeared to demonstrate an element of collective solidarity and professional sites offered comprehensive, supportive responses (3-5 times the typically length of peer responses). Although responders on both sites demonstrated empathy, understanding, and care for the youth experiencing struggles, suggestion to youth varied significantly. This is explored more thoroughly in the following sections, Peer-to-Peer Support: Collective Strength and Solidarity and Professional Supports. 4.4.1. Peer-to-Peer Support: Collective Strength and Solidarity   Despite experiencing extreme struggles themselves, youth were able to rally together and support each other, further normalizing commonly held experiences and generating a culture of solidarity and unification. In comparing these disclosures and responses to those of professionals there is a noticeable difference in the way in which 60 struggles were normalized. Where professionals were apt to make statements outlining the fact that many youth experienced struggles to similar ends and go into a process of referring youth to talk to parents and professional counsellors, peers were more inclined to acknowledge the difficulty, empathize with the disclosure, build upon the strengths, solidarity, and unification, and rally together to support their peers personally. Commonly shared experiences held significant meaning for youth in their feelings of being understood and supported. Youth appreciated “not being treated like a toddler” (CelestianCrow, p. 17) and feeling like others were in similar spaces as they were. This resiliency is demonstrated in youth’s mutual support for one another demonstrated online. What also became unique about peer sites was the mutual relational connection elements. Youth appeared to form relationships with responders and vice versa amounting to a help give-and-take, where youth would both offer support and receive it. After engaging in a back-and-forth discussion about struggling with ‘OCD’ over three posts i_am_Nicole_xo and hailey_madisonnn38 conclude their discussion in the following way: i_am_Nicole_xo wrote: Thank you so much for replying ! It makes me feel 100%  better knowing there are people out there who don't judge me for going through  this !  Your advice is amazing too. The past 2 days I haven't been giving in to  my compulsions, which has been difficult but getting through stuff like this  will have it's hard times. And I'm so glad I could help you too with your  relationship problems. I honestly thought I sucked at giving advice but I just  wanted to try and help people.  (i_am_Nicole_xo, p. 10, peer-to- peer) Peer Response to i_am_Nicole_xo: of course!! & I do not judge anyone as it is not my place to judge. im so proud that you overcame, though!! 2 days is a long time and you should be overjoyed with that accomplishment! & you did! you helped so much with my problems so im glad I could help you in a similar way. I hope you get to feeling better soon. just know that you are never alone and you are stronger than these problems! (: (hailey_madisonn38, p. 10, peer-to-peer) (‘OCD’, p.10, peer-to-peer)  61 The excerpts above illustrate the relational outcomes and trust that is perceived to be built through the development of a relationship where both parties could contribute. hailey_madisonnn38 was not only grateful for the support she had received from i_am_Nicole_xo, but increasingly motivated to support them, ‘you helped me so much with my problems so im glad I could help you in a similar way’. After considering peer-to-peer interactions similar to the one illustrated above, I can see how mutual friendship type encounters may hold unique benefits to professional responses for youth feeling isolated and disconnected from peers, especially if these are the types of relationships they are seeking. For example, the above interaction demonstrates reciprocity in relationships in a way that is specific to peer-to-peer interactions.  In seeking to understand the culture of online supports, the collective strength displayed in the findings of peer-to-peer support sites, where youth rallied together in solidarity to support one another despite tremendous personal difficulties, was clearly demonstrated through online narrative accounts. Compared to their professional counterparts, peers were much more inclined to personally identify with struggles. Sharing common experiences seemed to hold significant meaning for youth in their feelings of being understood and supported, CelestianCrow: I need someone I need help, this may be the first time I’ve ever   said that, even if it’s not aloud […]I feel like I’m at war with the world, I want to  be special, and not just to myself but I’m not. I can’t, be I can’t change anything. I  can’t change my skin without money I can’t fix my heart. I can’t fix myself and I’  just slowly breaking I don’t know what to do I’m so lost that I can’t even truly  explain how I feel so that someone can hopefully help. Peer response to comment, t33nl1n34u9: People picked on you because you're in the minority and thus vulnerable. They think it's funny and can get away with it, so it must not be a big 62 deal. Further weakening yourself is dangerous. You'll have to remember how you used to accept yourself…(t33nl1n34u9, p.17, peer-to-peer) Responders response to comment, CelestianCrow: I really appreciate how you word things, you don't treat me like  I’m a toddler, and I liked where you were going with your words, I actually feel  slightly understood for once in my life, Peers response to response expressing solidarity in similar experiences, CelestianCrow: Yes I definitely agree with the problem of not having patience or not having enough, I beg my body to give me enough patience to create what I have in my mind, to do the studies of art, anatomy, animals, how things work ETC…[CelestianCrow and peer responder (t33nl1n34u9) continued dialogue for four additional post in which they discussed their mutual interest in art] (I NEED HELP..,p.17, peer-to-peer)  In these brief excerpts from CelestianCrow and peer responder t33nl1n34u9, examples of mutual support and solidarity can be seen. For example, CelestianCrow makes specific mention of appreciating the way she is not being talked down to (i.e., ‘you don’t treat me like a toddler’) as well as the word choice and feeling understood (i.e., ‘I liked where you were going with your words, I actually feel slightly understood for once in my life’, ‘Yes I definitely agree’). Additional peer responses indicating solidarity can be found in other peer-to-peer response statements such as, “You could also call TeenLine. They are really helpful and understanding because they are teens just like us” (LastCityLostCity, p.4, peer-to-peer) or “I also want to get a therapist. I'm pretty sure I have depression, and it's only gotten worse… (INViSIgirl, p.3, peer-to-peer). In considering the impact of these peer-to-peer experiences it is important to mention that experiences of peer support directly counter expressions of social isolation, stigma, and judgement within youth’s personal narratives; and this was common throughout the findings on peer-to-peer sites.  Moreover, collective youth resilience was demonstrated through displays of mutual support. For some youth, mutual disclosure and access to casual conversation 63 online was essential to reducing anxiety about mental health services. Youth participants in online forms appeared grateful for the mutuality and openness they experienced in discussions, xxteganrxx: Thank you for saying what you did, it's nice to see that you are  willing to help others too.(‘I SMILE BECAUSE I’M SAD’, p.25, peer-to-peer) Although powerful displays of collective strength and tenacity were observed throughout peer-to-peer responses the following excerpt captures this phenomenon vividly, INVISIgirl: “we are strong, ---------. you are strong. just because you don't feel it  doesn't make it untrue. […] I can put on a mask and push though it. You can too.  Cause you are  not weak” (‘HOW TO GET A THERAPIST’, p.3, peer-to-peer) INVISIgirls response to their peer connects the individual struggle they are going through with a collective narrative built upon strength (i.e. ‘we are strong’) founded through overcoming challenges (i.e. ‘I can put a mask and push though. You can too.’). However, although INVISIgirl’s response demonstrates collective strength and was received positively by the peer they were responding to, being told to ‘put on a mask’ may have caused significant hurt for other youth in the same position. With this in mind, it is important to mention that in interpreting research findings I cannot speak specifically to how this response may have impacted the youth that had disclosed their struggle.   In disclosing similar experiences and expressing solidarity youth in peer-to-peer response sites commonly used peer support as an opportunity to position themselves in strength, taking on the role of ‘helper’ by offering their struggling peer friend advice. In taking on this position peers helpers would sometimes deviate from coming at things from a place of mutual support in offering advice that was not rooted in a place of experience (e.g. t33nl1n34u9’s response to CelestianCrow captured on p. 69).  64 However, these encounter do not appear to detract from what youth have to offer one another in terms of understanding based on shared experiences that could be attribute to collective identity rooted in resiliency. The shared experiences and collective identity found throughout peer-to-peer responses stands out as undeniably distinct from their professional counterparts, as youth with similar struggles were able to identify with one another and come together to overcome their struggles in a way professionals attempting to support youth could not. Experiences of collective identity become particularly interesting given the fact that there is no guarantee surrounding the age of respondents and adults may technically be impersonating youth. The fact that youth had no idea of the actual age of the responder in online environments leaves me questioning if positive interactions surrounding solidarity could be found in professional sites as well. Exploring if identifying within the same age bracket left peers more responsive to advice and/or responses would benefit findings. However, I was unable to explore this throughout my thesis because peer responses to professional comments and continued dialogue was not made available online. 4.4.2.  Professional Support 4.4.2.1. Value, Acceptance and Understanding While peer-to-peer sites displayed demonstrations of solidarity through reference to mutual experiences amongst the youth, unsurprisingly, responses from professionally monitored responses appeared distinct to youth responses for their consistent use of references to existing support resources youth could access, psycho-education, and strengths-based language. Additionally, professional responses were typically found to be 4-5 times the length of peer responses and demonstrated more similarities across 65 responses (i.e., looked the same from response to response); and, professionals typically responded to youth with immediacy (3-30 minutes according to times displayed on online forums). The consistency and type of responses used shows a determination on professionals’ part to ensure that youth felt valued, accepted, and understood, as illustrated in the example below:  ImAPerson12345: …I have things that I do that are probably like coping  mechanisms. I bite my nails constantly, crack my knuckles, shake my legs, move  my tongue back and forth against my teeth, etc. I also can't maintain eye contact,  and panic when I lock eyes with someone. I don't know what any of this is, or  how to ask for help from my parents. I doubt either parent would listen to me (for  the reason I listed above.)… Professional response to comment, Hi ImAPerson12345, You're a person that matters, someone with feelings, hopes and dreams.  You deserve to be heard, appreciated and loved.  You feel pain and disappointment like anyone else, and you are worthy of time and attention. (p.2, professional response) (‘How do I get help?’, p.1-2, professional response) Here the writer of the professional response reiterates the value and importance of ImAPerson12345, further affirming that they deserve to be ‘heard, appreciated and loved’. In addition to affirming youth’s posts, professionals also responded in a safe and supportive tone. Although, many peer responders utilized similar safe and supportive tones, the professional response displayed above stands out as distinct to peer responses for its consistency with use of supportive language. Although many youth were supportive, youth responses did not appear as deliberate in ensuring comments were safe and supportive. The professional’s ability to be both deliberate and sensitive in ensuring that a youth struggling with the possibility of having post traumatic stress disorder receives support is demonstrated below: 66 Fragile_heart: I'm just utterly horrified of the thought of confronting her with my  deepest darkest secret. No one knows why I avoid fast car rides at night, roller  coasters, or heated arguements. I thought I'd turn to you. Do you think I have PTSD? Should I confront my fears and face my mom? If so,  how can I do it? There are so many questions... Thanks for listening, - A Professional response to comment, Hi Fragile_heart Only a psychiatrist or psychologist can diagnose whether you have Post  Traumatic Stress Disorder...Your family Dr can certainly refer you to see  someone....I am so sorry that you were exposed to such a terrifying experience in  the car with your parents. I am so glad that you are reaching out and expressing  yourself :) When you express your pain and hurt it helps to move and change  it....[…] You deserve to be at peace...You deserve to get all the  support…guidance…love and care for how you are feeling....  (p.10, professional response) (‘I think I have PTSD’, p.10, professional response) Here the online supporter responded in manner that allowed the youth to feel safe and comfortable expressing their hurt, further reiterating that this youth deserved ‘support’, ‘love’ and ‘care’. This type of language was commonly used throughout professional responses. With supportive responses in mind it is important to mention that although youth were commonly responded to with language indicative of care, youth were often told to try to again in accessing supports from the currently existing system (e.g. being asked to see a doctor), further concerns and fears over potential mental health diagnosis were not always legitimized. This is further explored in the following subtheme: ‘Try Again’ Professionals Supporting Existing Supports and Services.  67 4.4.2.2. ‘Try Again’ Professional Supporting Existing Supports and Services Along with their consistency in using supportive, non- judgmental language when talking to youth, professionals were also consistent in their efforts at encouraging youth to retry in reaching out to adults in their lives (i.e. parents and teachers, or counselling supports). In the same supportive post referenced above the responder strongly encourages Fragile_heart to seek supports, to obtain professional help.  Fragile_heart: I am still feeling really anxious about it though and even used  drugs for the first time on Monday to try and cope. I know I know...bad idea. Professional response to comment, Hi Fragile_heart,  […] I urge you to seek professional help !! A counsellor/therapist/psychologist  can certainly help you to manage and change what you are experiencing inside  […] (p.10, professional response) Here the responder challenges fragile_heart to not only seek professional help, but mentions it with confidence stating that a “counsellor/therapist/psychologist can certainly help you.” Encouraging youth to seek professional supports or try again with their current avenues for support was noticed as a common trend. In some cases professional would suggest youth “try again” even after  acknowledging the hurt accompanying negative and potentially damaging experiences that may have occurred in the lives of youth, iiBrokenYoshi: I tend to have a lot of lows, depressed, worthless, ugly, fat,  mistake, disappointment, all adjectives that pretty much describe me. Sorry for the  long post, I know you probably don't care, but if you'll please just give me some  advice.. Thanks. (‘People just don’t  understand..’ , p.16, professional site) Professional Response to Comment, Hello iiBrokenYoshi, I'm sad to hear that no one you told was able to take how you were feeling 68 seriously. […]  I wonder if you were to try again? (p. 4, professional response) While the professional responses such as those illustrated above show empathy and support, I am left questioning whether statements like these may be setting youth up for disappointment. The fact that may professional responders encouraged youth to seek help from professionals regardless of what the youth was confiding in them about leaves me questioning the extent to which professionals may have been failing to offer appropriate individualized support specific to the youth struggling. For example, if iiBrokenYoshi were to seek in-person professional supports, after being assured with confidence that they would be helpful and found them to be unhelpful or even discouraging, could this dissuade youth from moving forward in their attempts towards improving their situation. Additionally, if iiBrokenYoshi were to continue to “try again” with their current support system and this were to fail, iiBrokenYoshi may internalize this failure. More importantly, do solutions rooted in adult or professionals’ ability and power to influence youth’s lives positively limit the development of youth’s personal resilience or access to important information about their rights? In one rare case, an online professional advocated that youth seek support beyond their immediate environment in order to have their rights (outlined by the UNCRC) met. After ImAPerson12345 ended their post with an indication that their parents may be neglecting them, they were given the information and resources needed to ensure they were protected from neglect,   ImAPerson12345: If they [parents] listened, they would probably ignore it (once,  my ankle was hurting, but they told me to walk it off. By the time I got to the  doctor, months later, I had a very badly sprained ankle that needed physiotherapy.  Never got it.) I'm not sure what to tell them to actually get help. Professional response to comment, Professional Response: Sometimes when a parent is being neglectful or not 69  getting the help that their child needs and deserves, a social worker from Child  Protection could talk with the child and the parents about the child's rights and  needs. Would that be helpful? (p.2, professional response) Despite outlined need for acknowledgment of oppressive and hurtful systems (i.e. counselling services, neglectful parenting) and environments, professionals often failed to fully recognize and express understanding. In my overview of fourteen youth disclosures linked to professional responses, the above exchange between the professional responder and ImAPerson12345 suggesting that ImAPerson12345 seek help from a social worker from Child Protection represents the only narrative account that directly advocates for the rights of the youth in this manner. Only once did a professional directly validate a youth’s difficulty with their parents by providing information on their rights according to the UNCRC and information to access a social work advocate in order that their environment be changed. It was far more common for professionals to encourage youth to try again with their existing support systems (i.e. family or counsellors) than seek advocacy. This approach of encouraging youth to retry in their existing environments can be clearly demonstrated in the professional response below,  Hello iiBrokenYoshi, It's clear in your post you are really hurting and feel like no one understands or cares […] You asked for some advice, and the advice that I have to give is that I wonder if you were to try again to try to talk to someone openly and honestly about how you're feeling …I wonder if you were to do this, if maybe, hopefully, you might have a different experience than the one you had before.  Of course, there are no guarantees, but it's clear that you are really, really hurting, and you need some real help. (p.4, professional response) Here we see iiBrokenYoshi’s hurtful experiences within their in person environment being acknowledged, yet even after acknowledging these experiences, iiBrokenYoshi is encouraged to ‘try again’ in the hope that a ‘different experience’ will occur allowing 70 them to achieve ‘real help’. Not only does this discount online supports, but as a social worker I am left questioning the potential harms that may be associated with encouraging youth to retry accessing supports in an environment in which they were hurt in the past. Through individualizing the experiences that iiBrokenYoshi had in accessing supports the professional involved with this youth failed to acknowledge important systemic barriers for youth wanting in person supports, in turn placing the blame on the individual youth rather then the system. Without offering alternative suggestions, this may come across as not fully validating their experiences or choices to seek another form of support, such as online support. This becomes especially concerning if the youth’s experience in accessing support does not improve and they begin to feel stuck in their current situation.  To conclude, both peer and professional online support services generated unique relational interaction experiences. Where peers were able to rally together and provide collaborative support for one another based on mutually shared experiences, responses found on professionally monitored sites provided support, thoroughness, and reference to important resources. The types of interactions, manner in which interactions are taking place, and rationale behind these interactions offer much to the observer curious about distinction between services.  71 Chapter 5. Discussion and Conclusion In conducting this thesis, I was able to add additional depth to the current body of research in the area of online support forums for youth, further allowing one to consider these online narratives within broader micro and macro level findings born out of previous scholars’ work. This thesis sought to provide an understanding of youth’s individual and collective experiences in online platforms through careful examination of personal narratives and interactions. Despite the fact that online intervention services for youth seeking mental health and/or relational support are being utilized by many youth (over 188,000 within the two sites I explored alone), little to no knowledge directly speaking to the experiences of youth accessing online supports or the interactions taking place between peers and professionals within these environments exists (Alvarez-Jimenez et al., 2016, p. 126). I was able to speak to researchers’ questions about the potential relational benefits of online supports for youth experiencing relational, emotional, or mental health struggles (Kral, 2011, p. 9), as well as inquiry about the feasibility of these interventions as a support tool for youth (Masuda et al., 2012, p. 748) using a narrative ethnography methodology grounded in social constructionism and postmodernism. This allowed me to speak to the specifics of youth’s experiences accessing support in online environments through capturing and qualifying language use and interactions taking place in these social media platforms.  Through consideration of narratives found online, I was able to more fully uncover what online disclosures have to teach us about the youth accessing them, with specific attention given to the way youth are representing themselves online (Stanley & 72 Temple, 2012, p. 280). Taking this approach allowed me to speak to youth’s experiences in obtaining power and autonomy within and/or outside of online environments.   This thesis has provided a contextual understanding of the interactions taking place in online platforms, by further exploring the questions: What are the current experiences of youth using online support services? How are youth representing themselves through personal narratives online? And, what are online support forums, specifically, offering these youth (relationally or otherwise)? The online narrative accounts explored throughout my research make clear that in spite of difficult struggles, many youth displayed tremendous self-determination and resilience in accessing either peer or professional online supports in order to achieve guidance, relational support, and resources, indicating that these interventions may hold significant benefits for struggling youth. The following discussion integrates the findings of my thesis with prior literature focusing on connections between the individual and collective experiences of youth accessing online supports/utilizing the internet in general (as discussed in Chapter 2) as well as, my conceptual framework framework grounded in the theoretical lenses of postmodernism and social constructionism (as discussed in Chapter 3). Finally, I will conclude with addressing the limitations of the research and offer some areas for future research and recommendations for social work practitioners and/or policy makers wishing to understand the area of online supports for youth.  5.1. Developmental Stage, Personal Disclosure and the Online Environments In deconstructing the narrative accounts explored throughout my thesis, 73 demonstrations of vulnerability through personal and emotional disclosures brought forth by youth become apparent. Although it may be asserted that the unique characteristics of online interventions (i.e., easy-access, ability to remain anonymous) may contribute to increased personal and/or emotional disclosures from youth, in order to better understand the factors contributing to youth willingness towards personal and emotional disclosures within online environments, it is important to consider both the larger body of youth bloggers they might represent, as well as the developmental stage of youth. Previous research conducted on youth internet users and bloggers states that over half (58%) of youth internet users do not interact with others online (Mitchell, Wolack, & Finkelhor, p. 287). However, the same researchers found that out of the same sample of youth, those accessing or utilizing blog sites, such as the ones explored in my thesis, were far more likely to have personal interactions with peers and disclose personal information about themselves online. In fact, when it came to youth posting on blog sites, youth were three times as likely to post personal information online (Mitchell et al., 2008, p. 288). This finding is consistent with observations of youth narratives considered throughout my research, in that they commonly contained personal content such as discouraging or difficult life experiences within disclosures.  Although Mitchell et al.’s (2008) study provides important information about the distinct tendencies of youth internet users and bloggers, it does not capture the specifics of interactions taking place online in the same way my study does, nor does it speak to larger demographic (i.e. vulnerable youth) or societal factors. First, drawing on the specific accounts of fewer youth using a narrative approach allowed me to explore the types of disclosures and responses taking place with more depth, further providing the 74 audience with an opportunity to consider the struggles youth are experiencing more closely (Goodall, 2004, p.187). Second, I add enhanced context to the demographic of youth accessing online supports by speaking to youth’s developmental stage and positionality. Understanding the content explored throughout online youth narratives is further enhanced through reflection upon the unique aspects of adolescence as a developmental stage. Adolescence is a stage of life comprised of heightened emotions, increased risk taking, and rapid change in brain development and behaviour (Jetha, 2012, p. 7). Furthermore, for youth struggling with mental health and behavioural concerns, Wright and Kutcher (2016) and Jetha (2012) suggest that there are negative impacts on young people’s ability to navigate social aspects of life during this stage. Moreover, research has shown that adolescence is a highly emotionally charged stage of life related to development of, and changes in the brain. Indeed, as Jetha (2012) and Wright and Kutcher (2016) have described, heightened emotions during this stage may be attributed to emotions maturing earlier and faster than “executive functions of planning and control”, therein leaving adolescence as the most emotional stage of life (p. 44). Understanding that ‘adolescence’, as a developmental stage, comprises increased susceptibility towards social difficulties, heightened emotions, and increased risk taking, coupled with the fact that youth bloggers tended to disclose personal information online, provides an important understanding about the demographic examined throughout my thesis (Jetha, 2012, p. 37; Mitchel et al., 2008, p. 290; Wright & Kutcher, 2016, p. 35).  It is within the realities of both adolescence as a developmental stage (i.e. consisting of heightened emotions) and youth blogger tendencies (i.e. frequent personal 75 disclosures) that the disclosures and responses contained throughout my thesis ought to be considered. In coming to understand that bloggers, in particular, are far more comfortable and likely to post personal information and that youth in general are more susceptible to experiencing heightened emotions, my research findings reflect a unique demographic’s (youth bloggers) approach to dealing with the emotional difficulties inherent within this developmental stage.  5.2. The Online Environment 5.2.1. Unique Characteristics of the Online Environment  Online environments remain distinct to the in-person supports youth may be accessing (i.e. in-person counselling, psychiatrist) for their offerings of a free, familiar, and easy to access online environment in which youth have the opportunity to form their identity and connect with others anonymously. Youth’s courage to be vulnerable in their disclosures and boldly take a stance in online environments can be seen in Weinstein’s (2014) study of civically engaged youth who utilized online platforms to promote themselves in civic arenas through alignment of personal civic ideals and purposeful use of online platforms for positive engagement with the public about politics. Although Weinstein’s (2014) study illustrates the important role that social media can play in empowering youth to speak openly about their opinions and views, it also demonstrates that when presented with the opportunity, youth will utilize the online environment to be bold, political, and assertive. Similar to Weinstein, in my study I observed youth approaching online platforms boldly, using the space to disclose deeply-felt personal narratives of painful past experiences. Furthermore, my research offers distinct important 76 insights in speaking to the dialogue taking place from peer-to-peer as well as peers and professionals, something not offered on many online platforms, such as the one explored in Weinstein’s study. Youth’s individual stories or narrative accounts were considered alongside their interactions within online environment’s (i.e. type and frequency of disclosure and responses). As such, in considering a wide representation of youth narratives, I provided a broader contextual understanding of the issues youth are raising, such as anxiety, relationship concerns, eating disorders, loneliness, shame, and guilt.  Along with the facilitation of what appears to be a safe environment for personal and/or emotional disclosures, online environments provided youth with the opportunity to story their lives and create identity in a manner they chose through the ability to choose a name (i.e. IAmAPerson12345, Alonelygirl2015) and title (i.e. ‘Help Please’, ‘I Think I Have OCD?’) that resonates with them. Moreover, it offered the opportunity to share their story while only disclosing the aspects they desired. Free from typical factors associated with in-person services, such as historical/contextual knowledge, questioning (e.g. in-person sessions where counsellors ask questions), or information from third parties (i.e. friends and families disclosing information or sharing beliefs with person(s) supporting youth), youth are provided the opportunity to only present information about their situation that they chose and/or are comfortable disclosing. In consideration of the interactions taking place within these online environments, my research demonstrates that in addition to posting questions, youth were also comfortable receiving support from peers and professional and responding to peers. In deconstructing the types of interactions occurring within these environments, tremendous amounts of resiliency can be seen. Youth accessing support through online environments 77 sought to achieve information and needed resources despite great feelings of fear, shame, isolation, loneliness, and felt powerlessness over changing their situation. Feelings of loneliness, fear, and stigma are witnessed through not only personal disclosures, but name choices such as, 4ever_alive_and_lost, FallingInPieces, INVISIgirl. Many of the youth choosing these types of names to describe their experiences in online environments reported struggling with feelings of shame over their experiences in in-person environments. In the following paragraphs, I explore factors contributing to the ways in which youth are identifying themselves online. 5.2.2. Identity Formation: The Internalization of Societal Factors Themes of aloneness, isolation, guilt, shame, and fear were undeniably shared by many, if not all, of the youth accessing online support forums on both peer-to-peer or professional sites. Although this finding is significant in and of itself, what stood out was the way in which youth narrated their stories of aloneness and shame, turning to a diagnostic, deficit-based, self-blaming narrative rooted on pathology, rather than fully acknowledging the multiple external barriers evident in their lives. Unfortunately, considering the online environment leaves me limited in my ability to critically explore the systemic or structural barriers youth accessing these support maybe experiencing as a result of socioeconomic status, gender, race, and so forth. Without an understanding of the social location of the writers I am limited to only being able to make assertions about a larger generalized demographic of adolescence based on age and use of online environments for mental health and or relational support. Unlike Castro & Osório’s (2013) qualitative exploratory content analysis of pro-anorexia blogs that reflected internalized media representations of body image my findings were only able to 78 demonstrate that youth internalizing broader societal messages such as a biomedical understanding of mental health through use of diagnostic language. Castro & Osório’s (2013) study considers the way internalization of societal factors amounts to an increased focus on body-image as meaningful for social acceptance, in my study youth are seen recounting feelings of shame and guilt over inabilities to fit into a perceived societal norm.  Although, Castro & Osório’s (2013) study provides a foundation for claiming that youths’ susceptibility towards internalizing societal messages, with a focus on body-image for youth accessing a pro-anorexia site, their studies were limited to body-image related messaging (p.326). In taking a different focus, the forums considered throughout my research welcomed the voices of youth with diverse mental health and/or relational struggles, my research demonstrated youth susceptibility towards internalizing societal messages on broader societal scale. This is important because speaking to additional ways and contexts in which youth are susceptible to societal messaging allows the audience to consider the general susceptibility of youth to internalize multiple societal messages targeting them. One example of the way my study did this is through uncovering the diagnostic language related to biomedical understandings of mental health (e.g., the Diagnostic Statistical Manual (DSM)) being brought forth by youth. This research finding further demonstrates that the commonly utilized DSM leaves youth with an increased susceptibility toward individualized and/or pathological thinking in that they are more inclined towards connecting personal hardship or difficulties to deficit based diagnosis. In turn, I would argue that interventions and support models stemming from the DSM or similar models may be contributing to the further oppression and/or 79 disempowerment of youth, in that they fail to bring into light greater societal factors (e.g. gender stereotyped behaviour presented by media) that are likely contributing to the adolescent struggle. Another example can be found in findings surrounding positionality and/or the internalization of negative experiences with those in their in-person environments that resulted in youth blaming themselves after experiencing disempowering interactions with family, rather than recognizing limitations to their right to voice or ramifications related to their current state of dependence. In deconstructing the individual narratives of youth seeking support through online forums, findings reflect the societal positioning of youth and mental health concerns in revealing that the use of biomedical related diagnostic language, as well as self-blame after disempowering interactions, was common amongst the youth accessing online supports. Without equipping youth with opportunities to critically consider and engage with the impact larger societal structures have on their lives, youth are left vulnerable to individualizing problems and blaming themselves.   In further unraveling internalized messages of diagnostic language and pathology, I came to acknowledge that despite recognition of how external factors (i.e. negative social environments, exclusion) impacted their lives personally, youth often storied their lives in narratives of self-blame. Considering these findings from a theoretical lens situated in postmodern and social constructionist theories provides additional depth. For example, according to labelling theory, labels that youth attribute to themselves falling under categories of social deviation (i.e. depressed, anxious, or socially awkward) are a reflection of how actions are viewed by others rather than the commitment of the act in and of itself (Becker, 1963, p.1). However, the marginalizing aspects of theses labels 80 were clearly felt by youth, as many reported shame and stigma, leading to a fear of disclosing their experiences and further perpetuating isolation and loneliness. Although, youth may connect experiences (past and present) to their current emotional feelings, by in large these feelings are being internalized. Becker (1963) outlines negative consequences associated with internalized self-blame as follows: potential loss in desired education, loss in employment opportunities, and low levels of self-esteem and resiliency (p.10). Although a certain correlation cannot be made, my research supports the notion that internalized self-blame may hold marginalizing effects for youth that could lead to high levels of shame, stigma, isolation, and loneliness. Taking this a step further, internalized self-blame resulting in high levels of stigma may be a largely contributing to youths discomfort with professional supports, especially supports rooted in model that continue to individualize youth struggles (e.g. models using the DSM). This leaves me questioning if part of the draw for youth to use online support interventions may be the freedom from self-blame, as online encounters appeared to affirm youths quest for normalizing their experiences. 5.2.3.  ‘A Safe Space:’ Freedom of Expression in Online Environments  Given the heightened emotions, social difficulties, and susceptibility towards internalizing struggles common to youth seeking mental health and/or relational support, appropriate response to disclosures of struggle become important. In recognizing the need for youth to have appropriate supports, it is important for responders to listen to youth’s unique voice and offer understanding towards their often complex, multi-layered stories (Hankivsky, 2004, p. 32, Lavie-Ajayi & Krumer-Nevo, 2013, p. 1770). Once youth realize their stories are legitimate, they, like any other group experiencing oppression and 81 marginalization, are allotted the freedom to express themselves openly and honestly, without the fear of being traumatized in the process of reliving their experiences.  According to Stone (2003), it is the way in which people tell their stories of past wounds that keeps them stuck, rather than the wound in and of itself (p. 168). In claiming authorship of one’s story, by recalling, reflecting, and reconstructing these stories to an audience of active listeners the healing process can begin (p. 179). Similarly, from an attachment perspective, youth accessing online support provided by caring professionals can be seen to reflect Bowlby’s (1979) ‘internal working’ model in which young people’s mental representations of themselves based on early childhood experience were positively transformed based upon this new relationship (p. 13). Ultimately, these online support services hold the ability to create capacity for young people to “re-story” their lives in a potentially more supportive environment (Stone, 2003, p. 180). In Spencer’s (2006) study considering the mentorship process between youth and adults, demonstrations of mutuality, collaboration, empathy, and authenticity through listening to youth were viewed as essential to relational and emotional development (p. 289). As long as online counsellors and peer responders continue to demonstrate qualities of positive care and youth are given an opportunity to freely disclose struggle in the online environment holds potential in supporting youth to move forward in the direction they choose.  However, with this in mind it is important to mention that there are significant limitations inhibiting youths’ ability to “re-story” (Stone, 2003) their lives in online environments (Stone, 2003). In the absence of online responders utilizing approaches rooted in social constructionism such as, narrative therapy to encourage alternative 82 narratives or ways of viewing experience, similarly to in-person support services, these environments will fail to challenge systemic oppression. This lack of perspective becomes particularly complicated when it comes to peer-to-peer support in online forums because although, on one hand, peers may be finding collective strength through solidarity in their experiences, without application of therapeutic approaches such as, narrative ethnography rooted in social constructive theory they will continue to foster the status quo. Therein both peers and professionals fail to empower youth to overcome structural barriers to their overall wellbeing through their inability to provide contextualization of youths’ personal narratives. The extent to which the online environment facilitates a safe environment where youth experience empowerment through supportive relationships is further examined in the following section exploring relational connection in the online environment. 5.3. Relational Connection in the Online Environments 5.3.1. ‘Responsiveness’ in Online Environments In reading through youth accounts, it was evident that online platforms became a place of refuge from experiences of judgment. Understanding that emotional turmoil and importance given to social stratification in relationships provides an important argument for experiences of enhanced need for empathy and compassion to be extended to youth from both peers and professionals. Supportive responses from peers and professionals were commonly received with appreciation and gratitude. In considering the ways in which this relates to youth’s positionality from a social justice perspective, it becomes important to recognize supportive responses, or more specifically, responsiveness as key 83 to the process of achieving social justice (Hankivsky, 2004, p. 37). Both Hankivsky (2004) and Spencer (2006) highlight appropriate responsiveness to the contextualized stories of injustice as key to healing or transformation for young people experiencing marginalization and oppression, as it allows for the processing of key thoughts, feelings, and emotions relevant to the situation. Bevington et al. (2015) claim that trusting relationships between youth and adults in their lives could not be emphasized enough for creating positive influence in the lives of youth (p. 158). In consideration of youth’s online accounts, it can be asserted that adolescents need reliable care and direction, as well as opportunities for self-expression and autonomy and a space for an independent voice. To highlight the importance of hearing young people’s voice in matters related to them, Cooper (2012) goes as far as to argue that decontextualizing and ignoring the multi-faceted nature of young people, especially those in the margins, directly facilitates oppression (p. 64).  While my research findings highlight the centrality of general ‘responsiveness’ in the online environment, important distinctions between peer-to-peer and professional responses emerged. Where professionals were apt to make statements outlining the fact that many youth experienced struggles (perhaps in attempts to normalize the situation) and go into a process of referring youth to existing resources, peers were more inclined to empathize with the disclosure in solidarity and rally together to support their peers. In the following subsections I more fully examine these distinctions. 5.3.2. Peer-to-Peer Where the significance of peer-to-peer supports becomes most profound is in light of the realization that peer relationships greatly influence adolescents’ overall wellbeing. 84 Scholars have suggested that this age cohort appeared most susceptible to sensitivity over social rejection or exclusion, ranking evaluations made by peers as influencing their self-worth at higher rates than any other age group (Jetha, 2012, p. 35). Wright and Kutcher (2016) found that social rejection is highly stressful for teens and that this rejection can lead to being ostracized and consequently hold dramatic impacts on course of development (p. 55). However, William and Anthony (2015) indicate that adolescents with friends who are both responsive and supportive of their needs have better overall health, well-being, and overall resilience amongst teens (p. 665). These research findings are consistent with youth’s experiences accessing online supports, suggesting that social media helps fill a void for youth experiencing social rejection and isolation.  5.3.3. Professional Through the use of empathy and authenticity, counsellors were able to connect and build positive rapport with the youth they were interacting with in online environments. Empathy is understood by relational theorists as “understanding another person's frame of reference and affective experience” (Spencer, 2006, p. 289). Authenticity can be defined as “relational responsiveness” leading to a “quality of presence,” ultimately allowing the “relational partner” to gain access to one's “thoughts, feelings, and intentions and also involves offering perceivable and engaging responses” (Spencer, 2006, p. 289). Experiencing empathy and authenticity in the therapeutic alliance is viewed by relational therapists as an essential component of the development of “close relationships” (Spencer, 2006, p.289). Working with vulnerable people within a social work capacity for several years has taught me the important place genuine and empathetic responsiveness holds in creating the relational connection and trust necessary 85 to walk along someone in crisis or transition. Consistently, professional responses were pronounced in their offering of validation through genuine, empathetic responses that offered youth avenues for support. This realness, or authenticity, could be viewed in theoretical terms as person-centred, focusing on individual strengths and capacity. Applying an empathetic person-centred approach that provided an opportunity for transparent, open, and honest relationship development was another common component of adult responses in professional supports.  The benefits that positive responses like these hold for youth previously struggling with pathology, isolation, aloneness, and fear are arguably significant. These responses appear to reframe youth’s current narrative or way of forming identity. Lavie-Ajayi & Krumer-Nevo (2013) claim that in order to change the label or narrative marginalized youth view themselves in you need to replace it with a “narrative of worth” (p. 1770). A narrative of worth actively avoids the criminalization of youth’s experiences, replacing them with a new dialogue rooted in respect and empathetic understanding for youth's claimed reality, perceptions, and internalized thought patterns (Lavie-Ajayi & Krumer-Nevo, 2013, p. 1771). Professionals working from this framework attempt to integrate the experiences they hear from youth into a new story with contextualized perspective rooted in a dialogue of understanding, respect, and empathy and actively avoiding the use of destructive language in describing youth (Lavie-Ajayi & Krumer-Nevo, 2013, p. 1770-1771).  However, in spite of outlined evidence that professional responders were able to create a safe space for youth to share their struggles and be heard, they failed to exemplify assistance with supporting youth in understanding structural barriers related to 86 their experiences. It is important to note that this lack of acknowledgement for structural barriers by professionals was also paralleled by peers who failed to help their peers recognize systemic barriers. Furthermore, only one case was found to provide youth with the resources and information needed to access freedom from an oppressive situation taking place within the youth’s life. In the section below, this concept of structural barriers preventing accessing power and autonomy for youth and the role of online interventions will be more fully explored in Section 5.4: Part Two: Power and Autonomy. 5.4. Power and Autonomy: Youth’s Right to ‘Voice’  The postmodern framework (Docherty, 2017) and social constructionist (Burr et al., 2015) theoretical lenses offer a way of framing the findings related to Power and Autonomy as it considers youth’s positionality (societal position in relation to others) within the broader societal context of which they are a part. The social constructionist perspective contends that experiences are socially constructed and therein must consider wider socio-political constructs such as the notion of positionality (Seymour, 2015). Although, the online nature of youth narratives limited my ability to critically consider the social location (e.g. social class, age, ability, religion, sexual orientation) of youth accessing online supports, consideration of the general positionality of youth in terms of their age demographic allowed me the important opportunity to highlight the personal and the political as “inextricable” (Seymour, 2015, p. 282). In attempts to make known the experiences and struggles of youth accessing online support forums, situating narratives in a theoretical grounding that fully embraced the connection between youth’s societal/political position (in terms of age demographic) and the “self” (the personal) within online narrative disclosures was necessary (Seymour, 2015, p. 282) As such, it is 87 important to consider systemic environmental factors inherent within broader social and political systems youth are part of in order to critically assess the way narratives and identity formation are taking place. Although, there are undoubtedly numerous systems (i.e., political, religious, educational) that hold significant impact and influence, what seemed to emerge as most significant in the findings of this research was related to youth’s state of dependency in the context of family of origin, and professional supports (i.e. therapist, counsellor). For youth being situated in a position of dependence meant their world was mediated by family or professionals. Findings demonstrate that adult caregivers are perceived as exercising decisions making on behalf of the youth (e.g. parents deciding whether or not to connect youth to a counsellor). According to youth’s online narrative accounts, experiences with adults in supportive roles carried significant ability to impact youth’s self-perception and ability to access resources. In consideration of the biological state of dependence, Orr (2014) notes that the parent-child relationship presents a fundamental challenge (next to only capacity arguments) to young people’s right to voice and autonomy as outlined in Article 12 of the UNCRC (United Nations Conventions on The Rights of The Child, p.88). Orr further states that children, being born into a biological state of dependence, “inevitably require a representative from the adult world, usually their parent, to assert their will or to act on their behalf” (p. 90). Those opposed to children’s right to ‘voice’, independence, and autonomy on the basis of parental rights believe that these movements “undermine parental authority, interfere with caregivers ability to raise and discipline their children, and make the rights of children more important than the rights of adults” (Fineman & Worthington, 2016, p. 9). State of dependence arguments in the areas of capacity and 88 dependence unavoidably position children and youth reliant on the adults in their life acting in their ‘best interests’. Nonetheless, these arguments must not take away from youth’s right to autonomously access needed supports, but, instead, be considered a necessary adjunct to the process.  Shifts in access to both power (increased access to knowledge, information, and resources) and voice (opportunities to express oneself openly) were made apparent in reading the narrative accounts of youth utilizing these easily accessible, free, anonymous, and non-judgmental online platforms. The anonymity provided for youth struggling to find information, connection, and resources in their current environment worked as a catalyst for taking an important first step in help seeking. In the following section I offer a human rights argument that supports the idea of online environments promoting power and autonomy. In particular, I consider the ways in which findings from my thesis work to enhance our understanding of youth’s ability to access ‘voice’ as allotted to them in article 12 of the UNCRC. 5.4.1. Experiences of ‘Voice’ in Online Environments: A Human Rights Argument The findings from this research illustrate how online forums were used by youth seeking support to ‘express their views’ on matters affecting their life. Theses findings make clear that youth are adopting online environments as a safe space to voice their perspective. The right to freely express oneself is considered a basic human rights of children (and youth). Indeed, this ‘right to voice’ is outlined in the UNCRC Article 12:   [C]hildren have the right to express their views on all matters that affect their lives. State parties shall assure to the child who is capable of forming his or her own views 89 the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with age and maturity of the child (United Nations Human Rights, 1996). However, without these expressions being seen or recognized in in-person environments by those in direct positions of power over them (i.e. teachers, counsellors, parents), the effectiveness of the online environment as an avenue for increasing power could be in question. To this end, it was outlined in my findings that in spite of youth disclosing that they did not feel as if their voices were being heard, recognized, or validated in their original attempts to access support in in-person environments, professional responders would encourage youth to ‘try again’ within these environments. This lack of validation for youths voiced concerns over previous experiences with professionals has important implications for social work professionals as it reaffirms the necessity of giving credence to youth voice. Although the agreed upon importance of child and youth participation has undoubtedly attributed to important global initiatives, such as Article 12 of the UNCRC, Bernard (2016) claims that, as it stands, the child's right to be heard lacks committed cohesive devotion (p. 130). Although the easy access, anonymity, and general empathy and authenticity contributing to safe online environment may have contributed to youth feeling comfortable sharing personal information online, whether or not these disclosures provided actual gains in power through increased weight being given to youth’s ‘voice’ has yet to be seen. Findings from this research also demonstrated that youth referenced experiences where their voice was not only discounted by people in positions of power over them, but received with negativity or unsupportive responses. This devaluing of the youth’s voice is most concerning in that it fosters inequality through oppressing the voices of the young. 90 In an analytical summary of current literature considering Canadian young people’s civic and political participation, O’Connor (2013) highlights complexities surrounding the idea of “young people as citizens”, further asserting that in this context, age is one of the “greatest sources of inequality” as young people are commonly viewed as “citizens-in-the-making,” and do not have the right to exercise full citizenship (p. 75). Orr (2014) argues that these views are perpetuated through neglecting youth’s mental and physical capacity, for fear full acknowledgment may threaten the parent-child relationship (Orr, 2014, p. 89). Holding youth’s right to freely express themselves as central, I observed youth utilizing the online platform to this advantage in openly sharing their story. The degree to which opportunities to voice personal struggles online was taken up by youth, leaves me with an enhanced appreciation for a societal shift towards balancing protection of these ‘citizens in the making’ while still ensuring space is provided to have these citizens voices heard. 5.5. Limitations and Areas for Future Research This section addresses limitations found throughout various components of my thesis, as well as areas of future research and has been broken up into several sub sections. First, I break down researcher bias. Then, consider the concept of “accuracy” in relation to the self narratives of youth. Following this, the next section is concerned with scope of the study with specific interest in the blogs considered. Further, I bring to light limitations specific to the context within which youth blogs were assessed. Finally, I considered the efficacy of online supports vs. in-person supports.  91 5.5.1. Researcher Bias In capturing the limitations of this study it becomes important to mention research bias. Despite taking measures (i.e. immersing myself in the large body of online narratives, reading and rereading posts, and choosing to focus on general posts) to ensure that the posts, forums, and responses chosen reflected common themes found throughout the wider selection of youth narratives, the fact that I personally chose the forums to explore for the purposes of this study, as well as the aspects (i.e. blog comments, name choices, peer and professional responses) of these posts to reference and highlight throughout this research must be acknowledged as bias. Given the nature of this study I was unable to separate myself and my bias from the research process (Bishop & Shepherd, 2011, p. 1285) 5.5.2.  “Accuracy” and the Narratives of Youth Further, it is my firm belief that the ‘accuracy’ of my research might be questioned for two reasons. First, the content considered throughout this research was taken from publically accessible online forums open for anyone to use and therefore in not holding the ability to inquire about or assess who was using these sites I am unable to say with certainty that these posts truly reflected the lived experiences of struggling youth, as they may represent fabricated responses written by others. Second, in holding little to no interaction with the youth utilizing these sites I am limited in my ability to probe, question, or observe this demographic in-person. Where on one hand, as a researcher devoted to passive outside observation, with no influence or connection to participants of my study, I hold to the belief that my research aims of making known the 92 experiences of youth accessing online support were strengthened through the inevitable alleviation of undue forms of research bias (e.g., leading interview questions). On the other hand, the inferences drawn from these accounts (e.g. use of diagnostic language, negative experiences with in-person support systems) are limited to my interpretation as I was unable to question youth regarding whether or not these findings resonated with them as true. With these limitations in mind, speaking strictly to interpretation of online narratives I can confidently say that throughout my research, I choose to stay faithful to the narrative ethnographers’ belief that “the more subjective and personal [the research] gets, the truer it is” (O’Brien & Clark, 2012, p. 281). Narrative ethnography and social constructionism are primarily concerned with ‘truth in story’ revealed through how someone stories her life and how this may impact our understanding of generalizability. Therein, research is not necessarily concerned with ‘generalizability’ or ‘accuracy’ but the resonance of someone’s experience. Stories are subject to change across the course of someone’s life, as well as the telling of the story to different audiences, as both personal and socio-cultural contexts shape how our story is told (O’Brien & Clark, 2012, p.281). It  is important to acknowledge that differences in stories does not make them less accurate or truthful. 5.5.3. Comprehensiveness and Scope of Research On one hand, my thesis was strengthened for its ability to offer in-depth analysis. On the other hand, it remained limited by the amount of online narrative accounts I was able to speak to using a narrative ethnography approach. In order to demonstrate the 93 unique individual experiences of youth participants I decided to make the necessary decision of limiting my sample size. Despite the inclusion of more generalized findings and field notes captured throughout the first five weeks of ethnography, my research inquiry was limited in the types of information I was able to achieve through this sample size.  Comprehension would have inevitably been enhanced through further investigative detail, increased sample size, and a lengthened period of inquiry. For example, if I had been able to access different blogs (outside of the two used throughout this study), I may have achieved different results. Future research would be strengthened by casting a wider net to determine if different forums would yield similar results. 5.5.4. Context and the Researchers Inquiry Considering the anonymous nature of the online environment I was unable to gather important contextual detail, as I did not have access to information about youth’s socio-cultural background or the ability to question them in this regard. This limited my abilities to make inferences connecting youth’s online narratives (e.g. access to resources) with socio-cultural and political context (e.g. lower socio economic status). Further inquiries into the connections between the context of youth’s lives and their personal experiences of struggle would benefit from research approaches that allowed the researcher to interview online users in addition to examining the users’ blogs.  Additionally, maintaining an active role as a researcher would allow one to influence the level and type of knowledge they are receiving, whether it be in-person or 94 online, through specifying questions, targeting specific demographics, and relating or linking questions to phenomena. 5.5.5. Efficacy: Online vs. In-Person Supports Although findings appear supportive of both peer-to-peer and professionally monitored social media interventions, the potential larger implications of these social interactions leaves room for investigation. As it stands, contention over the universal acceptance of online support models rest in the implicit sufficiency of ‘online’ versus relational ‘in-person’ connection. In concluding their participatory study on online peer support, Masuda et al. (2012) capture the researchers’ conundrum well, claiming that although “evidence for the efficacy of face-to-face peer support in youth abounds, online social support is still in its infancy” (p. 747). Research on the benefits of relational connection through internet use and social media would therefore benefit from additional comparison studies, using in-depth, inductive methodologies such as narrative ethnography, in attempt to capture and assess the full benefits of online compared to in-person interventions for vulnerable, marginalized youth. 5.6. Moving Forward: Recommendations for Social Work Practitioners Wishing to Engage with the Online World Findings from this thesis demonstrate that many youth accessing online supports are struggling with feelings of shame, stigma, and social isolation, rooted in narratives of self-blame. Additionally, many remain powerless over accessing desired supports despite an outlined readiness for change. These findings, therefore, have important implications for social workers. As social workers, it is important to recognize that youth are using the 95 online environment not just to access pop culture but as a tool to foster connections with others and to make sense of their lives. While this is realized through social media sites such as Facebook, it is also realized through sites that offer mental health support, such as those represented in this research. As shown in this study, these kinds of online environments offer youth, who may be isolated and vulnerable, a space to foster power and autonomy through access to information and resources, collective strength through solidarity in experiences, and opportunity for positive and supportive relationships. With this in mind, social workers would benefit from remaining cognizant of the fact that many youth, including those they are interacting with, are utilizing online platforms to access relational and/or mental health support. Therefore, social workers might want to alter their practice to include opportunities for youth to anonymously express themselves, and access resources. Additionally, for social work professionals responding to youth in online platforms being cautious over encouraging youth to ‘try again’ in their attempts to achieve support from traditional services in-person services despite youth’s disclosed  negative experiences (i.e. judgement, humiliation, breaking of trust) is important. As social workers we are obligated to utilize practices that are within ‘the best interest’ (Canadian Association of Social Work, 2014) of people we are working with and therefore must prioritize and legitimize the concerns expressed by youth. Many youth may have experienced their rights to voice disrespected by adults in positions of power over them; without social workers and others advocating for change in these areas, these disempowering experiences will continue. Additionally, social workers must also carefully consider youth’s access to the resources and supports needed to change abusive 96 and/or oppressive structural systems within their lives. If youths comfort with disclosing their experiences is correlated with the safety of anonymity found within online environments, it is advisable for social workers to take measures (e.g. stating and ensuring the maintenance of confidentiality) to ensure youth are provide anonymity and safety while seeking support. Ensuring practices are conducted in this manner would likely improve youth’s comfort with asking for resources they desire and/or need, but do not feel comfortable requesting. 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