It is an honour to write this letter of recommendation for Ms. Lauren Casey.

Lauren is an activist and leader, critically advocating for the health, human rights and dignity of one of our most vulnerable populations – sex workers. My evaluation is drawn from Lauren’s leadership work with various community partners, her role as a research consultant and interviewer on a three-year CIHR-funded project that I led which examines the occupation health and safety and relationship between stigma and health among marginalized service workers, and her former employment with our research team as Research Coordinator for the SSHRC-funded project Risky Business, located at the Centre for Addictions Research of British Columbia. I am currently leading a five-year CIHR grant entitled Team Grant on contexts of vulnerabilities, resiliencies and care among people in the sex industry, where Lauren was a co-principal investigator in one of the seven interlinked projects.

Lauren has completed and excelled in completion of her PhD and has vast knowledge of substance use/addictions and harm reduction. Lauren has an active program of research and has already demonstrated potential for building a strong record of scholarship. This has been reflected in a number of ways. She was first listed author in a peer-reviewed journal article entitled: A critical examination of the insertion of experiential knowledge into illicit substance use research and policy that was published in the Journal of Addiction Research and Therapy (2012). The development of illicit substance use treatment programs and harm reduction strategies has largely overlooked the fact that those in the best position to advocate for and develop these services – individuals who use drugs themselves – can, and do, provide innovative strategies that have proven to be successful in addressing their complex and multi-faceted needs. To date, very little academic literature exists that discusses experiential involvement in the development of programs and policies. This article contributes new knowledge by showcasing two successfully run organizations that have researched, developed, and implemented exciting harm reduction initiatives and addiction treatment services in Canada.

Lauren is an independent thinker and has contributed to health policy and program development in a number of ways. She was Executive Officer of the Canadian National Coalition of Experiential Women (CNCEW) – a consortium of women across Canada committed to the advancement of equality, health and human rights for sex workers. Since its inception, Lauren worked with the Government of Canada (Status of Women) on two initiatives. One contributed to better protection of children and youth from sexual exploitation and abuse. By communicating its organizational position of raising the age of consent to sexual activity, CNCEW contributed directly and relevantly to the policy development process on this issue. The government introduced Bill C-22 and by introducing this legislation, the Government of Canada has furthered its commitment to protect children from sexual exploitation.

Lauren’s perseverance abilities are demonstrated by her rigorous efforts to develop harm reduction strategies and policy/program development. She spearheaded a second initiative, funded by Status of Women Canada, in which she was lead investigator. The objective of this initiative was to pilot and test a harm reduction model of problematic alcohol and drug use treatment specifically for women in the sex industry. The program, entitled Sex Workers Addressing Treatment (SWAT), led to additional funding of over $350,000.00 from Public Safety Preparedness Canada, the Vancouver Foundation, and the Victoria Foundation to develop three advisory groups across Canada consisting of addictions specialists, health experts, police departments, social service agencies, academic scientists and policy-makers. After a series of knowledge exchange roundtables, training was provided to service providers to implement this program into their existing programs and services. Since its inception, the SWAT program has received international recognition and resulted in Lauren’s nomination for the Kaiser Foundation National Award for Excellence.

Lauren’s originality is reflected in the research she has undertaken in doctoral studies. Building on results that will be disseminated from a CIHR grant in which I am the Nominated Principal Investigator (Team grant on contexts of vulnerabilities, resiliencies and care among people in the sex industry), Lauren’s doctoral research examined how safety and health is negotiated by managers of off-street escort and massage parlor environments, including documenting the organizational and interpersonal conditions that enable the implementation of such practices as well as the conditions that challenge safety practices or result in their dissolution. The research paid particular attention to managers’ relationships with sex workers and clients, examining substance abuse/use in the workplace and how this affects workplace occupational health and safety. Research has often linked sex work with problematic substance use and/or addiction that results in an assortment of negative consequences for individuals, families and communities, including elevated outcomes of violence, trauma, and poor health, disrupted personal relationships, legal problems and financial hardships (Benoit et. al., 2010). Research on substance use within the off-street sex industry, however, is limited because of its narrow focus relying mainly on data from female street sex workers (Jansson et. al., 2010). Few studies have examined substance use and the prevalence rates of managers, off-street sex workers and their clients, nor included intersections with mental health, violence and trauma experienced within these work locations. The research will advance previous research by increasing an understanding of addictions, violence, and resiliency among individuals involved in the indoor sex industry in a more complex way that takes into consideration managers’ demographic characteristics and their interactions with their staff and customers. The dissertation research project will draw on a cross-sectional analysis of gender, violence, and trauma as determinants of substance use and select mental and physical health outcomes among the sample noted above. A number of control variables, including income, social exclusion, education, working conditions, age, race and ethnicity, were also included in the analysis. Qualitative analysis of related open-ended questions gained insight into the relationship between socio-structural factors, work contexts and personal experiences between managers, their staff and customers in indoor sex work establishments. The knowledge produced from this research filled critical gaps in the literatures while, at the same time, contributed to the development of evidence-based education, outreach, communication and health intervention policies that will be effective in addressing health disparities among vulnerable populations in Canada including those in the sex industry who experience elevated rates of violence and other harms. This research uncovered the interacting factors that result in violence exposure and resiliency in these often criminalized and hidden environments. This project made a novel contribution to the CIHR team grant it is affiliated with, and is also producing innovative material for violence prevention and occupational health.

Lauren has excellent organizational skills. As past Executive Director of PEERS Victoria, Lauren was instrumental in leading fundraising events serving highly vulnerable clients, and sitting in on meetings as a representative of our community academic research partnerships. Lauren is an impressive public speaker and is eager to both facilitate and lead discussion groups regarding community-academic research collaboration. She participated in a pan-Canadian research workshop held in Victoria and co-led by Dr. Fran Shaver from Concordia University and myself. The workshop brought together researchers and their community partners from across Canada who were studying the sex industry from different vantage points and using various methodologies. The event was held in large part at the PEERS office in downtown Victoria, and Lauren facilitated a lively meeting of community partners where major issues facing sex industry workers were discussed and a summary of research interests compiled. She has also given critical commentary on proposals submitted to CIHR for various team grants. Lauren has also worked closely with colleagues and myself as a collaborator on a number of our research projects. This has included researching the local organization of the indoor sex industry and communicating with escort agency owners and workers about our research, with the hope that their interest would be peaked and they would agree to come forward for an interview. Lauren has always kept us apprised of her progress by sending regular activity reports. Not only has she been highly successful in increasing our research participation rate; her reports and one-to-one meetings with other research staff have demonstrated her strong written communication skills, as well as her ability to work independently. Lauren conducted one-on-one interviews with participants in our Risky Business project, as well as coordinating other aspects of the research program. She has proven herself with her ability to conduct interviews with a diverse respondent population that ranges widely in regard to age, race, ethnicity, sexual orientation, gender, literacy level and occupational experience.

Lauren has a keen interest in discovery and is willing to expand her academic/training abilities in new and innovative ways. For example, in July 2011 Lauren met Drs. Eric Roth, Mikael Janssen and myself in Nairobi, Africa, where she provided qualitative interview training to a group of University of Nairobi graduate students, as part of our NIH grant, Kenya Free of AIDS. Lauren worked with me in the large urban Nairobi, Kibera, to conduct interviews with HIV+ female sex workers concerning negotiating their intimate partnerships, substance use, chronic illnesses, and other life challenges. The end result was the submission of a final report describing the intensive two-week research project, highlighting a unique methodology offering useful recommendations that can be used to inform future multi-disciplinary international research projects studying vulnerable populations.

Lauren’s research ability is reflected in her oral and written skills in a number of settings and I believe they are excellent. Lauren has co-written a published journal article with myself and colleagues entitled “In for the long haul: knowledge translation between academic and non-profit organizations” recently published in Qualitative Health Research (2010). She has also co-authored two book chapters: “Developing Knowledge Transfer with Non-profit Organizations Serving Vulnerable Populations” (University of Toronto Press: 2011) and “Volunteering on the Frontline: Caring for Sex Workers in Non-profit Organizations” (University of Toronto Press, 2011). Along with publications and scholarly contributions, Lauren has been the recipient of two competitive doctoral fellowship awards: the Centre for Addictions Research of British Columbia first year doctoral fellowship award and two years of the CIHR-funded Intersections of Mental Health Perspectives in Addictions Research Training (IMPART), an innovative multidisciplinary research training program designed to equip health researchers from across disciplines, sectors and settings to conduct sex and gender-based analyses with a focus on the intersections of violence, trauma and mental health with addictions.

Lauren is a highly accomplished individual who is a leader in both academic and non-academic settings. In 2011 the University of Victoria Department of Graduate Studies nominated her for the prestigious Trudeau doctoral scholarship award. Nominees for this award must be leaders across personal, academic, community and government/networks and must have a proven exemplary track record in their pursuit of human rights and dignity among vulnerable populations. She has contributed to a movement of Canadian scholars committed to excellence in research, scholarship, practice/policy and the restoration of health equity among stigmatized populations in Canada and around the world. She has undertaken many public speaking and media events to challenge the misinformation that is embedded in the public’s view of people involved in the sex industry. One such undertaking was participation in the documentary film entitled The Brothel Project (Butler-Parry, 2009). This film premiered at the Victoria Film Festival in 2010 and subsequently aired on Global Television’s series Currents across Canada and was nominated for a Leo Award. The film challenges stereotypes associated with sex industry work while, at the same time, drawing attention to the contradictory laws in Canada around prostitution. Her position as an expert witness in Bedford v. Canada – the Canadian constitutional challenge to the prostitutions laws in the criminal code led by Alan Young, Professor at Osgoode Hall Law School in Toronto, Ontario — gave her the opportunity to speak about how the criminal code harms people involved in the sex industry. This case has recently been won in the Supreme Court of Canada and has been described by many as a watershed moment with respect to the legal policy government the Canadian sex industry.

Lauren’s greatest asset in a research environment is her combination of experiential knowledge, community service experience, and academic achievement. Having both education credentials and community expertise, she is committed and motivated with regard to furthering scholarship research, and I have no reservations that she will be able to carry it out successfully, as she has been for our research team located in the Greater Victoria Region. I recommend her for without reservation.

If I can be of any further assistance, please feel free to contact me.


Cecilia Benoit, PhD

Scientist, Centre for Addictions Research of BC

Professor of Sociology, Department of Sociology