Medicine and Health Sciences Commons^™

Supervision Needs Of Novice Behavioral Health Providers In Integrated Primary Care Settings: A Delphi Study, Nicholas D. Schmoyer

Counseling & Human Services Theses & Dissertations

The integration of behavioral health providers (BHPs, i.e., clinical mental health counselors, clinical psychologists, clinical social workers, marriage and family therapists) into primary care settings has developed as a healthcare practice associated with enhanced patient clinical outcomes, enhanced patient satisfaction, reduced healthcare expenditures, and enhanced provider wellness and satisfaction, known together as the Quadruple Aim. For BHPs practicing in integrated primary care (IPC) settings, researchers have highlighted a variety of challenges they experience when integrating in these settings, with a consistent challenge being a lack of satisfactory training and supervision. Clinical supervision has been hailed as the “signature pedagogy” for …

Implementation Of Nurse Navigators For Behavioral Health, Theresa Papagna

Seton Hall University Dissertations and Theses (ETDs)

Mental health patients have been notoriously non-adherent with diligent medication conformity, office visit fidelity, candor about side effects, use of illegal substances for self-medication, and truthfulness about co-occurring conditions. This non-adherence makes treatment difficult for psychiatric providers, and all those who participate in the care of patients with mental illness. Patient non-adherence can cause frustration and can lead to provider burnout, which affects patients as well as providers. Also, there are concerning financial implications of excessive time and resources needed to adequately monitor mental health patients. Implications regarding 30- day re-admissions are tantamount to consideration of financial strains put on …

The Use Of Occupational Therapy Services In Outpatient Mental Health, Kelsey A. Wasik, Matt T. Valois, Kaylee M. Essenberg, Kelcie P. Beck

Masters Theses

The purpose of this study is aimed to explore the structure and utilization details of occupational therapy in outpatient behavioral health settings. Two occupational therapists participated in qualitative phenomenological interviews which were transcribed and analyzed using the thematic approach. A total of two themes emerged: billing and coverage, and education and advocacy. Participants identified there are necessary factors for reimbursement of services, in addition to the need for education and advocacy for occupational therapists to practice in outpatient behavioral health settings. Future research should be aimed at recruiting more participants, occupational therapists, and from other roles in these clinics such …

Minimizing Workplace Violence By Initiating An Evidence-Based Community Meeting, Olivia Gabrielle Foster

Dissertations

Problem: Workplace violence (WPV) in healthcare has become an epidemic demanding change. WPV is three to four times higher in the healthcare industry compared to other workplaces. For this project, WPV will be defined as any act of physical violence from a patient to a staff member. Community meetings are one evidence-based approach to decreasing WPV in psychiatric inpatient hospitals. Methods: This descriptive observational project compared data before and after implementing a targeted WPV community meeting, including unit rules, staff and patient expectations, a definition of WPV, and medication options available to reduce anxiety and irritability. This project …

Moral Distress Experienced By Behavioral Health Clinicians Who Have Worked With Maternal, Opioid-Using Clients, Jill Lee-Hubble

Walden Dissertations and Doctoral Studies

Moral distress (MD) is a concept that has been well studied in nursing and other medical fields as a precursor to provider burnout. Understanding how MD impacts behavioral health (BH) clinicians provides insights for counselor educators and supervisors to identify clinical situations that often lead to MD. This qualitative phenomenological study explored how MD was experienced by five BH clinicians who have worked in residential and hospital settings providing counseling to maternal, opioid-using clients. Interpretive phenomenological analysis (IPA) informed the research methodology and data analysis. Substance use during pregnancy is highly stigmatized in society; thus, a feminist conceptualization was integrated …

Multiple Baseline Interrupted Time Series: Describing Changes In New Mexico Medicaid Behavioral Health Home Patients’ Care, Jessica Reno

Mathematics & Statistics ETDs

In 2016, the CareLink New Mexico behavioral health homes program began enrolling Medicaid recipients with the goal of increasing care coordination, improving access to services, and decreasing long-term costs of care for adults with serious mental illness (SMI) and children with severe emotional disturbance (SED). To evaluate these aims, a retrospective interrupted time series study using Medicaid claims data was designed. First, a comparable subset of non-enrolled individuals was selected from the pool of Medicaid recipients with SMI or SED using propensity score matching. Then, segmented regression was applied to three outcomes: total Medicaid charges, number of outpatient behavioral health …

Appreciative Inquiry Of A Non-Profit Organization Transitioning To Teletherapy, Claudia Herrera

Department of Family Therapy Dissertations and Applied Clinical Projects

Mental health professionals have been required to make a transition to delivering services using technology during the COVID-19 pandemic. The non-profit agency participating in this study had already listed on its strategic plan the delivery of teletherapy. In 2020, due to the pandemic, the agency decided to expedite the delivery of teletherapy services. This study explored the experiences of the agency’s team, to determine what worked well while making this transition, as well as future dreams regarding the delivery of teletherapy. Appreciative inquiry was used as the method of data collection. Findings indicated the agency’s clinicians found keeping a positive …

A Behavioral Healthcare Approach To At-Risk Youth Substance Prevention Program Development, Debra Mcintyre

Walden Dissertations and Doctoral Studies

Providing quality services that meet the needs of clients is key to organizational sustainability for behavioral health organizations. Strategic development of substance prevention programs for at-risk youth will play an important role in capacity building. The focus of this study was to identify the need for developing a targeted and effective substance abuse prevention program to support at-risk youth who have trauma experiences before they begin misusing substances to cope with their challenges. The Baldrige excellence framework was used to guide this descriptive case study of a behavioral health organization in the Northeastern region of the United States. The data …

Can A Brief Online Intervention Change Low-Income Caregivers’ Reported Use Of Spanking? A Randomized Controlled Trial, Hilary L. Richardson

Dissertations

Spanking is commonly used by parents (64-94%) in the United States as a strategy for managing undesirable child behaviors. Research has found that the use of spanking is particularly high among young mothers, low-income parents, and African American families. Decades of literature on the use of spanking has identified abundant detrimental outcomes for children such as increased externalizing behaviors, decreased long-term compliance, and less guilt following misbehavior, as well as serious outcomes in adulthood such as depressed mood and alcohol/drug use. There is also a risk for spanking to escalate to physical abuse. Thus, safer, more effective discipline strategies are …

Barriers To Mental Health Treatment In Patients Referred By Primary Care, Rebecca Palmer

Dissertations

Problem: Limited access to mental health treatment is one of many potential barriers to treating mental illness in the United States. Where resources are readily available, reportedly high no-show rates for established mental health appointments suggests further investigation is necessary to identify frequent barriers within that population. This was a quality improvement project to identify common themes in patient-reported barriers to care.

Methods: A 4-question phone survey was offered to individuals that did not appear at their mental health appointment. Data was analyzed to identify the most commonly reported barriers to mental health treatment. Additional data collected includes reported history …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

Autoethnography Of A Whitegirl Marriage And Family Therapist's Experience Working On The Rez, Andrea L. Cuva

Department of Family Therapy Dissertations and Applied Clinical Projects

Despite the abundance of literature regarding potentially effective treatment modalities for Native American clients, researchers have been unable to identify an empirically proven effective treatment modality for this population. Common recommendations/considerations for therapists working with Native clients have been identified throughout literature; however, such findings were gathered by insiders (i.e., Native researchers or trained Tribal staff), which has left questions regarding the efficacy of such recommendations when applied by non-Native therapists. Due to Native American history, elaborate IRB requirements were put in place to ensure ethical research with this population but impedes the research process. I conducted an analytic autoethnography …

Alcohol And Substance Use Knowledge, Attitudes, Subjective Norms, Self-Efficacy, Perceived Behavioral Control, And Behavioral Intentions Among Omani College Students, Muna S. Bait Ajzoon

Health Services Research Dissertations

Alcohol and/or substance use among college students is a serious public health issue. In Oman, studies addressing college student’s alcohol and/or substance use are limited. The purpose of this study was to identify knowledge, attitudes, subjective norms, self-efficacy, and perceived behavioral control associated with alcohol and/or substance usage patterns among Omani college students (OCSs); identify behavioral intentions for alcohol and/or substance use among OCSs; and facilitate the development of culturally relevant evidenced-based interventions for Omani young people by communicating study findings to policymakers and healthcare program leaders.

A cross-sectional design used an online survey completed by college students from Oman …

Exploring The Relationship Between Occupational Burnout And The Behavioral Well-Being Of Social Workers, Damian A. Pisapia

Electronic Theses, Projects, and Dissertations

The purpose of this study was to determine if there was a relationship between occupational burnout and the behavioral well-being of social workers. Burnout is a multidimensional syndrome where workers experience feelings of emotional exhaustion, depersonalization, and reduced personal accomplishment as a consequence of work related stress and overwhelming job demands. Burnout can negatively affect organizational functioning, work performance, and pose significant health risks to workers. There are a limited number of studies focusing on the impact of occupational burnout on the behavioral well-being of workers. The findings of this study indicated that there was a significant relationship between burnout …

Assessment Of Gambling And Co-Occurring Mental And Behavioral Health Disorders: Implications For Public Health, Nene C. Okunna

Doctoral Dissertations

Gambling is a very popular form of entertainment and socialization in the US and is generally considered a safe form of recreational activity. There is some evidence of associations between positive health outcomes, as well as poor behavioral and mental health conditions with gambling. However, the relationship between recreational gambling and risk health behaviors has been under researched and thus poorly understood. The 2011 Massachusetts Expanded Gaming Act provides the impetus to understand gambling related problems prior to the introduction of new gambling opportunities. The objectives of the study are twofold: (1) examine associations between recreational gambling and, behavioral and …