Psychiatry and Psychology Commons^™

Experiences Of Black American Millennials: A Qualitative Study Of Internalized And Externalized Coping In The Face Of Racial Trauma, Natalia Angelique Giles

Doctoral Dissertations

The experiences Black Americans have faced when standing against racial trauma have impacted the Black community for generations. Though previous generations faced overt styles of racism throughout the eras of slavery and Jim Crow, the invalidation and discrimination have remained consistent within the experiences of the Black American millennial (BAM) generation. Current experiences BAMs face are a combination of both overt and covert styles of racism, which increase mental exhaustion, reduce motivation, and leave the individual psychologically defenseless. The purpose of this qualitative study was to examine the experiences of BAMs in the face of racial trauma. This qualitative research …

A Public Health Educational Campaign For Sudden Unexpected Infant Death (Suid) Intervention, Elia G. Peralta Landeros

Master's Projects and Capstones

Purpose: The rate of infant mortality serves as a crucial indicator of the overall health of society (CDC, 2022). The five leading causes of infant mortality are birth defects, preterm birth, sudden infant death syndrome, injuries, and maternal pregnancy complications. The prevalence of infant mortality varies across states, with eastern states and minority-ethnicity infants having higher prevalence. This thesis proposes utilizing the Safe to Sleep framework to introduce Giving Breath, a public health education campaign that introduced breastfeeding as an intervention to Sudden Unexpected Infant Death (SUID).

Methods:

1. Analyze current and new policies' impact on women's rights to breastfeed …

Tempers Rising: The Effect Of Heat On Spite, Jake C. Cosgrove

Master's Theses

The relationship between heat and harmful outcomes is well documented, with research connecting various adverse economic outcomes to the climate. In the presence of increasing global warming and climate change, understanding why the climate leads to negative economic outcomes is essential for forming peaceful institutions of the future. We study how behavioral economic outcomes change in the presence of heat through a lab experiment involving 1,110 observations conducted in five different countries. This paper specifically focuses on the social preference outcome of spite. We find that increased time exposure to the treatment effect of heat is required to elicit an …

Therapeutic Gardening For Addiction Recovery, Hugo A. Rivera Lopez

Master's Projects and Capstones

Problem: The use of evidence-based alternative forms of therapy like horticulture therapy and therapeutic gardening is underutilized in substance use recovery programs in the United States. As the country continues to struggle with addiction, it is important that recovery programs look to and incorporate these alternative therapies into official curricula. Currently, 46.3 million individuals living in the United States are living with a substance use disorder (U.S Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, 2022).

Context: The intervention was implemented at an all-male substance use treatment facility in San Jose, CA that houses up …

Therapeutic Gardening For Addiction Recovery, Hayley Milleson

Master's Projects and Capstones

The following study examines the potential benefits of implementing therapeutic gardening and outdoor activities as a supplemental resource for adult males with a history of substance abuse issues who have been affected by the criminal justice system and are seeking sobriety while in a residential treatment program. The goal is to investigate how therapeutic gardening can add to traditional addiction treatment methods. Through a review of current evidence-based practice, this study focuses on how alternative interventions such as therapeutic gardening and outdoor activity can improve overall mental health and well-being, promote a sense of community, improve social connections, alleviate stress …

Clinicians' Perspectives On The Effectiveness Of Trauma - Focused Cognitive Behavioral Therapy With African American Children: A Qualitative Study, Jada Carter

Doctoral Dissertations

Literature exploring clinicians' perspectives on the effectiveness of trauma-focused cognitive behavioral therapy with African American children who suffer from trauma-related disorders is very limited. The current study examined clinicians' perspectives on the TF-CBT model when utilized with this population, including their experiences working with African American children and families with observable types of trauma-related disorders. This research study also explored the various facets of trauma that African Americans encounter in childhood and the barriers that prevent them from receiving adequate mental health care. Thematic analysis was utilized to explore themes that emerged when treating African American children with TF-CBT. Five …

Designing And Implementing A De-Escalation Toolkit To Improve Staff Education And Competency On De-Escalation Within A Mental Health Outpatient Setting, Balraj Bajwa

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this study is to develop and implement a de-escalation toolkit to help improve memory, retention, and utility of de-escalation techniques within an outpatient mental health crisis stabilization unit.

Problem: The aforementioned crisis stabilization unit has elevated rates of patient aggression/violence and staff present with difficulty recalling de-escalation techniques due to the lapse in memory and/or retention.

Methods: The project was introduced to the stakeholders of the crisis stabilization unit and input was obtained on the design and components of the toolkit. Various analyses were conducted to ensure the appropriate implementation of the project.

Intervention: A de-escalation …

Community Based Participatory Research Informed Manualization And Piloting Of E-Training Of A Modified Dialectical Behavior Therapy Intervention, Annika M. Miyamoto

Doctoral Dissertations

This study explores the efficacy of delivering modified dialectical behavior therapy (m-DBT) to direct support staff who work with seriously mentally ill patients with neurocognitive deficits using remote web-based technology. The partnering facility for this study is a residential skilled-nursing facility that provides 24-hour care to individuals under conservatorship. Using a previously piloted m-DBT protocol, qualitative feedback was gathered from four participants with background training in psychology and varying experiences with DBT. All participants had direct knowledge of the treatment environment and experience working with the patient population. Gathered feedback was used to revise the m-DBT protocol to be used …

Educating Providers To Screen For Post-Traumatic Stress Disorder, Alyssa Fraino

Doctor of Nursing Practice (DNP) Projects

Background: The purpose of this evidence-based change in practice is to increase the knowledge base of psychiatric providers in outpatient psychiatric settings, by educating clinicians regarding the significance of implementing a post-traumatic stress disorder (PTSD) screening tool during the initial evaluation of patients. This can help to identify patients with PTSD that may not have been identified on initial visit, and may otherwise go unrecognized or untreated for PTSD, without the inclusion of a PTSD screening tool.

Problem: Evidence suggests that PTSD is underreported and overlooked in most populations. However, there is no standardized practice surrounding the routine use of …

The Use Of Mindfulness Meditation To Increase The Efficacy Of Mirror Visual Feedback For Reducing Phantom Limb Pain In Amputees, Nicolas Sebastian Mills

Doctoral Dissertations

Phantom limb pain is a chronic pain condition that negatively impacts the lives of over half of amputees, and results in considerable morbidity. Currently, there is no gold standard for treatment for phantom limb pain. However, a frequently used intervention is the use of mirror visual feedback, in which the amputee watches the reflection of the adjacent non-amputated limb move and exercise. In the last few decades, mindfulness-based interventions have been increasingly used with individuals living with different types of chronic pain. This study attempts to discover if the addition of a mindfulness-based intervention, such as guided meditation, will augment …

Safety Huddles: A Safety Net For Nurses Amid The Covid-19 Pandemic, Miranda Saint-Louis

DNP Qualifying Manuscripts

In March 2020, our 31-bed geriatric medical unit was designated the first COVID-19 unit in a teaching hospital located in a New York City COVID-19 hot zone. At the time, little was known about SARS-CoV-2 and the disease it caused. We needed to find a way to keep them calm, assure their safety, and provide competent and compassionate patient care in a situation where best practices had not yet been established. The concepts from this article can be applied to provide support staff in any crisis. Providing a safety net for staff enables a focus on life-saving patient care without …

Perinatal Substance Use Screenings In Marin County: A Brief Overview Of Screening Protocols And Identifying Gaps In Care, Breanna Wiliams

Master's Projects and Capstones

Introduction

Perinatal substance use continues to be a major public health issue in women’s health. The purpose of this study was to determine the frequency of substance use screenings in care and assess how well the existing services in Marin County are serving the needs of pregnant and parenting women and identifying the gaps and/or weaknesses in current practice.

Methods

Data for this study was collected via semi-structured interviews with five professionals that worked at the local community clinic, hospital and a non-profit agency. Some questions were slightly modified to be configured toward the participant’s specific profession.

Results

Results from …

Clinical Work With Adult Male Incest Survivors: Therapeutic Themes And Perspectives, Kathryn B. Rosenberg

Doctoral Dissertations

For psychotherapists, encountering clients who have experienced sexual trauma or abuse is inevitable, whether or not the abuse is disclosed to the therapist; however, mental health professionals receive extremely limited (if any) training on how to identify or effectively support adult clients who are survivors of childhood sexual abuse (CSA). Many people who experienced CSA, especially those who identify as male, remain isolated and invisible in their suffering as adults even within therapeutic spaces, facing what feel like insurmountable barriers – both internal and external – to getting help. When sexual abuse is intrafamilial, these barriers are both amplified and …

Identity Development In Transgender Women Of Color: An Interpretative Phenomenological Analysis, Angel Tseng

Doctoral Dissertations

Transgender women of color have been at the forefront of LGBT rights moments in the U.S. and has been credited for leading the Stonewall resistance (Roberts, 2018). Though much has changed since Stonewall, transgender women of color still face harassment, discrimination, and many other barriers and health risks today. One of the many challenges faced by transgender women of color is identity conflict. The purpose of the study was to examine the identity development processes of transgender women of color. This qualitative research study utilized Interpretative Phenomenological Analysis to explore the lived experiences and narratives of individuals from this community …

Increasing Rates Of Larc Uptake And Continuation Through Contraceptive Counseling: An Effective Approach For Women With Underutilization, Malia Johnson

DNP Qualifying Manuscripts

Unintended pregnancies in women with a substance use disorder are estimated to be nearly double that of the general population, of which negative health consequences are increased for both mother and neonate. Unintended pregnancies are preventable through the use of highly effective contraception that is less susceptible to the effects of typical versus perfect use. Long-acting reversible contraception (LARC) is ideal for this patient population. Therefore, a thorough literature review was performed to evaluate the role of contraceptive counseling on LARC uptake and continuation among women. The results indicated that contraceptive counseling does influence LARC uptake and continuation and it …

School-Based Mental Health Screening: Improving Outcomes Through Interprofessional Communication And Collaboration, Tiffany Gishizky

Doctor of Nursing Practice (DNP) Projects

For the adolescent population, the immediate impact a mental health disorder has on academics,relationships, and even suicide risk cannot be understated. Access to mental health care in low socioeconomic communities for adolescents is fraught with barriers. These include lack of transportation, lack of insurance coverage, fear of stigma, and a fundamental lack of knowledge regarding available resources. It is therefore a two-fold problem that exists for those in the care and observation of these adolescents; underutilization of appropriate routine screening and navigation to access care. This project aimed to remediate both of these issues at a high school located in …

Efficacy Of Integrated Mental Health Care With Dual Diagnosis Patients And Their Utilization Of Psychiatric Emergency Services, Denton Scott

Doctoral Dissertations

Historically, patients with dual diagnosis have been subjected to ineffective treatment and negative attitudes from healthcare providers. Further, these patients are plagued with myriad afflictions that exist beyond substance abuse and mental illness. The treatments and collateral damage associated with the diagnosis impose excessive healthcare costs and can be of significant detriment to society. Largely, patients suffering from dual diagnosis do not receive adequate treatment. As such, psychiatric emergency services are frequently utilized as an alternate treatment, wherein the main focus of care is on the substance abuse alone. This study argues that solely treating the substance abuse is not …

The Role Of Stigma On Mental Health Service-Seeking Among Armenian-American Men, Anthony Saroyan

Doctoral Dissertations

This study examined the role of stigma on mental health service-seeking among Armenian-American men who self-identified as having lived through or currently are living with a mental health issue. This qualitative study utilized interpretive phenomenological analysis to ensure that the lived experiences of Armenian-American men are represented through their perspective. A total of six participants engaged in this study. All participants self-identified as male and as having experienced a mental health issue, have utilized mental health services at least once in their lifetime, resided in the San Francisco Bay Area, and as being of Armenian descent. Through exploring the lived …

Black Women Surviving Sexual Trauma: The Cultural Components Used To Aid Recovery, Charrin Kimble

Doctoral Dissertations

The physical and psychological impacts women face as a result of sexual trauma has been researched extensively. While sexual trauma affects all women, far less attention has been given to cultural impacts on Black female survivors. Black women have unique experiences with sexual trauma due to the intersection of racism and sexism. Given the sociohistorical context of Black women and sexual trauma, research is needed to understand how cultural factors may aid the recovery process of Black women. This qualitative study examined the lived experiences of Black women who survived sexual trauma to understand the role cultural factors may have …

The Impact Of Depressive Symptoms On Cognitive Decline And Risk For Dementia, Katheryn Conde

Doctoral Dissertations

As of 2011, the life expectancy for Latinos in the U.S. was 81.6 years, which is higher compared to non-Hispanic Blacks (75.3 years), non-Hispanic Whites (79 years), and Hispanic Black populations (74.9 years; Arias, 2011; Arias, 2015). Latinos have higher age specific prevalence of dementia, which is higher than African Americans and non-Hispanic Whites (Gurland et al.,1999). Latinos experience Alzheimers disease symptoms 6.8 years earlier, with the average onset of 67.6 years which is younger than non-Hispanic Whites (73.1 years; Clark et al., 2005). Furthermore, older Latinos tend to experience depression at a rate of 13% and 35% with the …

Evidence-Based Verbal De-Escalation Techniques For The Family Nurse Practitioner: Education And Simulation, Rachael K. Misitano

Doctor of Nursing Practice (DNP) Projects

Background: Healthcare workers are 4 times more likely to be exposed to workplace violence than workers employed in private industry, with assault rates as high as 7.8 per 10,000 workers. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults, and or threats of assault, directed toward persons at work or on duty” (OSHA, 2015, p. 2). Verbal de-escalation techniques that assist with care of the agitated patient are not routinely taught to Family Nurse Practitioners (FNPs) throughout their years of advanced coursework, yet it is something they are likely to encounter …

Increasing Access To Aba Intervention For Children With Developmental Disabilities In Taiwan, Noel Hsu

Master's Projects and Capstones

Applied Behavior Analysis (ABA) uses a behavioral approach to help clients and their behavioral challenges. This treatment has been proven to be a highly effective intervention for children with developmental disabilities, such as autism spectrum disorders. It is widely practiced in the United States and many other developed countries; however, this intervention is not widely available in Taiwan. This phenomenon requires our investigation because it raises questions about the available supports and interventions for children with special needs in Taiwan. This project is to explore factors that influence the development of ABA intervention in Taiwan. The goal of this project …

Inside The Juvenile Justice System, Megan Phalon

Master's Projects and Capstones

The United States of America is known for freedom and integrity and being a nation that stands for justice and equality for all. Within the United States there are systems in place to better the people and communities in order to provide safety and order. However, just as any nation, there is a struggle with violent behavior and tendencies among adults and adolescents. Within the last three decades, the United States has created a correctional system that specifically targets adolescents, and that acknowledges the differences between adult and juvenile development and deviant behavior. Within this literature review, academic databases were …

Recovery-Oriented Care And Inpatient Psychiatric Nursing Practice, Julia M. Mclaughlin

Master's Projects and Capstones

For the past 15 years, major organizations such as the World Health Organization (WHO), Substance Abuse and Mental Health Services Administration (SAMHSA), and U.S. federal government have been committed to shifting mental health services from the medical model of care to the recovery-oriented model of care (Moller & McLoughlin, 2013). However, not all identified recovery-oriented practices have been fully implemented throughout mental health services, specifically in acute care settings. In 2015, San Mateo Medical Center’s acute psychiatric nursing staff completed McLoughlin’s (2005) Recovery Self-Assessment- Registered Nurse (RSA-RN). Data showed that 34% of nursing staff did not believe that the nurses …

Implementing Change To Decrease The Emergency Department Visits For Pediatric Clients Referred To Mental Health Services, Diane Sandoval

Master's Projects and Capstones

The purpose of this clinical nurse leader (CNL) internship project is to implement an improvement intervention to decrease emergency department visits or psychiatric emergency services visit rates for pediatric clients receiving mental health services through the ambulatory clinic. The goal is to increase client safety by preventing harm to themselves or others and improving quality of care provided through timely nursing telephone triage. The project is taking place in a county run pediatric ambulatory clinic. We will participate in a shared leadership team to make recommendations for improvement at the microsystem level. Team members include the charge nurse, clinic manager, …

Reducing The Time It Takes To Execute A Legal Hold On Patients Currently On A Voluntary Status And To Transport Them To A Locked Inpatient Psychiatric Facility, Ariel Cris B. Manipula

Master's Projects and Capstones

The purpose of this presentation is to improve the communication between departments involved in the “step-up” process. An improved level of communication is measured with the amount of time it takes to get patient from outpatient lobby to inpatient unit bed. This process begins when a patient is placed on a legal hold because they are a danger to themselves, danger to others or gravely disabled. The problem is that the current process takes up to an hour and varies heavily on whether or not the unit charge nurse and the admissions and records agent are properly trained and knowledgeable …

Reduction Of Psychiatric Patient Boarding In The Ed, Eriam S. Nnamaliri

Master's Projects and Capstones

REDUCTION OF PSYCHIATRIC PATIENT BOARDING IN THE EMERGENCY ROOM

ABSTRACT

Objective: Psychiatric patient boarding is a public health concern and a threat to patient safety. The prevalence of psychiatric emergencies in the United States continues to increase due to the strain on mental health services. There is a dire need to address psychiatric patient boarding before it gets even worse. The purpose of this project is to identify the causes and identify measures to decrease emergency department length of stay (LOS) for psychiatric patients in the ED. This project is to help facilitate the development of a more precise nursing …