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Mental and Social Health

2019

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Full-Text Articles in Social Work

Attrition And Psychotherapy, Jesse Barrington Homan Nov 2019

Attrition And Psychotherapy, Jesse Barrington Homan

Dissertations and Theses

Attrition in psychotherapy, also known as dropout, is a problem that affects clients who terminate, their families, therapists, mental health systems, and the overall community. Research on attrition is vast. However, the majority of this research has been done post hoc, relied on quantitative methods, and looked primarily at client demographic variables as the predictors of attrition. This has resulted in inconsistent findings, offers little to no useful information about attrition, and appears to blame clients for failed therapy. There has been little research on attrition from the perspective of clients who terminate. This study was designed to answer the …


An Interprofessional Collaborative Approach To The Development Of A Content Valid Interview Questionnaire For Persons With Hearing Loss And Their Communication Partners, Nancy A. Delich, Stephen D. Roberts Oct 2019

An Interprofessional Collaborative Approach To The Development Of A Content Valid Interview Questionnaire For Persons With Hearing Loss And Their Communication Partners, Nancy A. Delich, Stephen D. Roberts

JADARA

An assessment instrument needs to be valid in order for data to be accurately interpreted and applied. Currently, few rigorous content evaluations have been conducted on hearing-related questionnaires. This study describes a multiphase approach for obtaining content validity evidence in the development of a questionnaire that explores quality of life for persons with hearing loss and their communication partners. A panel of 15 interprofessional experts evaluated 41 questionnaire items for content relevance and content clarity. Findings revealed an overall scale of .99 for content relevance and .85 for content clarity, indicating high content validity for the revised 40-item questionnaire.


Adicción Como Un Hecho Político Económico: Un Análisis De Servicios De Atención De Abuso De Drogas Y Alcohol En Arica, Chile, Jack Steffy Oct 2019

Adicción Como Un Hecho Político Económico: Un Análisis De Servicios De Atención De Abuso De Drogas Y Alcohol En Arica, Chile, Jack Steffy

Independent Study Project (ISP) Collection

Research question – What is the current landscape of drug abuse in Chile and how has the state attempted to address this problem?

Objectives – The objectives of the paper were to characterize drug use patterns in Chile since 1994, revise drug abuse services, and offer possible improvements for the system of drug abuse treatment.

Background – Chile, despite being one of the most well economically-developed countries in South America, has some of the worst mental health indicators, one of these being drug abuse. Since 1994, use of alcohol and marihuana has increased, while use of cocaine products has remained …


“Las Mamás No Son Putas”: Percepciones Y Experiencias De Embarazo Y Maternidad En Trabajadoras Sexuales En Buenos Aires / Mothers Are Not Prostitutes: Perceptions And Experiences Of Pregnancy And Motherhood Among Sex Workers In Buenos Aires, Fiona Kennedy Oct 2019

“Las Mamás No Son Putas”: Percepciones Y Experiencias De Embarazo Y Maternidad En Trabajadoras Sexuales En Buenos Aires / Mothers Are Not Prostitutes: Perceptions And Experiences Of Pregnancy And Motherhood Among Sex Workers In Buenos Aires, Fiona Kennedy

Independent Study Project (ISP) Collection

En Buenos Aires, la gran mayoría de las trabajadoras sexuales también son madres. Sin embargo, ha habido pocos estudios en Argentina sobre los vínculos entre el trabajo sexual y la maternidad y las experiencias de embarazo para las trabajadoras sexuales. Las trabajadoras sexuales en Buenos Aires experimentan estigmatización y violencia institucional en múltiples entornos, lo que afecta tanto el acceso a la salud como el bienestar general. Este estudio tiene como objetivo examinar cómo estas vías afectan a las trabajadoras sexuales en la maternidad y el embarazo, con el fin de encontrar áreas de intervención. La mayoría de esta investigación …


Conflict Between Religious Beliefs And Sexuality: An Autoethnography, Carlos E. Gerena Sep 2019

Conflict Between Religious Beliefs And Sexuality: An Autoethnography, Carlos E. Gerena

The Qualitative Report

Despite the shift in attitudes in religious institutions toward homosexuals in the United States, there are some religions that continue to view same-sex behavior as a deviant and damning sin. For many, religious beliefs and values provide meaning and impact personal identity. Using autoethnography, I will explicate my own experiences with religious institutions and the ongoing conflict between religious beliefs and sexuality. I will discuss messages received from the Pentecostal church, family, and Latino community, and how these messages influenced my human development and emotional well-being. I show that internalization of the principles taught by the Pentecostal Church triggered a …


Trauma-Informed School Practices: Building Expertise To Transform Schools, Anna A. Berardi Phd., Brenda Morton, Edd. Sep 2019

Trauma-Informed School Practices: Building Expertise To Transform Schools, Anna A. Berardi Phd., Brenda Morton, Edd.

Open Textbooks

This textbook represents the combined insight and experience of Morton, a k12 educator, and Berardi, a psychotherapist, both of whom are also university educators with extensive work experience serving districts and their teachers seeking to incorporate trauma-informed principles into their school culture and classroom. The authors identify that the field of education is now ready to deepen its level of response to the paradigm shift created by advances in neuroscience and traumatology. Hence, the primary focus is on identifying and applying trauma-informed educator competencies needed to transform districts, schools, educators, classrooms, and the field of education itself, while also including …


Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez Sep 2019

Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez

Dissertations, Theses, and Capstone Projects

Previous research suggests ethnic identity, a sense of belonging to a particular cultural group, may be protective against symptoms of post-traumatic stress disorder (PTSD). However, the role of ethnic identity, in-group preference (i.e., an individual’s preference for interactions with members of their own ethnic group) and acculturation (i.e., the level of comfort with the mainstream culture) have not been investigated as protective factors for Latinas with a history of interpersonal and sexual trauma. In this study, ethnic identity, in-group preference and acculturation were assessed via self-report on the Scale of Ethnic Experience in two samples of undergraduate Latina and non-Latina …


Life Satisfaction And Healthcare Utilization Among Immigrants To The United States, Merritt Christian Rachel Harrelson Aug 2019

Life Satisfaction And Healthcare Utilization Among Immigrants To The United States, Merritt Christian Rachel Harrelson

LSU Master's Theses

Previous research suggests a relationship between life satisfaction and healthcare utilization or HCU (Habibov & Afandi, 2016; Kim, Park, Sun, Smith, & Peterson, 2014). However, no study was found that examined this relationship among elderly American immigrants. The purpose of this study was to determine whether life satisfaction is linked to HCU for this population. The researcher of the current study applied binary logistic regression to data taken from the Health and Retirement Survey to determine whether changes in life satisfaction could be linked to variance in HCU across seven domains, including hospitalization, overnight nursing home stays, doctors visits, dentist …


Perilous Times Call For Emergency Preparedness, Sonia K. Wrate, Ronda Christman May 2019

Perilous Times Call For Emergency Preparedness, Sonia K. Wrate, Ronda Christman

Adventist Human-Subject Researchers Association

As disasters become more frequent it is important that people are ready to respond. University students along with community volunteers learn with and from each other during a disaster simulation. Learn how participant’s perceptions of spirituality and civic engagement has changed following a disaster simulation.


Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr. May 2019

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …


Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler May 2019

Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler

Dignity: A Journal of Analysis of Exploitation and Violence

Female genital mutilation (FGM) destroys the capacity of women to experience sexual pleasure. It causes serious medical complications such as bleeding, painful urination, cysts, dangerous and recurrent bladder and urinary tract infections, the growth of scar tissue that make marital intercourse a nightmare and that turns childbirth into an experience of danger and torture. Due to immigration, FGM now poses a potential health crisis in the West, both in Europe and in the United States. To estimate how many girls who live in the West are at risk, one can measure the prevalence of FGM in the non-Western countries where …


Using “Remote” Training And Coaching To Increase Providers’ Skills For Working Effectively With Older Youth And Young Adults With Serious Mental Health Conditions, Janet S. Walker, Caitlin Baird May 2019

Using “Remote” Training And Coaching To Increase Providers’ Skills For Working Effectively With Older Youth And Young Adults With Serious Mental Health Conditions, Janet S. Walker, Caitlin Baird

School of Social Work Faculty Publications and Presentations

Since about the turn of the century, a growing awareness of the poor outcomes resulting from “as usual” community mental health care has led to increasing efforts to implement programs and interventions with empirical evidence of effectiveness. However, these efforts have encountered numerous barriers, in particular the high cost of implementation, which has severely limited uptake and sustainment of empiricallysupported programs and interventions. Typically, the largest contributor to cost is the training and coaching required to ensure provider competence and fidelity to the intervention or program model. This paper describes a social innovation that aims to provide high-quality training and …


A Crisis In The Farming Community: A Pathway To Acceptable, Accessible And Available Mental Health Care In Rural Minnesota, Trevor Frybarger, Laura Koch, Kathy Thao, Taryn Wicks Apr 2019

A Crisis In The Farming Community: A Pathway To Acceptable, Accessible And Available Mental Health Care In Rural Minnesota, Trevor Frybarger, Laura Koch, Kathy Thao, Taryn Wicks

Master of Social Work Student Policy Advocacy Briefs

Minnesota relies on farmers to put food on our tables and to help drive our economy. The chronic stressors associated with an unstable farm economy is taking its toll on farm families all across Minnesota. Chronic stress can contribute to marital tensions, domestic violence, work disruption, depression, anxiety, and suicide. Minnesota has only 1 mental health counselor dedicated to doing outreach and crisis counseling to farm families. Many mental health professionals lack competency in working in rural communities, including understanding farm related stressors. Minnesota is doing some things right, like the Minnesota Farm and Rural Help Line. But, it needs …


Women & Adhd Functional Impairments: Beyond The Obvious, Noelle Marita Lynn Apr 2019

Women & Adhd Functional Impairments: Beyond The Obvious, Noelle Marita Lynn

Masters Theses

Women with Attention Deficit Hyperactivity Disorder are an understudied and underserved population. Research on women with ADHD has shown that they are significantly impaired by ADHD and its functional impairments. It also shows that women often internalize their symptoms and impairments. However, no research was found that explores what this internalization does to the women. The researcher chose to begin to address this gap in the literature through this qualitative phenomenological study. The purpose of this study is to explore the impact of functional impairments caused by ADHD on the internal lived experiences of women.

The researcher conducted fourteen interviews …


The Experience Of Social Workers Who Utilize Therapy Dogs In Practice, Kathryn Jochems Apr 2019

The Experience Of Social Workers Who Utilize Therapy Dogs In Practice, Kathryn Jochems

Thinking Matters Symposium Archive

Animal assisted therapy, which incorporates animals into structured therapeutic interventions, and its use within social work has been shown to increase social interactions, communication, and the overall health and safety of clients (Nimer & Lundahl, 2007). However, there is a gap in the literature regarding the professional and personal experiences of individual social workers with incorporating certified therapy dogs into their practice. This study examined the approval process, perceived effects on practice, perceived effects outside of practice, and future implications of using therapy dogs in social work through the analysis of qualitative data from seven in-depth interviews with licensed social …


Experiences Of Veterans With Ptsd And Sud In An Outpatient Setting, Andrew Breault, Hannah Shifflett-Kohler Apr 2019

Experiences Of Veterans With Ptsd And Sud In An Outpatient Setting, Andrew Breault, Hannah Shifflett-Kohler

Thinking Matters Symposium Archive

In 2014, there were approximately 7.9 million adults in the United States with co-occurring Post Traumatic Stress Disorder (PTSD) and Substance Use Disorders (SUD) (SAMHSA, 2014). Of the veterans who served in the conflicts in Iraq and Afghanistan alone, 30% of those in SUD treatment also meet the criteria for PTSD (Seal et al, 2008, pp. 476). Furthermore, statistics show that about 20 Veterans in the United States complete suicide daily (Spiva, 2019, p. 8). The Department of Veterans Affairs is urgently seeking successful approaches to addressing the high incidence of suicides among all veterans along with the low retention …


Cyberbullying And Suicide Among Lgbtq Youth: Is There A Connection?, Holly Wright, Victoria Wilson Townley Apr 2019

Cyberbullying And Suicide Among Lgbtq Youth: Is There A Connection?, Holly Wright, Victoria Wilson Townley

Thinking Matters Symposium Archive

The suicide rate among children and teens has been rising over the last decade, and members of the LGBTQ youth population are at considerably greater risk for suicide than their heterosexual peers. LGBTQ youth are also at heightened risk of being bullied due to sexual orientation. Recent technological advancements have created a new platform for bullying, that of cyberbullying, which can contribute to feelings of depression and low self-esteem. The detrimental impact that cyberbullying can have on mental health suggests the possibility of a potential connection between cyberbullying and LGBTQ youth suicide. This qualitative study examines the possible link between …


Lgbt+ Teens, Social Media Use & Depressive Symptoms, Megan Curtis, Danielle Ryder Apr 2019

Lgbt+ Teens, Social Media Use & Depressive Symptoms, Megan Curtis, Danielle Ryder

Thinking Matters Symposium Archive

Sexual and gender minority youth are statistically more likely to face severe mental health challenges than their cisgender, heterosexual peers; they consistently comprise a disproportionate percentage of youth who report experiencing depression, suicide ideation and attempted suicide in the United States every year (e.g. Abreu & Kinney, 2018). The aim of this study was to fill a gap in the current literature base by investigating the effects of social media use on sexual and gender minority youth mental health. The researchers conducted an online anonymous questionnaire targeted toward American LGBT+ (Lesbian, Gay, Bisexual, Transgender, etc.) youth ages 14 to 18, …


A Thematic Analysis Of Adults’ Reflection On Childhood Experiences Being Parented By An Adult With Mental Health Issues, Jennifer Luja, Meg O'Malley Apr 2019

A Thematic Analysis Of Adults’ Reflection On Childhood Experiences Being Parented By An Adult With Mental Health Issues, Jennifer Luja, Meg O'Malley

Thinking Matters Symposium Archive

Children are impacted by their relationships with caregivers. The objective of this research was to develop awareness of the impact on children being cared for by caregivers with mental health issues by examining the experiences of individuals who had a caregiver with severe and persistent mental health issues during childhood. Researchers also gained insight on how social workers can be more supportive to children in these circumstances. The researchers conducted interviews with five participants, the recordings of which were then transcribed and coded to identify themes. Prevalent themes include critiques of available services, resiliency and challenges of family members as …


Perceptions Of Mental Health: Eight Conversations With Mainers From Africa, Teresa Sosa, Emelda Ogweta Apr 2019

Perceptions Of Mental Health: Eight Conversations With Mainers From Africa, Teresa Sosa, Emelda Ogweta

Thinking Matters Symposium Archive

As of 2016, 42 million refugees from around the world had been forced to flee their homes due to war, persecution, or natural disaster (George & Jettner, 2016). Due to these factors, as well as relocation and resettlement, refugees are at a significant risk for trauma and other mental health issues (George & Jettner, 2016). While the literature consistently validates this heightened risk for mental illness in refugees, more research is needed into refugee's perspectives on mental health. Through analysis of semi-structured interviews with eight refugees from Africa, this phenomenological study investigated refugee's perceptions of mental health and mental illness. …


Internamente Solo: Escuchando Y Resistiendo La Soledad De Adultos Mayores En La Araucanía, Chile / Internally Alone: Hearing And Resisting The Loneliness Of Seniors In La Araucanía, Chile, Grace Ellrodt Apr 2019

Internamente Solo: Escuchando Y Resistiendo La Soledad De Adultos Mayores En La Araucanía, Chile / Internally Alone: Hearing And Resisting The Loneliness Of Seniors In La Araucanía, Chile, Grace Ellrodt

Independent Study Project (ISP) Collection

Research Question: Which current patterns drive or diminish loneliness among seniors of the Region of the Araucanía in the city of Temuco and surrounding rural communes?

Objectives: Understand and interpret the roots and the antidotes of the loneliness phenomenon experienced by seniors in Temuco and surrounding communes in the present moment.

Identify and analyze the drivers of pathological elder loneliness in structural, intermediary, and proximal factors.

Highlight the perspectives and narratives of seniors, community leaders, and health resources with respect to strategies to reduce the crisis.

Background: Currently, the population of seniors has risen and will continue to rise in …


Social Support And Discrimination: The Experiences Of Recovering Heroin Addicts In Kunming, China, Phoebe Li Apr 2019

Social Support And Discrimination: The Experiences Of Recovering Heroin Addicts In Kunming, China, Phoebe Li

Independent Study Project (ISP) Collection

Opioids have had a long, complex position in Chinese society, dating all the way back to the Ming dynasty. In 1949, 5% of the overall Chinese population and 25% of the population in Yunnan smoked opium regularly, which led to societal collapse and economic downturn. Since then, the Chinese government has used many different methods to attempt to control drug use and trafficking, including registering all users, executing traffickers, and using Compulsory Rehabilitation Centers. Starting in 2008, the government switched to a harm reduction approach and began to invest in methadone clinics, community support groups, and needle exchange programs. Because …


A Multicase Study Exploring Women’S Narratives Of Infertility: Implications For Counselors, Staci L. Born, Christin L. Carotta, Kristine Ramsay-Seaner Mar 2019

A Multicase Study Exploring Women’S Narratives Of Infertility: Implications For Counselors, Staci L. Born, Christin L. Carotta, Kristine Ramsay-Seaner

Staci Born

Infertility affects 6.7 million women in the United States (Chandra, Copen, & Stephen, 2013). Women’s experiences with infertility are not only influenced by biological health factors, but also by social, cultural, and personal variables. Given the prevalence and complexity of infertility, additional research is needed to further examine the nuances of women’s experiences. The purpose of this multicase study, as informed by four individual cases, was to explore how women construct their infertility narratives. Review of reflective journals found five common elements: (1) Emotional Rollercoaster, (2) Mind-Body (Dis)Connection, (3) Secret Identity, (4) Supportive vs. Constrained Communication Patterns, and (5) Fatalistic- …


Unveiling The Mask:Sexual Trauma's Impact On Academic Achievement, Behavior, And Self-Identity, Teshaunda Hannor-Walker, Sarah Kitchens, Lacey Ricks Mar 2019

Unveiling The Mask:Sexual Trauma's Impact On Academic Achievement, Behavior, And Self-Identity, Teshaunda Hannor-Walker, Sarah Kitchens, Lacey Ricks

National Youth Advocacy and Resilience Conference

Sexual trauma is an unfortunate but a common and often masked experience for many students in America. While sexual trauma in itself is not a mental health disorder, it can become a risk factor for many academic and mental health problems. Trauma-informed schools can play an important role in helping students deal with the aftercare of a traumatic experience.


Bridging The Gap: Supporting Transition-Age Youth Living With Mental Health Conditions, Oreoluwa Dasylva, Abbie Ensrud, Brittany Kruse, Cindy Schulz Mar 2019

Bridging The Gap: Supporting Transition-Age Youth Living With Mental Health Conditions, Oreoluwa Dasylva, Abbie Ensrud, Brittany Kruse, Cindy Schulz

Master of Social Work Student Policy Advocacy Briefs

The transition from adolescence to adulthood is a crucial time in a person’s life. For young people living with mental health conditions, becoming an independent, well-functioning, and productive adult can be especially challenging. It is imperative that supports be put in place to ensure transition-age youth have a smooth passage from child to adult mental health services. Nearly half of all life-long diagnosable conditions present by age 14. The Substance Abuse and Mental Health Services Administration (SAMHSA) finds the co-occurrence of serious illnesses and substance use disorders exist among transition-age youth more than any other developmental age. When left untreated, …


Betrayed Partners And Men With Poisoned Souls: Interview With A Former Sex Buyer In Germany, Ingeborg Kraus Feb 2019

Betrayed Partners And Men With Poisoned Souls: Interview With A Former Sex Buyer In Germany, Ingeborg Kraus

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.


“Little Tablets Of Gold”: An Examination Of The Psychological And Social Dimensions Of Prep Among Lgbtq Communities, Christina J. Sun, Kirsten M. Anderson, Kim Toevs, Dayna Morrison, Caitlin Wells, Christina Nicolaidis Feb 2019

“Little Tablets Of Gold”: An Examination Of The Psychological And Social Dimensions Of Prep Among Lgbtq Communities, Christina J. Sun, Kirsten M. Anderson, Kim Toevs, Dayna Morrison, Caitlin Wells, Christina Nicolaidis

OHSU-PSU School of Public Health Faculty Publications and Presentations

There are significant psychological, social, and cultural dimensions to the HIV epidemic in the United States, especially among lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities. Biomedical HIV treatment has been shown to impact these dimensions. However, there is little understanding of the real-world psychosocial and sociocultural effects of the latest biomedical HIV prevention strategy, HIV pre-exposure prophylaxis (PrEP). This study explored the psychosocial and sociocultural dimensions of PrEP use among LGBTQ adults. We interviewed 23 LGBTQ adults who were current or former users of PrEP. Results included that PrEP users’ experiences were shaped by multiple forms of stigma. Participants …


Yoga-Specific Enhancement Of Quality Of Life Among Women With Breast Cancer: Systematic Review And Exploratory Meta-Analysis Of Randomized Controlled Trials, Daline El-Hashimi, Kevin M. Gorey Jan 2019

Yoga-Specific Enhancement Of Quality Of Life Among Women With Breast Cancer: Systematic Review And Exploratory Meta-Analysis Of Randomized Controlled Trials, Daline El-Hashimi, Kevin M. Gorey

Social Work Publications

Physical activities during and after cancer treatment have favorable psychosocial effects. Increasingly, yoga has become a popular approach to improving the quality of life (QoL) of women with breast cancer. However, the extant synthetic evidence on yoga has not used other exercise comparison conditions. This meta-analysis aimed to systematically assess yoga-specific effects relative to any other physical exercise intervention (eg, aerobics) for women with breast cancer. QoL was the primary outcome of interest. Eight randomized controlled trials with 545 participants were included. The sample-weighted synthesis at immediate postintervention revealed marginally statistically and modest practically significant differences suggesting yoga’s potentially greater …


Clinical Director Perspectives On Decision Making Of Family Involvement With Clients At Inpatient Substance Abuse Treatment Centers, Lauren Amber Serdencuk Jan 2019

Clinical Director Perspectives On Decision Making Of Family Involvement With Clients At Inpatient Substance Abuse Treatment Centers, Lauren Amber Serdencuk

Department of Family Therapy Dissertations and Applied Clinical Projects

Literature supports that family members of individuals who abuse substances are significantly influential, whether it be positive or negative (Liddle et al., 2001). Evidence-based family therapy decreases substance use by adolescents (Slesnick et al., 2006). The purpose of this study was to gain the perspectives of clinical directors regarding decision making of family involvement at inpatient substance abuse treatment centers. Clinical directors were the focus of this study due to their experience, credentials, and their ability to oversee all clients and programs in a substance abuse treatment center. Purposeful sampling was utilized to obtain participants. Saturation was reached at three …


Beyond Telling: A Phenomenology Of Adoptive Parents' Adoption Communication Openness With Early Adolescents, Jane D. Samuel Jan 2019

Beyond Telling: A Phenomenology Of Adoptive Parents' Adoption Communication Openness With Early Adolescents, Jane D. Samuel

Theses and Dissertations--Family Sciences

Despite calls for increased Adoption Communication Openness (ACO) within the adoptive family, research indicates that families still struggle to accomplish the recommended elements and levels of openness. What could be holding families back from this key process? Three focus groups comprised of 17 adoptive parents of early adolescents (aged 10-14) who were age 0-2 at the time of placement were thematically coded. This inductive analysis revealed the complexity rooted in being —sometimes successfully and sometimes not—communicatively open. Four key themes emerged painting a vivid and rich picture of: a) the breadth and depth of this experience; b) the work entailed; …