Digital Commons Network^™

Exploring Stress, Fatigue, Burnout, And Resilience Among Healthcare Personnel In Southeast Asia: A Scoping Review, Kelsey Trulik, Vijaya Arun Kumar, Wendy Wu, Muralidhar Varma, Mauli M. Patel, Kajol Manglani, Trini A. Mathew

Global Health Research Collaborative

This study aims to compare methods used to measure burnout, fatigue, stress, and resilience, as well as resilience-building interventions among healthcare personnel (HCP) in Southeast Asia. Even before COVID-19, HCP faced high levels of burnout and stress, exacerbated by the pandemic. Identifying effective resilience-building strategies is essential to supporting a healthier workforce. Studies published from January 2016 to December 2021 focusing on burnout, stress, fatigue, and resilience in HCP in Southeast Asia. A comprehensive literature search of seven databases (Jan 2016-Dec 2021), using terms related to resilience, HCP, and Southeastern Asian countries identified relevant English-language studies. COVIDENCE software was used …

Self-Awareness And Self-Efficacy In The Novice Professional Phase Of Marriage And Family Therapists After Person Of The Therapist Training, A Comparative Survey, Rubio Betsabé

Dissertations

The study focuses on examining the influence of person-of-the-therapist or self-of-the-therapist training on therapists’ self-reports of self-awareness (as a conscious awareness of one’s internal states and interactions with others) and self-efficacy (perceived beliefs in personal capabilities to perform in ways that give control over events that affect their lives) at the novice professional stage of their career. The study will examine the experiences reported by mental health providers actively providing clinical care by utilizing a survey design focusing on person of the therapist connecting through alumni lists and online solicitation. This research adds to the current literature by using a …

What Works In Telehealth Play Therapy? An Appreciative Heuristic Inquiry, Veronica Ann Ball

Dissertations

With the onset of coronavirus disease 2019 (COVID-19) in the United States in March 2020 (World Health Organization, 2020), professional counselors providing traditional in-person play therapy found themselves in a quandary regarding the delivery of services during a global pandemic (Evans, 2022; Mitchell, 2020; Whaibeh et al., 2020). Online counseling proffered a means to prevent the disruption of services, respond to the need for emerging counseling services, and comply with social restrictions (Evans, 2022). Prior to the pandemic, telehealth play therapy was used sparingly (Haslam & Harris, 2011; Smith et al., 2021), and many child-serving mental health professionals lacked training …

What About The Children? An Exploration Of Family Counselors' Play Therapy Training And Preparedness To Integrate Children Into Family Counseling, Patricia J. Walker Monical

Dissertations

Children are an important part of families, yet family counselor education programs often do not incorporate training for including children in family counseling. At some point in their careers, family counselors and therapists will encounter clients who have children 3–12 years old. The problem is that since these professionals often receive little to no training in play therapy and thus do not typically include young children in family therapy, these younger family members are often overlooked. Research has confirmed that, due to a lack of sufficient training and supervision in play therapy, many family therapists report feeling unprepared to work …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Caretaker Of Captors: The Experience Of Role Conflict Among State Correctional Officers, Camille M. Botticelli-Pohl

Antioch University Dissertations & Theses

A variety of policies at the national level over the last 70 years have resulted in the mass incarceration of various marginalized populations, inclusive of individuals with mental health problems or severe mental illness. Although Constitutional mandates require that psychology staff be available at all state and federal facilities, these providers spend a fraction of the time with incarcerated people than correctional officers do. Correctional officers seem to play an important, if often overlooked, supporting role in the management of the day-to-day lives of people in custody, including elements of their mental health care. They are also, theoretically, tasked with …

Nature Interaction Assists With Coping And Resilience: An Interaction Pattern Approach With Adolescents With Histories Of Trauma In A Youth Group Home, Chrystal L. Dunker

Antioch University Dissertations & Theses

Adolescents with histories of trauma often experience disruptions to their emotional, social, and behavioral development. For those living in group home settings, supportive environments can play a key role in fostering healing and resilience. While nature interaction is increasingly recognized as a valuable way to support mental health and resilience, little research has explored its role in these settings. This study introduces an innovative methodology—the Interaction Pattern Approach (IPA)—to examine the role of nature interaction in coping and resilience for 12 adolescents with Adverse Childhood Experiences (ACEs) living in a youth group home. In this design, IPA integrates photovoice data …

Examining The Addictive Qualities Of Smartphone Usage, Daniel J. Pasquini

Antioch University Dissertations & Theses

Individuals in today’s society, both nationally and globally, have become exceedingly reliant on their smartphones, i.e., cellular devices with the ability to perform many tasks similar to a traditional computer, for both recreational and productivity purposes. As smartphones become increasingly accessible and affordable for the general population, smartphone usage will continue to grow exponentially. As a result, a comprehensive investigation into the possible addictive properties of smartphone usage is warranted. The purpose of this study is to examine and highlight any possible addictive qualities of excessive smartphone usage. The research methodology that will be implemented within the study will be …

Home-Based Transcranial Direct Current Stimulation Treatment For Major Depressive Disorder: A Fully Remote Phase 2 Randomized Sham-Controlled Trial, Rachel D Woodham, Sudhakar Selvaraj, Nahed Lajmi, Harriet Hobday, Gabrielle Sheehan, Ali-Reza Ghazi-Noori, Peter J Lagerberg, Maheen Rizvi, Sarah S Kwon, Paulette Orhii, David Maislin, Lucia Hernandez, Rodrigo Machado-Vieira, Jair C Soares, Allan H Young, Cynthia H Y Fu

Faculty, Staff and Student Publications

Transcranial direct current stimulation (tDCS) has been proposed as a new treatment in major depressive disorder (MDD). This is a fully remote, multisite, double-blind, placebo-controlled, randomized superiority trial of 10-week home-based tDCS in MDD. Participants were 18 years or older, with MDD in current depressive episode of at least moderate severity as measured using the Hamilton Depression Rating Scale (mean = 19.07 ± 2.73). A total of 174 participants (120 women, 54 men) were randomized to active (n = 87, mean age = 37.09 ± 11.14 years) or sham (n = 87, mean age = 38.32 ± 10.92 …

Groundbreaking Insights On Trauma And Justice: A Review Of Sexual Violence, Dissociation, And Inequality: A Guide To Understanding Traumatic Memory By Muriel Salmona, Kate Rose

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Suicide Phenotyping From Clinical Notes In Safety-Net Psychiatric Hospital Using Multi-Label Classification With Pre-Trained Language Models, Zehan Li, Yan Hu, Scott Lane, Salih Selek, Lokesh Shahani, Rodrigo Machado-Vieira, Jair Soares, Hua Xu, Hongfang Liu, Ming Huang

Faculty, Staff and Student Publications

Accurate identification and categorization of suicidal events can yield better suicide precautions, reducing operational burden, and improving care quality in high-acuity psychiatric settings. Pre-trained language models offer promise for identifying suicidality from unstructured clinical narratives. We evaluated the performance of four BERT-based models using two fine-tuning strategies (multiple single-label and single multi-label) for detecting coexisting suicidal events from 500 annotated psychiatric evaluation notes. The notes were labeled for suicidal ideation (SI), suicide attempts (SA), exposure to suicide (ES), and non-suicidal self-injury (NSSI). RoBERTa outperformed other models using binary relevance (acc=0.86, F1=0.78). MentalBERT (F1=0.74) also exceeded BioClinicalBERT (F1=0.72). RoBERTa fine-tuned with …

Evaluating The Emotional Accuracy Of Ai-Generated Facial Expressions In Neurotypical Individuals, Antonio Pagán, Katherine A Loveland, Ronald Acierno

Faculty, Staff and Student Publications

This study examines the ability of generative artificial intelligence to produce facial expressions representing basic emotions in a neutral context using black-and-white cartoon imagery. Mentalization, the capacity to recognize and interpret one’s own and others’ mental states, is critical for social interaction and emotional regulation. We explored the emotional validation of artificial intelligence (AI)-generated images by assessing the agreement between human interpretations of emotions and those generated by an AI model. Thirty-four participants evaluated images depicting six basic emotions: sadness, anger, happiness, surprise, fear, and disgust. Our findings revealed significant variability in human agreement, with higher concordance for sadness, anger, …

Using Mindfulness To Manage Moral Injury In Veterans: Feasibility And Satisfaction Of A Pilot Randomized Controlled Trial, Michelle L. Kelley, Adrian J. Bravo, Elizabeth E. Burgin, Susan A. Gaylord, Christine Vinci, Megan Strowger, Jeffrey M. Gabelmann, Joseph M. Currier

Psychology Faculty Publications

Objective

The present study assessed program feasibility and satisfaction among recent-era veterans who participated in Mindfulness to Manage Moral Injury (MMMI), a live facilitated web-based 7-week mindfulness-based program targeting moral injury among veterans.

Method

In total, 56 post-9/11 veterans were recruited with 28 randomized to the MMMI condition and 28 to the Education and Support (ES) condition. Most participants identified as being White (71.4%), male (66.1%), and had a reported mean age of 41.50 years (Median = 39.50, SD = 9.26).

Results

Among the 56 participants, 82.1% attended at least one treatment session and 44.6% completed all seven sessions. There …

Check Your Data Before You Wreck Your Model: The Impact Of Careless Responding On Substance Use Data Quality, Abby L. Braitman, Anna M. Petrey, Jennifer L. Shipley, Rachel Ayala Guzman, Emily Renzoni, Alison Looby, Adrian J. Bravo

Psychology Faculty Publications

Background: The accuracy of survey responses is a concern in research data quality, especially in college student samples. However, examination of the impact of removing participants from analyses who respond inaccurately or carelessly is warranted given the potential for loss of information or sample diversity. This study aimed to understand if careless responding varies across a number of demographic indices, substance use behaviors, and the timing of survey completion.

Method: College students (N = 5809; 70.7% female; 75.7% White, non-Hispanic) enrolled in psychology classes from six universities completed an online survey assessing a variety of demographic and substance use-related information, …

Family Stress Processes Underlying Covid-19-Related Economic Insecurity For Mothers And Fathers And Children's Internalizing Behavior Problems, Joyce Y. Lee, Shawna J. Lee, Sehun Oh, Amy Xu, Angelise Radney, Christina M. Rodriguez

Psychology Faculty Publications

COVID‐19 and its economic fallout have resulted in unprecedented financial insecurity and material hardship for many American families, with a disproportionately negative impact on children and families from socioeconomically disadvantaged contexts. The current study applied the family stress model to examine the family processes underlying pandemic‐related economic insecurity and children's internalizing behaviours. Online survey data from an economically diverse sample of mothers and fathers, who experienced at least one type of pandemic‐related economic insecurity in the United States (N = 259), were collected across two longitudinal time points in the early weeks of COVID‐19: (1) 14 April and (2) 30 …

Identifying Salient Social, Environmental, And Situational Contexts Of College Drinking: Impacts Across Drinking Outcomes, Abby L. Braitman, Jennifer L. Shipley, Megan Strowger, Emily S. Renzoni

Psychology Faculty Publications

Background and Objectives: Drinking context, such as where, why, and under what social conditions drinking occurs, is consistently associated with daily variability in alcohol use. However, ecological momentary assessment (EMA) requires very brief measurement, not allowing for as many contextual assessments as researchers may like. The current investigation examined common contextual predictors and their associations with different alcohol outcomes.

Methods: A sample of N=528 college drinkers completed three surveys about their most recent drinking episode. This included contextual predictors (location, social context, who was present, alcohol offers, and drinking motives), as well as typical drinking outcomes (number of drinks, estimated …

Evaluation Of A 20-Item Version Of The Trauma-Related Drinking To Cope Questionnaire, Sage E. Hawn, Lauren Smith, Kaytlin Armitage, Selah Ball, Cathy Lau-Barraco, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Objectives: This study sought to develop and psychometrically evaluate an expanded version of the Trauma-Related Drinking to Cope (TRD) scale, a four-item self-report tool, which was developed to address a crucial gap in self-medication research. Before the development of the TRD, no measures existed which assessed alcohol use for coping with symptoms of posttraumatic stress disorder (PTSD) specifically. Previous work showed that the TRD has strong psychometric properties and clinical utility in its ability to identify individuals with PTSD who may be at risk for developing comorbid alcohol use disorder (AUD). The aim of the present study was to develop …

Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus

Antioch University Dissertations & Theses

Domestic violence profoundly affects multiple facets of a survivor’s life. While most existing literature on survivorship addresses the immediate aftermath of domestic violence, this study delves into the extended process following the trauma of abuse to attain “thrivership,” a new concept in the scholarly and practice literature that emphasizes enduring well-being and flourishing. This dissertation examines the journeys from surviving to thriving for 13 women who transformed themselves and their lives to achieve well-being after traumatic domestic violence. Bronfenbrenner’s ecological systems theory was applied to examine the multiple layers of environmental influences on an individual’s development, including the micro, meso, …

For Black College Students Who Considered Dropping Out When Grit Wasn’T Enough: A Mixed Methods Study Exploring The Influence Of Family Messaging On Collegiate Outcomes, Dawn M. Wilson

Antioch University Dissertations & Theses

Black college student outcomes are well researched areas in education literature. This dissertation sought to explore the influence of academic and ethnic racial socialization on experiences of shame and guilt and examine the association of those relationships on Black college student retention and persistence. This study employed an explanatory sequential mixed methods design to investigate the socialization experiences of 272 Black college students in the US. Conditional process model analyses revealed that academic socialization is associated with experiences of guilt and shame—guilt predicted improved retention outcomes, while shame predicted lower retention outcomes. The analysis also revealed that while ethnic racial …

A Phenomenological Study Of How Parents Of Lgbtqia+ Youth Experience School-Based Sex Education, Alisha Bachman

Antioch University Dissertations & Theses

Empirical research on LGBTQIA+ youth and Comprehensive Sex Education is scarce and now, due to the current political climate, is under threat. Utilizing an interpretive phenomenological approach applying ecological systems and queer theory, this study explored the lived experiences of how parents of LGBTQIA+ youth perceive school-based comprehensive sex education. By isolating the phenomenon of comprehensive sex education, this study focused on the immediate context of influence that comprehensive sex education makes on LGBTQIA+ youth and families. This research used data collected through semi-structured interviews with nine different parents. Four themes emerged from the data: Communication and Education about Sexuality …

The Importance Of Accessibility, Self-Advocacy, And Affirming Care: An Interpretive Phenomenological Analysis Of Transgender And Gender Diverse Older Adults’ Primary Care Experiences, Jason Vaught

Antioch University Dissertations & Theses

The present study explored the lived experiences of Transgender and Gender Diverse (TGD) older adults when receiving primary care. The methodology utilized for this study was Interpretive Phenomenological Analysis (IPA). Three participants completed individual, semi-structured interviews. The themes that emerged included “Lack of Accessibility to Services,” “Need for Self-Advocacy,” and “Value of Affirming Care from Providers.” These results illustrated the multifarious needs that arise for TGD older adults when accessing primary care. The findings provided recommendations for healthcare organizations, primary care physicians, and other healthcare professionals. Specifically, the recommendations emphasized two key practices for physicians treating TGD older adults: (1) …

Inheriting Power And Pain: An Examination Of Intergenerational Influences In The Stories Of Black Women In Professional Leadership Positions, Angela Banks

Antioch University Dissertations & Theses

This study aimed to explore the stories of Black women in professional leadership roles. Grounded in a Black feminist perspective (Crenshaw, 1989) and informed by historical and intergenerational trauma (Brave Heart, 1999), this study utilized Black storytelling as a methodological framework and employed thematic analysis to examine the narratives of participants. A total of nine Black women in leadership positions across various industries participated in one-on-one interviews. The findings revealed four key themes: (1) What I saw and what others saw in me: Community leadership, (2) Instilled values: The Strong Black Woman Schema, (3) The only one: Sole representation and …

Reality Shock And Systemic Strain: Understanding The Lived Experiences Of Pre-Licensed Mental Health Counselors, Sara Al-Khedairy

Antioch University Dissertations & Theses

The counseling profession is struggling to meet the rising demand for mental health care due to a growing workforce shortage driven by burnout, inadequate support, and low compensation—pressures that disproportionately impact pre-licensed clinicians. Despite their critical role in sustaining the field, pre-licensed counselors often face systemic barriers with little structural support. This qualitative study explored the lived experiences of pre-licensed clinical mental health clinicians through social-ecological and reality shock theories. Participants included 14 pre-licensed clinical mental health counselors who had graduated from CACREP-accredited programs within the last five years. Individual interviews were conducted to gain a deeper understanding of participants’ …

Exploring The Lived Experience Of Grief In Adults With Attention Deficit Hyperactivity Disorder, Martina Bauer

Antioch University Dissertations & Theses

The purpose of this phenomenological descriptive-interpretive study was to understand the lived experience of maintaining attention to one’s responsibilities while grieving among adults diagnosed with ADHD who have recently experienced bereavement in the United States. The population for this study included adults aged 18 and over who had experienced the loss of a loved one in the past 5 years and had a current diagnosis of ADHD. Participants were recruited using a sample of convenience via social media, email, and flyers, employing a snowball sampling technique. There were eight participants who met the inclusion criteria and participated in a semi-structured …

Experiences Of Dissertating Students: What Works?, Laura Durkin

Antioch University Dissertations & Theses

This study explores the experiences of doctoral graduates from Council for Accreditation of Counseling and Related Educational Programs (CACREP)-accredited Counselor Education and Supervision (CES) programs. Guided by theoretical frameworks on student attrition and institutional racism, the research investigates three primary questions: (1) What dissertation- specific programmatic factors influence time to completion for CES doctoral students? (2) What interventions most strongly promote a sense of social integration and belonging? and (3) What interventions most strongly promote academic integration and confidence in students’ ability to succeed? Data were collected anonymously through an online survey, which included demographic and open-ended questions. Twelve participants …

Intersectional Opportunities For Drama Therapy And Counseling, Erica Craig-Mann

Antioch University Dissertations & Theses

The purpose of this study was to explore the intersectional possibilities between the fields of drama therapy and mental health counseling through the lens of transformative learning theory. Specifically, the research sought to understand the lived experiences of professionals trained in both disciplines to identify how these fields might mutually inform, strengthen, and enhance one another through collaboration and/or dual training. Data were collected through a qualitative online survey and analyzed using thematic analysis. Five themes emerged: (a) Theoretical and Practical Overlaps and Distinctions; (b) Drama Therapy-Informed Counseling: Embodiment, Creativity, and Experiential Practice; (c) Counseling-Informed Drama Therapy: Frameworks for Practice, …

Outside Of The Counseling Room: Whiteness And Antiracism, Carlee D. Smith

Antioch University Dissertations & Theses

This dissertation explores the lived experiences of white counselors as they integrate antiracism practices into their non-clinical lives. Rooted in the Multicultural and Social Justice Counseling Competencies (MSJCC) framework, this study addresses the gap in literature surrounding how white counselors embody antiracist ideologies outside of the counseling room. Through narrative qualitative methods, the research examines the challenges, strategies, and reflections of white counselors committed to antiracist practices; practical integration into personal life often encounters barriers related to internal biases, social resistance, and limited educational support. Insights from this research highlight the critical need for ongoing self-reflection, community accountability, and structural …

Examining The Relationship Between Bicultural Stress And Mental Well-Being Among Second-Generation Filipino Americans Living In The United States, Krista Parker

Antioch University Dissertations & Theses

Research investigating the bicultural and mental health experiences of Filipino Americans, the third largest Asian American group in the United States, are consistently overlooked, with second-generation Filipino Americans (SGFAs) facing greater risk of adverse mental health outcomes. This quantitative study addresses a critical gap in research by examining the relationship between bicultural stress and mental well-being among SGFAs living in the United States. Using a cross-sectional survey design, a multivariate regression analysis examined the relationship between bicultural stress and four mental health constructs (as measured by depression, anxiety, stress, and self-esteem) among 302 SGFA participants. Results from this study strongly …

Frozen: A Grounded Theory Of Transgenerational Trauma Cycles In The Evangelical Slavic Diaspora Of Former Soviet Union Refugees, Yulia Shtareva

Antioch University Dissertations & Theses

This dissertation builds on historical and scientific assertions that Former Soviet Union immigrants survived distinct political traumas, resulting in unique, culturally adaptive behaviors and beliefs. Using constructivist grounded theory, it examined how these behaviors manifest in the evangelical Slavic community (ESC) of former Soviet Union Refugees (FSURs) in the U.S. The researcher asserts that (a) adaptations are generationally preserved in the ESC through a “cycle of authoritarianism,” and (b) survival strategies became maladaptive in new social environments. Narratives from eight young adults raised in the ESC were analyzed alongside a literature review and lived experience. Findings show that coping strategies …

Subthreshold Depression In The National Epidemiologic Survey On Alcohol And Related Conditions Iii (Nesarc-Iii): A Quantitative Analysis Of Prevalence, Characteristics, And Burden In A Nationally Representative Sample, Scott T. Young

Antioch University Dissertations & Theses

While subthreshold depression (subD) is relatively young for a diagnostic concept at a mere half century old, it has burdened individuals and societies for far longer. Research has established that it is a highly prevalent, clinically important entity with clear links to personal distress and impairment (including increased suicidal ideation and behavior), societal burden (e.g., increased reliance on public assistance programs), and economic costs (both personal and public). Research has also demonstrated that it represents a significant risk factor for incident major depression (MD) and that it likely represents both a prodromal and residual state in the normal course of …