Digital Commons Network^™

Reflecting On Psychotherapy In Adolescence: A Qualitative Analysis Of Processes Of Change, John Parigger

Electronic Theses and Dissertations

There is a sharp increase in anxiety and depression symptoms in adolescence, and many forms of psychotherapy are shown to be effective. However, most research has examined average effects for manualized treatments that address multiple areas of functioning, which makes it difficult to determine how psychotherapy causes positive change. Process-based therapy postulates that all psychotherapies work through promoting adaptive biopsychosocial patterns of behavior (i.e., processes of change). Research has increasingly focused on the process-based therapy model, and there is a need for qualitative studies to incorporate lived experience into our understanding of change processes. The current study utilized the process-based …

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

Kinesiology Department Chairs’ Perceptions Of Their Training And Preparation, Kason O’Neil

Electronic Theses and Dissertations

Department chairs are responsible for leading academic departments in higher education.  These individuals regularly make important decisions regarding such things as managing faculty and academic programming, overseeing budgets, and supporting student needs. Despite these responsibilities, many people become department chairs without receiving formal leadership training. This study explored how kinesiology department chairs across the United States viewed their preparation for the role and the importance of leadership training. A total of 111 department chairs completed an online survey about their background, previous training, and the importance of training for different administrative responsibilities. The results showed that most chairs had little …

Perceptions, Attitudes, And Experiences Of Persons Who Work In Forensic Mental Health Systems, Abigail Wiser

Electronic Theses and Dissertations

The forensic mental health system serves clients with dual needs —serious mental health concerns like psychosis and suicidality, and management of risk. Experiences and perceptions of professional and direct care staff may impact daily and therapeutic interactions and client success. These experiences may be marked by stigma, such as beliefs about what led to hospitalization, treatability of mental health concerns, and intentionality of behavior. Understanding this stigma, as well as the role of vicarious trauma, workplace burnout, and other relevant individual factors, may help us understand staff experiences and guide training, thus improving client care. 146 staff members across three …

Leveraging Mammal Mycophagy To Determine Environmental Drivers Of Truffle Diversity, Brittany Hartsock

Electronic Theses and Dissertations

Many mycorrhizal fungi are hypogeous (truffle-forming), producing underground fruiting bodies. Studying truffles is inherently challenging due to their hidden nature. However, mycophagous mammals provide a unique opportunity to study hypogeous fungi because they rely on truffles as a food source. Although several truffle species have recently been described in the southern Appalachian region, their fruiting patterns remain poorly understood. To address this, we quantified truffle richness and spore loads from 670 Peromyscus scat samples collected across 42 sites spanning an environmental gradient during 2024 in the Blue Ridge Mountains of East Tennessee. We found that truffle richness and spore abundance …

An Assessment Of Accessibility And Affordability Of Inpatient Psychiatric Care In Tennessee, Kailee Havrda

Electronic Theses and Dissertations

Introduction: Access to mental health has seen changes over the past decade, but little research and attention have been given to access to inpatient psychiatric facilities. Inpatient psychiatric care is crucial for patients experiencing mental health emergencies who need immediate access to care. Gaps in spatial accessibility, affordability, and the access and assessment process were identified due to a lack of available information in the field.

Methods: Secondary data from the Tennessee Department of Health were used to assess financial accessibility through payer source charges and patient encounters, as well as through mapping of inpatient psychiatric facilities and conducting drive …

Barriers To Veterans Affairs (Va) Healthcare Utilization: Exploring The Underutilization Of Va Healthcare Services Among Rural, West Texas Veterans, Adam G. Rodgers

Electronic Theses and Dissertations

Rural veterans forgo Department of Veterans Affairs (VA) healthcare at disproportionate rates, and this study found that the primary barrier is not enrollment but utilization. Seven of the eight participants were already enrolled yet remained functionally outside the system. The purpose of this qualitative single-case study was to explore why rural West Texas veterans forgo and underutilize Veterans Health Administration (VHA) healthcare. Two research questions examined the perceptions contributing to that decision and the barriers preventing access. Andersen’s behavioral model of health services use provided the framework. Semistructured virtual interviews with eight rural West Texas veterans were analyzed using Braun …

Adolescent Depressive Symptoms And Adult Functioning Within Major U.S. Racial Groups, Summer N. A. Millwood

Electronic Theses and Dissertations

Depression is the leading cause of disability among adults in the U.S and is associated with negative short- and long-term social, emotional, economic, and physical health outcomes. Notably, rates of depression among children and adolescents are rapidly increasing across the globe. Depression in youth disrupts crucial developmental processes that can adversely affect concurrent and longitudinal socioeconomic and health outcomes. Although extant research delineates the consequences of adolescent depression for adult functioning (e.g., lower educational attainment, fewer economic resources, worse physical health), studies that examine these associations within racially minoritized populations are scarce. This gap in the literature is especially striking …

The Development And Validation Of Gains-Id, A Guidebook For Adapting Intervention Sessions For Students With Intellectual Disability, Kayla Mccreadie

Electronic Theses and Dissertations

Targeted interventions can equip students with intellectual disabilities (ID) with essential academic skills that support positive post-secondary outcomes. However, the lack of interventions specifically designed for this population creates barriers to equitable education. Until more interventions are developed, educators may benefit from resources that help adapt evidence-based practices to meet the needs of students with IDD.

The first manuscript introduces GAINS-ID (Guide for Adapting INtervention Sessions for Intellectual Disabilities). Based on best practices and Universal Design for Learning (UDL), the guide offers examples of adaptations to various intervention components—such as time, materials, environment, …

Asian American Men's Experiences Of Gendered Racism In Online Competitive Gaming, Calvin Weiting Lee

Electronic Theses and Dissertations

In the U.S., Asian Americans men make up a large portion of active players in online competitive video games. In these settings, harassment, racism, and hate speech are prevalent and often normalized. The purpose of this study was to explore Asian American men’s experiences of gendered racism in online competitive gaming spaces. Using an Interpretative Phenomenological Analysis approach (Smith, Flowers, & Larkin, 2022) and applying the Intersectionality Framework (Crenshaw, 1989; Collins, 2000), six Asian American men were interviewed about their experiences of gendered racism while playing online competitive games. Two Group Experiential Themes emerged from their accounts: 1) Gendered racism …

Biases Toward Threat In Categorization And Attention Allocation When Evaluating Static And Dynamic Emotional Crowds, Delaney Mcdonagh

Electronic Theses and Dissertations

Visual representations are often biased, and these biases can manifest across many different stages of perception. For example, when categorizing nuanced, ambiguous, or fleeting emotional expressions, most perceivers are biased to interpret expressions as negative. Biases also manifest at the level of attention-allocation as observers dynamically examine and attend to expressions as they visually navigate a crowd. To comprehensively understand biased emotion perception, it remains critical to understand how bias manifests across the process of making emotional judgements, both as observers gather information about faces over time and as they make a final categorization of what they see. Biased patterns …

Behind Prison Walls: Unmasking The Victimization Experience Of A Transgender Inmate: A Narrative Study, Kevin E. Hemminger

Electronic Theses and Dissertations

Transgender individuals experience disproportionately high rates of victimization within the U.S. criminal justice system, at rates some studies estimate as four times greater than those of cisgender individuals (Marchi et al., 2025). Victimization may occur at the hands of correctional officers, institutional staff, or fellow inmates. This narrative study focuses on the life story of a formerly incarcerated transgender woman, tracing her experiences before incarceration, throughout her time at two different correctional facilities in two different states, and her life following release. While Community Based Research (CBR) was not adopted as a formal methodological framework, its principles — centering lived …

Exploring The Impact Of Artificial Intelligence Tools On Special Education Teachers’ Workload And Burnout In Colorado: A Qualitative Phenomenological Study, Rawa Suhail Abu Alsamah

Electronic Theses and Dissertations

In the United States, special education (SPED) teachers face complex workloads, high caseloads, and extensive documentation responsibilities, contributing significantly to burnout and retention issues. The recent integration of artificial intelligence (AI) into educational settings presents promising opportunities to alleviate teachers' instructional and administrative demands. To better understand the impact of AI on SPED teachers, this phenomenological qualitative study explored the lived experiences of licensed K–12 SPED teachers in Colorado who use AI tools in their professional practice. This study also examined how AI tools supported workload management, as well as their perceived impacts on burnout and intentions to remain in …

Cultural Humility, A Salve For Romantic Relationship Conflict, Lena Blum

Electronic Theses and Dissertations

Conflict communication and having a relationship consisting of differing sociocultural backgrounds (DISC Couples) have been viewed as obstacles or at best hindrances of relationship satisfaction in earlier couples’ psychology literature. More recent literature makes an argument that it is not merely conflict communication or the differences of culture within a couple, but rather how couples navigate both conflict and differences that impact relationship satisfaction. The present work aims to investigate the role of cultural humility in the association between cultural conflict communication and relationship satisfaction, as well as its relationship with the frequency of cultural conflict communication among DISC couples. …

Pushing Forward: The Dialectical Experiences Of Apida Psychologists In Predominantly White Counseling Settings, Shaun A. Fossett

Electronic Theses and Dissertations

Asian Pacific Islander Desi Americans (APIDAs) are the fastest growing racial group in the United States, yet they remain significantly underrepresented in the field of psychology and notably absent from research examining the professional experiences of racial and ethnic minority clinicians. Existing scholarship has documented the prevalence of racialized organizational structures, microaggressions, and the enduring “model minority” stereotype that both obscures and exacerbates APIDA challenges in professional environments. However, no known published studies have investigated the non–client-facing experiences of APIDA psychologists working in predominantly White counseling settings. The purpose of this interpretive phenomenological analysis (IPA) study was to explore how …

Examining Intimate Partner Violence After Pediatric Traumatic Brain Injury, Rebecca R. Suzuki

Electronic Theses and Dissertations

Pediatric traumatic brain injury (TBI) is linked with social problems in peer relationships that can last into adulthood. Little is known about how social problems impact the development of intimate relationships as pediatric TBI survivors grow up. This study addressed this gap by examining risk of intimate partner violence (IPV) in a sample of 50 young adult survivors of pediatric TBI prior to age 13 (M age = 22.96, SD = 1.70, 60% women) and tested social information processing (SIP) as a potential process through which TBI influences risk for IPV. Participants were recruited via Prolific and social media …

Initial Pilot Test Of A Single-Session Social Support Program For Increasing Social Approach Behavior And Social Support In Emerging Adults, Emily L. Jones

Electronic Theses and Dissertations

Emerging adulthood, the developmental stage between adolescence and young adulthood (Arnett, 2000), is marked by increases in autonomy, changes in social dynamics, and identity exploration (Arnett, 2015). During this stage, social stressors may trigger or exacerbate preexisting mental health problems (Slavich & Auerbach, 2018), though few emerging adults seek or receive mental health support (Zhao et al., 2025). Single-session interventions, or “specific, structured programs that intentionally involve just one visit or encounter” (Schleider et al., 2019), may present an opportunity to provide some support to those who face barriers to participation in traditional forms of treatment (Janota et al., 2022). …

Protest, Police, Peace, And Violence: Understanding Variation In Police Violence At Protests, Louis Pascarella

Electronic Theses and Dissertations

Why do police engage in violence at some protests but not others? Existing research highlights the importance of protest characteristics, political context, police culture, organizational incentives, and interactions between protesters and law enforcement. While these factors help explain patterns of repression, they provide limited insight into why police responses can shift rapidly from restraint to widespread violence during the course of a protest event.

This dissertation examines variation in police violence during the 2020 George Floyd Uprising through a comparative analysis of protest events in Denver, Colorado and Seattle, Washington. Drawing on original event reconstructions based on livestreams, helicopter footage, …

A Longitudinal Study Of Achilles Tendon Adaptation In Ncaa Division I Female Gymnasts: Associations With Menstrual Status, Birth Control Use, Pain, Limb Dominance, And Training Exposure, Mattie Jane Hyde

Electronic Theses and Dissertations

This longitudinal study evaluated Achilles tendon (AT) thickness in 22 NCAA Division I (DI) female gymnasts across three consecutive seasons in relation to menstruation, birth control use, pain, limb dominance, training week, and year of collegiate competition. Weekly ultrasound and athlete survey data were analyzed using mixed-effects models for absolute AT thickness and change in thickness from baseline measurements. Associations were primarily characterized by interactions rather than uniform effects of individual predictors. A Pain × Limb Dominance × Week × Year interaction was associated with both thickness outcomes across season-specific and combined analyses, with relationship directions varying by limb, season …

Disrupted Family Ecosystems: Intergenerational Estrangement, Nonnormative Events, And Perceptions Of Established Adults – A Case Study, Seth Wyncott

Electronic Theses and Dissertations

The issue of intergenerational family estrangement has gained increased exposure in research and popular literature; however, significant gaps remain in understanding the lived experience of adult-children who maintain separation from their parents. Complicating matters, the family is not a solitary unit but is intertangled within a macrolevel sociocultural ecosystem. This ecosystem includes normative and nonnormative stressors which are subject to diverse interpretations depending on the historic and evolving character of the family and its members. As such, it is important to examine the dynamic character of estrangement in familial and sociocultural context.

Utilizing a case study method with semi-structured phenomenological …

Well-Being Beyond The Binary In Perinatal Healthcare: An Application Of Reproductive Justice, Orphea D. Wright

Electronic Theses and Dissertations

Gender diverse birthing individuals face several systemic barriers to accessing affirming and empowering perinatal healthcare. The present study utilizes the term gender diverse and the abbreviation TGE to describe those who self-identify as broadly non-cisgender, an umbrella term for people whose gender identity differs from their sex assigned at birth. Gender identities that may be included in this definition include transgender/trans, gender expansive, non-binary, gender fluid, gender nonconforming, gender variant, gender queer/queer, and/or agender. Gender diverse individuals face unique barriers in perinatal healthcare due to the pervasiveness of cisnormativity in perinatal healthcare spaces. Research has documented the harm caused to …

The Invisible Poet: Stories Of Higher Education Professional Staff Program Experiences Via Poetic Inquiry Through A Wellness Dimensions Framework, Freyja Hofler

Electronic Theses and Dissertations

It is well documented that burnout and low levels of employee wellness have negative effects upon employees as well as the organizations that employ them (Gallup, 2019; Maurer, 2024; Wright & Bonett, 2007). This study was a program evaluation of the C2 Initiatives program via a constructivist paradigm, responsive evaluation approach, and summative outcome evaluation. The NWI’s Six Dimensions of Wellness model was utilized as the theoretical framework of the study and arts-based research was used as the conceptual framework.

Participants were given documents from the C2 Initiatives program as a text base to create blackout poetry, a type of …

Becoming A Therapist In A Foreign Land: Narratives Of International Trainee Clinicians Of Color In The U.S., Prathma Sharma

Electronic Theses and Dissertations

The focus of this dissertation project is on the community of trainee clinicians of color, who have been consistently overlooked in the literature on mental health. This dissertation employed narrative analysis as a methodological framework to explore the experiences of international trainee clinicians of color as they navigated the complex landscape of mental health training in the United States. In an increasingly globalized world, the voices and perspectives of these individuals offered critical insights into the challenges, triumphs, and unique pathways that shaped their professional development. Much of the literature on diversity and inclusion tends to individualize the challenging experiences, …

"Help Me Live It The Way You Do": Grounding Singaporean Responses To The Rorschach Situation, Casey Y. Lee

Electronic Theses and Dissertations

Contemporary research on the Rorschach and culture is striking for the latter’s disappearance as a variable of significance (Meyer et al., 2015; Meyer et al., 2007; Mihura et al., 2013; Viglione & Hilsenroth, 2001). This erasure is chronicled and reproduced in the narratives of universal objectivity, of extensive international meta-analyses, of replications, of standardized norms (Ritzler, 2004; Smith et al., 2018; Smith et al., 2020; Weiner, 2004). A different story emerges, however, when we ask, how has culture disappeared? The proposed study is a multimethod qualitative analysis of Singaporean responses to the Rorschach, aimed at generating sensitive yet critical discourses …

Bridging The Gap: Documenting The Effectiveness Of Counseling Education In A Speech-Language Pathology Graduate Program, Gianna Baker

Electronic Theses and Dissertations

This study aimed to examine the impact of a required counseling course through Duquesne University's Speech-Language Pathology program, particularly regarding student’s counseling self-efficacy and their ability to apply counseling skills within clinical practice. Nineteen first year Master’s students in Speech-Language Pathology at Duquesne University during 2025 participated in this study while enrolled in a counseling course and providing therapy to clients. Students completed the Counselor Activity Self-Efficacy Scales for SLPs (CASES) (Victorino & Hinkle, 2019) prior to beginning and after completion of the required counseling course. While observing video-recorded therapy sessions, the Counselor Competencies Scale-Revised (CCS-R) (Lambie & Swank, 2024) …

The Person As Foundation Of Responsibility: The Insufficiency Of Rights-Based Human Development Approaches, Jaclyn Berg

Electronic Theses and Dissertations

Building on the plethora of research that demonstrates the way rights language has been more useful for those with wealth and power to further expand capitalist markets, this text extends that criticism to human development programs and institutions. While they claim to be directed towards addressing global issues of poverty and hunger as well as climate crises, they continue to treat the symptoms without accurately diagnosing the disease. Approaches to development that rely on rights without questioning the way rights have been influenced by neoliberal capitalists or without questioning the capitalist global economic system will never be able to achieve …

Impact Of Taped Problems Intervention Modification On Children With Deafness, Clyniece Hodge

Electronic Theses and Dissertations

Children with hearing loss are at an increased risk of experiencing setbacks in various areas of life, including academic performance and employment opportunities. Academically, they are likely to experience poor academic achievement in reading, as well as in mathematics (ASHA, 2013). In comparison to gifted hearing students and average-ability hearing students, students with hearing loss are at a higher risk of low mathematics performance (Hassan & Mohammed, 2019). Despite these known challenges and risk factors, limited research has been conducted to identify effective intervention strategies for improving mathematical outcomes among this population. As such, this study aimed to evaluate the …

Integrating Naturalistic Developmental Behavioral Interventions In Inclusive Classrooms To Support Autistic Students, Paige J. Johnson

Electronic Theses and Dissertations

The current trend of an increasing prevalence rate of autism spectrum disorder creates a growing need for evidence-based interventions that can be accessed in the natural environments, such as within inclusive educational settings. Naturalistic Developmental Behavioral Interventions (NDBIs) integrate principles of applied behavior analysis and developmental psychology, and offer effective tools for increasing social communication behaviors in autistic children that align with the neurodiversity-affirming movement. The present study sought to evaluate the effectiveness of Behavior Skills Training (BST) in teaching core NDBI skills to a preschool teacher, examine changes in teacher self-efficacy related to supporting autistic students, and assess the …

A Mixed-Methods Pilot Study Of A 10-Week Wellness Program For Resident Assistants, Emily L. Lee-Chong

Electronic Theses and Dissertations

This mixed-methods pilot study used semi-structured interviews with 15 resident assistants (RAs), complemented by descriptive pre- and post-test data from the Five Factor Wellness Inventory (FFWEL), to explore their lived experiences of participating in a 10-week wellness program grounded in the Indivisible Self Model of Wellness (IS-WEL). The purpose of this study was to examine the program's perceived influence on wellness practices and to explore the feasibility of implementing wellness-focused programming. Using a hermeneutic inquiry approach, the study identified four themes reflecting participants’ experiences throughout the program. Themes highlighted the importance of self-awareness through the IS-WEL model, the value of …

Race And Trauma: An Analysis Of Trauma Symptomology Across Diverse Youth Populations, Mara J. Niccoli

Electronic Theses and Dissertations

The adverse effects of trauma, particularly among youth who identify as Black, is a critical issue. This study investigated the relationship between race and trauma symptomology among children and adolescents who received weekly trauma therapy. With the use of clinical assessment data, this study sought to determine whether Black youth presented to treatment with higher trauma acuity than non-Black youth and if there were disparate outcomes in symptomology after treatment. The results indicated that on average, Black youth presented to treatment with lower trauma acuity than non-Black youth, and there were disparate outcomes in trauma symptomology between the two racial …