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A Guest In Someone Else's House : The Construction Of Asian Americans As Foreigners, Deepa Ranganathan Sep 2013

A Guest In Someone Else's House : The Construction Of Asian Americans As Foreigners, Deepa Ranganathan

Theses, Dissertations, and Projects

Social workers, like many people, wrongly tend to think of Asian Americans as beings exempt from the problems of racism. The social work profession considers "race" to be a property inhering almost solely in African Americans. Meanwhile, the profession assigns the property of foreign "culture" primarily to Asian Americans. This thesis uses the work of Critical Race Theory (CRT) scholars to show that social workers, in presuming that Asian Americans are a class of people who are essentially foreign, are actually reproducing a form of exclusionist racism that Asian Americans have faced for generations. A partial solution to this problem …


Perspectives Of Bariatric Surgery Patients On The Role Of Pre And Post Bariatric Surgery Counseling, Daniel K. Rodrigues Sep 2013

Perspectives Of Bariatric Surgery Patients On The Role Of Pre And Post Bariatric Surgery Counseling, Daniel K. Rodrigues

Theses, Dissertations, and Projects

This research study explores the perspectives of bariatric surgery patients about the role of pre and post bariatric surgery counseling. Their perspectives were gathered through semi-structured, qualitative interviews, which explored participants' experiences with counseling throughout the bariatric surgery procedure. This study also aimed to identify what barriers patients encountered when seeking counseling and what improvements could be made to the process. Major findings were that most participants felt unprepared for surgery, and that the pre-surgical psychosocial intakes were not useful in preparation. Many participants felt intakes could have been helpful if conducted differently. It was also identified that intake clinicians …


To Hold And To Discipline : A Winnicottian And Foucauldian Examination Of Adolescent Athletics Through The Case Of Friday Night Lights, Westley C. Rutter Sep 2013

To Hold And To Discipline : A Winnicottian And Foucauldian Examination Of Adolescent Athletics Through The Case Of Friday Night Lights, Westley C. Rutter

Theses, Dissertations, and Projects

This theoretical study examined the impact of organized team sports participation on adolescent psychosocial functioning and development. Theoretical concepts were illustrated with examples present in the high school football themed television series, Friday Night Lights. Winnicottian theories were used to explain how athletics could facilitate adolescent development and be psychologically reparative for adolescents who experienced early childhood caregiver failures. In contrast, Foucauldian concepts were applied to demonstrate how disciplinary mechanisms in sports may augment the effects of internalized oppression for adolescents of color and economically marginalized adolescents. The study explored the possible impact of sports-based interventions for youth, cautioning social …


Attachment In Clinical Supervision : Relationships Between Attachment And The Supervisory Working Alliance, Karen E. Ladr-Finefrock Sep 2013

Attachment In Clinical Supervision : Relationships Between Attachment And The Supervisory Working Alliance, Karen E. Ladr-Finefrock

Theses, Dissertations, and Projects

The present study explored the alliance between Masters in Social Work (MSW) student trainees and their clinical supervisors using the lens of attachment theory. The sample consisted of 95 participants: 77 trainees (81.9% White; 88.3% female) and 18 of their supervisors (100% White; 83.3% female). Trainees completed The Experiences in Close Relationships-Relationship Structures questionnaire (ECR-RS; Fraley, Heffernan, Vicary and Brumbaugh, 2011) to assess their attachments to their supervisors, as well as their perceptions of their supervisors' attachments to them. Supervisors completed The ECR-RS to assess their attachments to their trainees, as well as their perceptions of their trainees' attachments to …


The Continual Journey : Parents' Spirituality After The Death Of A Child From Terminal Illness, Ellen C. Patterson Sep 2013

The Continual Journey : Parents' Spirituality After The Death Of A Child From Terminal Illness, Ellen C. Patterson

Theses, Dissertations, and Projects

This study sought to better understand bereaved parents' spirituality following the death of a child due to terminal illness. While previous research has looked at the role of spirituality following the death of a child, study populations have been predominantly female, Caucasian, and Christian. A goal of this study was to explore this issue among a more diverse population, in terms of religion, gender and ethnicity. The researcher met with and provided recruitment flyers to representatives of interfaith organizations, parent support groups, and local hospices. Additional recruitment included a snowball method utilizing acquaintances and colleagues of the researcher. Eleven individuals, …


An Exploratory Study Of Motivations Of White People Engaged In Antiracism Work, Bronwyn R. Shiffer Sep 2013

An Exploratory Study Of Motivations Of White People Engaged In Antiracism Work, Bronwyn R. Shiffer

Theses, Dissertations, and Projects

The purpose of this study was to explore the question: What motivates White people in doing antiracism work? The research was a qualitative study with a sample of 12 participants who self-identified as White clinicians or teachers and as engaging in antiracism work. Participants reflected on their motivations for entering and staying engaged in antiracism work during in-person or phone interviews. The findings of this study offer insight into the many factors of motivation of White people involved in antiracism work as well as what support structures sustain long-term action and engagement. Nearly all participants spoke about personal benefits from …


Students Of Color With Special Needs : An Analysis Of Exclusionary Disciplines In Massachusetts' Public Schools, Suzanne E. Rea Sep 2013

Students Of Color With Special Needs : An Analysis Of Exclusionary Disciplines In Massachusetts' Public Schools, Suzanne E. Rea

Theses, Dissertations, and Projects

Grounded in zero tolerance policies in public school systems, this secondary-analysis of Massachusetts's statewide data is used to ascertain information about the rates of exclusionary disciplines for students of color with special needs for the 2010-2011 academic school year. Literature has shown that students of color, and students with special needs are at higher risk for being given more frequent exclusionary disciplines than white students, and students without special needs; however, studies of students of color with special needs have not yet been conducted. The data used in this analysis was collected by the U.S. Department of Education and made …


The Question Of Self-Determination : An Analysis Of 21st Century Social Work Literature, Alexandra Prager Scalfano Sep 2013

The Question Of Self-Determination : An Analysis Of 21st Century Social Work Literature, Alexandra Prager Scalfano

Theses, Dissertations, and Projects

Self-determination is an integral part of the ethical foundation of the social work profession. However, the NASW Code of Ethics remains unclear in its definition of this and other important terms, such as social responsibility and professional judgment, that are often raised in discussions of self-determination and its implications to clinical social work practice. This analysis of twelve articles published in social work journals between the years 2000 and 2012 explores the field's current understanding of these terms and their implications as they are reflected in the current literature.


Happy Is The Woman Who Has No History : An Historical Discourse Analysis Of Women, Their Changing Roles And Society's Changing Perceptions, 1890-1920 In America, Sarah E. Pulver Sep 2013

Happy Is The Woman Who Has No History : An Historical Discourse Analysis Of Women, Their Changing Roles And Society's Changing Perceptions, 1890-1920 In America, Sarah E. Pulver

Theses, Dissertations, and Projects

This analysis examines the historical mental health needs that emerged for women at the turn of the 19th century as a result of drastic changes in the tenor of the United States. The research explores literature pertaining to women from 1890-1920 in the United States and relates to four main topic areas as a way to examine trends and patterns in mental health needs and supports at the time in history. The Historical Research approach is well suited for this research as the specific goal of the study is to examine the historical sources for patterns and trends to better …


Hope And Burnout Among Clinicians Who Work With Children At Risk Of Abuse, Neglect, Or Exploitation, Jonathan G. Mitchelmore Sep 2013

Hope And Burnout Among Clinicians Who Work With Children At Risk Of Abuse, Neglect, Or Exploitation, Jonathan G. Mitchelmore

Theses, Dissertations, and Projects

This research study was a quantitative, exploratory investigation of the relationship between hope and burnout among clinicians who work on cases involving children at risk of abuse, neglect, or exploitation. An electronic questionnaire, featuring the Maslach Burnout Inventory – Human Services Survey (MBI-HSS) and the Hope Trait Scale, was administered anonymously to 74 social workers currently practicing in the United States. The major areas of inquiry included levels of hope and levels of burnout. Demographic characteristics of the participants were correlated with their reported levels of hope and burnout. Participants had higher-than-average scores on the Hope Trait Scale, and lower-than-average …


Heart Work : Meaning Making, Rft Workers, And Physical Restraints : A Project Based Upon An Investigation Of Residential Treatment Facility Workers' Meaning Making Processes In Regards To The Utilization Of Physical Restraints As Interventions, Ruth A. Muellejans Sep 2013

Heart Work : Meaning Making, Rft Workers, And Physical Restraints : A Project Based Upon An Investigation Of Residential Treatment Facility Workers' Meaning Making Processes In Regards To The Utilization Of Physical Restraints As Interventions, Ruth A. Muellejans

Theses, Dissertations, and Projects

The purpose of this study was to explore the individual experiences of Residential Treatment Facility (RTF) workers utilizing physical restraints as an intervention with children, specifically looking at potential impact of these experiences, as well as the subsequent meaning making process. This exploratory study employed phenomenological qualitative methods of in-depth interviewing with six participants, creating a space through which these individuals were able to share their personal and collective narratives of working in RTFs. The data gathered through the phenomenological interview process displayed five salient and unanimous themes amongst the participants: the significance of their motivation for becoming a RTF …


What Happens When The Body Matters? : An Exploration Of Corporeal Textualities In The Life And Work Of Two White South African Authors And Its Implications For Clinical Social Work Practice, Asher Pandjiris Sep 2013

What Happens When The Body Matters? : An Exploration Of Corporeal Textualities In The Life And Work Of Two White South African Authors And Its Implications For Clinical Social Work Practice, Asher Pandjiris

Theses, Dissertations, and Projects

This project explores intergenerational transmission of trauma as evidenced in the body. Specifically, I focus attention on the somatic experiences of two white South African women, one historical/biographical and one fictional/contemporary, to elaborate the legacy of white colonial psychic disavowals in post-colonial South Africa. Using feminist and relational psychodynamic theories, this project addresses the alexithymia of the colonial predicament via an assertion that unwitnessed somatic distress as a result of disavowed trauma in individuals is potentially transmitted to subsequent generations and requires nuanced clinical attention. Additionally, this project argues that interrupting the intergenerational transmission of collective traumas such as colonialism …


Listening To Women's Voices : Clinicians' Perspectives On The Benefits Of Feminist Therapy In The Treatment Of Borderline Personality Disorder, Abigail W. Moore Sep 2013

Listening To Women's Voices : Clinicians' Perspectives On The Benefits Of Feminist Therapy In The Treatment Of Borderline Personality Disorder, Abigail W. Moore

Theses, Dissertations, and Projects

This qualitative, exploratory study examines the perspectives of practicing feminist therapists about the benefits of utilizing feminist therapy for the treatment of Borderline Personality Disorder (BPD). Twelve licensed clinicians were interviewed about their clinical experiences and perceptions of the benefits of feminist therapy in treating clients diagnosed with BPD. Clinicians discussed the theory and implementation of feminist therapy; how feminist therapists understand BPD in light of current debates on the use of this diagnosis; and the unique benefits feminist therapy may offer in the treatment of BPD. Participants were asked to give their reactions to the BPD diagnosis and the …


Hiv/Aids Serostatus Disclosure And Stigma In Asian And Pacific Islander Women : A Call For Intersectionality In The Treatment Of Depression, Andrea L. Mize Sep 2013

Hiv/Aids Serostatus Disclosure And Stigma In Asian And Pacific Islander Women : A Call For Intersectionality In The Treatment Of Depression, Andrea L. Mize

Theses, Dissertations, and Projects

In the United States the prevalence and incidence rates of Asian and Pacific Islander (AandPI) women with HIV/AIDS is increasing. As many as 1 in 3 may not know they are HIV positive. Existing literature using stigma theory revealed that AandPI HIV positive women can experience both positive and negative mental health effects from HIV serostatus disclosure. These findings are an important mental health issue as HIV serostatus disclosure has traditionally been encouraged for the benefit of those diagnosed and their kinship networks. The present study seeks to examine the correlation found in previous research between disclosure or nondisclosure of …


More Than Just An Exchange : How Does Access To Syringe Exchange Impact Actively Using Participants' Emotional Well-Being, Melissa A. Morelli Sep 2013

More Than Just An Exchange : How Does Access To Syringe Exchange Impact Actively Using Participants' Emotional Well-Being, Melissa A. Morelli

Theses, Dissertations, and Projects

This qualitative, exploratory study examines how accessing Syringe Access Services (SAS) directly impacts program participants' emotional well-being. The purpose of this research is to give voice to individuals who utilize SAS services; to gain personal and valuable information about the nature of the participant; and to reveal the emotional and mental health outcomes linked with SEP's. Twelve individuals who have been program participants of SAS for over a year were interviewed for this study. Participants were interviewed indoors at one of the SAS's fixed needle exchange sites in the Bay Area. In-person semi-structured interview questions elicited participants' experience with various …


The Role Of Trauma In Hoarding : A Project Investigating The Role Of Trauma In The Expression Of Hoarding Disease As Well As Features Associated With Hoarding, Hannah L. Mills Sep 2013

The Role Of Trauma In Hoarding : A Project Investigating The Role Of Trauma In The Expression Of Hoarding Disease As Well As Features Associated With Hoarding, Hannah L. Mills

Theses, Dissertations, and Projects

Hoarding Disorder (HD) is characterized by a difficulty discarding possessions and leads to the accumulation of clutter, causing marked distress and impairment (Mataix-Cols, et al., 2010). HD has been an increasing area of research and public interest, though little is known about how it develops or factors that influence its expression (Mataiz-Cols, Fernandes de la Cruz, Nakoa, and Pertusa, 2011; Frost, Steketee, and Tolin, 2011). High frequency of trauma among people with hoarding behavior has been reported (Saxena et al. 2011; Cromer, Schmidt, and Murphy, 2007; Hartl, Duffany, Allen, Steketee, and Frost, 2005), but none have examined it in detail. …


Ki Moun Mwen Ye? : Who Am I? : Factors Associated With Cultural Identity Formation In First Generation Haitian Americans, Joan V. Monplaisir Sep 2013

Ki Moun Mwen Ye? : Who Am I? : Factors Associated With Cultural Identity Formation In First Generation Haitian Americans, Joan V. Monplaisir

Theses, Dissertations, and Projects

This qualitative study explores the factors associated with cultural identity formation among first generation Haitian Americans (FGHA) born in the United States between 1975 and 1990. The purpose of this study is to inform clinical social work practice with immigrants and their families in a range of areas including the experience of cultural identity development and the process and effects of acculturation in the U.S. Audiotaped in-person and telephone semi-structured interviews elicited participant perceptions of, and connection to, a range of aspects of Haitian culture. Participants' experience of dominant U.S. cultural views of Haiti and the Haitian people, understanding of …


An Exploratory Study On White Empathy And Cross-Racial Experiences In The Virtual World, Caitlyn I. Keckeissen Sep 2013

An Exploratory Study On White Empathy And Cross-Racial Experiences In The Virtual World, Caitlyn I. Keckeissen

Theses, Dissertations, and Projects

This mixed-methods, exploratory study was conducted to investigate two areas of inquiry: (1) whether the experience of playing SecondLife™ as an avatar of color had an impact on White-identified Americans' beliefs and values about race and racism; and (2) what participants identified as relevant to their process of developing empathy for people of color and acknowledgment of racism. Seven self-identified White adult Americans completed pre- and post-experiment measures of colorblind and symbolic racism as well as 6 non-consecutive hours over the course of one month, and then participated in a qualitative interview to reflect on the process. The study investigator …


"90% Catholic 100% Vodou" : Haitian Immigrant Religious And Spiritual Identity, Cindy L. Lys Sep 2013

"90% Catholic 100% Vodou" : Haitian Immigrant Religious And Spiritual Identity, Cindy L. Lys

Theses, Dissertations, and Projects

This cross-sectional exploratory qualitative study highlights the religious/spiritual identity of twelve adult Haitian American immigrants from the Chicago area and New York City using non-probability snowball sampling and a semi-structured interview with open-ended questions. The primary research question was: How have the religious/spiritual identities of Haitians evolved since their immigration to the United States? Subsumed under the primary question was the following: How did adult Haitian immigrants in the United States identify religiously and/or spiritually? How had their religious/spiritual identity changed since their immigration to the United States? How did their religious/spiritual identity affect how they cope with times of …


The Long Term Effects Of Racial Socialization Of African American Sons Through Communication Patterns From Their Mothers, Jacqueline A. Johnson Sep 2013

The Long Term Effects Of Racial Socialization Of African American Sons Through Communication Patterns From Their Mothers, Jacqueline A. Johnson

Theses, Dissertations, and Projects

This study explored the long-term effects of racial socialization patterns from African American mothers to their sons to discover whether they are enhancing or impeding the wellbeing the African American males. While several distinct socialization types emerge throughout the literature with egalitarian, and barrier socialization messages predominating, the measures have focused primarily on the effects of racial socialization on academic performance. This qualitative study attempted to illuminate a gap in the literature: the long-term effects of mother to son racial socialization messages as evidenced by the limited research examining the later life experiences of adult African American men. The results …


Experiences Of Caregivers For Relatives With A Chronic Severe Mental Illness : Riding The Roller Coaster : A Descriptive Study, Diana E. Mark Sep 2013

Experiences Of Caregivers For Relatives With A Chronic Severe Mental Illness : Riding The Roller Coaster : A Descriptive Study, Diana E. Mark

Theses, Dissertations, and Projects

This qualitative study explored the experiences of caregivers to a mentally ill family member, focusing on the needs and problems they face. The demands for families to act as caregivers to their psychiatrically ill relatives have increased; their involvement has reduced relapse rates. Understanding caretakers' perspectives in fulfilling this vital role was a goal of this study. Twelve one hour interviews were held with fourteen caregivers who were actively involved with NAMI, Rhode Island. The relatives they cared for had been diagnosed with schizophrenia, schizoaffective disorder and bipolar disorder. Open-ended questions enabled participants to provide descriptive accounts of their caregiving …


Successful Leadership In Social Work : Leadership Characteristics To Accomplish A Paradigm Shift In Services, Jacqueline M. Kinsley Sep 2013

Successful Leadership In Social Work : Leadership Characteristics To Accomplish A Paradigm Shift In Services, Jacqueline M. Kinsley

Theses, Dissertations, and Projects

The implementation of the Children's Behavior Health Initiative (CBHI) as the U.S. Court ordered resolution of the landmark decision of the class action commonly known as Rosie D. v. Romney is an opportunity to examine a radical change to the delivery of mental health care for children and the construction of a whole new delivery system on a state-wide basis (Center for Public Representation, 2012). What were the leadership characteristics of and the key decisions made by those who successfully created Community Service Agencies (CSAs) to accomplish the delivery of such a paradigm shift in services? Executives, program directors/managers, and …


Secure Attachments And How They Promote Resilience In Children Of Alcoholics, Sheena A. Mahoney Sep 2013

Secure Attachments And How They Promote Resilience In Children Of Alcoholics, Sheena A. Mahoney

Theses, Dissertations, and Projects

Children of alcoholics (COAs) experience risk factors including difficulties in school, behavioral issues, psychological distress, and the potential to become a substance abuser themselves. However, there is also research to support that not all COAs experience negative outcomes as a result of their alcoholic parent's influence. This qualitative study sought to explore whether positive attachments promote resilience in COAs from the perspective of COAs themselves. Semi-structured interviews were conducted with nine participants who were COAs and could identify a positive attachment relationship from the time period when they lived with their alcoholic parent(s). The major finding of this study was …


Professional Experience, Motivation And Preparedness For Practice With Older Adults : Implications For The Msw Curriculum, Nicole M. Loux Sep 2013

Professional Experience, Motivation And Preparedness For Practice With Older Adults : Implications For The Msw Curriculum, Nicole M. Loux

Theses, Dissertations, and Projects

This quantitative study explores Smith College School for Social Work (SCSSW) Master of Social Work (MSW) alumni perceptions of the SCSSW curriculum in the area of agingrelated practice, and the contribution of their educational experience to their preparedness, motivation, and decision to work with older adults. SCSSW MSW alumni from the years 2007 to 2011 (N = 77) comprised the study sample. The 50-item online survey, including two openended questions, was emailed to participants based on contact information they had provided to the alumni office of the School. Questions included original items developed by the author of this study and …


Expressive Writing As An Adjunct To Talk Therapy : Considerations For A Creative Intervention For Depressive Disorders, Anna C. Hogeland Sep 2013

Expressive Writing As An Adjunct To Talk Therapy : Considerations For A Creative Intervention For Depressive Disorders, Anna C. Hogeland

Theses, Dissertations, and Projects

This theoretical thesis offers considerations for expressive writing as an adjunct to talk therapy, particularly for adults with depressive disorders and ruminative thoughts. This thesis asks: how do theories and empirical studies inform the use of expressive writing as an adjunct to talk therapy in adults with depressive disorders to decrease ruminations, and how can clinicians integrate this treatment intervention into practice? The primary aims of this thesis are to expand upon the limited knowledge about the therapeutic effects of expressive writing, to offer direction for further research, and to propose a model for the implementation of expressive writing into …


Social Workers Who Become Life Coaches : What Does The Social Work Field Have To Learn, Alexandra A. Jost Sep 2013

Social Workers Who Become Life Coaches : What Does The Social Work Field Have To Learn, Alexandra A. Jost

Theses, Dissertations, and Projects

This exploratory, qualitative study of social worker/coach practitioners elucidates themes about what motivates social workers to become coaches, how they integrate these roles in practice, and how this integration impacts their social work identity, adherence to professional ethics, and the types of clients they serve. The sample of 14 participants was recruited through professional listserves, social media, and a snowball technique. Key findings include that participants who integrated the role of coaching into their practices were able to connect more closely to a strengths-based and client-centered approach, feel more authentic and empowered, and make use of training in both disciplines …


Attempting Whiteness : Black Women's Expected And Actual Results Of Skin Bleaching, Alcia C. Jackson Sep 2013

Attempting Whiteness : Black Women's Expected And Actual Results Of Skin Bleaching, Alcia C. Jackson

Theses, Dissertations, and Projects

This qualitative study was aimed at exploring skin bleaching among black women. The study addressed women's motives, expected results of the process, actual results and whether or not the expected and actual results were similar. Nine black women, from varying ethnic backgrounds were asked a series of questions that addressed the above aims, but also sought to gain information on their process of skin bleaching. A total of 16 questions were asked over a 30-45 minute timeframe. Major findings from the study indicated that a desire to become light skinned and to remove facial imperfection were the two most common …


An Examination Of The Relationship Between Exposure To Violence In The Home And Attachment Characteristics Among Youth With Sexually Harmful Bahaviors, Talia J. Jackson Sep 2013

An Examination Of The Relationship Between Exposure To Violence In The Home And Attachment Characteristics Among Youth With Sexually Harmful Bahaviors, Talia J. Jackson

Theses, Dissertations, and Projects

The aim of this study was to investigate the relationship between exposure to violence in the home and attachment characteristics in youth with sexually harmful behaviors. In this study the following was investigated: whether maternal/paternal attachment plays a mediating role in the relationship between exposure to violence in the home (both experienced and witnessed) and adolescent sexual/non-sexual offending. The sample size was 296 male youth with sexually harmful behaviors placed in six residential treatment facilities. Four mediation models were used to examine attachment and exposure to violence in the home in youth with sexually harmful behaviors. Results showed no support …


"What Are You, Anyway?" : How Parents Help Their Multiracial Children Live In A World Of Singular Racial Categories, Chloe A. Jhangiani Sep 2013

"What Are You, Anyway?" : How Parents Help Their Multiracial Children Live In A World Of Singular Racial Categories, Chloe A. Jhangiani

Theses, Dissertations, and Projects

The growing numbers and visibility of multiracial individuals in the United States necessitate that social workers, parents, and researchers understand the unique strengths and stressors multiracial individuals face. This study qualitative study explored the ways in which parents racially socialized their multiracial children. Fifty-three multiracial adults completed online surveys about their childhood experiences with racism, monoracism and racial socialization. Participants wrote about how their parents handled racial socialization (or how they did not) in a variety of ways: by embracing racial stereotypes, denying the existence of race and racism, giving general pride but no discussion of race, teaching about racism, …


Stigma, Race And Mental Illness : African-American Clinicians' Perceptions Of How These Factors Influence Help-Seeking Behaviors In African Americans, Rabi'ah S. Jamar Sep 2013

Stigma, Race And Mental Illness : African-American Clinicians' Perceptions Of How These Factors Influence Help-Seeking Behaviors In African Americans, Rabi'ah S. Jamar

Theses, Dissertations, and Projects

This qualitative study explored the stigma of mental illness within the African American community from the perspective of African American clinicians. Nine clinicians were interviewed and were asked to discuss personal messages received about mental illness within their family, community, and religious organizations. They also shared their perceptions of African American attitudes, based upon client interactions, towards mental illness and whether a change has occurred within the past 5-10 years; identifiable stigmas within the African American community; inhibitors to help-seeking behaviors; variables that influences help-seeking behaviors; and their recommendations for improving African Americans' comfort with disclosure within the therapeutic setting. …