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Exploring Counselor Perspectives On The Role Of Ecotherapy In Mental Health Treatment: A Qualitative Study, Kimberly Seid
Exploring Counselor Perspectives On The Role Of Ecotherapy In Mental Health Treatment: A Qualitative Study, Kimberly Seid
Walden Dissertations and Doctoral Studies
This grounded qualitative study explored the common themes of ecotherapy in practice. The research problem was the limited understanding of how counselors implement ecotherapy in clinical practice, hindering the field’s ability to fully integrate nature-based approaches into mental health treatment. The purpose of this grounded theory study was to explore counselor perspectives on ecotherapy using the biophilia hypothesis and Swarbrick’s wellness model. The research questions focused on how licensed mental health counselors understood, implemented, and evaluated the impact of ecotherapy. Qualitative data were collected through an online survey with open-ended questions from 15 licensed counselors across the United States who …
The Stress Parents Face When Their Autistic Child Turns 21, Everetta Joyce Irene Davis
The Stress Parents Face When Their Autistic Child Turns 21, Everetta Joyce Irene Davis
Walden Dissertations and Doctoral Studies
This exploratory study examined the lived experiences of parents whose autistic children turned 21 and aged out school and services provided by the federally funded Free Appropriate Public Education (FAPE) program. Although researchers have conducted numerous studies on autism, limited research has focused specifically on the stress parents face when their autistic child turns 21 and loses access to FAPE. The purpose of this qualitative narrative inquiry was to gain a deeper understanding of the emotional, logistical, and systemic challenges these parents encountered during the transition out of high school. Family Systems Theory provided the conceptual framework for exploring these …
Staff Education To Reduce Relapse Rates Among Individuals With Substance Use Disorders, Joyce Chioma Nwakor
Staff Education To Reduce Relapse Rates Among Individuals With Substance Use Disorders, Joyce Chioma Nwakor
Walden Dissertations and Doctoral Studies
The program created a more encouraging recovery environment by greatly increasing staff competency in relapse prevention. Staff reported having more conversations with patients about preventing relapses. These enhancements might result in lower relapse rates and better long-term recovery outcomes.
The Lived Experience Of U.S. Law Enforcement Officers And The Challenges They Face While Investigating Sexual Assault Victim Reports, Ariekan Josephs-Greene
The Lived Experience Of U.S. Law Enforcement Officers And The Challenges They Face While Investigating Sexual Assault Victim Reports, Ariekan Josephs-Greene
Walden Dissertations and Doctoral Studies
Sexual assault is a pervasively dangerous crime affecting persons of all ages, races, and genders, both in the United States and globally. Essential in the safeguarding of American citizens, U.S. law enforcement officers are among the first responders on scene to investigate reports of sexual assault claims. However, echoed in previous research are the sentiments of victim-survivors who experienced negative encounters with officers who exhibited an implicit lack of victim-centered training and were dismissive in their investigative approach. Consequently, this gap in the literature requires exploration; therefore, this study focuses on the lived experiences of U.S. law enforcement officers and …
Staff Education To Improve Primary Care Providers’ Knowledge And Confidence In Utilizing The Phq-9 For Routine Mental Health Screenings, Debra Ann Stewart-Delancy
Staff Education To Improve Primary Care Providers’ Knowledge And Confidence In Utilizing The Phq-9 For Routine Mental Health Screenings, Debra Ann Stewart-Delancy
Walden Dissertations and Doctoral Studies
Summary The ineffective use of the PHQ-9 tool to assess depression during primary care was the problem that this quality improvement project aimed to resolve, which is a hindrance to timely diagnosis and equitable behavioral health care. Inconsistent use of screening of depression was tackled in the project. The treatment and detection of it at its early stages were constrained by gaps in provider knowledge and confidence. The project assessed the effect of a formal staff educational intervention to increase knowledge, confidence, and the probability of incorporating the PHQ-9 depression screening tool into the workflow of a primary care clinic. …
Community-Based Counselors’ Preparedness For Providing Trauma-Informed Care, Lashaunda Smith
Community-Based Counselors’ Preparedness For Providing Trauma-Informed Care, Lashaunda Smith
Walden Dissertations and Doctoral Studies
This constructivist grounded theory study examined how community-based mental health counselors perceive their preparedness to provide trauma-informed care. Guided by Charmaz’s constructivist grounded theory, semistructured interviews were analyzed through coding and constant comparison to co-construct meaning around counselors’ lived experiences. This study explored how counselors define, develop, and sustain preparedness for trauma-informed care. The purpose was to generate an interpretive understanding of how counselors constructed meaning around their preparedness, including how training, supervision, and professional experiences shaped their ability to serve trauma-affected clients. Participants included 12 master’s-level licensed and pre-licensed community-based mental health counselors with experience serving trauma-affected clients. Findings …
Deprescription Of Benzodiazepine, Oji Gibson
Deprescription Of Benzodiazepine, Oji Gibson
Walden Dissertations and Doctoral Studies
Background: Benzodiazepines are commonly prescribed for anxiety disorders; however, long-term use increases risks of dependence, cognitive impairment, falls, and overdose. Despite established guidelines recommending time-limited use, inappropriate chronic prescribing remains prevalent in primary care. Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to develop and implement an evidence-based clinical practice guideline (CPG) to reduce benzodiazepine overprescribing for adults with anxiety disorders in a primary care setting. The goal was to improve prescriber adherence to current best practices and promote patient safety. Methods: This quality improvement project utilized the Johns Hopkins Evidence-Based Practice Model to guide development, …
How Law Enforcement Officers’ Perceived Public And Self-Stigma Predicts Their Willingness To Seek Mental Health Services, Elizabeth Mae Mooney
How Law Enforcement Officers’ Perceived Public And Self-Stigma Predicts Their Willingness To Seek Mental Health Services, Elizabeth Mae Mooney
Walden Dissertations and Doctoral Studies
The work of previous researchers has shown officers to have higher rates of depression, posttraumatic stress disorder (PTSD), generalized anxiety, and suicidality than the public, and a lower rate of mental health service-seeking. Stigma, both public and self-stigma, has been revealed by previous researchers to be the predominant barrier that deters officers from seeking out needed and/or desired services. A gap in research existed in examining alternative service types, and whether law enforcement officers perceived these service types as more or less stigmatizing than traditional methods. This study employed a quantitative research design to predict the probability that law enforcement …
Understanding The Barriers And Challenges Of Spanish-Speaking Latinos Who Received Calaim Initiative Social Support Services, Jessica De Lara Vallejo
Understanding The Barriers And Challenges Of Spanish-Speaking Latinos Who Received Calaim Initiative Social Support Services, Jessica De Lara Vallejo
Walden Dissertations and Doctoral Studies
Spanish-speaking Latinos continue to face significant barriers when attempting to access social support services through healthcare initiatives such as California Advancing and Innovating Medi-Cal (CalAIM). Despite previous efforts to address this issue, this population continues to encounter barriers such as systemic discrimination, language barriers, and limited access to culturally responsive care. This qualitative study was guided by the consolidated framework for implementation research and used an interpretative phenomenological analysis approach to explore the lived experiences of Spanish-speaking Latino parents whose children received CalAIM asthma home remediation (AHR) services. The purpose of this study was to understand the barriers and challenges …
Effect Of Workplace Diversity, Equity, And Inclusion Programs On Black Women Leaders At Nonprofit National Associations Of Regulatory Boards, Staci Mason
Walden Dissertations and Doctoral Studies
Research has shown that due to their intersecting identities, Black women must contend with both racism and sexism in the workplace, resulting in oppressive work environments and limited access to career advancement. Studies also highlighted Black women’s disillusionment with workplace diversity, equity, and inclusion (DEI) programming and its role in addressing these negative impacts. However, these issues have not been studied through the perceptions of Black women leaders at national associations of regulatory boards. The purpose of this generic qualitative study was to examine perceptions of these Black women regarding the impact of DEI programs on their career. Using Benet’s …
The Impact Of Microaggression Exposure On Emotional Reactivity And Distress Following An Emotionally Provocative Movie Scene, Gwendolyn Jefferson
The Impact Of Microaggression Exposure On Emotional Reactivity And Distress Following An Emotionally Provocative Movie Scene, Gwendolyn Jefferson
Walden Dissertations and Doctoral Studies
This quantitative study explored how past experiences with racial microaggressions affect emotional reactions to racially charged media and whether factors like age and gender influence that response. Using Minority Stress Theory as a guide, 183 African American adults completed the Racial and Ethnic Microaggressions Scale and the State-Trait Anxiety Inventory before and after watching a racially provocative film clip. The first analysis found no direct link between microaggression exposure and emotional change. However, further testing with analysis of variance showed that people with higher exposure reported much stronger emotional distress than those with lower exposure, F(1,180) = 38.12, p < .001, η² = .175. When demographic factors were added in a hierarchical regression, the model became significant, F(7,175) = 2.06, p = .036, R² = .076, showing that age (β = .086, p = .009) and gender (β = 1.505, p = .039) influenced emotional responses. Thus, older African American women showed the strongest distress, suggesting that the combined effects of race, gender, and age increase vulnerability to racial stress. These findings support the idea that racial trauma is complex and shaped by overlapping social identities. The study highlights the need for culturally sensitive mental health support, inclusive media portrayals, and greater awareness of generational and caregiving stress among African American women. By showing how overlapping identities shape emotional well-being, this research advances social change through empathy, reduced stigma, and institutional accountability, encouraging equity-driven practices that foster racial healing, fairness, and psychological resilience across communities.
Perspectives Of Therapists Treating First Responders On The Role Of Peer Support In Psychological Recovery And Development Of Ptsd Symptoms, Audrey Ramos
Walden Dissertations and Doctoral Studies
First responders face an increased risk of posttraumatic stress disorder (PTSD) due to repeated exposure to traumatic events. While traditional treatments like cognitive-behavioral therapy and medication remain standard, peer support has become a supplementary strategy. However, limited research has investigated how licensed therapists view the role of peer support in clinical care. Therapists’ perspectives on the effectiveness, limitations, and integration of peer support in first responder PTSD recovery were explored in this qualitative, phenomenological study. Guided by Lazarus and Folkman’s transactional model of stress and coping and Masten’s resilience theory, how peer support serves as both a coping mechanism and …
Patient Safety In Ambulatory Hysteroscopy, Myko Lanier
Patient Safety In Ambulatory Hysteroscopy, Myko Lanier
Walden Dissertations and Doctoral Studies
NA
Perceptions Of Academic Success Among African American Male High School Graduates In Urban Areas, Anthony Bourne
Perceptions Of Academic Success Among African American Male High School Graduates In Urban Areas, Anthony Bourne
Walden Dissertations and Doctoral Studies
African American males encounter more severe penalties, academic under-performance, and lower graduation rates compared to their Caucasian male counterparts. Numerous studies have delved into and elucidated the schooling experiences of African American male students from various perspectives, encompassing cultural, structural, racial, community, family, and school viewpoints. However, there remains a scarcity of voices documenting the experiences of African American males who have successfully completed high school in urban settings. The purpose of this descriptive qualitative study was to examine the schooling experiences of African American males who graduated from high schools located in urban settings. The Critical Race Theory and …
Improving Retention Of Newly Hired Nurses In Home Care, Chidi D. Ihezue
Improving Retention Of Newly Hired Nurses In Home Care, Chidi D. Ihezue
Walden Dissertations and Doctoral Studies
In the home care setting, there is an increasing need for home care services due to aging populations and the rising prevalence of chronic diseases, as well as a scarcity of qualified home care staff to meet the health needs of patients in this setting. A home care agency's onboarding program, particularly its capacity to deliver comprehensive orientation and robust mentoring for new nurses, plays a crucial role in supporting the retention of newly employed nursing staff within the home care environment. Research indicates that without ongoing support and close monitoring, newly hired nurses may disengage during the onboarding and …
Stress First Aid Implementation To Address Stress Among Acute Care Nurses, Obioma Maryann Asiegbu
Stress First Aid Implementation To Address Stress Among Acute Care Nurses, Obioma Maryann Asiegbu
Walden Dissertations and Doctoral Studies
Acute care nurses face persistent occupational stress that contributes to burnout, anxiety, depression, and high turnover rates within healthcare systems. The Stress First Aid (SFA) framework offers a proactive, evidence-based approach to identifying and managing psychological distress among healthcare workers. The purpose of this Doctor of Nursing Practice project was to implement and evaluate the SFA program as a structured, early-intervention model to improve nurse well-being, retention, and patient care outcomes in an acute care setting. Guided by the Stress Continuum Model and organizational change theory, this project emphasized early recognition of stress, peer support mechanisms, and continuous outcome monitoring. …
Examining Social Workers’ Perceptions Of Collaborating With Police Officers To Foster Community Trust In Oklahoma, Lashonda Lanette Dale
Examining Social Workers’ Perceptions Of Collaborating With Police Officers To Foster Community Trust In Oklahoma, Lashonda Lanette Dale
Walden Dissertations and Doctoral Studies
The current study was administered in order to examine Oklahoman social workers’ perception of collaborating with police officers to foster community trust. The goal was to determine whether the collaboration amongst social and police officer fostered trust when collaborating during services calls. The theory of planned behavior and policing (TPBP) studied by Ishoy and giving credit to Ajzen’s were the foundational theory used to support this study. Collaboration among social workers and police officers can foster community trust and benefit both parties. Such collaboration could also lead to joint training and education, as well as alleviating public fears and misconceptions. …
Staff Education To Improve Phq-9 Depression Screening And Management In Primary Care, Elizabeth Ezeamaka
Staff Education To Improve Phq-9 Depression Screening And Management In Primary Care, Elizabeth Ezeamaka
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice staff education project aimed to improve staff knowledge and enhance the consistency in administering and interpreting the Patient Health Questionnaire-9 (PHQ-9) within a mental health clinical setting. The practice problem was significant because variability in PHQ-9 use resulted in unreliable depression screening data, potentially leading to missed detection of depression or suicidal ideation, which undermines patient safety and quality of care. The guiding practice-focused question was: Among healthcare staff administering the PHQ-9, what effect does an educational program have on their knowledge related to the administration, documentation, and interpretation of depression screening? The purpose of …
Improving Hiring Processes In Manufacturing: Hiring Strategies To Support Well-Being And Organizational Effectiveness, Timothy J. Winn
Improving Hiring Processes In Manufacturing: Hiring Strategies To Support Well-Being And Organizational Effectiveness, Timothy J. Winn
Walden Dissertations and Doctoral Studies
Delays and inefficiencies in the hiring process can significantly hinder production and create instability within the manufacturing workforce. This, in turn, has a negative effect on employee well-being and the overall effectiveness of the organization. The purpose of this qualitative research project, grounded in the Job Demands-Resources model, was to explore successful strategies hiring managers use to address hiring inefficiencies. The study was guided by a pragmatic inquiry design and included semistructured interviews with six hiring managers in the manufacturing sector who held responsibilities related to hiring. Data were analyzed using thematic analysis following Braun and Clarke’s six-step framework. Data …
Optimizing Urgent Care Workflow To Improve Wait Times For Patients, Keanna A. Evans
Optimizing Urgent Care Workflow To Improve Wait Times For Patients, Keanna A. Evans
Walden Dissertations and Doctoral Studies
Leaders in urgent care centers across the United States continue to face challenges with patient flow, long wait times, and inconsistent staffing. The purpose of this integrative review was to explore strategies that help improve workflow efficiency and reduce wait times in urgent care settings. The review question pertained to strategies and best practices that could be implemented to improve patient flow management in urgent care centers. This study was guided by general systems theory, which views urgent care as a connected system where people, processes, and technology work together to influence outcomes. A review of literature published within the …
Employee Perception Of Administrator Leadership Behaviors In Southeastern U.S. Hospitals That May Contribute To Employee Turnover, Kim Steele
Walden Dissertations and Doctoral Studies
Given the increasing significance of employee turnover, administrative leadership in U.S. Southeastern hospitals stands at a critical turning point. The specific research problem is that leadership behaviors may create an intolerable environment for employees, leading to an intent to leave and turnover. The purpose of this descriptive phenomenological study was to explore administrative leadership behaviors that contribute to employee turnover, with a specific focus on leadership behaviors in U.S. Southeastern hospitals. The conceptual framework included grounded theory, which examines underlying social processes, and behavioral theory, focusing on leadership practices and behavior change. Fifteen administrative employees, four men and 11 women, …
Intimate Partner Violence: Serving Heterosexual Male And Same-Sex Victims, David Welch
Intimate Partner Violence: Serving Heterosexual Male And Same-Sex Victims, David Welch
Walden Dissertations and Doctoral Studies
Intimate partner violence (IPV) is an ongoing social problem across nationalities, cultures, socioeconomic statuses, sexual orientations, and genders. Historically, research into IPV has focused on the heterosexual female victim and male perpetrator paradigm, including identifying the root causes of this phenomenon and appropriate treatment models. There is a distinct gap in the current literature addressing how therapists in the psychological community approach working with heterosexual male and same-sex victims of IPV, beginning with case conceptualization. To explore the unique case conceptualization considerations of therapists as they encounter heterosexual male and same-sex IPV victims in their practice, a general phenomenological research …
Improving Healthcare Providers’ Knowledge On Heart Failure Self-Care Management, Linda Nkeiruka Ukwu
Improving Healthcare Providers’ Knowledge On Heart Failure Self-Care Management, Linda Nkeiruka Ukwu
Walden Dissertations and Doctoral Studies
N/A
Strategies To Reduce Emergency Department Overcrowding At Hospitals In Puerto Rico, Nicole Melissa Rivera Sánchez
Strategies To Reduce Emergency Department Overcrowding At Hospitals In Puerto Rico, Nicole Melissa Rivera Sánchez
Walden Dissertations and Doctoral Studies
Emergency department (ED) overcrowding has become an increasingly critical issue for the healthcare system of Puerto Rico, resulting in delayed care and increased patient morbidity, among other challenges faced by hospital leaders and administrators. This paper explores evidence-based strategies tailored to the Puerto Rican healthcare context to alleviate ED overcrowding. An integrative review of literature published between 2020 and 2025 was conducted. For this review, 15 articles were selected and appraised using the Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals. The strategies gleaned from the literature comprised six themes and 21 subthemes, centered on two major outcomes: …
Implementing A System- Wide Program To Reduce Burnout Among Healthcare Providers, Caroline Njeri Munene
Implementing A System- Wide Program To Reduce Burnout Among Healthcare Providers, Caroline Njeri Munene
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) project addresses the pervasive health issue of burnout among healthcare providers, focusing on a community mental health clinic where internal data revealed high levels of staff turnover, absenteeism, medication errors, financial constraints, poor patient outcomes, and low staff satisfaction. Shortage of healthcare providers, exposure to patient trauma, high emotional demands, and administrative burdens are the systemic stressors of burnout at the project site mental health facility. These factors collectively underscored the need for a system-wide burnout reduction program to safeguard provider well-being and ensure the delivery of high-quality patient care and safety.
Staff Education To Improve Staff Knowledge On Self-Care Management Of Hypertension, Zainab Kebbie Turay
Staff Education To Improve Staff Knowledge On Self-Care Management Of Hypertension, Zainab Kebbie Turay
Walden Dissertations and Doctoral Studies
Summary This DNP staff education project focused on improving staff knowledge on self-care management of hypertension. The overarching patient care problem at the project site was uncontrolled hypertension among adult patients with lack of staff knowledge and confidence in delivering related patient education. Addressing uncontrolled hypertension is vital within nursing practice due to its impact on public health and the opportunity for a nurse-led evidence-based intervention to improve patient outcomes. The practice-focused question for this project was: “In adults with uncontrolled hypertension, does staff education program on hypertension self-care management improve staff knowledge on how to educate patients on self-care …
Staff Education To Enhance Nurse Practitioner Competency In The Identification And Management Of Generalized Anxiety Disorder In An Outpatient Clinic, Obioma Linda Okeke
Staff Education To Enhance Nurse Practitioner Competency In The Identification And Management Of Generalized Anxiety Disorder In An Outpatient Clinic, Obioma Linda Okeke
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) staff education project was a quality improvement initiative focused on enhancing nurse practitioners’ (NPs’) competency in the identification and management of generalized anxiety disorder (GAD). The practice problem identified at the local project site through organizational feedback and observation was the inconsistent use of the Generalized Anxiety Disorder-7 (GAD-7) screening tool across NP encounters. The practice-focused question for this project was: In NPs in an outpatient clinic setting, how does staff education on GAD-7 and clinical guidelines influence their knowledge, confidence, and consistent use of anxiety screening practices? The purpose of this doctoral project …
Evaluating The Compliance Of A Patient-Centered Daily Care Plan In An Acute Care Setting, Abigale Tzu
Evaluating The Compliance Of A Patient-Centered Daily Care Plan In An Acute Care Setting, Abigale Tzu
Walden Dissertations and Doctoral Studies
This Doctor of Nursing Practice (DNP) quality improvement evaluation project addressed inconsistent use of the Patient-Centered Daily Care Plan at a local acute care hospital. The problem was a gap in compliance with California Title 22 requirements, creating risk for survey deficiencies and limiting interdisciplinary communication. The purpose of this project was to evaluate whether the revised daily care plan improved individualized documentation and organizational compliance. De-identified aggregate data from pre-implementation (August–October 2023) and post-implementation (June–August 2024) periods were analyzed descriptively. Results showed a meaningful improvement in checklist completion, with compliance increasing from 94.8% to 97.3%. These findings demonstrated stronger …
Executive Summary: Quality Improvement Initiative Enhancing Early Identification Of Adolescent Depression And Anxiety, Delphine Sirri
Executive Summary: Quality Improvement Initiative Enhancing Early Identification Of Adolescent Depression And Anxiety, Delphine Sirri
Walden Dissertations and Doctoral Studies
Universal staff training to increase the validity and reliability of adolescent mental health screening was implemented in this quality improvement (QI) initiative. Depression and anxiety disorders often emerge between ages 12 and 17, yet evidence-based screening measures such as the Patient Health Questionnaire (PHQ-9/PHQ-9M) and Generalized Anxiety Disorder (GAD-7) are underutilized due to provider knowledge gaps, workflow inefficiencies, and cultural barriers. Guided by the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, the project evaluated whether structured staff education improved early identification and diagnosis of adolescent depression and anxiety compared to routine practice. In workshops, web-based learning modules, case simulations, and …
Executive Summary: Organization Change Process Initiative Usability And Integration Of A Nutrition Screening Tool In Outpatient Mental Health Care, Jennifer Marie Ross
Executive Summary: Organization Change Process Initiative Usability And Integration Of A Nutrition Screening Tool In Outpatient Mental Health Care, Jennifer Marie Ross
Walden Dissertations and Doctoral Studies
Summary This doctoral, practice-focused quality improvement project used a mixed-methods design to evaluate the usability, acceptability, and clinical integration of a nutrition screening tool in a mental health outpatient clinic. The project addresses a key practice gap, the lack of evaluation of the implementation of a systematic nutrition screening for individuals with severe mental illness (SMI), which contributes to worsening psychiatric symptoms and delayed recovery. Aligning with nursing’s holistic and patient-centered framework, the initiative aimed to strengthen interprofessional collaboration and preventive care. The guiding practice-focused questions addressed: How usable and acceptable is the clinical practice guideline (CPG) tool among clinic …