Medicine and Health Sciences Commons^™

Providing Family Centered Care Within Pediatric Integrated Care Settings, Emily D. Bebber

Counseling & Human Services Theses & Dissertations

Parent engagement remains critical to pediatric care. Both pediatric medical and mental health care remains dependent upon parent/guardian engagement to support successful outcomes for children and adolescents. Efforts to enhance Family Centered Care (FCC) has been spotlighted within pediatric care since the 1950s and the inclusion of counselors within integrated behavior health (IBH) teams ushers a need for an evolved understanding of the implementation of FCC, including parent/guardian engagement across professional roles. Using an explanatory mixed-method design, I examined team implementation of Family Centered Care (FCC) among different provider types (e.g., physicians, nurses, licensed mental health providers, social workers, technicians) …

A Grounded Theory Of Counselors’ Post-Graduation Development Of Disability Counseling Effectiveness, Michele Rivas, Nicole R. Hill

Journal of Counselor Preparation and Supervision

Many persons with disabilities engage in counseling services in a variety of settings. However, the development trajectories of counselors who seek to compensate for the lack of training and advance their post-graduation skillset to work effectively with clients with disabilities has not been explored. This grounded theory study illuminated several dimensions involved in twenty-one Licensed Professional Counselors’ post-graduation development of disability counseling effectiveness. In this study, counseling effectiveness refers to self-perceived improved skillset rather than a benchmark (i.e., competence). The core category, Evolving Commitments, was common to all participants’ trajectories when developing disability counseling effectiveness. The other categories (causal conditions, …

A Single-Case Alternating Treatments Design Utilzing Quantitative Electroencephalography To Observe And Measure Mental State Trends During Individual Participant Non-Nature-Based Small Initiative Adventure Therapy Experiences, Patrick Lane Robert Mcmillion

Graduate Research Theses & Dissertations

This single-case alternating-treatments design research study observed and measured mental state trends during the counseling approach known as Adventure Therapy (AT) using quantitative electroencephalography (qEEG). Participants wore a qEEG headset while participating in a multi-stage AT experience. Two problems were addressed in this study. The first was the lack of research in AT utilizing other empirical measures beyond subjective report surveys and the outcomes of specific programs. The second was the lack of neuroscientific measurement of counseling approaches and interventions within the field of counseling in general. There is a need for empirical evidence supporting AT to address access barriers …

Experiences And Perceptions Of Bilingual Spanish-English Latinx Clients And Bilingual Spanish-English Latinx Therapists In Psychotherapy: A Systematic Review, Irvin I. Navarrete

Theses and Dissertations

As the bilingual Spanish-English Latinx population in the United States increases, so will the need for culturally and linguistically competent mental health therapists. While past research has focused on providing culturally competent care, the role of language in the process of psychotherapy has received limited attention. This study aimed to comprehensively analyze the existing literature on bilingual Spanish-English Latinx clients’ and bilingual Spanish-English Latinx therapists’ experiences and perceptions within a bilingual psychotherapy setting and identify recommendations to enhance language proficiency. A systematic review was conducted and identified nine studies for inclusion. Results highlight seven themes focusing on bilingual Spanish-English Latinx …

Influences On The Attachment Style Of Deaf Adults With Hearing Parents, Ellen Schaefer-Salins

JADARA

The current study explored variables that could contribute to the development of a secure or insecure attachment style of 15 deaf adults between the ages of 30 and 50 with hearing parents. There is a paucity of information on the relationship of deaf adults to their hearing parent and how that relationship may influence attachment. For the current study, quantitative methods were used to explore both childhood and adulthood variables, such as type of communication used with parents, type and level of schooling, and current attachment style. Variables also studied include age, gender, race, birth order, marital status, the hearing …

The Mother Of Exiles Is Abandoning Her Children: The Systemic Failure To Protect Unaccompanied Minors Arriving At Our Borders, Rosa M. Peterson

The Scholar: St. Mary's Law Review on Race and Social Justice

Unaccompanied minors arrive at the United States border every day. Many brought by the hope of finding a life lived without fear, a luxury many United States citizens take for granted. Their truths become the barriers and shackles which keep them in detention centers and unaccompanied minor facilities throughout the United States; children find their very words wielded as weapons against them in immigration court. Words often spoken to therapists in perceived confidence, during counseling sessions. This practice is a systemic failure to protect unaccompanied minors arriving at our borders who are seeking protection and help. The United States …

Exploring The Potential For Therapeutic Art-Making In School Psychology Practice: A Single Case Study Of A Training Experience, Alexandra G. Manion

Electronic Theses and Dissertations

The purpose of this study was to investigate the impact of a training experience on the use of therapeutic art-making for school psychologists, with a focus on how to incorporate these concepts into their school-based mental health practice. Therapeutic artmaking includes the use of visual art activities (drawing, painting, clay, and collage) with specific therapeutic intent. Although there are examples of art therapists providing inschool therapeutic art-making services to support the mental health needs of students, there is far less information regarding the use of therapeutic art-making by school-based mental health providers, including school psychologists. This single case study explored …

“If I Had Felt Comfortable Or Accepted, I Would Have Made More Progress”: A Phenomenological Investigation Into The Experiences Of Lgbtq+ Persons In Clinical Professional Counseling, Valerie Moreno-Tucker

Graduate Research Theses & Dissertations

The counseling literature has indicated that LGBTQ+ persons have experienced fewer positive mental health outcomes than cisgender heterosexual persons. Professional counselors, despite their requirement to provide culturally sensitive counseling services for all communities, must learn how to better need the needs of LGBTQ+ persons and communities. This dissertation elevates LGBTQ+ persons’ voices by examining the experiences of LGBTQ+ persons in clinical professional counseling. Specifically, the IPA approach was utilized in analyzing data from six individuals who each participated in two interviews lasting 45-90 minutes each. This investigation found commonalities between each participant regarding both their helpful and unhelpful experiences in …

Stress, Resiliency, And Burnout Among Leaders In The Counseling Profession, Adriana Bovee

Walden Dissertations and Doctoral Studies

Leaders in the counseling profession face many demands. The purpose of this quantitative regression analysis study was to determine if there was a predictive relationship between the independent variables of stress and resiliency and dependent variables of burnout, emotional exhaustion, depersonalization, and personal accomplishment among leaders in the counseling profession. Transformational leadership theory and resilience theory were applied as the theoretical framework of this study. A cross-sectional data collection method was used, and data were collected through anonymous online surveys from a purposive sample of 75 counseling leaders. Data analyses methods included descriptive statistics and multiple linear regressions. Results indicated …

Weight And The Therapeutic Relationship: Implications For Counselors, Emily Shank

Educational Specialist, 2020-current

Central to the healthcare system in the United States is the belief that weight is an accurate measure of health. This belief, which is the foundation of the Weight Centered Health Paradigm (WCHP), is linked to the proliferation of diets, weight cycling, and weight stigma. However, a growing body of research indicates that higher weight is not necessarily linked to negative health outcomes and that the impact of weight cycling and weight stigma pose far greater risks to health. Counselors and other mental health professionals function within the weight-normative healthcare system in the United States and are faced with the …

Using A Cognitive Behavioral Approach In Individual Counseling With Patients Undergoing Bariatric Surgery, Nina Marie Ditommaso

Doctoral Dissertations

Morbid obesity is linked to physical and psychological well-being. Bariatric surgery has shown tremendous success with rapid weight loss in the patient population with morbid obesity. These patients experience issues with weight regain post-surgery, which can be linked to psychological and social factors. Despite this, mental health counseling is rarely offered in bariatric surgery programs. The primary investigator used a six-session Cognitive Behavioral Therapy (CBT) approach in individual counseling with patients following bariatric surgery. The primary investigator used a single case research design to treat four participants. The primary investigator measured the effectiveness of a six-session CBT treatment, assessing for …

Laughter As A Priming Agent For Change, Linnea M. Heintz

Graduate Theses and Dissertations

The purpose of this study was to analyze the importance of laughter as a factor in influencing employee job satisfaction ratings. The Job Satisfaction Survey (Spector, 1985, 1997) and pulses of laughter were used in this study. To explore the relationship between laughter and job satisfaction, results of the Job Satisfaction Survey (Spector, 1994) were collected quarterly (four times a year) for three consecutive years, beginning six months prior to the start of the two-year study and six months post. The study sample was composed of 545 employees (34% male, 66% female) operating out of 10 employee-owned retail chain locations …

Application Of Self-Efficacy Training In Group Aural Rehabilitation: An Interprofessional Collaborative Model, Stephen D. Roberts, Nancy A. Delich

JADARA

Few studies have explored self-efficacy training with persons with hearing loss (PHLs), yet alone with their communication partners (CPs). The purpose of this mixed-method study was to examine the impact of self-efficacy training as a framework for an Interprofessional Psychosocial Group Aural Rehabilitation (IPGAR) workshop with PHLs and their CPs. Four PHLs and their four CPs consented to participate in the IPGAR workshop that employed interventions including short lectures, psychosocial exercises, communication strategies training, speech perception training, adaptive/stress reduction exercises, and group discussions relevant to mutually established shared goals for each couple. The participants reported improved communication abilities in the …

The Adult Public’S Perception Of The Utility Of Play Therapy, Margaret L. Hindman

Graduate Theses and Dissertations

Children communicate through symbolism and play as toys are children's words and play is their language (Landreth, 2012; Oaklander, 1988; Piaget, 1951; Ray, 2016). Play therapists facilitate developmentally appropriate support for children (Landreth, 2012). Often parents are unaware of the importance of play in children’s counseling (Brumfield & Christensen, 2011; Landreth, Bratton, Kellam, & Blackard, 2006).

Since adults often make decisions for children, it is important to know adults’ perceptions of play therapy utility. There is little research on parents’ knowledge of mental health services especially research specific to play therapy (Gallo, Comer, & Barlow, 2013; O’Connor & Langer, 2018). …

Exploring The Experience Of Psychological Distress For Young Adults With Cancer: Implications For A New Diagnosis Of Medical Traumatic Stress, Audrey Ryan

Counseling and Psychology Dissertations

The purpose of this qualitative study was to investigate how a serious medical diagnosis, such as cancer, can act as an acute or prolonged trauma. This was explored through the lived experiences of psychological distress of young cancer survivors. Participants were 12 men and women who had been diagnosed with cancer within the past seven years when they were between the ages of 18 and 39. From these interviews several themes emerged that describe the phenomenon of what I have termed medical traumatic stress.

Trauma from a medical event does not currently meet criteria for PTSD in the DSM-5 …

From Isolation To Communication: Connecting Adults Who Have Hearing Loss With Their Communication Partners, Stephen D. Roberts, Nancy A. Delich

JADARA

As Baby Boomers enter the late adulthood stage of life, hearing loss continues to be one of the most prevalent, chronic, and isolating conditions facing older adults today. Research has focused on the negative consequences of hearing loss on the health and the person’s well-being, but it is equally important to recognize that hearing loss also leads to communication loss. The resulting social isolation and the collateral effects of hearing loss on the communication partner are the focus of this mixed-method study that explored the hearing loss-related quality of life for both parties. Five overarching themes emerged from the analysis, …

Power In The Counseling Relationship: The Role Of Ignorance, Izaak L. Williams, Peg O'Connor

Journal of Human Services: Training, Research, and Practice

This article explores the role of therapist self-disclosure in clinical settings. Distinctions are made between the enmeshed concepts of privacy, secrecy, and confidentiality to elucidate the role of ignorance in maintaining the power dynamics in therapeutic relationships. While some measure of privacy is essential to counseling practice, secretive behavior (in which the counselor divulges too little about themselves) can have a negative impact on the therapeutic relationship and the client’s therapeutic outcomes. There is, therefore, an under-appreciated and delicate balancing act between withholding information to protect the client and the counselor and revealing enough personal details to empower the client’s …

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

JADARA

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

Tattoo Narratives And Counseling, Danny Lane Mccarty

Graduate Theses and Dissertations

Much research has been done on tattoos and on those who acquire them, but most of the research has focused on negative correlations that might exist with people who have tattoos. This current research, however, showed that people’s tattoo narratives can relate to how they view self, others, and the world, and to how they approach life. A narrative approach to qualitative research was used, and ten people participated in the study. Participants’ views of self, others, and the world were discussed as these views emerged from the narratives. Their possible approaches to life were also addressed. Themes that emerged …

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

Staci Born

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

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

The Qualitative Report

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

Why Should We Care? Psychodynamic Theory And Practice In Counselor Preparation, Elyssa Smith

Journal of Counselor Preparation and Supervision

Abstract

This constructivist grounded theory investigation explored the experiences and perceptions of seven counselors-in-training regarding psychodynamic theory and practice. Two categories, five themes including three subthemes, and a tentative theory which spoke to the experiences, perceptions, and attitudes of students regarding contemporary psychodynamic psychotherapy emerged. Implications for counselor education and the training of counselors are discussed.

Keywords: counselor preparation, psychodynamic, reflective practice

Complicated Grief And Art Therapy, Rachel Brandoff

Expressive Therapies Dissertations

Complicated grief (CG) has come to be a common enough occurrence in mental health treatment to warrant research, literature, and discussion of markers, causes, prevalence, symptoms, measures, and treatment protocols. Art therapy presents one possible mode of treatment for individuals suffering from CG, and yet few art therapists know about CG or have training in this area. A systematic review of art therapy programs and educational requirements showed no current standards or training requirements for grief or CG. Art therapists are master’s trained clinicians who work with people with a variety of mental health challenges, and training in CG may …

The Novice Licensed Professional Counselor's Perceived Preparedness To Use Self-Disclosure, Nicole Pfaff

Walden Dissertations and Doctoral Studies

Self-disclosure is used by feminist, humanistic, client-centered, and a variety of other counselors to build therapeutic alliances with clients. However, little research has been conducted on counselors' perceptions of their preparedness to use self-disclosure. This exploratory multiple-case study used attachment theory as a framework to explore the perceptions of novice licensed professional counselors' preparedness to use self-disclosure. The 12 participants who participated in face-to-face interviews practiced as licensed professional counselors in Delaware, New Jersey, or Pennsylvania. The participants described how they learned, practiced, and used self-disclosure. After analyzing interview data through cycle coding and peer review, themes emerged showing participants' …

An Exploration Of The Experience Of Open Awareness Co-Meditation At The Beginning Of Therapy Sessions, Aneeqa Ishtiaq

Graduate Theses and Dissertations

Mindfulness and meditation have been seen as beneficial for mental health and mindfulness-based therapies have proliferated alongside an increase in popular interest in mindfulness (Germer, Siegel, & Fulton, 2013). However, many therapists are unaware of how to add mindfulness-based interventions. It may seem especially ambiguous for therapists and clients unfamiliar with the concept. In this dissertation, the history and current research on mindfulness-based psychotherapy, and its benefits and contraindications, are reviewed, and the researcher’s relationship to the topic is explained. It is identified that one way to add mindfulness to psychotherapy is for the therapist and the client to co-meditate …

An Exploratory Factor Analysis Examining Experiences And Perceptions Of Campus Safety For International Students, Sonia H. Ramrakhiani

Counseling & Human Services Theses & Dissertations

Although international students make up a significant percentage of the college population and contribute to higher education institutions in multiple ways, a lack of attention is paid to their safety needs. This dissertation examined the experiences and perceptions of campus safety among international college/university students in the United States. The researcher sampled participants from different institutions around the country, who self-identified as international students. A researcher-developed 53-item Likert scale questionnaire, International Students’ Safety Questionnaire (ISSQ), was administered to the sample. Findings from the exploratory factor analysis (EFA) provided evidence for the four-factor solution for the 26-item ISSQ accounting for 48.65% …

Online Versus In-Person Therapy: Effect Of Client Demographics And Personality Characteristics, Joel Joseph Kofmehl

Walden Dissertations and Doctoral Studies

Traditionally, mental health professionals have provided psychotherapeutic services through face-to-face sessions. As the Internet has become an increasingly important part of individuals' personal and professional lives, psychologists and clients have used this medium to expand access to psychotherapy. The purpose of this quantitative correlational design was to investigate whether demographic variables and the personality traits of extroversion/introversion (E/I), as assessed by the Big Five Inventory, predicted clients' preferences for a specific method of administered psychotherapy. The theoretical framework for this study was social information processing through computer-mediated communication. An online survey site was used to assist in survey design and …

Clinicians' Perceptions Of Trauma Treatment For People With Intellectual Disabilities, Katherine Elaine Schoech

Walden Dissertations and Doctoral Studies

People with intellectual disabilities (ID) experience trauma and posttraumatic stress disorder (PTSD) in similar ways as individuals in the general population. The purpose of this phenomenological study was to explore and describe clinicians perceptions of trauma treatment for people with ID. Theories of trauma, PTSD, and stigma were part of the conceptual framework from which interview questions were developed. Purposive and snowball sampling were used to recruit 8 participants in the Denver, Colorado area. Four participants had experience working with people with ID, and 4 participants did not have this experience. Participants sat for semi structured open-ended recorded interviews, which …

Experiences Of Parents Of Self-Harming Adolescent Children, Sheila Nicole Russell

Walden Dissertations and Doctoral Studies

Adolescent self-harm is a growing epidemic in the United States with thousands of adolescent children being treated in hospitals every year. Despite awareness that self-harm impacts the family unit, little attention has been given to the full impact that self-harm has on parents. Due to this lack of knowledge, counselor educators and supervisors are not equipped to train counselors to work with parents of self-harming adolescent children leaving counselors feeling unprepared to work with parents. The purpose of this phenomenological study was to explore the lived experiences of parents who have self-harming adolescent children. Family systems theory was used to …

The Relationship Between Counselors' Multicultural Counseling Competence And Poverty Beliefs, Madeline Elizabeth Clark

Counseling & Human Services Theses & Dissertations

The relationship between increased levels of poverty and decreased levels of psychological wellbeing and overall wellness is well documented. Although poverty clearly impacts mental health and wellness, little research in counseling has been conducted exploring the poverty attitudes of counselors. This study explored the relationship between professional counselors’ multicultural counseling competence (MCC), poverty beliefs, and select demographic factors (i.e. counseling specialty, gender, age, ethnocultural identity, poverty counseling experience, and personal poverty experience). Data were collected using survey-based methods from professional counselors of all specialties. Results of a hierarchical linear regression indicate that increased MCC, adjusted for select demographic factors, is …