Medicine and Health Sciences Commons^™

Social Determinants Of Health Theory: Policy Entry Points For Healthcare Providers, Kiah R. Vandergrift

Electronic Theses and Dissertations

This thesis examines a shifting paradigm in the U.S. healthcare system that will re-define the role that the healthcare provider plays in the production of health. It does this by first acknowledging two differing economic theories on the production of health: Human Capital Theory and Social Determinants of Health theory, and how both schools of thought have contributed to the paradigm that healthcare providers only play a role in the end stages of health production - to heal those who are already ill. However, policy, payment, and delivery system reforms have begun to force healthcare providers to re-think how they …

How Informational Imperfections Lead To Sub-Optimal Solutions In Health Savings Plan And Potential Remedies In A Competitive Marketplace, Jacob Gene Dengg

Electronic Theses and Dissertations

In the growing trend of consumer-driven health insurance, more consumers than ever have access to a high-deductible health plan paired with a health savings account, where consumers can save pre-tax income for healthcare but also face higher out-of-pocket prices, in hopes that consumers will become smarter shoppers. The Health Savings Plan is successful at lowering costs, but at the expense of consumers lowering their adherence to healthcare, raising health risk. Even in a competitive market, HSP plan designs require smart shoppers and more active healthcare self-management, but without dealing with the informational imperfections that need to be overcome to encourage …

Stigma In The Post Crisis Age: External Barriers To Accessing Hiv Treatment, Internalized Trauma, And Strategies Of Support In Orlando, Florida, Julian Cerrell Nilsson

Electronic Theses and Dissertations

In 2017, The CDC (center for disease control and prevention) released a memo confirming popular medical opinion that an HIV positive person with an undetectable viral load was unable to transmit the HIV virus. While treatment and prevention options are advancing, this advancement may not translate directly into reduced stigma, which is produced and reproduced by external barriers to accessing healthcare, and internalized by HIV positive people as emotional trauma. This research explores the relationship between the availability of contemporary resources for the treatment and prevention of HIV/AIDS, and the environment of stigma experienced by positive gay and bisexual men …

Utilizing Music Therapy To Enhance Competency Restoration Treatment, Cory Linder

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

In Dusky v. the United States (1960), the Supreme Court ruled that the U.S. Constitution requires all defendants to be competent to proceed before the judge issues a verdict. Specifically, to stand trial, defendants must have a factual and rational understanding of court proceedings and the capacity to work with their attorneys. Those who are found incompetent to proceed frequently have severe and persistent mental illness and often exhibit cognitive deficits (Mossman et al., 2007). Competency restoration utilizes therapeutic services to treat symptoms that inhibit defendants from being opined competent to proceed. Existing research suggests music therapy can be used …

Telebehavioral Health Program Needs Assessment Conducted At Aurora Mental Health Center, Iwei Wang

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The purpose of this project was to conduct a needs assessment for a Telebehavioral Health Program at Aurora Mental Health Center (AuMHC) to determine how telebehavioral health aligns with the organization’s interests, needs, services, target population, and readiness for telebehavioral health services. This investigator used survey and content analysis methods to conduct this investigation. Findings of this assessment showed that both literature and existing programs at AuMHC were supportive of moving forward with telebehavioral health services. Considerations of AuMHC’s contextual conditions and recommendations for successful implementation are provided.

Becoming A Better Therapist: Eight Lessons From Running, Kelsey Hyde

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper seeks to identify lessons that can be taken from the sport of running to serve as a map for learning skills needed to become a better therapist. The practice of running mirrors the practice of learning therapy skills. This paper takes the lens of how to practice to become a better runner and applies it as a new approach to skill development for therapists. Additionally, this paper incorporates self-reflection and disclosure as I myself identify as a female runner and therapist. I will use personal examples to highlight the ways that lessons from running have served as a …

A Behavior Analytic Translation Of Erving Goffman's Frame Analysis, Tim Chi

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The sociologist Erving Goffman's 1974 work, "Frame Analysis," is an attempt to account for how people construct and organize meaning in their experiences. The central principle in this approach is that of the frame: An abstractive concept that refers to the totality of environmental events and stimuli exerting some influence on how people behave in a particular setting and time, with respect to the expectations, roles, and norms to be observed.

Though Frame Analysis was developed within the discipline of sociology, it converges in apparently useful ways with the work of clinical psychology, both in its content and epistemology. Goffman's …

The Utility Of Neuropsychological Measures On The Differential Diagnosis Of Adhd-Inattentive Type Versus Anxiety In A Pediatric Outpatient Behavioral Health Population, Emily Stapleton

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This study examined the differences in inattention and executive function between a group of children diagnosed with ADHD and a group diagnosed with anxiety disorders to establish differential profiles for these two disorders. This study evaluated the differences among children with ADHD and anxiety disorders, using parent-report and performance-based measures of inattention and anxiety. A retrospective chart review was completed for a total of 58 patients who met the criteria for an anxiety disorder or for ADHD-C and ADHD-I at the completion of the neuropsychological assessment. Analyses compared the ADHD group and the Anxiety group on select scales and subscales …

Psychotropic Medications And Children: Perceptions Of Mental Health Professionals, Elinor Jane Brereton

Electronic Theses and Dissertations

This project explores mental health professionals' perspectives on the prescription of psychotropic medications to children. It emphasizes the placement of biomedicine within its larger social, economic, and political context, and the influence these structures have on the way mental illness is conceptualized and treated in children. Eight semi-structured interviews were conducted in Denver, Colorado with psychiatrists, psychologists, social workers, and a pharmaceutical board member to capture multiple perspectives from different positionalities within the field. Participants discussed factors that they believe influence prescribing practices including: professional role changes, issues of access, limited evidence, cost, and institutional pressures to practice within a …

An Exploratory Study Of Session Limited Models Of Therapy Outcomes In An Employee Assistance Program, Ivy C. Donaldson

Electronic Theses and Dissertations

Employee Assistance Programs (EAPs) have grown increasingly popular over recent years. The prevalence of organizations utilizing and investing in EAP services for their employees has grown; however, companies that purchase EAPs are not well-informed as to which session-models are most effective for various diagnoses. The current study is the first to explore treatment outcomes of session-limited models (measured by Therapist Perception of Change, TPC) for diagnoses (anxiety and depression) in an EAP delivery system. Outcomes were measured by TPC ratings including: a) Regressed, b) remained at Baseline, c) Improved, and d) issue was Resolved. Analyses (Chi-Square and =t-test) were used …

The Impact Of Sudden Gains And Deteriorations On The Psychotherapy Process, Joanna Mary Drinane

Electronic Theses and Dissertations

Within the field of psychotherapy research, there has been significant evidence to suggest that people change and improve because of treatment (Lambert & Ogles, 2004). One common phenomenon that has been observed when looking more closely at outcome trajectories has been termed sudden gains/deteriorations. These are defined as sudden changes in outcome (either positive or negative) of 25% or more from the pre-change level of symptoms that are in turn sustained over time (Tang & DeRubeis, 1999). Although there are data regarding how people who experience sudden gains end up after treatment, no studies have examined the impact that sudden …

Working With Transnational Women From Latin American Countries From A Feminist Therapy Framework: A Guide For Mental Health Providers Working With This Population, Diana Hinojosa

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The experiences of transnational families in the United States have largely been examined as they relate to the impact that separation and migration have on the family system. In most recent years, women have assumed the experience of migration and have moved to countries like the United States to work and provide for their families back home. Transnational families are typically understood as family members who live separated from each other, often across national borders, but continue to maintain unity and connections with each other. The following literature review will examine the social factors impacting Latin American women’s decision to …

Six-Month Post-Release Outcomes For Inmates With Traumatic Brain Injury In Supported Community Programming, Elizabeth O. Ahlers

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Traumatic brain injury (TBI) is a serious public health issue. The incidence of TBI is much higher in the incarcerated population than in the general population, making this a uniquely vulnerable population. Methods: This study looks at data from the Jail Based Behavioral Health Services (JBBS) to examine recidivism rates among inmates participating in supportive programming. It also uses data from a state brain injury program to examine the impact of case management on community engagement in the justice-involved population with a history of brain injury. Results: Statewide data for a population of inmates who elect to participate …

Cinematherapy With Inside Out: A Theoretical And Practical Guide, Jessica Rosenfeld

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Since its release in 2015, the Disney/Pixar film "Inside Out" has received widespread critical and commercial acclaim. Despite the film's basis in established psychological theories, little has been published regarding its clinical applicability, particularly for adolescent and adult clients in traditional talk therapy. Through the use of cinematherapy, a deeper examination of the film is offered, and suggestions for treatment use are provided. Via the lens of modern psychodynamic (Intersubjectivity) and behavioral (ACT) techniques, this paper offers diverse options for integrating "Inside Out" in psychotherapy and proves that it contains clinical applicability for a wide range of practitioners.

Guidelines For Adapting Structural Family Therapy Approach For Immigrant Generation East Asian American Families, Shijia Liu

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The author developed detailed guidelines for adapting the structural family therapy approach for therapists who work with immigrant east Asian American families. Due to different acculturation levels among family members, immigrant parents often have conflicts with their children, which have become an important reason why Asian American families seek mental health services. The review of both traditional east Asian family-related cultural values and European American cultural values illustrates the parenting emphases that vary to a great extent between these two broad cultural groups. The widely accepted child development theories, parenting theories, and family therapy approaches were developed primarily based on …

Cultural Adaptation To Suicide Prevention Interventions On College Campuses, Leisha Marie Chiles

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Suicide is the second leading cause of death for adolescents and young adults ages 15 to 34. Given that college students are within that age range, it is believed they are at a similar risk. As college campuses try to address the suicide risk among their diverse student body, many have developed a public health approach, including the use of gatekeeper trainings. Many of these population-based interventions take a one-size fits all approach to suicide prevention, but with an increasingly diverse student population represented on college campuses this type of approach may fall short and fail to meet the cultural …

Horses In Therapy: The Practice Of Equine Facilitated Psychotherapy, Mandi J. Turner

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Horses are being used in psychotherapy at increasing rates despite a lack of evidence establishing efficacy of the practice (Anestis, Anestis, Zawilinski, Hopkins, & Lilienfeld, 2013; Selby & Smith-Osborne, 2013). Without common and consistent practices based on a working theory of how Equine Facilitated Psychotherapy (EFP) creates change, it is unknown how varied the practice is across the United States (Anestis et al., 2013). A lack of studies establishing efficacy leaves providers to determine effectiveness based on anecdotal evidence that may be at risk for bias (Lilienfeld, Ritschel, Lynn, Cautin, & Latzman, 2014). The American Psychological Association (APA) provides recommended …

A Qualitative Evaluation Of A Substance Abuse Treatment Program For Athletes, Megan K. Lavoy

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The focus of this study was to examine the experiences of two past participants of an athlete­-specific drug and alcohol rehabilitation program. Researchers have discussed the vulnerability of an athlete population and prevalence of substance use among athletes ( e.g., Turrisi, Mastroleo, Mallett, Larimer, & Kilmer, 2007; Martens, Watson, Royland, & Beck, 2005). Some rehabilitation programs and specific approaches to treating substance abuse in athletes have started to emerge and are beginning to be discussed in the literature (Donahue et al., 2014). However, there remains a gap in the research of studies examining the experiences of these athletes who have …

Understanding Gender Differences In Sports-Related Concussions Among High School Athletes: Implications For Diagnosis, Treatment, And Management, Hillary Grady-Speckhals

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Growing research on both the immediate and long-term effects of sports-related concussions (SRCs) in professional athletes has called attention not only to understanding the impact of concussions in high school athletes, but has also focused on understanding how SRCs may impact female athletes differently than male athletes (Covassin & Elbin, 2011; Kirkwood, Yeates, & Wilson, 2006). There are many studies that have highlighted the neurocognitive, academic, and socioemotional implications of these brain injuries on developing youth, but there are few studies that focus on gender differences in adolescent athletes (Daneshvar, Nowinski, McKee, & Cantu, 2011; Kirkwood, et al., 2006). Understanding …

The Roles Of Perceived Stress, Coping Styles, And Perceived Social Support On The Alcohol Consumption Among American College Students, Jesse Wynn

Electronic Theses and Dissertations

The intention of this study was to better understand how certain aspects in a college student's life (i.e., perceived stress, styles of coping, and social support) or how combinations of these variables may contribute to higher levels of alcohol consumption. The present study examined the relationship between perceived stress, functional coping strategies, dysfunctional coping strategies, and perceived social support using Lazarus and Folkman's model of stress, appraisal, and coping. A sample of (N = 201) University of Denver undergraduate students between the ages of 18-25 complete measures of perceived stress, coping strategies, perceived social support, and alcohol use. Results …

Preclinical Assessment Of Immunocal® As A Preventative Treatment For Traumatic Brain Injury (Tbi) In A Mouse Model Of Closed Head Injury, Elizabeth Eugenia Ignowski

Electronic Theses and Dissertations

Over the past three decades, traumatic brain injury (TBI) has been considered a "silent epidemic" and recognized as an emergent public health problem by the Centers for Disease Control and Prevention (CDC). TBI is defined as a bump, blow, or jolt to the head that disrupts the normal function of the brain. Due to the debilitating effects and prevalence of TBI, novel preventative treatment regimens are highly desirable in at risk populations. According to the CDC groups disproportionately affected by TBI include athletes, people aged 75+, and service men and women, among others. Here, we investigated a unique whey protein …

Ballroom Dancing In Conjunction With Emotionally Focused Couples Therapy: Increasing Emotional Connections Through Non-Verbal Communication, Shana B. Kronish

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Emotionally Focused Couples Therapy (EFCT), Dance Movement Therapy (DMT), and ballroom dance have each been found to be beneficial in developing individual and interpersonal verbal and non-verbal communication and emotional awareness; however, very little research has been performed on the combined therapeutic use of any of these modalities. In this study, semi-structured interviews were conducted with therapists and ballroom dance instructors who work with couples in order to facilitate dialogue regarding the limitations and benefits of therapy and ballroom dance. The core theme of this study was the ‘Interest in Application.’ The eleven additional themes that evolved were ‘Benefits of …

The Stigma Effect: The Role Of Internalized Racism And Internalized Homophobia In Risky Sexual Behavior Among Black Gay Men, Darren Lovell Whitfield

Electronic Theses and Dissertations

Black gay, bisexual, queer, and same-gender-loving (GBQSGL) men account for less than 1% of US population, yet account for 36% of all new HIV infections. While, Black GBQSGL men experience higher rates of HIV infection compared to other gay, bisexual, and men who have sex with men (MSM) from other racial groups, they are no more likely to report engaging in condomless anal sex (CAS). These findings suggest that one possible explanation is that the context of sexual behavior for Black GBQSGL men may be riskier because of the prevalence of HIV in the community. Furthermore, research suggests that racism …

The Caregiver–Child Relationship, Youth Mental Health, And Placement Stability In A Child Welfare Sample, Laura A. Rindlaub

Electronic Theses and Dissertations

Objective: Healthy relationships between adolescents and their caregivers have been robustly associated with better youth outcomes in a variety of domains. Youth in contact with the child welfare system are at higher risk for worse outcomes including mental health problems and home placement instability. A growing body of literature points to youth mental health problems as both a predictor and a consequence of home placement instability in this population; the present study aimed to expand our understanding of these phenomena by examining the interplay among the caregiver-child relationship, youth mental health symptoms, and placement change over time. Method: The sample …

The Perceived Effects Of Dance For Individuals With Parkinson’S Disease And Healthy Amateurs, Taylor Marie Mastin

Electronic Theses and Dissertations

The objective of the present study was to compare the effects of dance participation on physical and psychological functioning as perceived by two distinct groups of dancers: dancers with Parkinson's disease (PD) and healthy amateur (HA) dancers. Dancers in the Parkinson's sample group were gathered from participants in the Dance for PD® program, while healthy amateur dancers were recruited from university dance departments and through social media. Both groups were administered measures related to affect, self-efficacy, quality of life, and which aspects of dance classes were most helpful and/or challenging. Several open-ended questions for both groups were included, along with …

Maternal Perception Of Child Body Weight And Physical Activity Behavior Patterns: Interactions With Gender And Ethnic Minority Status Of Preschool Children, Kayla F. Brooks

Electronic Theses and Dissertations

Childhood overweight and obesity is a complex disease that requires early identification and intervention. Little research has investigated the influence of maternal perception of child body weight on reported child physical activity behaviors and importance to change these behaviors. Using parent survey and child body mass index (BMI) data, the current study evaluated the difference between maternal perception of child weight status and reported physical activity and sedentary behavior levels amongst preschool-aged children. Reported child physical activity and sedentary behavior levels were not significantly different depending on maternal misperception. A significant interaction, however, between maternal perception of child body weight …

Longitudinal Perspective Of Participation In A Double Blind Placebo Surgery Trial, Jessica Kuhne

Electronic Theses and Dissertations

Parkinson’s disease (PD) is a chronic and progressive neurological disorder that causes both motor symptoms and non-motor symptoms in individuals. Overall, PD impacts the physical, emotional and social functioning in the lives of those impacted by the disorder. In 2001, Freed et al. investigated the effects of fetal tissue transplantation in participants with PD by conducting a double-blind sham-controlled surgery trial. The quality of life (QoL) study was conducted concurrently by McRae et al. (2004) in order to determine whether QoL improved in participants in the transplant group compared to the sham group after the one-year period of the double-blind. …

Social Support And Affectionate Communication In Animal-Assisted Interventions: Toward A Typology And Rating Scheme Of Handler/Dog Messages, Amy Mccullough

Electronic Theses and Dissertations

Animal-assisted interventions (AAIs) are a treatment modality that incorporates a trained animal into a person's healing and learning process in order to benefit the person physically, emotionally and/or socially (Delta Society, 1996). From an interactional perspective, two mechanisms that may contribute to these health benefits are social support and affection exchange. Although there is growing evidence of the health and well-being benefits of AAIs, there remains a need for scientific research to understand more precisely the communicative and behavioral components that constitute a therapeutic intervention involving an animal (Kazdin, 2010). Additionally, there is a need to develop a means of …

Substance Use And Drug Distribution At The Individual Level: A Grounded Theory Approach, Evan Thomas Stanforth

Electronic Theses and Dissertations

Substance use regularly occurs among individuals that distribute drugs and there is a limited amount of research that has examined both use and distribution. A grounded theory approach was used to develop a framework for analyzing relationships between use and distribution behaviors. 15 participants (five female, 10 male) that had experience selling drugs and using drugs were recruited from a residential substance abuse treatment center. Each participant was interviewed for one hour with an interview protocol aligning with the stage of analysis. A model was developed to explain Involvement and Integration in a Drug World with the codes Substance Use, …

Alaska Winter's Relationship To Domestic Violence And Alcohol Abuse, Jennifer Marie Read

Geography and the Environment: Graduate Student Capstones

Alaska is known for its long, dark, cold winter months. Daylight savings time exists to cope with months that have little sunlight, but that still leaves on average, five hours of daylight. Special light bulbs exist to help with the darkness by providing light that tricks the body into thinking it is getting more sun than it really is. As daylight decreases, the weather turns colder; depression, alcohol, and domestic violence begin to rise. Studies show alcohol related crime and domestic violence occur more during the winter months in Alaska. This research paper will analyze the data pertaining to alcohol …