Mental and Social Health Commons^™

The Underlying Psychophysiology Of Pedophilic Disorder And The Implications For Treatment Approaches, Tonise Florexil

Dissertations

Sexual crimes are a persistent and significant social dilemma that continues to plague our society (Lee, Jackson, Pattison, & Ward,2002). Past research has made considerable advancements in terms of the types of interventions that clinicians can utilize when they work with individuals who have a history of child sexual offenses. However, current literature lacks an understanding of the risk factors that influence the development of Pedophilic Disorder. A history of sexual trauma also affects families. The children of traumatized individuals have more adjustment difficulties than their counterparts who did not have a parent(s) with a sexual trauma history. This clinical …

Barriers To Mental Health Treatment In Patients Referred By Primary Care, Rebecca Palmer

Dissertations

Problem: Limited access to mental health treatment is one of many potential barriers to treating mental illness in the United States. Where resources are readily available, reportedly high no-show rates for established mental health appointments suggests further investigation is necessary to identify frequent barriers within that population. This was a quality improvement project to identify common themes in patient-reported barriers to care.

Methods: A 4-question phone survey was offered to individuals that did not appear at their mental health appointment. Data was analyzed to identify the most commonly reported barriers to mental health treatment. Additional data collected includes reported history …

Physician Stress: Is The Electronic Health Record To Blame?, Zack Ward

Dissertations

The purpose of this study was to explore the potential relationship between Family Medicine physician burnout and the electronic health record. To do so, this study utilized the Copenhagen Burnout Inventory to assess burnout among physicians, along with specific questions regarding usage of the electronic health record and measurement of physician perceptions of the electronic health record. Members of the Kentucky Academy of Family Physicians were sent two separate invitations to participate in the study twice over a one-month period via email.

The study yielded no significant differences in Family Medicine physician demographics and their degree of burnout, or the …

A Collaborative Perspectives Approach For Understanding Effective Care Coordination In Autism Spectrum Disorder, Rachel Severs

Dissertations

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that causes significant impairment in social and communication areas. The severity of the disorder can often result in a substantial degree and amount of service access and expenditures relating to a child’s needs. This study examined the experiences of how family caregivers and service providers of children with ASD view service delivery using a basic qualitative research design. For the study, 10 participants (five family caregivers and five service providers) were enrolled and interviewed. Interview data were collected and coded to produce a qualitative analysis of the experiences of these individuals who …

Journey With Autism: Successful Educational And Social Interventions From A Single Case Study, Kwame M. De Jonge-Moore

Dissertations

Problem

Statistics indicate that Autism Spectrum Disorder (ASD) is on the increase in America and worldwide (Xu, Strathearn, Liu, & Bao, 2018; Baio et al., 2018). Autism spectrum disorder can impair an individual’s ability to engage in neurotypical behavior, which has the potential to increase their vulnerability to being shunned and bullied. This makes autism a major societal concern with significant costs to the individual, their family, private/public health insurance, state financial aid programs, and to the nation. This present study was undertaken to determine, in the opinions of those connected to the case, whether the interventions engaged in this …

Finding Hope In Chaos: The Development Of A Tool To Identify Key Factors That College Students Use To Effectively Deal With Adversity, Joetta Harlow Kelly

Dissertations

The purpose of this study is to identify techniques that could be developed into a resource for counselors and other professionals who assist college students in dealing effectively with adversity. In a series of four surveys, 200 people were asked to participate. These included professional counselors and ministers both on and off campus, as well as directors in Student Affairs, such as those in student support services and student life. To accomplish this, questionnaires were developed to identify and allow for tabulation of the counseling techniques most commonly used for students dealing with adversity by those working with college students. …

Beta-Testing Of An Interactive Multimedia Computer Program Of Exposure Therapy For Ptsd, Marie C. Barrett

Dissertations

Posttraumatic Stress Disorder (PTSD) results in significant impairment for the individual and substantial costs to society. Research indicates that cognitive behavioral psychotherapy (CBT) is the most effective treatment for PTSD and that among CBT treatments, exposure therapy is the treatment technique with the strongest evidence to recommend it for PTSD treatment. Computerized programs that deliver evidenced-based treatments offer a potential solution to barriers that prevent individuals from accessing and completing treatment. The present study evaluates the clinical and practical functionality of a computer-based program designed for the treatment of PTSD. Results indicate that completion of the program is associated with …

Qualitative Analogue Study On Student Therapist’S Reactions To Client Suicidality, Cynthia A. Beevers

Dissertations

Suicidal clients are a reality for both professional and student therapists providing counseling (Chemtob et al., 1988; Dexter-Mazza & Freeman, 2003; Goodman, 1995; Howard, 2000; Jacobson, Ting, Sanders, & Harrington, 2004; Kleespies, Penk, & Forsyth, 1993; Kleespies, Smith, & Becker, 1990; Mackelprang, Karle, & Cash, 2014; McAdams & Foster, 2000). Previous research has investigated the experiences of professional therapists working with suicidal clients, but little is known about student therapists’ experiences with suicidal clients. Only two studies were found investigating the experiences of student therapists working with suicidal clients (Kleespies et al., 1993; Kleespies et al., 1990). However, in the …

Demonstrating Functional Analytic Psychotherapy As An Independent Variable In Efficacy Research: A New Measure Of Treatment Fidelity, Lindsey E. Knott

Dissertations

Functional Analytic Psychotherapy (FAP) is a contextual behavior therapy that takes an in session, in vivo focus to improve client outcomes. This in vivo (IV) focus is distinctive of FAP and involves the therapist utilization of contingencies in session to decrease problematic response classes and increase more adaptive response classes (i.e., a differential reinforcement procedure). This contingent responding is proposed to be FAP’s mechanism of action leading to client change. FAP efficacy research mainly consists of small n single-case studies or group designs combing FAP with another CBT intervention. Maitland & Gaynor (2012) offered recommendations for increasing FAP efficacy research, …

Evaluation Of A Youth Emergency Room Enhancement Program For Behavioral Health, Anne Thatcher

Dissertations

Problem. Pediatric mental health complaints and subsequent hospitalizations have been steadily increasing. The Behavioral Health Network (BHN) developed an intensive outreach case management program aimed at reducing youth mental health emergency department (ED) visits and inpatient psychiatric admissions. The Youth Emergency Room Enhancement (YERE) program was a process improvement initiative to provide immediate case management to youth and caregivers for mental health care.

Methods. A Plan-Do-Study-Act (PDSA) method utilizing a retrospective case record review occurred over a six-month period. A convenience sample of youth aged 6-20 years presenting to one of eight healthcare facilities for either ED or inpatient hospitalization …

The Effect Of Mantram Repetition On Qol In Low-Income, Urban Dwelling Older Adults, Marissa Katerina Mackiewicz

Dissertations

Background: Quality of life is an important concept of increasing significance for the healthcare in the United States, especially when taken in perspective of the aging population. Low-income, urban dwelling older adults are challenged in a number of ways that may negatively impact their QOL. This unique group is prone to report lower QOL, therefore, interventions targeted to improve QOL are timely. The purpose of this study was to describe the effect of mantram repetition (MR) on QOL in a sample of low-income, urban dwelling older adults.

Methods: A quasi-experimental pre-posttest study was conducted using a sample population of low-income …

The Prospective Influence Of Religiousness On Alcohol Use: What Role Do Perceived Norms Play?, Corey Todd Brawner

Dissertations

Alcohol misuse is recognized as one of the most pressing health hazards for college students. Previous research has supported a protective relationship between religiousness and problematic alcohol use, but it is less clear what aspects of religiousness are protective and through what mechanisms its effect is exerted. The current study utilized a prospective design to accomplish three primary goals: (1) Delineate the protective effects of religious motivation and public participation on alcohol use and alcohol-related problems in a sample of undergraduates at a large public university in the southeastern United States, (2) determine whether effects were maintained long-term, and (3) …

The Predictors Of Juvenile Recidivism: Testimonies Of Adult Students 18 Years And Older Exiting From Alternative Education, La Toshia Palmer

Dissertations

Purpose: The purpose of this descriptive, qualitative study was to identify and describe the importance of the predictors of juvenile recidivism and the effectiveness of efforts to prevent/avoid juvenile recidivism as perceived by previously detained, arrested, convicted, and/or incarcerated adult students 18 years of age and older exiting from alternative education in Northern California. A second purpose was to explore the types of support provided by alternative schools and the perceived importance of the support to avoid recidivism according to adult students 18 years of age and older exiting from alternative education.

Methodology: This qualitative, descriptive research design identified …

From War To Home: The Systematic Issues Operation Enduring And Iraqi Freedom Veterans Face Transitioning With Ptsd, Tiffany D. Ware

Dissertations

Purpose: The purpose of this phenomenological study was to describe the perceptions of Operation Enduring and Iraqi Freedom veterans with PTSD, who are transitioning from active duty to civilian life, regarding their participation in the Disabled Transition Assistance Program.

Methodology: The methodology for this research study will be qualitative from a phenomenological perspective. When thinking of research as it pertains to qualitative methods, it is appropriate to use when a researcher is trying to study the lived experiences of individuals (Flipp, 2014; Patton, 2015). This method will describe perceptions of Operation Enduring and Iraqi Freedom veterans with PTSD, who are …

Finding Common Ground: Learning From Leaders Who Have Utilized Conflict Transformation Behaviors In The Mental Health Field In The United States, Tamarah E. Tilos

Dissertations

Purpose: The purpose of this study was to discover and describe how exemplary leaders establish common ground and produce breakthrough results in the mental health field by utilizing the 6 domains of conflict transformation: collaboration, communication, problem solving, process, emotional intelligence, and ethics.

Methodology: This thematic, phenomenological study was accomplished through examination of the lived experiences of exemplary leaders with firsthand experience transforming conflict and finding common ground. The target population for this study included executive-level leaders of nonprofit organizations, governmental institutions, state and national associations, and private businesses serving adults and children with mental illness, developmental or behavioral disabilities, …

Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples

Dissertations

Abstract

Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …

A Healthcare Provider Needs Assessment Regarding Transgender Patient Health For A Student Health Services Center, Dorothy J. Cochran

Dissertations

Objective: This study sought to identify education and training needs of university health service providers regarding transgender patient care. Transgender patients are a vulnerable population who tend to have negative health outcomes. Limited information exists regarding transgender patients and their providers at student university health services nationally.

Methods: The researcher conducted a one hour semi-structured focus group with the professional staff at a Midwestern state university health service. The focus group conversation was guided by a list of prepared questions but other issues were allowed to arise. Two readers qualitatively analyzed the focus group transcripts for predominant themes.

Participants: The …

Discriminative And Reinforcing Effects Of Cocaine-Levamisole Combinations, Zachary J. Zimmermann

Dissertations

The behavioral and neurochemical effects of cocaine are well established, and it is one of the most widely abused illicit drugs. Illicit cocaine is often adulterated with levamisole, which is an anthelmintic that was withdrawn from the U. S. market in 2000. It has been hypothesized that levamisole, unlike other common adulterants which are added as simple bulking agents, has effects of its own which may be responsible for its use as an adulterant. Although these effects are speculative, the addition of levamisole to cocaine has become an increasing public health concern, as serious adverse effects (e.g., vasculitis, neutropenia) of …

Post-Intensive Care Syndrome: Comparison Of Educational Interventions To Educate Parents Of Children Hospitalized In The Pediatric Intensive Care Unit At St. Louis Children’S Hospital, Stephanie A. Esses

Dissertations

Background: Family members of children hospitalized in the pediatric intensive care unit (PICU) can develop cognitive, psychological, and physical manifestations of post-intensive care syndrome (PICS). Targeted education to help parents/caregivers recognize the signs and symptoms of PICS may result in better awareness of the syndrome and greater willingness to seek and receive support during their child’s PICU admission.

Objective: to evaluate three targeted PICS educational interventions to increase PICS awareness among parents/caregivers in the St. Louis Children’s Hospital (SLCH) PICU.

Results: A total of 62 parents/caregivers received one of three educational interventions: informational brochures (n=22), scripted informational conversation (n=20), or …

Job Retention And Job Satisfaction At The Behavior Therapist Level Working In Aba Companies In The Home Setting, Melissa M. Dauster

Dissertations

Purpose: The purpose of this relational study was to identify and compare the factors related to job satisfaction and job retention as perceived by behavior therapists working with children diagnosed with autism. A second purpose of the study was to determine the relationship between the level of burnout related to job retention, and the intrinsic and extrinsic level of motivation related to job satisfaction as perceived by Behavior Therapists working with students with autism. A further purpose of the study is to describe the improvements in the work place that behavior therapists working with students with autism identified as necessary …

Factors Affecting Mental Health Seeking Behaviors Of Law Enforcement Officers, Vincent M. Haecker

Dissertations

The intent of this study was to elicit perspectives from law enforcement counselors, clinicians, chaplains, and peer group leaders for factors affecting law enforcement officer’s (LEOs) seeking mental health assistance. The law enforcement and mental health communities have gone to great lengths to ensure assistance is available to LEOs in an effort to counter the stress and trauma associated with the policing profession. Past studies attempted to elicit LEOs attitudes on mental health services, generating mixed results and were unable to establish why available services were underutilized. This study employed a qualitative methodology to elicit perspectives on this phenomena from …

The Associations Among Expressed Emotion, Relationship Satisfaction, Ptsd Symptoms, Alcohol Use, And Depression: A Longitudinal Investigation With A Military Sample, Laci Lee Zawilinski

Dissertations

PTSD in military personnel is highly prevalent and accompanied by elevated rates of additional issues such as depression, problematic alcohol use, and interpersonal relationship problems. Family members and spouses of military personnel have also been shown to be negatively impacted by PTSD symptoms. Previous research has indicated that family members and spouses’ expressed emotion regarding the PTSD patients’ symptoms negatively impacts treatment outcome in civilian populations. However, studies have yet to investigate the effect of expressed emotion on the course of PTSD symptoms and associated problems in military personnel. Therefore, the purpose of the present investigation was to examine the …

Integration Of Professional Identity And Christian Religious Identity In Undergraduate Social Work Students, Lolene K. Bargerstock

Dissertations

Undergraduate social work programs are responsible to prepare students who will practice in accordance with the NASW Code of Ethics. Such preparation is not simply limited to developing a body of knowledge or set of skills but extends to adoption of a professional identity. Several research studies point to religious values as a significant motivational factor in choosing social work as a profession, yet little research has been conducted to investigate the integration of religious identity with an emerging professional identity. The current study sought to explore the experience of professional identity formation in undergraduate Christian social work students …

Campus Mental Health Practices And The Stigma Of Mental Illness: A Quantitative Analysis Of Student Affairs Professionals, Megan Krone

Dissertations

Around half of undergraduate college students will experience mental illness to some extent during their academic careers, yet a low percentage of students experiencing signs and symptoms of mental illness will seek help despite the availability of proven, effective treatments. The field of higher education has demonstrated a genuine concern for individuals with mental illnesses and mental health care on campuses, yet implementation of practices that connect students to treatment is inconsistent and effectiveness is uncertain.

This study searched for associations between campus practices and campus culture regarding mental illness. While institutions of higher education are using both traditional and …

Integrated Dual Disorder Treatment: Co-Occurring Evidence-Based Practice Implementation, Alteration, And Fidelity Over Time, Jennifer Harrison

Dissertations

Individuals with co-occurring illnesses are at risk for poor outcomes related to criminal justice, hospitalization, housing, and employment. High fidelity evidence-based practice models, including Integrated Dual Disorder Treatment (IDDT), are associated with significant improvements in outcomes. Although IDDT has been well-researched in small scale clinical trials, the implementation, alteration, and sustainability in real world applications over time has not been well-researched or understood. Initially, a descriptive analysis of a secondary dataset including the full population of 68 IDDT fidelity teams from 2006–2012 evaluated by the Michigan Fidelity and Assessment Team (MiFAST) in one state was completed. IDDT fidelity significantly improved …

Saliva Cotinine As A Measure Of Abstinence In A Lottery-Based Contingency Management Treatment For Smoking Cessation, Catherine M. Gayman

Dissertations

Contingency management decreases smoking by delivering monetary incentives contingent upon objective verification of abstinence. The present study investigated the effectiveness of monitoring saliva cotinine twice weekly in a contingency-management treatment for cigarette smoking using a cash prize-based payment system. Participants were randomly assigned to either a contingent reinforcement group or a non-contingent reinforcement group. The study began with five consecutive Baseline days during which participants smoked as usual, and was followed by four consecutive Shaping days, during which participants were asked to gradually decrease smoking. During the subsequent three-week Abstinence phase, participants submitted saliva cotinine and breath carbon monoxide samples …

The Effects Of Schedule Density Of Reinforcement For Alternative Behavior On Resurgence, Kathryn M. Kestner

Dissertations

Resurgence is the reemergence of a previously extinguished response when an alternative response no longer produces reinforcement. Although returning to previously successful methods for obtaining reinforcement is likely advantageous, resurgence also occurs in the form of treatment relapse. An individual may return to problematic behavior (e.g., aggression, self-injury, drug use) when an alternative behavior (e.g., communication response, coping skill, social behavior, etc.) is no longer successful at producing a reinforcer. Behavior analysts rely on treatments based on differential reinforcement of alternative behavior, and resurgence has been demonstrated following changes to reinforcement schedules due to errors in treatment integrity or intentional …

Functional Analysis Of Gambling, Mack S. Costello

Dissertations

Given high rates of gambling and the growing population of disordered gamblers, there is a need to develop assessment strategies with improved treatment validity. More specifically, assessment strategies are needed that identify the controlling variables for disordered gambling and, thus, provide guidance in the selection of treatment and prevention strategies. This study sought to develop a functional analysis for gambling by utilizing a simulated gambling environment in which contextual variables hypothesized to be causally linked to disordered gambling could be systematically manipulated. Seven experienced gamblers participated in the multi-element, single-subject experimental study. Participants who endorsed at least some problems from …

An Evaluation Of The Attitudes, Beliefs, And Mental Health Literacy Of Young African American College Graduates, Marshae Antoinette Mcneal

Dissertations

The aim of this study was to examine the relationships between the attitudes, beliefs, and mental health literacy of young college-educated African Americans as compared to their Caucasian counterparts. Previous research indicates these two populations differ when receiving services for mental illness. The goal of this study was to see if this difference is due to their mental health literacy level, attitudes toward seeking help, as well as their attitudes and beliefs toward mental illness. A quantitative analysis was conducted using elements of the MacArthur Mental Health Module and the Attitudes toward Seeking Professional Psychological Help Scale-Short Form (ATSPPHS-SF) to …

Preferences For Evidence-Based Depression Treatments: An Emphasis On Patient-Focused Care, Lauren A. Frye

Dissertations

Research indicates most depressed patients in the general U.S. adult population seek depression treatment in primary care settings where the prevailing method of treatment is antidepressant medication. Although primary care physicians regard this approach as a preferable first line method of depression treatment, studies indicate many patients do not. Several studies have found depressed patients in these settings prefer psychotherapy or counseling over anti-depressant medication. Many advocate patient preferences should be integral to the treatment decision making process. There is a demonstrated propensity towards psychotherapy or counseling over antidepressant medication among depression patients. However, it is unclear which psychological depression …