Mental and Social Health Commons^™

Understanding Hispanic Cultural Strengths Through Parents’ Voices: Insights For Interdisciplinary School Personnel, David Moran, Johana Rocha, Kristy Carlisle

Journal of Human Services Scholarship and Interprofessional Collaboration

Examining the strengths of Hispanic cultural values among K-12 school students is a generally understudied concept, and from their parents’ perspective specifically. This study sought to take a qualitative approach toward the exploration of Hispanic parents’ perspectives on how their cultural values promote strengths within their school-aged children. Hispanic parents (N = 8) participated in bilingual (i.e., Spanish and English) focus groups, with the results providing content that can inform culturally responsive prevention and intervention strategies to support the roles of interdisciplinary school personnel who regularly interact with the children. Findings pointed to (a) interaction with peers and school …

Improving Anxiety Screening In Active-Duty Military: Policy Recommendation For Implementing Ham-A Alongside Gad-7, Alex Judkins

Student Scholarly Projects

Practice Problem: Military personnel appear to be at increased risk for mood and stress-related conditions, such as anxiety and depression. These are frequently associated with traumatic brain injury (TBI), yet existing policies and practices may not fully capture this symptom complexity.

PICOT: For healthcare policymakers and providers (P), how does a policy review and recommendation for implementing the HAM-A screening tool for anxiety (I), compared to continued reliance on GAD-7 (C), impact the early identification and policy alignment for somatic and psychic anxiety management among active-duty military personnel (O)?

Evidence: Investigating psychological illnesses and their physiological manifestations in isolation fails …

Adolescent Students’ Adaptability During The Covid-19 Pandemic Impacting Their Academic Preparedness In College: A Qualitative Exploration Of Resilience In Secondary School Disruptions, Nicole Tyanne Jameson

Dissertations

This study, conducted several years after the onset of the COVID-19 pandemic, takes a unique approach to investigating the long-term effects of the pandemic-induced disruptions on adolescents during secondary schooling and their academic preparedness in college. The study combined a descriptive qualitative analysis of academic routine data with quantifiable resilience scores, providing a comprehensive understanding of the challenges students faced, their adaptability and resilience, and the overall impact on their education journey into college. This comprehensive descriptive qualitative study utilizes triangulation of quantitative data and qualitative approaches to understand the subject matter thoroughly. The quantitative scores meticulously analyzed resiliency and …

The Relationship Between A School Psychologists Workplace Stressors To Their Home Life Functioning, Trevor Burns

Masters Theses & Specialist Projects

School psychologists face increasing professional demands due to rising caseloads, paperwork requirements, and staffing shortages, which contribute to elevated levels of occupational stress. Although prior research has examined job-related stress within the profession, little attention has been given to how these stressors may impact practitioners’ personal and home lives. The purpose of this study was to examine how occupational stress experienced by school psychologists relates to stress experienced in their home lives. A total of 176 practicing school psychologists from across the United States completed an anonymous online survey, which included the School Psychologist Distress Inventory (SPDI) and a newly …

Improving Collaboration With Hospital Security And Nursing Staff, When Treating Patients In Acute Crisis, By Implementing A Modified Sbar Card., Yuna Choi

Doctor of Nursing Practice Papers

Inpatient psychiatric units provide assistance to patients experiencing acute mental health crises such as psychosis or suicidal ideation. Patients experiencing acute mental health crises can sometimes become agitated or aggressive towards staff, themselves, or other patients, which can pose a significant risk to everyone’s safety. The purpose of the project is to improve staff satisfaction and collaboration by standardizing the interdisciplinary communication between hospital security and nursing staff. Over a period of two weeks, the facilitator educated security and unit staff on a SBAR card during shift huddle to implement on the unit in the event of an acute mental …

Dermatoglyphic Fluctuating Asymmetry In Schizotypy, Marcus R. Thomas

All-Inclusive List of Electronic Theses and Dissertations

Schizotypy has been linked with many of the proposed endophenotypes of schizophrenia, but research is limited on the relationship between schizotypy and dermatoglyphic fluctuating asymmetry. The present study sought to examine relationships between schizotypy, dermatoglyphic fluctuating asymmetry, handedness, and season of birth. 146 undergraduate students were identified as schizotypes (n = 52) or controls (n = 94) based on the Multidimensional Schizotypy Scale and had their finger and palm prints collected along with completing additional measures of schizotypy and handedness. Schizotypes did not exhibit a greater degree of dermatoglyphic fluctuating asymmetry, negative schizotypy was associated with increased absolute finger ridge …

Caregiver Perceptions, Knowledge, And Likelihood To Intervene With Suicidal Youth, Amber L. Willwerth

All-Inclusive List of Electronic Theses and Dissertations

This study utilized an online survey to target primary caregivers of a child aged 5-18. The survey highlighted factors regarding caregiver involvement in suicide prevention efforts, such as their knowledge, comfort and confidence intervening with a youth experiencing suicidality, and barriers to doing so. It was found that caregivers who had experienced suicide prevention training reported higher levels of comfort and confidence intervening with their own child and another child than those who had not, as well as lower levels of worry. Higher levels of education were also found to predict lower levels of worry, suggesting that further training and …

Resonant Disruptions: Understanding Canadian Nurses’ Practice With Youth Survivors Of Sexual Exploitation, Danielle E. Giebelhaus, Andrew Estefan Phd, Rpn

Dignity: A Journal of Analysis of Exploitation and Violence

The sexual exploitation of youth is a global concern. Youth survivors of sexual exploitation present to and require healthcare services, but most nurses do not feel effectively equipped to care for this population. There is currently little nursing literature to guide nurses in their practice with youth survivors. In this article, we report on a qualitative, hermeneutic study undertaken to explore nursing practice with youth survivors of sexual exploitation. Hermeneutics is concerned with understanding, and is a helpful way to conduct research when little is known about a topic. In this study, we asked the research question, “How might we …

Delusional Parasitosis With Depression, Hypertension And Migraine, Mouli Mandal, M Kishor, Mr Murali

Digital Journal of Clinical Medicine

Delusional Parasitosis (DP) , also known as Ekbom Syndrome, is a psychiatric disorder characterised by the unshakeable belief of infestation by parasites, insects or other organisms, despite the absence of objective medical evidence.
This case report presents a 49 year old female with a history of chronic headaches, progressively worsening insect crawling sensations. She was initiated on treatment and supportive psychotherapy.
This case highlights the importance of a thorough multidisciplinary approach in managing Delusional Parasitosis, emphasising the need to differentiate between primary and secondary forms, address the potential medical and psychiatric comorbidities, and implement appropriate pharmacological and psychotherapeutic interventions.

Associations Between Mental Health Outcomes And Discrimination And Victimization Among Adult Lgbtq+ Community Members Or Guardians Of Lgbtq+ Children, 2023-2024, Perla Gisel Mercado

Open Access Theses & Dissertations

BACKGROUND: LGBTQ youth face unique challenges and experiences that can significantly impact their mental well-being. Discrimination, stigma, prejudice, and struggle for self-acceptance contribute to increased rates of mental health issues within this population. Almost one in 8 people, or 970 million individuals worldwide, were living with a mental disorder. PURPOSE: Assess the relationship between discrimination and victimization and mental health outcomes among sexual and gender minorities (SGMs) in the Paso del Norte Region. METHODS: Data was collected through a cross-sectional needs assessment survey among adult LGBTQ+ community members or parents/guardians of LGBTQ+ children/youth living in New Mexico or Texas in …

Integrating Art Therapy And Emerging Technologies For Enhanced Neuroplasticity And Ptsd Intervention, Piper Hutson, James Hutson

Faculty Scholarship

Post-traumatic stress disorder (PTSD) remains resistant to many conventional treatments, underscoring the need for integrative approaches that harness neuroplasticity. Art therapy, with its capacity to facilitate nonverbal trauma processing and multisensory engagement, has shown distinctive advantages over verbal and pharmacological interventions. Recent innovations, including virtual reality (VR), artificial intelligence (AI), and biofeedback have amplified the therapeutic efficacy of art-based interventions by enabling adaptive, real-time modulation of emotional and physiological states. This review synthesizes current research on technologically enhanced art therapy, comparing it to established treatments such as cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). Findings indicate …

Intergenerational Family Dynamics Among Caregivers And Children’S Social-Emotional Development In China, Weiman Xu

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

The early years of a child’s life are pivotal for social-emotional development. While extensive research has explored the role of family settings in fostering children's social-emotional development (Bornstein, 2005), the impact of grandparental involvement, particularly the caregiving dynamics between generations, remains less well understood. This study aims to fill this gap by examining two critical aspects of intergenerational dynamics among caregivers (i.e. parent-grandparent coparenting and parent-grandparent relationship quality) and their associations with children’s social-emotional development (i.e. social skills and problem behaviors). Two specific aims were delineated: 1) examine the unique contribution of parent-grandparent coparenting, especially the power and authority domain …

The Tree That Would Not Fall: An Educator’S Autoethnographic Journey Of Healing Through Words, Raeanna Marie Carlson

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

To say the world has changed since the 2020 COVID-19 shut down is to minimize the micro and macro social changes that infiltrated the school system. In the wake of it all, we find a landscape marred by a both rising teacher attrition and struggling student motivation. This autoethnographic dissertation explores the deeply personal experience tethered to a deeply problematic system that contributes to not only teacher burnout but what I came to know as teacher demoralization. Personal traumas of teachers profoundly impact their experience in the classroom, and as I examined my own near departure from the classroom, I …

Hormonal Modulation Of Sexual Approach And Avoidance Among Women With A History Of Sexual Trauma, Anneliis Susan Sartin-Tarm

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

A history of sexual trauma places women at a high risk for sexual dysfunction and other health sequelae, yet the influence of ovarian hormones in this population is poorly understood. This dissertation tested the theory that the effects of ovarian hormones are mediated by cognitive approach-avoidance systems to shape sexual well-being, and that this process is moderated by sexual trauma history. This was investigated across three studies examining the menstrual cycle, hormonal contraceptive use, and menopause. Across each chapter, I present complementary evidence demonstrating that hormones interact with the interpretation of ambiguous internal and external cues with respect to sexual …

“Self-Compassion Has To Be The Heartbeat Of How I Move Through Life”: A Mixed Methods Study Of Family Caregiver Emotional Well-Being, Sarah O. Rasby

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Often referred to as “hidden patients,” family caregivers endure numerous physical, emotional, psychological, and social hardships due to the demands of caregiving, which often results in their own needs going unmet. With the projected 61.3 million of the baby boomer generation entering the long-term care phase by 2029 along with a mass shortage of professional caregivers post-pandemic, more and more family members are expected to fill in for the role of care without sufficient access to support services (Pollard & Scommegna, 2014; Smith & Chang, 2016). An exploratory, mixed-methods study using a three-group intervention design was utilized to investigate the …

The Connection Between Workplace Wellness Activities And Job Satisfaction In Manufacturing, Lori Scott Dreiling

Graduate Theses and Dissertations

Employers in all industries are concerned with creating and maintaining a workplace where their employees are engaged in their work. Job dissatisfaction is shown to lead to higher levels of turnover, absenteeism, and presenteeism. The purpose of this quantitative study will be to examine the connection between workplace wellness activity participation and job satisfaction, specifically for manufacturers in Southwest Missouri, Southeast Kansas, and Northeast Oklahoma. Manufacturers have experienced increased global competition in the last three decades, not just for their products or services but for quality talent. The value of this study is to show manufacturing employers that by providing …

Privacy In Perspective: Research Participants’ Priorities And Concerns Related To Sharing Data Generated In Human Neuroscience Studies, Christi J Guerrini, Jill O Robinson, Norah L Crossnohere, Mary A Majumder, Kathryn Maxson Jones, Whitney Bash Brooks, Sameer A Sheth, Amy L Mcguire

Faculty, Staff and Students Publications

The societal benefits from sharing and reusing data collected in human neuroscience studies are widely appreciated. However, there are persistent barriers to data sharing as well as privacy concerns related to unauthorized access, misuse, and reidentification of deidentified data. Thus far, few studies have been conducted with neuroscience research participants to understand their data sharing priorities and concerns. We conducted a survey utilizing an experimental design with N=52 participants in neuroscience studies funded by the U.S. National Institutes of Health representing diverse neurotechnologies and health conditions. Respondents prioritized sharing practices that maximize reuse of data to benefit patients and reduce …

Data-Driven Approach To Dynamic Resting State Functional Connectivity In Post-Traumatic Stress Disorder: An Enigma-Pgc Ptsd Study, Carissa W Tomas, Jacklynn M Fitzgerald, C Lexi Baird, Courtney C Haswell, Chadi G Abdallah, Michael Angstadt, Justin T Baker, Hannah Berg, Jennifer U Blackford, Josh Cisler, Andrew S Cotton, Judith K Daniels, Nicholas D Davenport, Richard J Davidson, Terri A Deroon-Cassini, Seth G Disner, Wissam El Hage, Negar Fani, Jessie L Frijling, Evan M Gordon, Daniel W Grupe, Xiaofu He, Ryan Herringa, David Hofmann, Ashley A Huggins, Ahmed Hussain, Jonathan Ipser, Neda Jahanshad, Tanja Jovanovic, Milissa L Kaufman, Yoojean Kim, Anthony King, Saskia B J Koch, Sheri Koopowitz, Amit Lazarov, Lauren A M Lebois, Isreal Liberzon, Shmuel Lissek, Antje Manthey, Geoffrey May, Katie A Mclaughlin, Laura Nawijn, Steven M Nelson, Yuval Neria, Jack B Nitschke, Bunmi O Olatunji, Miranda Olff, Matthew Peverill, Yann Quidé, Orren Ravid, Kerry Ressler, Marisa Ross, Lauren E Salminen, Kelly Sambrook, Chiahao Shih, Anika Sierk, Scott R Sponheim, Dan J Stein, Jennifer Stevens, Thomas Straube, Benjamin Suarez-Jimenez, Paul M Thompson, Nic J A Van Der Wee, Steven J A Van Der Werff, Sanne J H Van Rooij, Mirjam Van Zuiden, Dick J Veltman, Robert R J M Vermeiren, Henrik Walter, Xin Wang, Hong Xie, Xi Zhu, Sigal Zilcha-Mano, Christine L Larson, Rajendra Morey

Faculty, Staff and Students Publications

Using functional magnetic resonance imaging (fMRI), symptoms of posttraumatic stress disorder (PTSD) have been associated with aberrations in brain networks in the absence of a given cognitive demand or task, called resting-state networks. Prior work has focused on disruption in the static functional connectivity (FC) among specific regions constrained by a priori hypotheses. However, dynamic FC, an approach that examines brain network characteristics over time, may provide a more sensitive measure to understand the network properties underlying dysfunction in PTSD. Further, using a data-driven analytic approach may reveal the contribution of other larger network disturbances beyond those revealed by hypothesis-driven …

Sirt5 Inhibition Impairs Mitochondrial Metabolism And Enhances Venetoclax-Induced Elimination Of Acute Myeloid Leukemia Cells, Moran Wang, Ruiqi Zhu, Donald Small, Lan Lin, Li Li, Shengling Ma, Linghui Xia, Shanshan Luo, Wenjuan He, Jianming Yu, Junying Li, Ruowen Wei, Ao Zhang, Wei Shi, Yu Hu

Faculty, Staff and Students Publications

Metabolic reprogramming is a key focus of targeted therapies in acute myeloid leukemia (AML). The mitochondrial sirtuin SIRT5 removes succinyl groups from specific lysines and impacts cell metabolism, but its role in AML tumorigenesis has not been extensively explored. A recent study highlighted that SIRT5 regulates AML cell activity by modulating glutamine metabolism, but its molecular targets in AML remain unclear. This study aims to identify the substrates of SIRT5 in AML. It was found that a total of 83 proteins with 121 lysine (K) residues showed increased succinylation after SIRT5 knockdown, as determined by succinylome analysis of MOLM-13 cells. …

Notice-Ed: Nurse Or Technician Insights Into Cognitive Evaluations In The Emergency Department, Sarah J Nessen, Anita N Chary, Annika R Bhananker, K Jane Muir, Lauren T Southerland, Kyra O'Brien, Ari B Friedman

Faculty, Staff and Students Publications

Background: Several strategies have been proposed to increase chronic cognitive impairment (CI) screening in the emergency department (ED). Our goal was to assess the feasibility and acceptability of implementing specific CI screening tools and strategies in the ED from an ED registered nurse and technician perspective.

Methods: We performed a qualitative study using semi-structured interviews with a purposive sample of ED nurses and ED technicians (EDTs). Participants worked at an urban academic hospital and were interviewed between November 2023 and March 2024. Interviews assessed participants' opinions on the feasibility and acceptability of CI screening and the use of machine learning …

Safety And Efficacy Of Deep Tms For Adolescent Depression Based On Large Real-World Data Analysis, Yiftach Roth, Aron Tendler, Gaby S Pell, Teejay Tripp, Philip Yam, Dianne Dekeyser, Mah Mekolle, Jayson Tripp, Aaron J Dahl, Owen S Muir, Carlene M Macmillan, Kevin R Rosi, Steven A Harvey, Teresa Poprawski, Kevin M Kinback, Oluremi Adefolarin, Alexander Rohr, Mark E Blair, Diana Ghelber, Raymond Y Cho, Hannah R Kelly, Raymond C Garcia, Amita Jha, Richard A Bermudes, Colleen A Hanlon

Staff and Researcher Publications

Adolescent major depressive disorder (MDD) is a prevalent and serious mental health condition. Pharmacological treatments are commonly used but often have poor tolerability and severe side effects, such as suicidal ideation. Deep transcranial magnetic stimulation (TMS) is currently cleared treating MDD in individuals 22-86 years old. This post-marketing surveillance study was designed to evaluate the safety and efficacy of using this tool as a treatment for MDD in younger patients. Data were collected from 56 sites, resulting in 1257 patients that met inclusion criteria (e.g. 11-21 years old, H1 coil, 18 Hz or iTBS, treatment-resistant MDD). Treatment was well tolerated …

Lack Of Relationships Between Ketamine Treatment And Peripheral Neurotrophic And Inflammatory Factors In A Randomized Controlled Ketamine Trial Of Major Depressive Disorder, Manivel Rengasamy, Benjamin Panny, Zakary Hutchinson, Anna Marsland, Tessa Kovats, Angela Griffo, Crystal Spotts, Robert H Howland, Meredith L Wallace, Sanjay J Mathew, Shabnam Hossein, Rebecca B Price

Staff and Researcher Publications

Background: Ketamine is a rapid-acting treatment for treatment-resistant depression (TRD), though mechanisms related to ketamine's effects remain unclear. Blood-based neurotrophic and inflammatory factors (NIFs; e.g., brain-derived neurotrophic factor, interleukin-6) have emerged as markers potentially linked to ketamine and ketamine treatment response.

Methods: In this secondary analysis of a randomized controlled trial (RCT), 133 adults with TRD received a single-dose infusion of ketamine (n = 89; 0.5 mg/kg) or saline (n = 44) and provided measures of peripheral blood NIF levels and depression severity across a five-day post-infusion period. Differences between ketamine and saline groups were examined for (1) NIF levels, …

The Real Story Of “The Happy Mother”: A Narrative Inquiry Exploring The Construction Of Motherhood And Postpartum Depression, Elizabeth Erin Falconer

Seton Hall University Dissertations and Theses (ETDs)

The transition to motherhood is a complex and challenging period, during which mothers undergo a considerable number of biological, hormonal, and identity changes. The first six to eight weeks following childbirth is a time of great susceptibility to postpartum depression for mothers. Despite its prevalence, there is a lack of research beyond the biological understanding of the experience. Prior literature has examined the biological aspects of postpartum depression and its societal influences on motherhood. However, no prior study has explored how postpartum depression impacts mothers’ construction and understanding of motherhood through investigating their subjective, lived experiences. This study fills that …

How Was Rehab? A Follow-Up To A Randomized Effectiveness Control Trial Of A Brief Acceptance And Commitment Therapy Protocol For Inpatient Detoxification Patients, Alexander J. Twohy

Dissertations

Residential treatment for Substance Use Disorders (SUD) is a common treatment modality. However, the literature is sparse on modifiable predictors that affect change during the residential treatment stay. Acceptance and Commitment Therapy (ACT) has been shown to be an effective treatment for SUDs. Weststrate et al. (2023), in a randomized controlled effectiveness trial, compared ACT plus medication management to medication management during detoxification. The addition of ACT increased consumer satisfaction and ACT skills use, while decreasing psychological inflexibility and reducing withdrawal symptoms.

This study explored whether the brief ACT intervention had impacts during participants' subsequent residential stay. Forty out of …

Emotional Safety In Pediatrics: The Impact Of Child Life Services On Healthcare Professionals’ Perceptions Of Their Own, Patients’, And Families’ Outpatient Experiences, Jenni Davis

All Dissertations

Medical visits, regardless of setting, are stressful for children and their families. Care that focuses on the emotional safety of children and families can help reduce this stress. However, not all staff feel prepared to provide emotionally safe care. Child life specialists (CLSs) are specifically trained to support emotional needs during healthcare encounters. Their presence may help staff stress as well, not just stress for children and families.

This study used three surveys to understand stress among healthcare staff working in pediatric outpatient clinics and surgery settings, and how support from a CLS affects staff, children, and families. All staff …

Exploring Transgender And Gender Expansive Youth's Experiences With Vicarious Minority Stress, Erin T. Pereida

Graduate Doctoral Dissertations

In the United States (U.S.), transgender and gender expansive (TGE) youth experience elevated rates of depressive symptoms, self-harm behaviors, and suicidality compared to cisgender peers. Mental health professionals and researchers often use the gender minority stress model to explain these elevated rates, positing that stressors related to minority identity experienced above and beyond normative daily stress contribute to adverse mental health outcomes. One emerging component of the model requiring further investigation is vicarious minority stress; stress experienced indirectly through witnessing or learning of gender minority stressors affecting other TGD individuals or the community more broadly. The present study explored this …

Bridging Psychiatry And Rare Genetic Diseases: A Scoping Review Of Therapeutic Strategies And Diagnostic Delay Paired With Healthcare Economic Burden Analysis, Sheldon R Garrison, Isaac J Siegel, Christopher R Takala, Sarah L Vaithilingam, Gene W Yang, Anthony W Zoghbi, Madeline M Hartig, Sreya Vadapalli, Margaret E Anderson

Duncan NRI Faculty and Staff Publications

Rare genetic diseases (RDs) with primary neuropsychiatric symptoms pose unique challenges for diagnosis and management. While the majority of these RDs have neuropsychiatric symptoms that are secondary to the RD, a subset presents with primary neuropsychiatric symptoms directly linked to their underlying pathophysiology. This subset has significant unmet medical need with delayed diagnoses leading to prolonged delays in treatment optimization and the trialing of medications that fail to target the underlying pathophysiology. This comprehensive review identifies 108 RDs with central neuropsychiatric symptoms that have a 7.7-year average diagnostic delay. Optimal management strategies for these RDs typically includes non-psychotropic medications, dietary …

'Managed Hearts’ In Helper-Education: Gender Non-Binary Helper-Educators’ Experiences Of Emotional Labor, Jordan Pearce

Counseling & Human Services Theses & Dissertations

The unique experiences of people who identify with a gender beyond the binary paradigm dominant in the Global West are not well understood. The literature provides little insight into the experiences and perspectives of these individuals in a variety of contexts, including in their workplaces. As various social movements collide, they bring amplified attention to the mental health of marginalized communities and to workers, as well as the dynamics of modern work environments, and the specific needs of certain individuals doing certain types of work. The current study explored the experiences of gender non-binary individuals (GNI) working as helper-educators engaged …

Student Impressions Of Undergraduate Art Therapy Education: A Survey, Shana Baird

EVMS School of Health Professions Theses & Dissertations

In addressing art therapy education, Taylor (1991) suggested that undergraduate art therapy education is controversial in that professional entry into the field is at the masters' level. Undergraduate programs offering degrees in art therapy range from providing a combination of psychology and studio art courses, offering art therapy courses and fieldwork experience, in addition to psychology and studio art, with variances in program curricula and requirements between the two extremes.

Therefore, graduates of undergraduate art therapy programs who further study art therapy at the graduate level enter with diverse levels of introduction to the field, preparation, and experience. Because differences …

A Focused Ethnography: Mental Health Therapists In Pediatric Integrated Care, Melanie Agustin

Counseling & Human Services Theses & Dissertations

The scope of practice for Licensed Professional Counselors (LPCs) and counseling residents (LPC-R) in integrated behavioral health (IBH) settings is grounded in accredited, theory-informed education and training. The benefits of IBH models are well-documented, however there is limited research that addresses how counselors develop professionally and clinically function, while navigating within pediatric inpatient environments. This qualitative dissertation used a focused ethnographic design to explore the lived experiences of ten purposively sampled counselors (n = 10) through demographic surveys, field observation, and semi-structured interviews. Reflexive journaling bracketed researcher bias, and thematic analysis, supported by NVivo and new member checking, guided interpretation. …