Mental and Social Health Commons^™

Adhd Diagnosis And Treatment Within Ethnic Minority Groups, Dianthe Hoang

Undergraduate Honors Theses

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is commonly diagnosed in childhood, and the National Survey of Children’s Health reported that ADHD had a prevalence of around 6.1 million children aged 2-17 years old (NSCH, 2016). This review discusses the cultural and socioeconomic barriers that contribute to the underdiagnosis and treatment in members of ethnic minority communities. Black, Hispanic, Native American, and Asian adults received less mental health care compared to White Americans. Previous findings indicated that cultural factors, such as misinterpretation of symptoms from families and teachers and cultural perceptions of mental health, contributed to disparities …

Using Natural Materials In Art Therapy To Address Accessibility And Well-Being In Low-Income Older Adults, Ahlyana J. Richardson

Expressive Therapies Theses

This study investigated the implementation of natural materials during the artmaking processes in an older adult art therapy group (eco-art therapy), and its effects on their well-being and the role of accessibility in their lives. An open-studio approach was applied to emphasize the artmaking process being driven by the participants independently, while also sharing a collaborative space and creating community with each other. There was an exception to this condition in this study, being that the participants were encouraged to ask for assistance in using unconventional materials in their artwork if they felt they needed it. The participants were older …

Alive Old-Time Radio Play: Performance-Based Drama Therapy With Cognitively Healthy Older Adults, Aaron T. Dore

Expressive Therapies Theses

The live radio play format is uniquely positioned to offer social benefits for older adults when explored through a performance-based drama therapeutic lens. Though firsthand familiarity with old-time radio is not a prerequisite for meaningful participation in a group styled after this bygone era of storytelling, the format naturally supports accessibility needs common among the older adult population. The minimal blocking requirements, script-in-hand approach, and adaptable format make it especially accommodating to a wide range of skill levels and areas of interest. Research into therapeutic interventions for older adults tends to rely on reminiscence and life review approaches with an …

Icanfeel: A Digital Art Activity To Support Distress Detection In Adult Oncological Patients, Marie J. Deschamps

Expressive Therapies Dissertations

Considered the 6th vital sign, distress, a combination of hopelessness, anxiety, fear, and depression, can impact patients’ quality of life, treatment adherence, and mortality. While screening is required in oncological centers, distress remains under-detected. This study examined the use of Icanfeel, a novel digital art-based tool, to complement traditional psychometric assessments such as Edmonton Symptom Assessment System (ESAS), to support patients’ expressions of symptoms and distress detection. Hospitalized adult oncological patients (N = 22) engaged twice with Icanfeel and with an active control condition. At various time points during the protocol, patients self-reported symptom burden using ESAS, self-disclosure …

Dance/Movement Therapy Interventions That Can Address And Decrease Impacts Of Developmental Prosopagnosia: A Literature Review, Caitlin Rivenbark

Expressive Therapies Theses

This literature review explores dance/movement therapy (DMT) as a treatment modality for developmental prosopagnosia (DP) or face blindness. Research on DP causes and assessments are limited, as well as research on treatments and supportive management. In order to conceptualize how DMT might support people with DP, this paper focuses on mitigating the impacts of having the condition by exploring treatments for conditions with similar impacts including attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and social anxiety disorder (SAD). The interventions included were pharmacotherapy, behavioral contingencies, mainstream therapies, and alternative therapies including DMT and drama therapy (DT). The various …

The Authentic Self In Mental Health Practitioners Through The Use Of Internal Family Systems And Character Card Creation In Art-Based Therapy, Tracy J. Evans

Expressive Therapies Theses

Mental health practitioners, or therapists, are complex beings who carry not only the trauma from their life experiences but are also presented with the undertaking of trauma stewardship for clients. This study explores how participating with clients fosters self-expression and promotes emotional regulation, while enhancing social interactions within myself. Combining the terminology from the Internal Family Systems (IFS) Model and the concept of collaged card creation from SoulCollage to create character cards, made with clients, that represent the various parts of the personality. This qualitative study on the intervention found that it provided a safe space for both clients and …

How Can Tattoos Be Understood As Intermodal Expressive Arts Therapy?: Integrating Visual Art, Personal Narrative, And Embodied Experience: Development Of A Method, Rachel S. Hall

Expressive Therapies Theses

This paper explores the inherent intermodal nature of tattoos through the lens of expressive arts therapy, demonstrating how tattoos integrate visual art, personal narrative, and embodied experience. A group intervention was designed and implemented in an outpatient setting, drawing on existing literature and the Expressive Therapies Continuum (ETC) to examine how tattoos function as therapeutic tools that support identity formation, emotional healing, and self-expression. The intervention guided participants through an intermodal process that began with reflective writing on identity-forming experiences, followed by visual art-making and somatic engagement. This approach illuminated the transformative potential of tattoo conceptualization within a therapeutic context, …

A Proposal For The Theoretical Integration Of Cognitive Behavioral Therapy And Dance/Movement Therapy, Sarah Crain

Expressive Therapies Theses

A recognized integration of cognitive behavioral therapy (CBT) and dance/movement therapy (DMT) has not been developed because the concept currently lacks a strong philosophical and theoretical background. Observations from adjacent integrative expressive therapies and clinical practice provide encouragement that these models may provide a unique contribution to the field of psychotherapy. CBT would support the field of DMT toward better establishing an evidence-based theoretical background and framework. It is proposed that a well-supported approach to CBT and DMT should be built from a theoretical integration that upholds integrity of both models while identifying connective philosophical roots. This literature review initiates …

How Can Art Therapy Be Utilized To Support Emotional Communication For Autistic Individuals With An Alexithymic Profile?, Kathryn L. Cohen

Expressive Therapies Theses

The expressive nature of art therapy can aid those with communication and sensory processing differences. Art making allows for the individual to access and emote in a way that spoken language cannot. This literature review will investigate and explore the features of the processing differences related to autism, interoception and alexithymia. The findings from the research explore the effectiveness of utilizing art therapy as a method to expand emotional communication. There are many challenges pertaining to emotional regulation and communication for autistic individuals. Accessing mental health resources and service providers familiar with communication differences is another challenge for this population. …

"La Vida Es Un Carnaval": An Exploration Of Cuban Identity And Nostalgia Through Dance/Movement Therapy - A Community Engagement Project, Maria Fernanda Mendez Mendoza

Expressive Therapies Theses

“La Vida Es Un Carnaval” is a community engagement project and thesis that explores how identity and nostalgic resilience show up through dance/movement therapy with Cuban immigrants living in the United States, specifically Massachusetts. This project brought together six Cuban-born participants, ages 26 to 67, each with their own unique migration stories; from the Rafter Balsero Crisis of 1994, to the “Wet-Foot/Dry-Foot” policy, and family reunification. Through a mix of in-person and online sessions, participants explored their experiences using intermodal activities including dance/movement therapy techniques, conversation, journaling, artwork, and music. Themes of cultural pride, “Cubanía” – Cuban-ness, culture shock, and …

To Bear Witness: Analyzing Dmt As An Effective Trauma-Informed Approach For Treating Youth & Adolescents: A Critical Review Of The Literature, Jade Dennis

Expressive Therapies Theses

This literature review proposes dance/movement therapy (DMT) as a trauma-informed intervention for children and adolescents who have experienced psychological, emotional, or physical trauma. The project, inspired by internship experiences with young trauma survivors, explores the ways in which trauma manifests in the body, indicating that DMT may offer effective pathways toward healing. Many children exposed to potentially traumatic events exhibit emotional dysregulation, insecure attachment patterns, and behavioral or somatic symptoms that are not easily addressed through traditional talk therapy. As a body-based expressive arts modality, DMT engages the sensory, emotional, and relational aspects of trauma by supporting nonverbal expression, self-regulation, …

Therapeutic Qualities And Applications Of Clay In Expressive Arts Therapy: A Literature Review, Julia Caruso

Expressive Therapies Theses

This literature review investigates the therapeutic qualities and clinical applications of clay within the framework of expressive arts therapy (ExAT), with particular focus on sensorimotor, somatic, and developmental interventions. Drawing upon the expressive therapies continuum (ETC), this review synthesizes emerging research highlighting clay's kinesthetic and tactile properties as key mechanisms for facilitating emotional expression, accessing unconscious material, and promoting psychological resilience. Evidence is presented for specialized therapeutic modalities such as clay art therapy (CAT) and Clay Field Work, which engage the body-mind connection to support trauma integration and emotion regulation. Findings demonstrate that clay's inherent adaptability and sensory richness allow …

Spravato® Fda-Approved As Monotherapy For Adults With Treatment-Resistant Depression, Rileigh Rahrig, Kennedy Kosikowski, Haylee Whyde, Kiley Devoll, Allie Honigford, Macy Davis, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza

Pharmacy and Wellness Review

Treatment-resistant depression (TRD) is a challenging and possibly life-threatening condition that affects millions of people worldwide. Patients with major depressive disorder (MDD) are diagnosed with TRD once they have tried and failed to respond to two antidepressant treatments at the maximum dose for a full trial of six to eight weeks. Most traditional antidepressant therapies work by increasing the levels of monoamine neurotransmitters such as dopamine, serotonin, and norepinephrine in the brain. These medications have a delayed onset of action, ranging from two to eight weeks, and often fail to relieve depressive symptoms in a patient with TRD. Therefore, targeting …

Fda Approval Of Cobenfy: A New Therapeutic Option For Schizophrenia, Brenna Hissong, Penlope Mazivanhanga, Alexander Defranco, Linda Azap, Haley Brown, Megan Rizo, Joshua Honaker, Samantha Mccord, Lindsey Ferraro

Pharmacy and Wellness Review

Schizophrenia is a complex illness characterized by behavioral, emotional, and cognitive dysfunctions. Common symptoms include hallucinations, delusions, cognitive decline, and social withdrawal. The disorder is related to structural brain abnormalities, neurotransmitter imbalances, and a combination of genetic and environmental elements, and affects about 24 million individuals globally. Currently, two medication classes are most commonly used to treat schizophrenia. These medications are first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs). Due to the side effect profiles that both medication classes carry, research is being conducted for new drug classes.

Cobenfy (xanomeline/trospium chloride), also known investigationally as KarXT, is a new class of …

Social Determinants Of Health Extraction From Clinical Notes Across Institutions Using Large Language Models, Vipina K Keloth, Salih Selek, Qingyu Chen, Christopher Gilman, Sunyang Fu, Yifang Dang, Xinghan Chen, Xinyue Hu, Yujia Zhou, Huan He, Jungwei W Fan, Karen Wang, Cynthia Brandt, Cui Tao, Hongfang Liu, Hua Xu

Faculty, Staff and Student Publications

Detailed social determinants of health (SDoH) is often buried within clinical text in EHRs. Most current NLP efforts for SDoH have limitations, investigating limited factors, deriving data from a single institution, using specific patient cohorts/note types, with reduced focus on generalizability. We aim to address these issues by creating cross-institutional corpora and developing and evaluating the generalizability of classification models, including large language models (LLMs), for detecting SDoH factors using data from four institutions. Clinical notes were annotated with 21 SDoH factors at two levels: level 1 (SDoH factors only) and level 2 (SDoH factors and associated values). Compared to …

Misused And Misunderstood: Examining The Inappropriate Use Of Stimulant Medications, Connor Dains, Madilyn Paphanchith, Makayla Eversole, Chaehyeon Jin, Minhwan Yang, Joshua Honaker, Samantha Mccord, Kayla Petkus

Pharmacy and Wellness Review

Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children, characterized by inattention, hyperactivity, and impulsivity. The American Academy of Pediatrics (AAP) endorses stimulant medications as the first-line treatment option. When combined with behavioral therapy, this pharmacologic class can improve focus, executive functioning, and the overall quality of life. While stimulant prescriptions can have a positive effect when used as directed, there is concern for the potential of provider overprescription and patient misuse related to these medications. Consequently, the Food and Drug Administration (FDA) revised the boxed warning and prescribing information for stimulant medications. Healthcare providers must educate …

Shifting To A Culture Of Inclusion By Design: Applying A Mixed-Methods Approach To Advance Accessibility Of Public Health Emergency Information & Communication Technology, Jessica L. Franks, Erin Vinoski Thomas

Developmental Disabilities Network Journal

Adults with intellectual and developmental disabilities (IDD) experience inequities in access to timely, accurate, and understandable information and communication technology (ICT), which increases risk for public health emergency (PHE)-related health disparities and impedes opportunities to achieve optimal health. This study assessed federal COVID-19 webpage accessibility levels and explored existing knowledge of and experience with filing accessibility complaints for federal ICT among adults with IDD. Through a mixed-methods approach, we evaluated compliance with accessibility standards for 18 federal agencies’ COVID-19 webpages (study 1) and interviewed 16 adults with IDD about experiences accessing federal webpages and filing accessibility complaints (study 2). We …

The Cost Of Accommodative Burdens: Prevalence & Impact On Deaf And Hard Of Hearing Individuals, Lorelei Becktel

Undergraduate University Honors Capstones

This exploratory qualitative study (n=8) investigated the mental health effects of lack of reciprocity in accommodation and the resulting accommodative burden on deaf and hard of hearing individuals. Lack of reciprocity occurs when the split of the burden for communication accommodations falls significantly more on the deaf or hard of hearing individual. The resulting accommodative burden occurs when deaf and hard of hearing individuals adapt to make communication easier for hearing people at a level that is uncomfortable, unwanted, and/or detrimental to their needs. Effects, determined by participant responses, were examined via semi-structured interviews and analyzed via thematic analysis. Relationships …

Assessing One-Year Health Impacts From Wildfires In Rural Communities: Roles For Extension In Promoting Wildfire Preparedness And Recovery, Marc T. Braverman, Sandi Cleveland Phibbs, Emily Jane Davis, Amanda Rau, Elijah Penner

Journal of Extension

Wildfires can produce health impacts that persist for years in affected communities. This article describes an Extension-led study of health impacts in rural Oregon communities one year after a destructive wildfire. Data collection included key informant interviews (n=36), an online survey (n=80), and three focus group interviews with survivors (n=23). Mental health, exposure to contaminants, physical stress, food insecurity, and other issues were frequently identified health concerns. Survivors’ difficulties in dealing with housing displacement significantly exacerbated health challenges. We describe potential roles for Extension in addressing wildfire risk and mitigating health impacts, including a description of the Oregon Fire Program.

Food Insecurity In Adolescent Athletes, Andrew Donaldson, Shannon Margherio, Jay Roberson, Kevin Latz

Research Days

Background: The prevalence of food insecurity among children in the United States is estimated at 21%. Food insecurity during childhood leads to worse school performance, more emotional and behavioral health concerns, and increased suicide attempts. Further, food insecurity has been noted to have multiple deleterious effects on the collegiate student athlete, including lower GPA, disordered eating, and substance use.

Hypothesis: Food insecurity is prevalent in the adolescent athlete population and exists across demographics.

Methods: Voluntary surveys were distributed to parents at all sports medicine clinics at our institution. Demographic data was collected including athlete age, race, school and school district, …

Evaluating Scheduling Tool To Improve Behavioral Health Counseling Scheduling Rates On Same Day Of Referral, Edward Delesky, Md, Oluwatoni Okuboyejo, Md, Elizabeth Franko, Md, Nwamaka Amobi, Md, Ronak Ahir, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Studies suggest 1 in 5 adults in the US suffer from mental illness, with up to 46% of Philadelphia residents reporting poor mental health.
• Care integration beginning with primary care physician evaluation and management is becoming more common.
• Behavioral health counseling (BHC), provided by a primary physician and trained psychologist, is vital in management of mental health conditions.
• Studies suggest same-day scheduling of follow up appointments improves treatment adherence.
• Goal: improve BHC scheduling rates on same-day of initial referral across two practice teams

Viral Hepatitis And Hiv Screening Amongst Inpatients With Substance Use Disorder: An Initial Pdsa Cycle Analysis, Christine Papastamelos, Md, Elizabeth Novick, Md, Carolyn Kramer, Md, John Zurlo, Md, Nikhil Seval, Md, Mollie Tucker, Md, Daniel Taupin, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• ~67,000 individuals in Philadelphia county are estimated to be living with substance use disorder (SUD).¹
• Persons who inject drugs (PWID) are at disproportionately higher risk of acquiring HIV and viral hepatitis compared to the general public.² 
• A 3-month retrospective chart review (11/6/23-1/22/24) of 160 inpatient SUD encounters with an Infectious Disease (ID) consult showed that 35%-42% of HIV and hepatitis C screening opportunities were missed.

Recommendations For Telesupervision: Promoting Ethical, Legal, And Effective University And Clinical Supervision Using Technology, Madeleine M. Stevens, Yegan Pillay, Edisa Music, Elena Shahen

Journal of Counselor Preparation and Supervision

The expansion of the use of technology in counseling has implicated counseling professionals in considering how to legally and ethically incorporate it into all facets of practice, including university and clinical supervision settings. In this article, we provide scholarship-backed recommendations for doing so as well as provide suggestions for incorporating psychodynamic and cognitive-behavioral (CBT) supervision models into telesupervision.

Exploring Race In Addiction Treatment And The Need For An Anti-Racist Approach, Jackie D. Dell, Mei Tang

Journal of Counselor Preparation and Supervision

Extensive literature documents that Black people, Indigenous people, and People of Color (BIPOC) have been historically and systematically discriminated in addiction and substance use disorder treatment and services. This systemic oppression is the result of the creation and intersection of multiple systems that are rooted in White supremacy, which continue to fail to recognize racism as a critical factor in health disparities. The complexities of the structural factors that contribute to these racial health disparities, and opportunities to better address these disparities were reviewed to discuss their impact on BIPOC clients and the necessity for anti-racist approaches to addressing addiction …

Applying Supervision To Animal Assisted Therapy: Using The Integrative Development Model, Rachel W. Rachlinski, Kelli A. Mcfarland

Journal of Counselor Preparation and Supervision

A study conducted by Hartwig and Smelser (2018) reported 91.7% of clinicians being aware of animal assisted therapy (AAT) who agree it is a legitimate treatment model. However, 57% of respondents expressed interest in receiving AAT training. Although published standards and competencies published by ACA and IAHAIO indicate the requirement for clinical supervision when implementing AAT, research does not address supervision protocols for AAT. This manuscript suggests a protocol for supervising the implementation of AAT. The consequence of untrained supervisors is the potential harm to the well-being of the client as well as the clinician and the animal. As such, …

Culturally-Affirming Service-Learning For Counselors-In-Training: Child-Parent Relationship Therapy Training With Spanish-Speaking Families, Karen M. Roller, Szu-Yu Chen, Katrina Volante

Journal of Counselor Preparation and Supervision

The Spanish-speaking community is the largest underserved language group in the United States. To advance social justice advocacy and multicultural humility for this language group, the field of counselor education needs to create pedagogical scaffolding for non-Spanish-speaking counselors-in-training to work with interpreters to support Spanish-speaking families, while also enhancing language-concordant training for Spanish-English bilingual counselors-in-training. We utilized a critical race research design to explore six counselors-in-training’s experience participating in service-learning through online facilitation of Child-Parent Relationship Therapy with Spanish-speaking families. Interpretative phenomenological analysis of qualitative data yielded four major themes: (a) collaboration, (b) improved awareness, (c) growth and strength, and …

“Invisible Populations”: A Policy Brief Approach To Address Housing Data Needs In Vulnerable Communities, Kristin E. Moser

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Dependent adult children with severe mental illness (ASMI) living with aging parents have been an increasing population over decades due to lack of supportive housing and services in the community. ASMI living with aging parents is a high-risk group for housing instability and future homelessness. Local Problem: A limited amount of literature and data exist to determine the size and needs of the population of ASMI living with aging parents. A collaboration with University of San Francisco (USF) and non-profit, Solutions for Supportive Homes (S4SH) of San Mateo County (SMC) formed to disseminate information and quantify the “invisible …

Group Therapy For Young Adults With Intellectual Disabilities And Anxiety, Rayah Secrist

Educational Specialist, 2020-current

The purpose of this Ed.S. project is to propose a therapy group for individuals with intellectual disabilities who are struggling with anxiety. This paper will explore the literature on social and emotional barriers, mental health access inequality, and evidence-based practices in therapy for young adults with intellectual disabilities. Drawing on the research, this paper aims to provide clinicians with a guide for leading effective therapy groups tailored to this specific demographic.

Functional Brain Connectivity Of The Salience Network In Alcohol Use And Anxiety Disorders, Dhruv M Patel, Guillermo F Poblete, Alexandra Castellanos, Ramiro Salas

Staff and Researcher Publications

The interplay between alcohol use disorder (AUD) and anxiety disorders (ANX) is well-documented, yet the underlying neurobiological mechanisms remain elusive. This study aims to elucidate these mechanisms by examining the resting-state functional connectivity (RSFC) within the salience network and to the amygdala, both implicated in alcohol and anxiety disorders. We analyzed data from 264 inpatient participants culled from a wider group of 518 inpatients at The Menninger Clinic in Houston, TX, categorized into four groups (n = 66 each) based on DSM-IV diagnoses: AUD without ANX (AUD), ANX without AUD (ANX), concurrent AUD and ANX (BOTH), and neither (NEITHER). Our …

Burnout And Self-Efficacy: Exploring The Rewards And Challenges Faced By Crisis Counselors Working In Emergency Department Settings, Ellen Dotas

Dissertations, 2020-current

This dissertation explores burnout and self-efficacy in counselors who work with clients in crisis in emergency department settings. Mental health and emergency departments are two areas that tend to report higher levels of burnout than are reported in other occupational fields. While much research has been done on the topics of burnout and self-efficacy, limited information is available about counselors who work in these crisis roles. This dissertation follows a three-manuscript format and includes a conceptual, qualitative, and quantitative manuscript. The conceptual manuscript explores the nature of the crisis assessment itself, focusing on the area of risk assessment. The qualitative …