Clinical and Medical Social Work Commons^™

A Comprehensive Literature Review Of Barriers And Facilitators To Alcohol Use Disorder Screening And Treatment, Lizette M. Orihuela

Capstone Experience: Master of Public Health

Background: Alcohol Use Disorder (AUD) remains a significant public health issue with extensive personal, societal, and economic impacts. Recent studies indicate that no amount of alcohol consumption is entirely safe, linking it directly to increased chronic disease risks, including cancer. Despite well-documented negative health outcomes, clear guidance on what constitutes AUD through diagnostic criteria provided by the DSM-5, AUD continues to be underdiagnosed and undertreated.

Objectives: This comprehensive literature review explores the key barriers and facilitators influencing AUD screening and treatment engagement.

Methods: A comprehensive literature review was conducted, gathering from various databases including, PubMed, PsycINFO, Scopus, Google Scholar, and …

Unbridled Healing: Identifying The Barriers Of Equine-Assisted Therapy, Sally A. Hamm

Human Development and Family Sciences Undergraduate Honors Theses

Despite the documented benefits of equine-assisted therapy (EAT) for mental health conditions, this complementary approach remains underutilized. This qualitative study investigated barriers preventing wider EAT implementation by examining challenges faced by clients, facilities, and volunteers. Data collected through open-ended surveys from 33 participants and the researcher's autoethnographic observations revealed eight common barriers: Accessibility (48 mentions), Money (43), Time (30), Awareness (23), Physical Factors (13), Relationships (13), Risk (13), and Weather (7). Clients identified financial constraints as their primary barrier, particularly insurance limitations. Facilitators struggled most with accessibility challenges, including lack of resources, trained staff, suitable horses, and appropriate facilities. Volunteers …

Use Of Interdisciplinary Rounds For The Identification Of Hospitalized Adults In Need Of Palliative Care, Brenda A. Blunt

Evidence-Based Practice Project Reports

Palliative care (PC) is specialized care that aims to provide relief from the stress and symptoms of living with a serious illness (Center to Advance Palliative Care, 2022). PC services are often underutilized in the hospital, leaving a significant number of patients with unmet needs (Haranis et al, 2023; Kawashima & Evans, 2023; Smith et al, 2019). The purpose of this evidence-based practice project was to improve processes for identifying hospitalized patients for referral to specialty inpatient PC. The intervention involved interdisciplinary rounds (IDR) for adult inpatients on two medical-surgical (MESG) units in an 84-bed community hospital in suburban Milwaukee, …

Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano

Psychology Division Scholarship

Repeated eras of mass incarceration, criminalization of marginalized communities, and substance use policies have created a revolving door of justice involved populations. The ever-increasing prison population has repeatedly become the largest contingency of mental health clientele for an overburdened mental health system. Those who work with formerly incarcerated individuals in the community often don’t know the unique set of challenges faced by practitioners within the system. Increased understanding and coordination of care can offer opportunities for sustained recovery and reduced levels of recidivism. In this presentation participants will learn about the unique insights on mental health treatment that can be …

Analysis Of The Tennessee Covenant Marriage, Lucy C. Spivey

SPARK Symposium Presentations

Most recent data from the World Population Review suggests that Tennessee’s divorce rate (3.3% per 1,000 people) is among the highest divorce rates in the country (2024). Although the country and state average rate has decreased in the past five years, many Tennesseans are concerned at the number of failed marriages. House Bill 0315, introduced by Republican Representative Gino Bulso, is a result of this growing concern. House Bill 0315, better known as the “Tennessee Covenant Marriage Act,” aims to strengthen Tennessee marriages by limiting divorce options for couples and requiring a premarital counseling course (Jenkins, 2025). Proponents of this …

Supporting Elementary Educators Through A Nervous System Regulation And Social-Emotional Learning Skills Workshop Intervention: An Musc Capstone Project, Lily Morgan

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Teachers have a great influence on developing children’s emotional intelligence, regulatory capacity, and occupational engagement. These professionals also happen to report some of the highest rates of stress, mental health challenges (Agyapong, B. et al, 2022), and burnout (Xie, M., et al, 2022). Providing teachers with education and support on nervous system regulation, social-emotional learning skills, and related topics can improve their ability to manage job stress, enhance modeling and interactions with students, and improve their quality of life. This project aimed to enhance knowledge, provide access to resources, and serve to support elementary educators at an inner-city school in …

Los Inmigrantes Indocumentados Y Su Pelea Para La Salud Medica En Los Estados Unidos, Alejandro Del Rello

World Languages and Cultures Senior Capstones

This essay explores the critical issue of healthcare access for undocumented immigrants in the United States. Despite contributing significantly to the economy through labor and taxes, undocumented immigrants face systemic barriers to medical care, including lack of insurance, fear of deportation, and economic troubles. These barriers result in untreated illnesses, mental health struggles, and increased use of emergency services, which generate higher long-term costs. The paper argues for inclusive healthcare policies, such as Medicaid expansion and protections for patient privacy, to improve public health, reduce disparities, and enhance economic stability. Drawing from U.S. and international examples, the essay demonstrates that …

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

“I Learned To Bottle Up My Feelings From A Young Age”: A Narrative Analysis Of Latina Young People’S Family Mental Health Socialization, Jenn M. Lilly

Social Service Faculty Publications

Latina young people report high levels of mental health problems and low levels of helpseeking

compared with their white peers, but little research has examined factors influencing

their mental health views. Inductive analysis of 25 participants’ narratives revealed that Latina

young people described three stages in the development of their mental health-related beliefs,

attitudes, and behaviors: undergoing a process of family mental health socialization, suffering

in silence, and attaining a new perspective. Within each of these phases, participants shared

stories that attest to their agency and resilience. This research uncovers a novel theoretical

construct, “family mental health socialization,” which elucidates …

Racial Health Disparities Among Pregnant Women Of Color In New York City: Biological And Systemic Impacts, Kaylin Peña

Pitzer Senior Theses

Racial Health Disparities Among Pregnant Women of Color in New York City: Biological and Systemic Impacts

Abstract

This thesis aims to explore how racial health disparities, underrepresentation in gynecology, and socioeconomic barriers contribute to adverse pregnancy outcomes among women of color in New York City. Through an interdisciplinary approach that combines resources from medical anthropology and human biology, this research will examine the biological implications of chronic stress, specifically HPA axis dysregulation, and its role in maternal health outcomes. With the idea of intersectionality, as conceptualized by Kimberlé Crenshaw, the study analyzes the various effects of systemic inequities and social …

Advance Care Planning Utilization Among Non-White Individuals With Heart Disease And Cancer Using Health Retirement Study (Hrs) Data, Trizah M. Njoroge

Nursing Dissertations - Archive

Advance Care Planning (ACP) is a critical component of patient-centered care, yet its utilization remains disproportionately low among Non-White populations in the United States, particularly among individuals with chronic illnesses such as heart disease and cancer. This article explores racial disparities in ACP engagement using secondary analysis of the 2018 and 2020 waves data from the Health and Retirement Study (HRS), guided by Bandura’s self-efficacy theory (SET). The study examines how race, disease type, comorbidity, and survey year predict ACP service utilization, defined as completing five key ACP components: a legal will, a medical care discussion, surrogate assignment (DPOA), a …

“It Is Tiny And It Is Everything”: Exploring The Effects Of Arts-Integrated Gardening On Experiences Of Ecological Grief Through Autoethnographic Research, Christina Kingsbury

Theses and Dissertations (Comprehensive)

This study explores how arts-integrated gardening affects experiences of ecological grief through autoethnography and draws on my personal experiences as a survivor of environmentally linked cancer and artist working with gardens through social practice. My research builds on two areas of emergent scholarship—investigations of ecological grief and gardens as sites for social work practice—to explore how social work may address ecological grief through arts-integrated gardening. I use a quilting autoethnography as a method of inquiry to foreground my subjective knowledge and analyze it through intersectional feminist, disability and decolonizing theories. By incorporating narrative analysis and arts-based inquiry—writing in place, poetic …

Leadership In Behavioral Health, Rebecca Mccoy

School of Business Student Theses and Dissertations

Abstract

Leadership in healthcare is difficult when dealing with human contact in its most raw and vulnerable way. Leadership in behavioral health is just as challenging as direct practice practitioners tend to be the ones who move up into these roles. This study will exam “Identifying factors that promote successful leadership and challenges that cause barriers to having successful leadership in behavioral health.” This includes soft and hard skill knowledge, growth opportunities and the strengths and struggles in moving into leadership roles in this industry.

The study is based on phenomenological research to gain an understanding of the individual experience …

Assessing The Relationship Between Perceived Psychological And Physical Pain In Adults With Orthopedic Pain, Daniel C. Karimi Dehkordi

Honors Undergraduate Theses

Suicide remains a public health concern in the U.S., particularly among individuals experiencing chronic pain and psychological distress. This cross-sectional study investigated the relationship between perceived physical and psychological pain in 41 adults with chronic orthopedic conditions. The relationship between other risk and protective factors and perceived levels of pain distress was also examined. Results showed a significant positive correlation between psychological distress and physical pain (r(39) = 0.388, p < .05) and psychological distress and depressive/anxiety symptoms (r (39) = 0.477, p < .01). Psychological distress was moderately associated with feelings of hopelessness (r (39) = 0.403, p < .01), however, the relationship between physical pain and hopelessness was weak and nonsignificant (r (39) = -0.06, p = .71). Contrary to expectations, emotional support did not buffer the effects of psychological distress (r (39) = 0.07, p = 0.66). Mediational analysis confirmed that emotional support did not influence the relationship between physical pain and psychological distress (Beta (β) = -0.969, p = 0.572; Sobel Z = 0.5598, p = 0.575). Age was not correlated with psychological distress (r (39) = -0.24, p = 0.13) or mental health symptoms (r (39) = -0.05, p = .77). While there was no significant difference across sex, males reported higher mental health symptomatology and psychological distress scores than female counterparts. These findings underscore the direct impact of physical pain on psychological distress and challenge assumptions about the protective role of social support. The study highlights the need for integrated, multidisciplinary interventions targeting both physical and psychological pain to mitigate suicide risk among individuals with chronic orthopedic conditions. Future research should iii explore alternative support mechanisms and resilience-building strategies to address the complex interplay of pain, distress, and suicidality.

Learning To Be An Autistic Therapist: Personal Steps Towards An Autism-Affirming Psychotherapy, Sasha D. Strong

Ought: The Journal of Autistic Culture

How can Autistic therapists understand and support themselves, and how can this help them support their clients? In this paper, I recount my personal journey of healing and growth as an Autistic psychotherapist, 16 months after self-identification. Here is an overview of conceptual frameworks from #actuallyautistic authors, critical theory, queer theory, and social justice that I have found helpful. I also share some of the therapeutic and wellness approaches that have been important to me, including mindfulness and bodyfulness. Organic knowing has been pivotal for me in discerning between masking and aliveness, and regaining a choice around masking behaviors. This …

Making An Easy Return To School After An Extended Illness Diagnosis, Ashlyn Eads, Mary Jan Greer, Julie Boykin

Fall 2024 OTD Capstone Symposium

This poster provides information on the capstone program created at a pediatric site. This program addresses how play-based therapy can help children with an extended illness transition back into the school setting. Both the children and their caregivers need support before, during, and after the return to school. The goals of this program were to educate caregivers on how to advocate for their child for positive outcomes, provide caregivers with resources to promote successful transition to school, provide play-based strategies for children addressing handwriting, social Skills, upper body strength, education, fine Motor Skills, and provide the site and caregivers with …

¿Qué Dijo El Médico?: Creating A Procedural Preparation Booklet For Spanish-Speaking Patients And Families In The Pediatric Hospital Setting, Caitlyn Bockbrader

Honors Projects

The purpose of my Honors Project is to demonstrate the need for and creation of a resource that supports Spanish-speaking children’s ability to cope through commonly stressful medical procedures. In developing this project, I conducted a literature review on the efficacy of preparation booklets in lessening pre-procedural anxiety, cultural considerations for the Hispanic community, and current barriers to equitable language access in healthcare settings. My final product was designed to answer the following question: How can the psychosocial outcomes of Spanish-speaking children in U.S. hospitals be improved through the use of Child Life procedural preparation materials? In answering this question, …

Disparities In The Pregnancy Experience: A Multi-Case Analysis, Tiffany C. Thomas, Lindsay Gietzen

Pacific Journal of Health

Racial disparities in maternal healthcare continue to be a significant issue, with Black women experiencing worse outcomes compared to White women. Despite improvements in healthcare, Black women are still 2.5 times more likely to die from pregnancy-related causes, and they face higher rates of preterm births, low birth weight, and insufficient prenatal care. This paper examines the experiences of three African American women from high socioeconomic backgrounds, focusing on where these negative experiences are most common throughout pregnancy, childbirth, and postnatal care. The study uses the Pregnancy and Maternity Care Patients' Experiences Questionnaire (PreMaPEQ) to explore different stages of care, …

Benefits Of Meditation Practices In Alleviating Posttraumatic Stress Disorder (Ptsd) Symptoms For Individuals Already In Therapy, Jeanette G. Mann, Lindsay Gietzen

Pacific Journal of Health

Abstract

This study examines the impact of adding and incorporating a meditation practice into a treatment plan for Posttraumatic Stress Disorder (PTSD) for three adult patients at a Federally Qualified Health Center (FQHC). The cases involved included patients with persistent PTSD symptoms who had experienced limited improvement with standard therapies. Data from Electronic Health Records and clinician notes showed that adding an eight-week meditation practice enhanced emotional regulation and reduced anxiety. In all three cases, the meditation practice increased the benefits of the traditional therapy. This helped the patients have greater control over their PTSD symptoms and improve their quality …

Comprehensive Community Medicine, Alexander Walther

Capstone Projects and Master's Theses

Comprehensive Community Medicine (CCM) is a theoretical framework designed to address the complex needs of individuals with dual diagnoses of mental illness and substance use disorders (SUDs). Dual diagnosis is highly prevalent, particularly among populations experiencing homelessness, and is associated with poorer health outcomes and increased healthcare service utilization. Structural inequities, including a fractured healthcare system, exacerbate the challenges faced by this vulnerable group. Research indicates that effective care for dually diagnosed individuals requires a layered approach addressing clinical, systemic, legal, and housing barriers.

The development of CCM has been informed by interviews with local stakeholders, including County EMS board …

Msw Portfolio, Dallin C. Ball

Graduate Student Portfolios, Professional Papers, and Capstone Projects

No abstract provided.

The Relationship Between Gender And Experienes Of Weight Stigma From Healthcare Providers, Isabella J. Aceituno, Shannon Sagert

Undergraduate Research Symposium Posters

Healthcare providers are a common source of weight stigma, which is associated with lower physician trust, poorer patient outcomes, and the avoidance of healthcare services. Currently, there is a lack of consensus in research on whether women and men are equally likely to experience weight stigma from healthcare providers. The present study examined whether gender differences exist in weight stigma received from healthcare providers in childhood or adulthood, comfort seeking medical care, and healthcare avoidance. Adult participants (N = 196) reported the frequency at which they experienced stigmatizing experiences in healthcare environments in the past 12 months and during childhood …

Post-Pandemic Needs Of Unpaid Family And Friend Caregivers To Effectively Continue Caregiving Duties In One Northern Ontario Health Authority, Jodi Webber, Erin Mulroney, Mark Tatasciore, Brianna Smith, Patti-Jo Duggan, Louis Ferron, Hannah Albani, Bianca Feitelberg, Laura Tenhagen, Sophia Myles

Patient Experience Journal

The Covid-19 pandemic had a significant impact on the support networks for older adults and caregivers as health and social care systems were forced to dramatically change the ways patients and clients interacted with providers, services, and programs. In Northern Ontario, caregivers are older, caring in more intense situations, more likely to be caring for multiple care recipients simultaneously and less likely to be in contact with health professionals. This research sought to explore the post-pandemic needs of caregivers in a Northern Ontario health catchment to better understand the needed supports. Using a collaborative and co-design approach with caregiver advisors …

Supporting African Communities To Increase Resilience And Mental Health Of Kids With Developmental Disabilities And Their Caregivers Using The World Health Organization’S Caregiver Skills Training Programme (Spark Trial): Study Protocol For A Cluster Randomised Clinical Controlled Trial, Melissa Nortey, Vibian Angweny, Beatrice Mkubwa, Rosa Hoekstra, Andrew Healey, Rahel Birhane, Nadine Seward, Temesgen Azmeraw, Fikite Girma

Institute for Human Development, East Africa

Background: Most children with developmental disabilities (DD) live in low- and middle-income countries, but access to services is limited, impacting their ability to thrive. Pilot study findings of the World Health Organization’s Caregiver Skills Training (WHO CST) intervention, which equips caregivers with strategies to facilitate learning and adaptive behaviours in children with DD, are promising but evidence from an appropriately powered trial delivered by non-specialist facilitators is lacking. This study will investigate the effectiveness and the resource impacts and costs and consequences of the WHO CST intervention in four sites in rural and urban Kenya and Ethiopia.

Methods: …

The Impact Of Health Status On Health Care Utilization Of Children In Foster Care, Jill Mcleigh, Gunjan Singh, Rong Huang

Health Status, Outcomes, and Literacy and Healthcare Utilization

This study sought to understand the health status of children in foster care; the relationship between their health status and health care utilization; and demographic and placement factors associated with health care utilization.

For questions about this study or others, please email [email protected]

childrens.com/fostercare

Family Fragments: Pressure And Proximity In First-Episode Psychosis, Cassandra B. Seltman

Dissertations, Theses, and Capstone Projects

This study explores the value of assuming a position that decenters the identified patient in families with a member with schizophrenia. Instead, a systemic view of the family is taken, as subject to pressures from without and within, and utilizing observable processes for the management and discharge of tension. It attempts the difficult balance of thinking dynamically without sacrificing scientific rigor, considering the social without discounting the biological, and exploring the functionality of the family without collapsing into blame, reductive cause-and-effect thinking, and the search to prioritize one true origin.

When treating family members as discrete units around an identified …

Conceptualizing Recovery From Mental Illness In Indonesia: A Scoping Review, Flora Cohen, Agus Sugianto, Hans Pols, Clement Bayetti

Makara Human Behavior Studies in Asia

Understanding how recovery is defined and realized across different cultural contexts is vital to upholding the dignity and rights of people with mental illnesses. Within the Indonesian context, there is a dearth of research on conceptualizations of recovery from mental illnesses. Questions remain regarding the extent to which service users and providers share common definitions of recovery. We conducted a scoping review to interrogate current definitions of recovery from the perspectives of the various actors working with people with lived experiences of mental illness and extreme mental distress. We found that definitions of recovery differ across multiple domains and include …

Impact Of Provider Obesity Bias And Stigma In Western Medicine, Cassandra A. Da Valle-Chervellera, Madhu Sundarrajan, Lindsay Gietzen

Pacific Journal of Health

Societal obesity stigma is greatly impactful on one’s life that is experiencing obesity. Limited data is available discussing the impact obesity stigma has on care coordination. This is a commentary paper outlining current research addressing obesity stigma in United States medicine. From the limited research, verbal and non-verbal stigma surrounding obesity is prevalent in America. A call to action is vital to begin education with clinical providers. Increased education catalyzes the cultural shift within health care to improve clinical providers’ empathy and care coordination efforts for this vulnerable population. Learning more about obesity stigma and how clinical medical providers can …

Expressive Therapies And Resiliency – Resistance In Mental Health: A Literature Review, Gabrielle Lopez

Expressive Therapies Capstone Theses

This review evaluates the current literature on psychological resistance amongst human service professionals experiencing burnout and the effect of Expressive Arts interventions on resiliency. Concepts include identifying the main symptoms, risk factors, causes, and treatments for burnout in education faculty, medical staff, and clinicians. Qualitative, quantitative, and meta-analysis studies are included to identify the most prevalent intervention frameworks for reducing stress including Arts-Based and Mindfulness-compassion based techniques. The effectiveness of Arts-based tools on strengthening identity, self-esteem, emotional regulation, and meaning-making in combating burnout is presented. Based on analysis of the literature, the author proposes a three-step intervention framework for utilizing …

Reflection And Connection: Trauma-Informed Yoga And Its Aid In Trauma Healing In Female Identifying College Students, Gabrielle V. Sandoval

Graduate Theses and Dissertations

Traumatic experiences affect female identifying folks at an unequal rate compared to other populations. Trauma-informed yoga (TIY) has become a popular intervention for treatment of symptoms related to trauma. By utilizing tenets such as meditation, intentional movement, and trauma-informed language and positioning, this practice focuses on the mind-body-connection to establish feelings of safety. Although trauma education and interventions are becoming commonly implemented on college campuses, there is a gap in implementation and empirical studies evaluating such campus programs. To explore how TIY could aid this population, a four-week yoga intervention was created. Four participants engaged in a weekly TIY class …