Clinical and Medical Social Work Commons^™

The Development And Implementation Of Trauma-Informed Care Within A Clinical Setting, Molly Hildebrandt

All Graduate Theses, Dissertations, and Other Capstone Projects

This capstone project facilitated the classification of CSSM as a trauma-­‐informed service system for children. Following a specific framework, the project included the development and implementation of an intake model for the agency to follow in order to begin the process. The student designed a new intake procedure, in which all children were screened for the possibility of trauma and then linked with a trauma-­‐ informed therapist based on a positive screening. This procedure produced the ability to effectively link children with trauma-­‐informed services.

Best Practices For Implementing Trauma-Informed Care With Youth Who Are Homeless Or At- Risk Of Being Homeless, Ellen Morrow

All Graduate Theses, Dissertations, and Other Capstone Projects

Exposure to traumatic events during childhood can affect brain development, how someone reacts to stress, and what they may find threatening or unsafe. Trauma can be a precursor to the development of a range of psychopathology including post-traumatic stress disorder, depression, anxiety, substance abuse, personality distortions and psychosis (APA, 2000, Rose, Freeman & Proudlock, 2012). Left untreated trauma can also result in medical conditions later in life including heart disease, cancer, respiratory problems and social conditions such as homelessness, prostitution or delinquency (Steele & Malchiodi, 2012; WISQARS, 2010). Maschi and Schwalbe (2012) cite studies which estimate up to 93% of …

Evidence-Based Treatment For Anxiety Disorders And Marijuana Use Across The Lifespan, Tanya Borchert

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this capstone project was to identify evidence-based practices relating to anxiety disorders and cannabis use throughout the lifespan. Identification of the practices will more effectively meet the needs of the clients served at the Dual Recovery Program and allow the agency to best serve clients with co-occurring anxiety disorders and cannabis use in a parallel manner. The literature indicates that there is a correlation between anxiety disorders and cannabis abuse (Buckner & Schmidt, 2011; Buckner, Zvolensky, & Schmidt, 2012; Bricker, et al., 2006; Bonn-Miller, Vujanovic, Boden, & Gross, 2011). If the anxiety disorder can be properly diagnosed …

The Use Of Electroconvulsive Therapy In An Acute Care Setting: Enhancing The Knowledge And Skills Of Mental Health Professionals, Lori Thom

All Graduate Theses, Dissertations, and Other Capstone Projects

1.To enhance the knowledge of mental health professionals working in the psychiatric care unit of the New Ulm Medical Center on the current use of electroconvulsive therapy (ECT).

2.To enhance the knowledge, insights, and skills of mental health professionals working in the psychiatric care unit of the New Ulm Medical Center in working with patients and their families when ECT would be a beneficial component of mental health treatment.

The Working Alliance: A Survey Of An Outpatient Mental Health Center, Jennifer Bramstedt

All Graduate Theses, Dissertations, and Other Capstone Projects

This research investigated the working alliance between therapist and client at RiverView Clinic, an outpatient mental health center. Utilizing data captured by the Working Alliance Inventory-Short Revised (WAI-SR), the research posited the following:

• median total scores from therapist’s would be higher than median scores of the working alliance from clients
• clients who presented with mild to moderate concerns would have higher working alliance scores than clients who reported moderate to severe concerns
• new clients would have higher task and goal sub-scores than clients in therapy for more than fifteen sessions
• if working alliance scores reflected ruptures or strains in the …

A Guide To Understanding, Building And Sustaining An Effective Therapeutic Community, Sara Loose

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this guide is to facilitate an understanding of therapeutic community/ milieu therapy concepts as well as building and sustaining an effective therapeutic community on each unit, in each cottage, and within Leo A. Hoffmann Center as a whole. This guide includes evidence based research that supports the use of therapeutic community principles, and interventions and evaluation tools that can potentially be used by Leo A. Hoffmann Center to enhance services. Ultimately, the goal of the project is to provide the agency with a tangible, well rounded resource that can be used by the multidisciplinary team to provide …

A Community Based System Of Integrated Clinical Care: Primary Care, Mental Health And Substance Use Treatment, Terri Reuvers

All Graduate Theses, Dissertations, and Other Capstone Projects

Our segregated medical and mental health care system misses opportunities for early detection of physical disease. Missed opportunities lead to increased costs. Colorado’s Medicaid health plan estimates that an integrated health program will reduce costs for patients with psychiatric disorders by 10%. The cost of doing nothing may exceed $300 billion per year in the United States (NCCBH, 2010). The purpose of this Capstone project is to critically examine existing models of Integrated Primary and Mental Health care. These models will then be evaluated to identify those most compatible with rural communities in Southern Minnesota.

Evaluation Of Family Skills Group At Fernbrook Family Center, Jessica Robertson

All Graduate Theses, Dissertations, and Other Capstone Projects

This project evaluated the Parenting Piece by Piece curriculum. This project sought to gain feedback on the ways the agency can improve family skills groups to better meet the needs of the client population Fernbrook Family Center serves. Parenting Piece by Piece is an eight-week program teaching parents new parenting skills.

Identification Of Effective Play Techniques For Use With Children In A Outpatient Mental Health Clinic, Jan Schwarzrock

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this research project was to identify which play techniques are the most effective and produce good outcomes for children. Children enter therapy for a number of reasons to improve their emotional and cognitive wellbeing, however engaging them can be challenging. During a therapeutic session, children use play to share experiences through the toys they choose, whereas adults verbally express themselves. The Allina Health/NUMC Outpatient Therapy Department was interested in the identification of play techniques that they could be used to enhance their work with children with the intent to explore the impact of using play techniques on …

Supervision And Education As A Factor Of Self Efficacy In Novice Therapists, Natalie D. Dewitt

Graduate Theses

The hypothesis of this exploratory study is aimed at examining novice therapist’s self- efficacy towards counseling, observing self efficacy modifications during practicum, and creating implications for future therapists. There were 20 participants surveyed using the Counselor Self Efficacy Scale, as well as questions generated towards the education experience as well as the supervision experience. A Pearson’s correlation was conducted comparing the supervision and education experience, there was a negative correlation, resulting in the education experience decreasing as the supervision experience increased. A r-test was conducted and the difference in means was consistent with the Pearson correlation confirming higher supervision scores.

Perceived Neighborhood Safety And Psychological Distress: Exploring Protective Factors, Jaime Booth, Stephanie L. Ayers, Flavio F. Marsiglia

The Journal of Sociology & Social Welfare

While a growing body of literature has established a relationship between "disordered" neighborhoods and psychological distress, less is known about the specific mechanisms at work. Using data collected in the 2008 Arizona Health Survey (N = 4,196), hierarchal linear regression was conducted to assess both the independent effect of perception of neighborhood safety on psychological distress, as well as the mediating effects of powerlessness, social isolation and mistrust. The findings suggest that the more safe individuals feel in their neighborhood, the less psychological distress they experience (b = 1.07, SE = .17, p < .001). This relationship appears to be partially mediated by feelings of powerlessness, social isolation and mistrust, indicating potential risk and protective factors.

Patterns Of Residential Mobility Of People With Schizophrenia: Multi-Level Tests Of Downward Geographic Drift, Christopher G. Hudson

The Journal of Sociology & Social Welfare

This study tests the geographic drift hypothesis that the negative SES-MI correlation results from individuals first developing conditions such as schizophrenia and then moving frequently because of their disability to low income and urban areas, and to neighborhoods with high concentrations of SMI persons. This is a secondary analysis of hospital records of 1,667,956 individuals in Massachusetts, USA, between 1994 and 2000. It employs a longitudinal cohort design and techniques of multi-level modeling. Downward geographic drift of those with schizophrenia was found to be small, but greater than other groups examined. The small level of drift was best explained by …

Competency And Voters With Psychiatric Disabilities: Considerations For Social Workers, Jennifer K. Davis

The Journal of Sociology & Social Welfare

The ability of those with psychiatric disabilities to vote is an important activity impacted by competency issues and potentially overlooked by social workers. The purpose of this article is to assist social workers in making informed decisions about preserving and supporting voter participation among those with psychiatric disabilities. Common issues regarding the voting rights of individuals with psychiatric disabilities within the legal system and other systems of interest to social workers are explored.

Exploring Barriers To Inclusion Of Widowed And Abandoned Women Through Microcredit Self-Help Groups: The Case Of Rural South India, Margaret Lombe, Chrisann Newransky, Karen Kayser, Paul Mike Raj

The Journal of Sociology & Social Welfare

Microcredit programs have been applauded as the magic bullet for the poor, especially women with limited financial resources. Building on previous research, this study examines effects of a microcredit self-help group (SHG) program on perceptions of social exclusion among widowed and abandoned women who participated in groups established after the 2004 Indian Ocean Tsunami in Tamil Nadu, India (N=109). Data were collected on key aspects of the program such as loan amount and investment patterns, group experience, demographics, and perceived barriers to inclusion. Results indicate that investment patterns and group experience impacted the women's perception of barriers to social inclusion. …

Clean Needles And Bad Blood: Needle Exchange As Morality Policy, Elizabeth A. Bowen

The Journal of Sociology & Social Welfare

The morality policy framework is a lens for understanding the unique characteristics of policies that attempt to regulate personal morals and behaviors. Needle exchange, a controversial intervention for reducing the transmission of HIV in injection drug users, shares many of the hallmark characteristics of morality policies. Analyzing needle exchange from a morality policy perspective, focusing on the 21-year ban on federal funding for needle exchange, reveals how value-based arguments have been used in the needle exchange debate and explains why the issue is likely to remain controversial in the United States. This analysis adds to the understanding of moral and …

Spiritual Care Within Oncology Care: Development Of A Spiritual Care Program At An Indian Health Service Hospital, Catherine Witte, Tamana D. Begay, Kathryn Coe

Journal of Health Disparities Research and Practice

Spiritual care is essential in providing quality health care for patients and their families and is supported in the mission of the Indian Health Service (IHS). Their mission is to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level. This paper will describe the spiritual care programs at the Phoenix Indian Medical Center, an IHS hospital located in Phoenix, Arizona. Two hospital committees, the Volunteer Chaplains’ Association and the Traditional Cultural Advocacy Committee, provide spiritual care for the medical center and work to sustain a presence of spiritual and cultural awareness …

Evaluation Of Support Groups For Adults With Diabetes, Julie Angelita Gonzalez

Theses Digitization Project

The purpose of the study is to evaluate support groups for people with diabetes to find out information about the facilitators, social workers involvement, if any, details of how the groups are facilitated, resources used and the way in which behavioral change is addressed.

Medical Practitioners' Death Anxiety And The Advance Directive, Daisy Macias, Natalie Macias

Theses Digitization Project

This study examined whether there is a correlation between medical practitioner's level of death anxiety and communication about the advance directive. Even though there is a lot of common sense in stating the obvious complexity of issues surrounding end of life, there is also a clear discomfort with accepting the advance directive and the patient's wishes at face value and the underlying reasons for that may lie in the physician's own feelings over death.

Dual Diagnosis Treatment Group Curriculum, Julie M. Wood

All Graduate Theses, Dissertations, and Other Capstone Projects

The social workers at the MSH are treating many patients who have previous placements in chemical dependency treatment in addition to previous hospitalizations for their mental illness. Licensed Drug and Alcohol Counselors (LADC) are employed at the hospital but not on unit 800 which is the crisis and intake unit. The hospital does not have funds available in their budget to add additional LADC staff at the present time.

Having a treatment group focusing on dual diagnosis would enable the patients to receive education and therapy for their addiction issues much earlier in the course of their treatment at MSH. …

Survey Of Emergency Department Patients' Perceived Barriers To Accessing Services And Community Resource Utilization, Kelsey Ann Wilke

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this project is to describe the patients being served by Avera McKennan’s emergency department (ED) and to explore perceived barriers to accessing services and current community resource utilization in order to prevent further non-emergent visits.

Research Questions: 1) What are the demographic characteristics of emergency department patients that are referred to the emergency department social worker? 2) What are the perceived barriers that emergency department patient’s encounter when trying to access services and community resources?

"First Impression": Creating An Intake Procedure That Is Welcoming To Clients And Useful To Clinicians, Brandi Embacher

All Graduate Theses, Dissertations, and Other Capstone Projects

Have you ever contacted an agency and felt doubtful about their ability to help you due to the phone interaction or written correspondence you received? The significance of this Capstone project is to create an intake procedure that will leave a positive first impression for individuals seeking services with Mankato Marriage and Family Therapy Center (MMFTC).

Stroke Rehabilitation, Length-Of-Stay, And Re-Admission Rates: A Literature Review, Morgen Hagedorn

All Graduate Theses, Dissertations, and Other Capstone Projects

Stroke is shown to be a significant U.S. health problem with a profound impact on the nation’s rising healthcare costs (Hall, Levant, & DeFrances, 2012). Longer patient length-of-stay [LOS] and higher re-admission rates have brought consequences to healthcare systems as institutional budgets are unable to reconcile the additional services and the influx of healthcare demands. Through a comprehensive literature review, the author illustrates the general knowledge available on the stroke experience, on stroke care and rehabilitation, and on patient LOS and re-admission rates. The literature review is based on general medical research with a focus on the stroke population. The …

Policies In Hospital Social Work, Jolene L. Reisdorfer

All Graduate Theses, Dissertations, and Other Capstone Projects

The goal of this project was to create an environment that provides a professional standard of care to ensure patient safety. This project will address the absence of policies in the Social Service Department at Mayo Clinic Health System, Southwest Region. A standard of care is a detailed standardized model of an intervention process that discusses the goals, objectives, settings, process, procedures and interventions (Gayle, 2005). Policy development must occur to assure that patients with social service needs are being identified appropriately and are being provided necessary interventions to meet their needs (Gordon & Rehrs, 1969). The project also identified …

A Review Of Developmentally Appropriate Evidence-Based Effective Parenting And Resources For Parents, Kari Schwecke

All Graduate Theses, Dissertations, and Other Capstone Projects

Krisma Counseling, a counseling center located in rural southern Minnesota, offers high quality and affordable consumer-centered mental health services to individuals, families, couples, including in-home therapy. In order to provide adequate services and care that abides by the Nation Association of Social Workers Code of Ethics, there needs to be standard ethical practice rooted in evidence based literature. The purpose of this project was to research developmentally appropriate evidence-based effective parenting and create a resource guide for clinicians to use in their work with parents of children ages two to 17.

Bridging Tactics: Parental Support Systems: A Proposal For A Psycho-Educational Parent Group, Emily F. Thompson

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this Capstone project is to design and present a new intervention program for increasing supportive services to the parents of clients being served through the infant/early childhood mental health program at CSSM. The goal of this project is to provide CSSM with a culturally-­responsive, theoretically grounded, evidence-­based proposal for the development of a psycho-educational group that includes a clear rationale for why this intervention is needed and how it will help the agency achieve the outcomes of infant/early childhood mental health program.

Needs Assessment Of Emergency Department Social Workers In Southwestern Minnesota In Relation To Emergency Department Expansion, Gina Marie Njugunah

All Graduate Theses, Dissertations, and Other Capstone Projects

Expansion of a hospital emergency department will affect the role of the emergency department social worker. This research project was conducted to assess the needs, concerns, and strengths of the social workers working in the emergency department of a regional medical center. The study included 13 participants who completed an on-line survey. Results showed that participants were concerned with the increase in patient volume as well as the possible increase in wait time for patients. Participants also expressed how concerns could be addressed. The most common solution was to track information about the cases, including wait times for patients, in …

Health Service Access For Rural People Living With Hiv/Aids In China: A Critical Evaluation, Xiying Wang, Xiulan Zhang, Yuebin Xu, Yurong Zhang

The Journal of Sociology & Social Welfare

The increasingly serious HIV/AIDS epidemic creates a significant burden for the public health system; however, little attention has been paid to the issue of health service access in rural China. Based on a qualitative study of 34 Chinese rural People Living with HIVIAIDS (PLWHA) and 13 health providers, this study fills a gap by examining health service access from both the demand and supply-side. Utilizing access theory, this study explores the availability, affordability and acceptability of health services in rural China. Moreover, this study focuses on access barriers and institutional obstacles that PLWHA meet during their illness and considers the …

Emergency Room Use By Undocumented Mexican Immigrants, Ayse Akincigil, Raymond Sanchez Mayers, Fontaine H. Fulghum

The Journal of Sociology & Social Welfare

This study examined emergency room use by undocumented Mexican immigrants and their sources of health care information. Thirty-eight percent of the respondents reported that they would use a hospital emergency room (ER) for primary medical care. ER use rates declined with time spent in the United States. Emergency room use rates varied significantly by region. Respondents receiving information from a church reported less ER use, compared to all others; respondents receiving information from U.S. newspapers reported higher ER use rates. Lack of health care access for undocumented immigrants remains a public health issue as well as a social justice concern.

Depression And Its Associated Risk Factors In Medical And Surgical Post Graduate Trainees At A Teaching Hospital: A Cross Sectional Survey From A Developing Country, Aisha Yousuf, Sidra Ishaque, Waris Qidwai

Department of Family Medicine

Objectives: To determine the frequency of depression among post graduate medical trainees in a teaching hospital of Pakistan and to explore the associated factors contributing to depression in them. Methods: It's a cross-sectional study at the Aga Khan University Hospital, Karachi. It was done in June 2008 till August 2008. Zung Self-Rating Depression Scale was administered among 172 post graduate trainees. Self administered questionnaires were used to assess the associated demographic and work related risk factors. Adjusted odds ratios (OR) were calculated by logistic regression. Results: The survey response rate was 172(82.69%). Depression in the overall sample was 103(59.88%), of …

Likelihood Of Asking For Help In Caregivers Of Women With Substance Use Or Co-Occurring Substance Use And Mental Disorders, Suzanne Brown, David E. Biegel, Elizabeth M. Tracy

Social Work Faculty Publications

Family members are important to the well-being of their relatives with substance use disorders or cooccurring substance use and mental disorders. Many caregivers experience high levels of burden, negatively impacting their capacity to provide support to their ill family member. The Andersen health care utilization model (Andersen & Newman, 1973, 2005) was used to identify the impact of predisposing, enabling, and need factors hypothesized to predict caregivers’ likelihood of asking for help and support with their caregiving role. The sample include 82 women recruited from outpatient or inpatient substance abuse treatment centers and 82 family caregivers nominated by these women. …