Psychiatric and Mental Health Commons^™

The Novice Licensed Professional Counselor's Perceived Preparedness To Use Self-Disclosure, Nicole Pfaff

Walden Dissertations and Doctoral Studies

Self-disclosure is used by feminist, humanistic, client-centered, and a variety of other counselors to build therapeutic alliances with clients. However, little research has been conducted on counselors' perceptions of their preparedness to use self-disclosure. This exploratory multiple-case study used attachment theory as a framework to explore the perceptions of novice licensed professional counselors' preparedness to use self-disclosure. The 12 participants who participated in face-to-face interviews practiced as licensed professional counselors in Delaware, New Jersey, or Pennsylvania. The participants described how they learned, practiced, and used self-disclosure. After analyzing interview data through cycle coding and peer review, themes emerged showing participants' …

Lgb Help-Seeking For Mental Health And Substance Abuse Services In Rural Northern Michigan, Jennifer Towns

Walden Dissertations and Doctoral Studies

Lesbian, gay, and bisexual (LGB) individuals are often exposed to stressors based on their nonheterosexual status; they may have unique needs related to help-seeking for mental health in a rural area where more people identify as religious or as politically conservative. To date, there have been no studies on the mental health help-seeking experiences of LGB individuals in rural Northern Michigan. This qualitative, single case study was completed to explore the help-seeking experiences of 10 LGB individuals who were recruited through criterion and snowball sampling. In-depth, semi structured interviews were conducted. Transcribed interview data were entered into Nvivo software for …

Differential Treatment Outcome Factors For Custodial And Noncustodial Mental Health Care Programs, Sheila Fay Waters

Walden Dissertations and Doctoral Studies

Researchers have suggested that jails and prisons in the United States are becoming the new mental health clinics, contributing to the phenomenon of mass incarceration and costing upwards of $15 billion per year in public revenue. The problem is no conclusive evidence exists that treatment in these custodial environments is more effective than that provided by noncustodial programs; especially for substance users. Additionally, the continuing incarceration of people with mental health problems by the hundreds of thousands poses a difficult ethical dilemma regarding why this population does not receive noncustodial or hospital treatment instead. The study addressed the research question …

Stress, Anxiety, And Depression: Role Of Campus Connectedness, Social Support, And Coping Among Nepalese Nursing Students, Priscilla Samson

Walden Dissertations and Doctoral Studies

High levels of stress, anxiety, and depression (SAD) can adversely influence physical health, psychological well-being, and academic and clinical performance of nursing students. Numerous studies have identified the factors associated with SAD; however, a paucity of empirical research addresses the relationship of SAD with campus connectedness (CC), perceived social support (PSS), and coping. The purpose of this quantitative cross-sectional study, guided by Lazarus and Folkman's theory of stress, coping, and adaptation, was to determine the prevalence of SAD and examine its relationship with CC, PSS, and coping among undergraduate nursing students of Nepal. Survey research was conducted using depression anxiety …

Educational Interventions To Improve Aggressive Behavior Recognition For An Acute Psychiatric Setting, Marie Elois Ortiz

Walden Dissertations and Doctoral Studies

Nurses working in an acute psychiatric setting within a veterans' administration hospital must maintain a therapeutic milieu by recognizing and managing aggressive behaviors before violence ensues to reduce injuries to staff nurses and patients. The purpose of this project was to develop an evidence-based and theoretically grounded educational program that will help staff nurses manage escalating aggression, violence, and acting out behaviors to provide a safe environment for patients and staff through high risk identifier recognition and intervention training. During the data and information gathering stage, 23 articles were reviewed, rated, and graded to provide the most significant information used …

Professionals' Perspective On Mental Health Courts, Martha M. Amos

Walden Dissertations and Doctoral Studies

In recent years, the percentage of incarcerated individuals with mental illness has dramatically increased. It is very hard to provide treatment and care for these defendants in jails or prisons. Currently, there are more mentally ill individuals incarcerated than in psychiatric hospitals. Furthermore, as budget cuts are being decided, urban and rural communities in America are looking at ways to help the mentally ill by initiating a mental health court (MHC) or continuing to fund an already existing MHC. Guided by the therapeutic jurisprudence theory, the purpose of this study was to elicit the opinions from MHC professionals regarding the …

Teacher And Student Variables Affecting Special Education Evaluation And Referral, Lorenzo Adrian Woodson

Walden Dissertations and Doctoral Studies

Past research has revealed that African American/Black boys are referred for special education evaluation at disproportionately higher rates than boys of other racial/ethnic groups. This correlational study used survey methodology to examine whether student and teacher demographic variables predicted how likely a teacher would refer boy students for special education evaluation. The following questions guided this research: 1) To what degree does student race/ethnicity, teacher gender, teacher race/ethnicity, and teacher attitude toward inclusion predict how likely a teacher would refer boys' to special education after controlling for teacher's years of experience in general and special education? 2) What are the …

A Case Study Exploration Of Teachers' Perspectives On Children's Mental Health Service Needs In Title I Elementary Schools, Natalie Denise Yates

Walden Dissertations and Doctoral Studies

Children go to school for approximately 32 hours each week of an academic year. Many children who are in need of mental health treatment do not get the services they need because of barriers such as lack of access and stigma. Teachers are one of the primary sources of referrals for children's mental health services, and they often make referrals based on their perceptions of their students' mental health needs. Although teachers are typically the primary source of referrals for mental health services, they usually do not have any specialized mental health training. The purpose of this study was to …

Vicarious Trauma Coping And Self-Care Practices Among Trauma Therapists., Annette Zaccari

Walden Dissertations and Doctoral Studies

Therapists who specialize in trauma therapy are indirectly exposed traumatic events presented by clients within the therapeutic relationship. The potential consequences for trauma therapists may be the risk of vicarious trauma. Effective coping and self-care are essential in the practice of trauma work. The research question for this study is: Do coping skills and self-care practices in trauma therapists moderate the disruptive effect of vicarious trauma on the fulfillment of their psychological needs (trust/dependence and control)? The purpose of this research study was to examine quantitatively, the role of trauma therapists' beliefs in the effectiveness of coping skills and time …

Reducing Stigma And Encouraging Help Seeking Intentions Through A Mental Health Literacy Program, Nicole Loreto

Walden Dissertations and Doctoral Studies

Many individuals do not seek help for a mental health problem due to stigma and fear of rejection by peers and family. Researchers have highlighted that the age group least likely to seek help is youth. Stigma acts as an important barrier to help-seeking. Evidence indicating how mental health literacy can reduce stigma and encourage help-seeking remains inconclusive. In this study, the health belief model was used to understand how college students perceived an individual's susceptibility to mental illness and the barriers associated with seeking help. A posttest-only randomized controlled trial evaluated the impact of the Is It Just Me? …

Online Versus In-Person Therapy: Effect Of Client Demographics And Personality Characteristics, Joel Joseph Kofmehl

Walden Dissertations and Doctoral Studies

Traditionally, mental health professionals have provided psychotherapeutic services through face-to-face sessions. As the Internet has become an increasingly important part of individuals' personal and professional lives, psychologists and clients have used this medium to expand access to psychotherapy. The purpose of this quantitative correlational design was to investigate whether demographic variables and the personality traits of extroversion/introversion (E/I), as assessed by the Big Five Inventory, predicted clients' preferences for a specific method of administered psychotherapy. The theoretical framework for this study was social information processing through computer-mediated communication. An online survey site was used to assist in survey design and …

Spirituality Among African American Christian Women Who Have Contemplated, Marilyn Wiley

Walden Dissertations and Doctoral Studies

The Centers for Disease Control and Prevention reported that African American women had the lowest recorded number of suicide completions among all ethnic and gender groups in the United States. In addition, the number of suicides among African American women continued to soar without a clear reason or understanding of their lowest completion rates. Further research in the area of spirituality among African American women may be critical in understanding why African American women's rates of completed suicides are statistically lower than other ethnic groups and how to prevent future rate increases. A phenomenological framework was used to examine the …

Evaluating The Impact Of Integrated Care On Service Utilization In Serious Mental Illness, Heidi C. Waters

Walden Dissertations and Doctoral Studies

Serious mental illness (SMI) affects 5% of the United States population and is associated with increased morbidity and mortality. Use of high-cost healthcare services is common, including hospitalizations and emergency department (ED) visits. Integrating behavioral and physical healthcare may improve care for consumers with SMI, but prior research findings have been mixed. This quantitative retrospective cohort study addressed the impact of integrated care on physical health and ambulatory care sensitive (ACS) utilization via a program evaluation of an integrated health clinic (IHC) at a community mental health center (CMHC). The research questions assessed whether there was a predictive relationship between …

Social Workers' Perceptions Of A Rural Emergency Mental Health Trauma Service, William L. Getz

Walden Dissertations and Doctoral Studies

Studies have shown that emergency mental health trauma (EMHT) services can significantly reduce the long-term effects of trauma after a disaster. However, rural municipalities may find they do not have the capacity to create such a service, or may not realize that their disaster planning includes no provision for emergency mental health care. Such was the case in a rural island community in the state of Washington, where, in 2014, several residents initiated a discussion that helped to identify the community's lack of EMHT services. This project, framed by action research and based on collaboration theory, sought to advance the …

The Critical Role Of The Psychiatric Emergency Response Team In The Adoption Of A Violence Risk Assessment Tool., Angela Mackay

Walden Dissertations and Doctoral Studies

Workplace violence is a persistent problem in health care, and incidence rates have increased over the years. Traditional reporting systems, relying mostly on paper formats, are inadequate for developing effective predictive models for intervention and reducing acts of violence by patients to staff. The purpose of the development and deployment of the psychiatric emergency response team (PERT) was to provide effective intervention within the MIAHTAPS (Altered Mental status, Irritability, Agitation, History of Violence, Threatening, Attacking Objects, Pacing, and Staring) behavior prediction tool to reduce the severity and rates of violence in a hospital setting. Lewin's change theory was used to …

Concept Of Self: Approach To Behaviors In Mental Health, The Tapout Program, Tina Goodrow

Walden Dissertations and Doctoral Studies

Violence in mental health care continues to be a problem. The incidence of violent episodes in healthcare settings with aggressive behavior of patients aimed at staff members or other patients is almost four times greater in healthcare than in other industries. Reducing violent episodes enhances the quality of care and improves safety for staff members and for patients. The project focused on development of a staff education program exploring the practice-focused question: Will this program effectively guide staff member approaches to mental health patients with challenging behaviors? The purpose of this project was to address the identified gap in practice …

A Clinical Practice Guideline To Reduce Behavioral Outbursts In Veterans With Posttraumatic Stress Disorder, Mary Adejumoke Badru

Walden Dissertations and Doctoral Studies

In a Department of Veterans Affairs hospital on the East Coast of the United States, behavioral outbursts result in 2 out of 10 veterans dismissed from a posttraumatic stress disorder (PTSD) unit prior to completing the 6-week program. The purpose of this evidence-based quality improvement project was to create a clinical practice guideline (CPG) based on social cognitive theory (SCT) to provide new strategies for managing veterans with PTSD and to improve the confidence of the nurses in managing outbursts. The Star Model guided the project development with the Delphi method to achieve participant consensus, the AGREE II to assess …

Relationship Between Educational Leisure Motivation And Recovery From Mental Illness Among Members Of Clubhouse International, Dianna Rene Pearce

Walden Dissertations and Doctoral Studies

Individuals with serious mental illness (SMI) exhibit low motivation to participate in educational leisure activities at Clubhouses accredited by Clubhouse International (CI). This correlational study examined the relationship between each of 4 motives, intellectual, social, competence-mastery, and stimulus-avoidance, to engage in leisure activities, and the perception of recovery from SMI. Knowles's theory of andragogy supported the concept of informal self-directed learning, which occurs with leisure activities. Literature indicates that participating in leisure activities such as those offered at Clubhouses aids in the recovery from SMI. Quantitative data were collected from a convenience sample of 75 individuals at 4 CI clubhouses …

Psychological Resilience In Correctional Officers: The Role Of Demographics, Manuel Chapa Villarreal

Walden Dissertations and Doctoral Studies

Correctional officers occupy an important societal role in maintaining safety and assisting in the rehabilitation of inmates; however, both their performance and mental health are highly susceptible to fatigue because of working in a high stress environment. This study investigated the relationship between correctional officers' demographic factors (level of education, marital status, gender, and race/ethnicity) and their psychological resilience. The Connor-Davidson Resilience Scale 10 (CD-RISC-10) was used to measure correctional officers' resilience when responding and or coping with stress. This study utilized the stress-vulnerability model as a framework to investigate protective factors against and risk factors for psychopathological symptoms. Participants …

Executive Director Experiences With Consumer Operated Service Provider Governing Board Members, Merideth Mccallick Erickson

Walden Dissertations and Doctoral Studies

Consumer Operated Service Providers (COSPs) are programs that are directed and administratively controlled by mental health consumers for their peers. As such, many mental health consumers have been placed in the position of serving on a COSP and often with unclear descriptions and no training. As a result, there is often a disconnect between the will of the board and the vision of the executive director, leading to tension and the possibility of failed mission. Using servant leadership as the guide, the goal of this case study was to explore the experiences of executive directors who operate Consumer Operated Service …

Recovery-Oriented Care In A Psychiatric Health Setting, Renita Denise Hargrow

Walden Dissertations and Doctoral Studies

Psychiatric recovery-oriented care is aimed at improving patients' quality of care while increasing the efficiency of health care providers. Despite the benefits of recovery-oriented care, this approach is often lacking in health care settings. The purpose of this project was to implement a recovery-oriented training on psychoeducational groups on a 26-bed psychiatric unit. The Iowa model of evidence-based practice and adult learning theory provided the framework for the project. The objectives were to (a) assess training needs, (b) evaluate barriers for recovery-oriented psychiatric nursing, (c) develop strategies to address barriers, (d) train staff in psychoeducational approaches, and (e) evaluate the …

Experiences Of Parents Of Self-Harming Adolescent Children, Sheila Nicole Russell

Walden Dissertations and Doctoral Studies

Adolescent self-harm is a growing epidemic in the United States with thousands of adolescent children being treated in hospitals every year. Despite awareness that self-harm impacts the family unit, little attention has been given to the full impact that self-harm has on parents. Due to this lack of knowledge, counselor educators and supervisors are not equipped to train counselors to work with parents of self-harming adolescent children leaving counselors feeling unprepared to work with parents. The purpose of this phenomenological study was to explore the lived experiences of parents who have self-harming adolescent children. Family systems theory was used to …

Working Alliance Between Interpretive And Noninterpretive Therapy Services For Deaf Individuals, Sherri Lee Spain

Walden Dissertations and Doctoral Studies

Deaf individuals typically have access to 2 types of therapeutic services: interpretive (with an interpreter) and noninterpretive (with a sign-fluent therapist). Previous research indicates that the presence of an interpreter may hinder development of working alliance and attachment. There is a lack of empirical evidence assessing the effect of working alliance and attachment based on whether or not therapy incorporates an interpreter. The working alliance theory and the attachment theory were the theoretical foundations for this study. This study examined the difference between the strength of working alliance and attachment to the therapist given the presence or absence of an …

Clinicians' Perceptions Of Trauma Treatment For People With Intellectual Disabilities, Katherine Elaine Schoech

Walden Dissertations and Doctoral Studies

People with intellectual disabilities (ID) experience trauma and posttraumatic stress disorder (PTSD) in similar ways as individuals in the general population. The purpose of this phenomenological study was to explore and describe clinicians perceptions of trauma treatment for people with ID. Theories of trauma, PTSD, and stigma were part of the conceptual framework from which interview questions were developed. Purposive and snowball sampling were used to recruit 8 participants in the Denver, Colorado area. Four participants had experience working with people with ID, and 4 participants did not have this experience. Participants sat for semi structured open-ended recorded interviews, which …

Impact Of Distance, Diagnosis, And Demographics On Attendance For Rural Outpatient Treatment, Trey Howard Jensen

Walden Dissertations and Doctoral Studies

Missed psychotherapy appointments inhibit mental health treatment, limit the availability of treatment to those waiting for care, and reduce clinician revenue. Previous research has revealed that the factors that predict missed appointments vary depending on the geographic location in which that research is conducted. There is not a complete understanding of the characteristics of people who miss appointments in a rural context. This study used information from 281 client records to examine the predictive relationships among missed appointments and the distance traveled to the clinic, mental health diagnosis, age, and gender at a rural outpatient mental health clinic. The purpose …

A Curriculum On Culturally Competent Practices To Prevent Retraumatization In Diverse Survivors, Luana Rodriguez

Walden Dissertations and Doctoral Studies

This DNP project addresses the healthcare issue of intimate partner, domestic, and sexual violence (IPDSV), its impact on survivors, and reducing the potential for retraumatization by those who care for them in the clinical, behavioral, and social settings. Trauma-informed care interventions are designed to address the sequelae of trauma, promote recovery, and support resilience. Since IPDSV is a global health issue, supporting cultural needs of all clients is an essential aspect of trauma-informed care. This project was guided by a central research question that examined if trauma-informed, culturally competent curriculum be viewed by community stakeholders as an appropriate intervention for …

Wellness Intervention As A Quality Of Life Predictor In Mentally Ill Veterans, Tosha Lashon Ellis

Walden Dissertations and Doctoral Studies

Veterans with serious mental illness (SMI) are at high risk of developing conditions such as insulin resistance, obesity, and smoking, which may lead to chronic medical problems. As a result, the morbidity and mortality of people with SMI are high compared to the general population. It appears that integrated care improves the wellbeing of veterans; however, there is a gap in the literature on wellness-based interventions for veterans with SMI. The purpose of this cross-sectional study was to evaluate the association between a wellness intervention for veterans and their perceived quality of life (QOL). Social cognitive theory was the theoretical …

Supervisory Working Alliance And Job Satisfaction In Community Mental Health Settings, Jennifer Weigelt

Walden Dissertations and Doctoral Studies

Researchers have written extensively on many facets of supervision in the counseling profession, including the supervisee benefits associated with a strong supervisory working alliance. While the majority of studies have focused on the working alliance in academic settings with student trainees, there has been a lack of research exploring the role of the supervisory working alliance in workplace settings, where supervision can be different from supervision offered in a university clinic or counseling center. Employee job dissatisfaction has been a problem identified within the mental health workforce. Researchers have identified effective supervision as a mediating factor. The purpose of this …

Barriers To Colorectal Cancer Screening In People Obtaining Care From Community Mental Health Agencies, Kelly L. Gardiner

Walden Dissertations and Doctoral Studies

Barriers to Colorectal Cancer Screening in People Obtaining Care

From Community Mental Health Agencies

by

Kelly Gardiner

MSN, Wayne State University, 1997

BSN, Wayne State University, 1988

Dissertation Submitted in Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Public Health

Walden University

August 2016

Despite being highly treatable with early intervention and preventative screenings, the overall mortality rate of colorectal cancer is substantially higher in participants with a preexisting mental disorder. Variables affecting the likelihood of completing screening for those with mental illnesses were unknown in people who obtain services from a Community Mental Health agency. Using …

The Perception Of African American Clergy Regarding Mental Health Services, Tamara White

Walden Dissertations and Doctoral Studies

The rise in diagnosable mental illness disorders in the United States is a major concern. However, researchers indicate that African Americans are far less likely to seek mental health treatment than Caucasian Americans. This qualitative, phenomenological study addressed a research gap regarding the beliefs, perceptions, stigmas, and practices of African American clergy regarding their promotion of mental health services. Two conceptual frameworks consisting of the sociocultural theory and the social learning theory guided the study. There were two research questions used to guide the exploration of the purposive sampling of 6 African American clergy from major African American denominations across …