Psychiatric and Mental Health Commons^™

Integrating Clinical Reasoning Into Mental Health Diagnosis: A Conceptual Framework For Counseling Practice, Ashley F. Waddington, Alexander M. Fields, Haley Ault

Journal of Human Services Scholarship and Interprofessional Collaboration

Clinical reasoning has long guided diagnostic accuracy in nursing and medical fields, but its application in mental health counseling remains limited. This paper presents a conceptual diagnostic decision-making (DDM) process to embed clinical reasoning into the diagnostic process for counselors, incorporating two vital constructs: counselor self-efficacy and counselor bias (implicit and explicit). Grounded in Bandura’s theory of self-efficacy (1977) and Carvalho et al.’s (2017) clinical reasoning model, the framework highlights the cognitive, behavioral, and contextual factors that shape diagnostic decision-making in early-career counselors, including counselor biases. The paper calls for reform in counselor training, emphasizing curriculum enhancements as pathways to …

Counseling And The Neurodiversity Paradigm: A Call To Action, Emily Goodman-Scott, Rawn Boulden, Aaron Albright, Jenna Alvarez, Betsy M. Perez

Counseling & Human Services Faculty Publications

The counseling profession is rooted in prevention, wellness, mental health, and a critical social justice approach to serving historically marginalized communities, including people with disabilities. The overarching construct of disability comprises subtypes, such as neurodivergence. Given the prevalence of neurodivergent individuals worldwide (approximately 15%-20%), the counseling profession must be prepared to support this community. At the same time, there is a dearth of peer-reviewed literature on neurodiversity specifically for the counseling profession. In this article, we address a timely topic in the profession. We discuss utilizing a critical counseling lens and centering marginalized identities, such as people with disabilities; prominent …

Reimagining The Counseling Profession: Preparing Counselors For Ai And Digital Health Integration, Carl J. Sheperis, Dusti L. Annan-Coultas, Caronne C. C. Rush

Journal of Counselor Preparation and Supervision

Digital health technologies including artificial intelligence (AI) are transforming mental healthcare delivery, creating new opportunities and challenges for counseling practice. This article examines digital health applications in counseling, including telehealth, mobile apps, digital therapeutics, virtual reality, and AI-powered tools. We explore key implications for practice, including enhanced accessibility, impacts on therapeutic relationships, and ethical considerations. The article presents a six-domain competency framework covering privacy and security, technical proficiency, ethical literacy, clinical integration, therapeutic adaptability, and administrative management. A case study illustrates the practical application of hybrid digital care, while a discussion of counselor education highlights the need for curriculum updates. …

Multidisciplinary Lethal Means Safety Counseling Design And Implementation: Training And Identifying Barriers In A Children's Hospital, Cassandra L. Stegall, Brendon Carnell, Jaime M. Golden, Rupa Kapoor, John H. Fanton, Paul C. Mullan, Alexandra P. Leader

Department of Pediatrics Faculty Publications

Background

Access to lethal means contributes significantly to suicide completion. Lethal means safety counseling (LMSC) is an injury prevention strategy to limit access to firearms, medications, and other means of injury. Not previously evaluated in the trauma setting, this study aims to design and implement a standardized LMSC protocol for pediatric patient discharge education in emergency (ED), trauma, and inpatient psychiatry settings.

Methods

A single-center quality improvement study at an academic pediatric urban tertiary Level-one trauma center was performed from July 2023 to February 2024. Protocol was implemented for pediatric patients discharged from three departments: ED, surgery trauma service, and …

Exploring Psychological Implications Of The Contemporary Lung Transplant, Isaac C. Machar

Williams Honors College, Honors Research Projects

Since its inception in 1963 at the University of Mississippi Medical Center, more than 50,000 lung transplant procedures have been performed. During its 50-year anniversary, 2023 saw just over 3,000 lung transplants performed in the United Sates. However, as this procedure continues to increase in execution each year, it is critical that the psychological implications of this procedure are explored. In this paper, I hope to develop an understanding of the psychological background of contemporary lung transplantation. Reviewing the lung and double lung transplant, the goal is to apply biopsychology principles to the field. Background information about transplant science is …

Yoga As A Self-Care Practice For Mental Health Counselors Who Treat Trauma, Kari Michelle Fitzgerald

Graduate Research Theses & Dissertations

Given the high rates of burnout and compassion fatigue among trauma-exposed counselors, understanding effective self-care practices is critical for sustaining clinical effectiveness and well-being. Utilizing Interpretative Phenomenological Analysis (IPA), exploration of the lived experiences of licensed mental health counselors who treat trauma and use yoga as a self-care practice was conducted. Eight participants who were regular yoga practitioners each participated in one semi-structured interview and submitted one pre- and one post-interview reflective journal entry. Thematic analysis was used to identify six major themes; 1) emotional impact and sacred responsibility of clinical work, 2) yoga as a regulating and restorative practice, …

Unmc Quick Checks: An “Opt-Out” Model For Health Profession Student Appointments With Mental Health Counseling Services, Hannah K. Tandon Md, Taylor J. Kratochvil Md, Ms, Katherine L. Keiser Ms, Limhp, Nicole J. Kent Bs, Kaitlyn E. Schultis Bs, Jeffrey W. Knapp Msw, Jeffrey P. Gold

Innovations in Health Sciences Education Journal

Background: Health professions trainees experience high rates of anxiety and depression but are often reluctant to seek help. Institutional outreach during pre-clinical training may identify vulnerable students, improve resource awareness, and destigmatize psychological counseling. The University of Nebraska Medical Center (UNMC) Quick Check program is a novel opt-out program connecting health professions students to mental health counselors.

Objective: The purpose of this study was to evaluate student perceptions and utilization of mental health resources after participation in the UNMC Quick Check program.

Methods: For this limited pilot study, second-year pharmacy students were assigned to UNMC Quick Check appointments with UNMC …

The Hidden Impact Of Sociocultural Determinants In Adolescence, Lauren B. Robins, Nicholas Schmoyer, Atiya Smith, Krystal L. Clemons, Jill Kivikoski

Journal of Human Services Scholarship and Interprofessional Collaboration

This study, guided by the Social Determinants of Health framework and Social Ecological Model, examined how SDOH impact the presence of anxiety during adolescence. This study set out to understand what sociocultural determinants predict anxiety, using the 2018 National Survey of Children’s Health dataset. The analysis included a logistic regression to determine the predictability of SDOH on anxiety in adolescence. The results indicated that various SDOH are significant predictors of anxiety, while also indicating that the absence of adverse SDOH predicts the lack of anxiety. Further, unique findings related to race/ethnicity, age, and gender set the stage for additional research …

A Grounded Theory Of Counselors’ Post-Graduation Development Of Disability Counseling Effectiveness, Michele Rivas, Nicole R. Hill

Journal of Counselor Preparation and Supervision

Many persons with disabilities engage in counseling services in a variety of settings. However, the development trajectories of counselors who seek to compensate for the lack of training and advance their post-graduation skillset to work effectively with clients with disabilities has not been explored. This grounded theory study illuminated several dimensions involved in twenty-one Licensed Professional Counselors’ post-graduation development of disability counseling effectiveness. In this study, counseling effectiveness refers to self-perceived improved skillset rather than a benchmark (i.e., competence). The core category, Evolving Commitments, was common to all participants’ trajectories when developing disability counseling effectiveness. The other categories (causal conditions, …

An Exploration Of Quality Of Life Perceptions Of Cochlear Implant Recipients And Their Frequent Communication Partners, Jessica L. Bishop, Ashley G. Flagge

Ashley Flagge Publications

Purpose: Quality of life (QoL) after cochlear implantation has been investigated using a variety of QoL questionnaires. However, few studies have examined the perceived QoL of cochlear implant (CI) recipients compared between the recipient and a frequent communication partner (FCP) using both hearing-related (hearing-specific), and health-general (health-general) measures.

Method: For this multiple case study, five participant pairs were recruited, consisting of five adult recipients who were implanted at least six months prior to the time of evaluation, and five adult frequent communication partners who lived with the recipient at the time of evaluation. All ten participants (five pairs) completed a …

Stress, Resiliency, And Burnout Among Leaders In The Counseling Profession, Adriana Bovee

Walden Dissertations and Doctoral Studies

Leaders in the counseling profession face many demands. The purpose of this quantitative regression analysis study was to determine if there was a predictive relationship between the independent variables of stress and resiliency and dependent variables of burnout, emotional exhaustion, depersonalization, and personal accomplishment among leaders in the counseling profession. Transformational leadership theory and resilience theory were applied as the theoretical framework of this study. A cross-sectional data collection method was used, and data were collected through anonymous online surveys from a purposive sample of 75 counseling leaders. Data analyses methods included descriptive statistics and multiple linear regressions. Results indicated …

Moral Distress Among Master’S Counseling Students Attending A Cacrep Accredited Counselor Training Program, Matthew Stevens

Walden Dissertations and Doctoral Studies

Moral distress, an understudied phenomenon among the counseling profession, has been defined as an experience of knowing the right thing to do but being institutionally prevented from doing what is believed to be right. This phenomenon often occurs in hierarchical relationships, such as those between student and teacher or supervisor and supervisee, and may lead to psychological impairment, deviation from ethical standards, and professional burnout, which threatens the ability of professional counselors to initiate and maintain healthy professional relationships. The purpose of this descriptive, phenomenological study was to explore the lived experiences of six master’s level students attending counselor training …

The Lived Experiences Of Group Practice Ownership By Female Licensed Professional Counselors, Ashley Garrett

Walden Dissertations and Doctoral Studies

The U.S. counseling profession is mostly female, with many practitioners interested in starting their own business. However, little is known about women’s lived experiences of owning a group counseling practice. An interpretative phenomenological analysis approach was used to explore the lived experiences of six female licensed professional counselors who have owned a group counseling practice for at least 5 years. Phenomenology and feminist theory provided a framework for the study. Eight themes emerged from the study: (a) factors associated with the decision to create a group practice, (b) a continuum of preparatory engagement for group practice ownership, (c) the influence …

“If I Had Felt Comfortable Or Accepted, I Would Have Made More Progress”: A Phenomenological Investigation Into The Experiences Of Lgbtq+ Persons In Clinical Professional Counseling, Valerie Moreno-Tucker

Graduate Research Theses & Dissertations

The counseling literature has indicated that LGBTQ+ persons have experienced fewer positive mental health outcomes than cisgender heterosexual persons. Professional counselors, despite their requirement to provide culturally sensitive counseling services for all communities, must learn how to better need the needs of LGBTQ+ persons and communities. This dissertation elevates LGBTQ+ persons’ voices by examining the experiences of LGBTQ+ persons in clinical professional counseling. Specifically, the IPA approach was utilized in analyzing data from six individuals who each participated in two interviews lasting 45-90 minutes each. This investigation found commonalities between each participant regarding both their helpful and unhelpful experiences in …

Therapists’ And Teachers’ Experiences Of Children With Aggression: A Children’S Partial Hospitalization Program, Kimberlee Joy Dunlap

Walden Dissertations and Doctoral Studies

Aggression is an indicator of future criminal behavior. It can be a result of trauma, substance-abusing parents, or executive functioning. Research has shown that aggression in childhood often creates criminal behavior later in life, thus researchers suggest that more studies are conducted on programs that help children with aggression. The purpose of this qualitative study was to examine the experiences of therapists who work with aggressive children in a children’s partial hospitalization program, and those teachers who have had these children in class before entering the program and upon discharge from the program. The qualitative study was done using semi-structured …

Black Women, Mental Health Treatment, And Spiritual Healing: A Transcendental Phenomenological Study, Grace M. Abraham Lewis

Walden Dissertations and Doctoral Studies

Counselor educators are ill-equipped to train counselors to prepare to meet the needs of Black Christian Pentecostal Women (BCPW) because there is a lack of information on this population. To increase cultural competency, counselors need to be more aware of the experiences of this population. The purpose of this study was to explore the lived experiences of BCPW who sought community mental health counseling concurrent with deliverance practices through the church. Using Edmund Husserl’s transcendental phenomenological approach as the conceptual framework, semi-structured interviews via zoom were conducted with 4 BCPW who were active members of the Christ Throne International Ministries …

Laughter As A Priming Agent For Change, Linnea M. Heintz

Graduate Theses and Dissertations

The purpose of this study was to analyze the importance of laughter as a factor in influencing employee job satisfaction ratings. The Job Satisfaction Survey (Spector, 1985, 1997) and pulses of laughter were used in this study. To explore the relationship between laughter and job satisfaction, results of the Job Satisfaction Survey (Spector, 1994) were collected quarterly (four times a year) for three consecutive years, beginning six months prior to the start of the two-year study and six months post. The study sample was composed of 545 employees (34% male, 66% female) operating out of 10 employee-owned retail chain locations …

The Efficacy Of Neurofeedback In The Treatment Of Individuals With Anxiety-Spectrum Disorders: A Meta-Analysis, Gordon Michael Russo

Electronic Theses and Dissertations

A number of authors have published articles that assert the efficacy of neurofeedback (NFB) in the treatment of people with anxious symptomatology. Despite this, many insurance companies identify NFB as experimental, which prohibits individuals from utilizing benefits to obtain this therapeutic treatment. In order to examine these discrepancies, the present meta-analyses were conducted and guided by research questions designed to examine the overall effectiveness of NFB, the impact of participant characteristics, and identify the if there is a significant difference in anxiety-spectrum outcomes. Twenty-six trials were divided based on design (14 single group [SG]; 12 between group [BG]) and analyzed …

The Social Work Perspective Regarding The Underutilization Of Mental Health Services Among African American Families, Carissma Tempest Hughes

Walden Dissertations and Doctoral Studies

The underutilization of mental health services amongst African American families has been a long-standing concern in the African American community within large metropolitan cities in Texas. The metropolitan cities are Austin, Dallas/Fort Worth, Houston, San Antonio and McAllen. There remain experiences that impede families’ ability to engage in mental health services. These experiences involve the conflict between prayer and therapy, stigma, lack of awareness of local mental health services, and cultural competency. The purpose of this qualitative research study was to explore experiences of African American families and how those experiences affect mental health engagement, as well as how practicing …

Predicting Mental Health Counseling Professionals’ Willingness To Discuss Sexuality Issues With Clients, Becca L. Thompson

All Graduate Theses, Dissertations, and Other Capstone Projects

Sexuality is fundamental to the human experience and sexuality issues will affect every individual across the lifespan. Mental health counseling professionals (MHCPs) will likely encounter a client in their practice that presents with some facet of sexuality concern. MHCPs may be challenged by these disclosures or neglect to inquire about these needs due to underlying factors that contribute to decreased willingness to discuss sexuality with clients. This study explored the relationships of some of these factors, including sexual intervention self-efficacy, state anxiety, and trait anxiety, and further examined the extent to which these factors predict willingness to discuss sexuality with …

Language Deprivation Is A Game Changer For The Clinical Specialty Of Deaf Mental Health, Neil S. Glickman, Charlene Crump, Steve Hamerdinger

JADARA

In this paper, the medical, social and historical forces resulting in much smaller numbers of deaf children having quality access to natural sign languages are presented. These forces mean that people who work in the clinical specialty of Deaf mental health are seeing more clients with atypical or dysfluent sign language. An historical overview of the development of this clinical specialty is outlined, followed by a discussion of how the problem of language deprivation is a “game changer” for the work of mental health clinicians, interpreters, communication assessors, and administrators of Deaf mental health services. Special attention is given to …

College Education Can Induce Stress, Anxiety, And Depression – Are You Sad?, Nathan L. Boyd

2020 Symposium Posters

College students must manage a great deal of stress, including heavy loads of coursework, deadlines, finances, families, working part-time or full-time, and choosing their lifelong careers. The Center for Collegiate Mental Health has reported that stress, anxiety, and depression (SAD) are the leading reasons that students reach out for mental health services. However, stigma has been identified as the primary barrier to treatment. Students should be encouraged to seek the help of medical professionals and develop healthy habits because these serious conditions can negatively affect educational performance, work performance, and quality of life. Secondary research methods will be used to …

Power In The Counseling Relationship: The Role Of Ignorance, Izaak L. Williams, Peg O'Connor

Journal of Human Services: Training, Research, and Practice

This article explores the role of therapist self-disclosure in clinical settings. Distinctions are made between the enmeshed concepts of privacy, secrecy, and confidentiality to elucidate the role of ignorance in maintaining the power dynamics in therapeutic relationships. While some measure of privacy is essential to counseling practice, secretive behavior (in which the counselor divulges too little about themselves) can have a negative impact on the therapeutic relationship and the client’s therapeutic outcomes. There is, therefore, an under-appreciated and delicate balancing act between withholding information to protect the client and the counselor and revealing enough personal details to empower the client’s …

Law Library Blog (March 2019): Legal Beagle's Blog Archive, Roger Williams University School Of Law

Law Library Newsletters/Blog

No abstract provided.

An Investigation Of The Help-Seeking Attitudes Of African American Christian Churchgoers, Kristi Madison

Walden Dissertations and Doctoral Studies

The Black Church has been a powerful support system for African Americans, providing economic, and psychological support in addition to meeting spiritual and religious needs. African American church leaders continue to provide a multitude of services to the community; however, research has shown that African American Protestant Christian churchgoers'€™ preference for informal supports may exacerbate some symptoms of mental illness as people may postpone seeking formal help. Utilizing a nonexperimental, cross-€sectional design, this study examined the relationship between these churchgoers'€™ attitudes toward religious help-€seeking and attitudes toward professional help-€seeking. One hundred four African American Protestant Christian churchgoers in the mid-Atlantic …

Demographic And Symptomology Differences Among Sexually Assaulted Children With Posttraumatic Stress Disorder, Kathleen Bethel-Pracht

Walden Dissertations and Doctoral Studies

Trauma due to sexual assault becomes a life changing event during a child's critical developmental years. Bronfenbrenner's ecological systems theory outlines the process of understanding an individual's environment and how disruptions in one level may affect other levels. This study determined if gender and ethnicity among sexually traumatized children diagnosed with post-traumatic stress disorder (PTSD) predict symptom severity as measured by the Trauma Symptom Checklist for Children (TSCC) after controlling for the socioeconomic level and home environment. The population consisted of 126 children aged 8 through 16 with at least a second-grade reading level. Multiple regression examined whether male and …

Law Library Blog (December 2018) : Legal Beagle's Blog Archive, Roger Williams University School Of Law

Law Library Newsletters/Blog

No abstract provided.

The Relationship Between Mental Health And Ultra-Running: A Case Study, Joshua Justin Cook

Graduate Theses and Dissertations

This instrumental case study sought to explore the relationship between ultra-running and mental health through the lived experiences of a single participant who self-identifies as an ultra-runner. Three research questions were used to explore this relationship; how did the individual decide to participate in ultra-running, what aspects of ultra-running impact the participant’s mental health, and how has engaging in ultra-running impacted the participant’s mental health? The case study utilized three semi-structured interviews, two participant observations, video documentary review, and journaling to answer these questions. A thematic analysis of the data revealed four essential themes; 1) Development of participation, 2) Promotes …

Law Library Blog (March 2018): Legal Beagle's Blog Archive, Roger Williams University School Of Law

Law Library Newsletters/Blog

No abstract provided.

The Lived Experiences Of Opioid Withdrawal: A Phenomenological Study, Eliza Mall

DNP Research Projects

The United States is in the midst of an opioid overdose epidemic resulting to 40,000 accidental drug overdose deaths. In 2016, the number of deaths related to opioid overdose increased to 116 people per day resulting to $504 billion in economic costs. This research study explored the lived experiences of drug addicts having experienced opioid withdrawal symptoms. Phenomenology is useful in discovering the narrative lived experiences that cannot be obtained in quantitative approach. Six themes emerged to describe the lived experiences of opioid addicts who have undergone withdrawal: (a) Increasing desires that are hard to resist (b) Helplessness and hopelessness …