Psychiatric and Mental Health Commons^™

The Critical Need For A Culturally Sensitive Suicide Risk Assessment Instrument For American Indian And Alaska Native Youth, Courtney E. Shaw

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: This systematic literature review was conducted to better understand why there has been a significant increase in America Indian/Alaska Native (AI/AN) youth suicides in tribes across the United States today. The intent of this review is to understand key issues surrounding the increasing numbers of AI/AN youth with suicide ideation, plans, and attempt in order to be able to answer the following clinical question: Is there a valid and reliable culturally sensitive assessment tool designed to recognize at-risk AI/AN youth presenting for primary care? If not, what are key aspects to consider for developing an instrument that could …

Therapists' Perspectives On Aiding Individuals To Maintain Social Connection While Struggling With Health Concerns, Shari Howington-Carlin

Theses and Dissertations

This applied dissertation was designed to explore therapists’ perspectives on aiding individuals to maintain social connection while struggling with health concerns. Social relationships support physical and psychological well-being, yet individuals struggling with physical or mental health issues often have difficulty maintaining their relationships. Therapists, as health professionals, often discuss physical as well as emotional health concerns with their patients, including components of physiological and psychological heath care. Emerging neuroscience is aiding in understanding how research in this field supports early intervention for health outcomes around healthy social and family relationships during chronic disease or illness onset.The researcher conducted a phenomenological …

Addressing Suicide In Entry-To-Practice Occupational Therapy Programs: A Canadian Picture, Nadine Larivière, Marc Rouleau, Kim Hewitt-Mcvicker, Lorie Shimmell, Catherine White

Journal of Occupational Therapy Education

Worldwide, over 800,000 people die each year by suicide, leaving many behind to grieve the loss. Preventing suicide involves reaching people before they are in crisis (prevention), helping them to navigate a crisis that could result in suicide (intervention), and addressing the aftermath of a suicide loss or attempt (postvention). Healthcare professionals, including occupational therapists, unitedly acknowledge the lack of skills, knowledge, and competence in all facets of suicide awareness and prevention in their professional training and in practice. To improve this situation, suicide prevention skills must be taught in entry to practice programs, so they will filter into the …

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 …

Group Sandtray Therapy With Adult Survivors Of Childhood Sexual Assault: A Single-Case Research Design, Jana Elaine Scott

Electronic Theses and Dissertations

Childhood sexual assault (CSA) is a growing problem in our society. A child who experiences a sexual assault not only deals with the immediate trauma surrounding this event, but also the aftermath of this event as they progress into adulthood. Trauma and sexual trauma is an umbrella term that incorporates all of the various implications of experiencing a negative event. In the instance of trauma, neurobiological implications have been well researched and established. This knowledge highlights the need for counseling techniques to be developed and studied that target those who have experienced CSA. The aim of this single-case research design …

Reducing The Rate Of Physical Interventions By Increasing Staff Confidence When Using Verbal De-Escalation Techniques, Elizabeth Pavlesich

Walden Dissertations and Doctoral Studies

When working with patients who have the potential to become physically aggressive, verbal de-escalation is an important technique that can defuse a dangerous situation. At the project site in the mental health emergency department (MHED), workplace violence was on the rise based on the reported use of physical interventions (rates of brief holds and physical restraint use). The purpose of this quality improvement evaluation project was to determine whether an educational training program on verbal de-escalation techniques would increase staff’s confidence in the use of verbal de-escalation and decrease the rate of physical interventions used in the MHED. The change …

Missionary Kids And Trauma, Lindsay Elizabeth Stone

Walden Dissertations and Doctoral Studies

AbstractMissionary Kids and Trauma by Lindsay E. Stone

MA, Walden University, 2019MA, Southwestern Baptist Theological Seminary, 2010 BS, Charleston Southern University, 2006

Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Human and Social Services

Walden University February 2021 Abstract Missionary kids (MKs) around the world are more exposed to trauma than non-MKs. MKs often struggle with grief, loss, and stressors of cross-cultural living. Childhood trauma leads to short-and long-term effects of trauma, often into adulthood. The purpose of this basic qualitative study was to explore adult, Christian MKs’ perceptions of external trauma on …

Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher

Walden Dissertations and Doctoral Studies

AbstractOver the years, the infection rates for HIV in the United States has changed partly due to lack of engagement and medication adherence which can lead to substantial declines in individual health. Factors that contribute to the individual’s adherence can include transportation cost, childcare, and lack of finances to name a few. These barriers can often be decreased with the help of supportive service providers and improvement in the patient-provider relationship. Currently, there is limited research that explores how to reduce patient barriers to care, specifically in rural areas. This qualitative study examines how Illinois health care providers help HIV-positive …

A Behavioral Healthcare Approach To At-Risk Youth Substance Prevention Program Development, Debra Mcintyre

Walden Dissertations and Doctoral Studies

Providing quality services that meet the needs of clients is key to organizational sustainability for behavioral health organizations. Strategic development of substance prevention programs for at-risk youth will play an important role in capacity building. The focus of this study was to identify the need for developing a targeted and effective substance abuse prevention program to support at-risk youth who have trauma experiences before they begin misusing substances to cope with their challenges. The Baldrige excellence framework was used to guide this descriptive case study of a behavioral health organization in the Northeastern region of the United States. The data …

Social Support Experiences Of Stably Housed Emancipated Foster Youth, Camron L. Whitacre

Walden Dissertations and Doctoral Studies

Youth emancipating from foster care are at increased risk of housing instability and homelessness and have reduced access to needed social supports to aid in the difficult transition to independent living. The purpose of this hermeneutic phenomenological study was to understand the lived formal social support experiences of stably housed emancipated foster youth. Purposive sampling techniques and inclusion criteria guided the recruitment of nine study participants from a state-administered postemancipation services program to take part in semistructured interviews. A conceptual framework, including social convoy and attachment theories, informed inquiry, and interpretation of findings. Participant lived experiences illuminated the importance of …

Mental Health Disparities In Social Work Practice Of Minority Youth Offenders, Beverly Ann Rivera

Walden Dissertations and Doctoral Studies

AbstractA large number of minority youths placed in the juvenile justice system across the United States have mental health disorders. Most of these youths do not receive mental health services or support within the system, which increases risk factors such as undiagnosed and untreated mental illness and adverse outcomes such as recidivism. This action research sought to uncover whether mental health disparities in social work practice in the juvenile justice system were due to race and ethnicity and asked social workers to recommend strategies to improve mental health availability, access, and provision. Participants in the study were social workers who …

Substance Use, Mental Health Problems And Missed Appointments By Race, Gender, And Sexual Orientation Among Hiv-Infected Individuals, Abraham Adonis Anderson

Walden Dissertations and Doctoral Studies

Human Immunodeficiency Virus (HIV) disproportionately affects African American men who have sex with men. According to the Centers for Disease Control and Prevention, in 2020 African American adult and adolescent African American men accounted for 42% (16,002) of all HIV diagnoses (37,968). Furthermore, while substance use is common among this population, in previous studies very few individuals with HIV have reported receiving substance abuse treatment or discussing substance use with HIV medical providers. The purpose of this study was to examine the differences in substance use/mental health problems by race, gender, and sexual orientation among HIV-infected individuals. This study also …

Criminal Thinking, Age, Psychological Well-Being, And Recidivism Among Recently Released Female Violent Offenders, Nyasia Monae Belfrom

Walden Dissertations and Doctoral Studies

High rates of incarceration among female inmates as well as high rates of recidivism characterize the U.S. justice system. Though some research has been conducted on gendered differences between prisoners, a gap existed in the application of criminal thinking theory for female offenders following their release. The purpose of this quantitative research study was to analyze the relationship between criminal thinking, age, psychological well-being, and recidivism among recently released female violent offenders in the region of Central Texas through the use of Yochelsen and Samenow’s criminal thinking theory. The sample for this study consisted of N = 98 female participants …

Working With Sexually Violent Persons: Grit, The Supervisory Working Alliance, And Burnout, Stalina Harris

Walden Dissertations and Doctoral Studies

Clinicians who work with sexually violent persons (SVPs) are faced with various problems related to the nature of their job duties, job settings, and the specificity of the population they serve. Although researchers have investigated the phenomenon of burnout extensively over the last decade, research focusing on burnout among counselors who work with SVPs is insufficient. The purpose of this quantitative comparative survey study was to investigate differences in burnout among clinicians working with SVPs by examining their grit, the supervisory working alliance, and job settings. The Grit Short Scale (Grit-S), the Supervisory Working Alliance Inventory—Trainee version (SWAI-T), and the …

Understanding Resilience Among Individuals With Adverse Childhood Experiences (Aces), Meghan Larson

Walden Dissertations and Doctoral Studies

Adverse childhood experiences (ACEs), such as abuse, neglect, and dysfunction in a child’s home are considered a public health crisis due to their correlation to health disparities and psychosocial problems in adulthood such as substance use, relationships, education, and maintaining employment. However, some individuals are resilient and demonstrate the ability to adapt and function well despite experiencing adverse events. To better understand resilience when ACEs are present, I conducted a basic qualitative research study to explore the lived experiences of individuals in Tennessee with elevated ACE and resilience scores. A purposeful sample of 12 participants who scored high on ratings …

Importance Of Childhood Maltreatment On Borderline Personality In Adults: Meta-Analysis, Lisa Nicole Trentacosti

Walden Dissertations and Doctoral Studies

Early childhood maltreatment (CM) is a risk factor for later psychopathology specifically Borderline Personality Disorder (BPD). CM has been found to negatively affect social, emotional, and psychological development as well as the ability to foster and sustain interpersonal relationships throughout all stages of life. There are evidence-based interventions for different kinds of CM including Trauma-Focused Cognitive-Behavior Therapy (TF-CBT), Alternatives for Families - Cognitive Behavioral Therapy (AF-CBT), relaxation training, and social skills training. The current study is a meta-analysis of published research into CM as it contributes to BPD in adults and is designed to examine the effect size of childhood …

African American Mothers’ Experience In The Neonatal Intensive Care Unit, Lauren Magruder

Walden Dissertations and Doctoral Studies

Black/African American (B/AA) mothers struggle disproportionately with problems related to childbirth. B/AA mothers have higher rates of premature births, infant death prior to age one, and death during childbirth. The purpose of this research was to add to present knowledge regarding B/AA mothers who have had a baby in the Neonatal Intensive Care Unit (NICU). Womanist theory was selected as a framework for the study because it focuses on the intersection of gender and race in relation to B/AA women. The experience of B/AA women in U.S. society is unique, in that it involves several pervasive stereotypes and controlling images. …

Master’S Level Mental Health Counselor Experiences Working With Offenders In Correctional Settings, Jennifer Bernard

Walden Dissertations and Doctoral Studies

Forensic mental health is considered a specialty at a doctoral level, yet a majority of mental health services in correctional settings are provided by master’s-level mental health counselors. These clinicians lack the specialized education, training, and experience needed to work with offenders in correctional settings. There is limited research on how master’s-level counselors experience providing mental health services in correctional settings and how they manage challenges. The purpose of this qualitative study was to understand the lived experiences of master’s-level mental health counselors working with offenders in correctional settings. A hermeneutic phenomenological approach was used to facilitate an understanding of …

Caring For The Caregiver: Second Victim Recovery Following A Serious Medical Error, Beulah Patrice Vance

Walden Dissertations and Doctoral Studies

In 1999, it was estimated that 98,000 deaths were attributed to medical errors and were the fourth most common cause of death in the United States. In 2016, medical errors were estimated as the third leading cause of death, with a mean death rate of 251,454 each year. Nurse involved in errors are known as second victims. Almost one in seven staff members reported that they had experienced a patient safety event within the last year that caused personal problems such as anxiety, depression, or concerns about their ability to perform their job. This project explored whether nurses are able …

Service Providers' Perceptions Of Stigma And Its Impact On Mental Health Services, Arthur Gabriel Montes

Walden Dissertations and Doctoral Studies

Stigma is one of the most significant barriers to access and utilization of mental health services in the United States. Delays in receiving mental health services significantly contribute to health disparities and poor health outcomes. Social workers play an integral part in implementing best practices within health care settings and reducing health inequities impacting vulnerable populations. The purpose of this qualitative action research study was to explore social work service providers perceptions' toward stigma and how it affects mental health services among patients in California's Medicaid program. Stigma theory was applied to gain an understanding of how stigma interacts and …

More Than A Myth: The Benefits Of Incorporating Holistic Healing Methods From Native American And Mexican Cultures To Approach Opioid Use Disorder (Oud) Treatment, Juliana Favela

CMC Senior Theses

Opioid Use Disorder (OUD) is a substance use disorder that characterizes a dependence on and an addiction to opioids. Opioids attack the prefrontal cortex, the dopaminergic reward system, and the hypothalamic-pituitary-adrenal (HPA) axis which is responsible for the body’s stress response. Opioids constantly shift one’s “set point” to the point where normal actions that cause joy and excitement no longer cause those feelings, resulting in craving and dependence. The opioid epidemic is currently ravaging the United States and has disproportionately affected Native American populations specifically in the rural areas (Tipps, et.al, 2018). The current methods for addressing OUD include medicine …

The Effects Of Therapist Expertise And Concerns Of Involuntary Hospitalization On The Disclosure Of Suicidal Ideations And Behavior, Zane Hensel

All Graduate Theses, Dissertations, and Other Capstone Projects

Suicide continues to grow as a complex and multi-faceted problem in prevention and treatment, particularly for college students with an increased predictor of risk of suicidal behaviors. Previous research has indicated that one of the largest concerns for suicide disclosure is a fear of involuntary hospitalization. Over 200 college students participated in examining therapist expertise and understanding information on involuntary hospitalization on their rate of suicide disclosure. A 2x2 MANOVA, a 2x2x2 MANOVA that included gender, and a factor analysis were performed on an ad-hoc 11-question survey assessing suicidal ideation and suicidal behavior disclosure. The results indicated that there was …

The Relationship Between The Stigmatization Of Mental Illness, Communication Apprehension And The Willingness To Communicate, Madeleine Louise Winkler

All Graduate Theses, Dissertations, and Other Capstone Projects

This project explores how mental health stigmatization influences communication apprehension and the willingness to communicate about mental illness. A total of 153 people completed an online survey regarding three variables. Perceived stigma and communication apprehension when communicating about their own mental health were found to be positively correlated. Perceived stigma and communication apprehension when communicating about someone else’s mental health was also found to be positively correlated. Communicating about one’s own mental illness lead to higher levels of communication apprehension compared to communicating about someone else’s mental illness. Communication apprehension when talking about one’s own mental health and willingness to …

Examining Differences In Rural, Micropolitan, And Metropolitan School Psychologists Roles And Delivery Of Mental Health Services, Ashley A. Williamson

All Graduate Theses, Dissertations, and Other Capstone Projects

Mental health service delivery in rural settings has become increasingly limited while rates of mental health concerns among youth have increased. Schools form a common hub in rural areas and they present an opportunity for the assessment of developing disorders as well as a means for delivering mental health services in an affordable and acceptable fashion. School psychologists supporting rural school districts are presented with a unique opportunity to provide various aspects of rural mental health service delivery. Over the last 40 years, little research has been published on rural school psychologist’s roles and responsibilities and their relationship to mental …

Harassment And Mental Health In Surgical Training: A Pilot Survey Of Surgical Trainees In Pakistan, Russell S. Martins, Syeda Amrah Hashmi, Hina Inam, Mahin Janjua, Mahim Malik

Medical College Documents

Objective: To assess harassment among surgical trainees and its effects on mental health, and to explore its association with gender.
Methods: The nationwide cross-sectional pilot study was conducted by the Association of Women Surgeons of Pakistan from July to September 2019, and included surgical trainees of either gender working in both public and private hospitals. Data was collected using an anonymous online survey form to assess harassment and self-perceived burnout and depression. Data was analysed using SPSS 22.
Results: Of the 147 respondents, 49(33.3%) were males; 98(66.6%) were females; and 118(80.3%) were residents. Workplace harassment was reported by 80(54.4%) trainees. …

Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell

Theses and Dissertations--Family Sciences

The World Health Organization (WHO; 2002) has indicated that sexual violence is a serious public health concern, and both the WHO and the United Nations (UN) have declared that violence against women, in particular, is a profound violation of human rights (UN General Assembly, 1993; WHO, 2017). Although the systemic and negative impact of trauma on family and intimate relationships have been well documented, the empirical literature regarding the effects of adult sexual trauma on relationship satisfaction is less robust. These studies are designed to address this gap and will do so with analyses centered on an understudied population: the …

Postpartum Depression Rates In Latine Birthing Parents During The Covid-19 Pandemic: A Closer Look At Cultural Protective Factors And Acculturation, Perla Barajas

CMC Senior Theses

In the Latine community, the prioritization of social or familial support (familism) serves as a cultural protective factor that has typically guarded against unfavorable health outcomes. However, during the COVID-19 pandemic, social interactions and familial support were substantially limited. A vulnerable population during this pandemic was Latine birthing parents because previous studies have shown that perception of social support directly impacts postpartum depression (PPD) in this group. This study will use data from the Pregnancy Risk Assessment Monitoring System to compare PPD rates for Latine birthing parents from before the COVID-19 pandemic to the PPD rates during the pandemic. Moreover, …

Opioid Use Disorder: The Timeline For Medication Assisted Therapy, Alexander Cristofori

Capstone Showcase

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached …

Naloxone/Buprenorphine, Methadone, Naltrexone And Their Role In Medication Assisted Treatment, Robert Barrett

Capstone Showcase

Abstract

Opioid use disorder (OUD) is an increasingly common diagnosis that has drastically increased in the last 5 years. Though multiple treatment modalities exist for treating OUD (naltrexone, buprenorphine, methadone), few studies have compared treatment outcomes in adults on long term therapy. This is an important topic to understand as providers as we will undoubtedly come into contact with patients either actively abusing opioid antagonists or in recovery from opioid abuse. Since the introduction of Oxycontin and subsequent over prescription of opioid analgesics, opioid overdoses have increased by over twelve-fold. Once providers began to realize a widespread pattern of abuse, …

The Efficacy Of Combination Of Psychosocial Interventions And Pharmacotherapeutic Intervention Compared To Standard Care In Patients Age 16-40 Diagnosed With Schizophrenia When Looking At Functional Capacity, Lisa Roth

Capstone Showcase

Introduction: Schizophrenia is a complex mental illness that arises from a combination of genetic factors, brain chemistry, substance use and environmental factors that affects the way a person behaves, thinks, and perceives. Schizophrenia has no cure, but it has several options for treatment including antipsychotic medications, psychotherapy, and education. Medication is frequently prescribed, and there is little evidence of how often psychotherapy is practiced to properly treat negative symptoms. The combination of these symptoms can have an impact on the functional capacity of an individual; this means that they may have less of an ability to proceed in a typical …