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2021

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Articles 61 - 90 of 256

Full-Text Articles in Counseling Psychology

Effectiveness Of College Counseling Interventions In International Student Adjustment To United States Higher Education Systems: A Meta-Analysis, Joshua Ebby Abraham Jul 2021

Effectiveness Of College Counseling Interventions In International Student Adjustment To United States Higher Education Systems: A Meta-Analysis, Joshua Ebby Abraham

Counseling & Human Services Theses & Dissertations

International students in U.S. higher education institutions face many emotional, social, and institutional challenges as they navigate their academic and acculturative journeys. College counseling centers serve as valuable support resources, but low utilization rates and high early termination rates among the international student population presents a major concern for the college counseling field. To begin the development of an empirically supported, responsive approach to structuring counseling work with international students, this study utilized a metaanalysis to review the literature on counseling intervention effectiveness. The following questions guided this research: What adjustment outcomes are produced by college counseling interventions across modes …


Solution-Focused Zone Of Proximal Development: A Vygotskyan Contribution To Solution-Focused Therapy, Stephanie Freeman Jul 2021

Solution-Focused Zone Of Proximal Development: A Vygotskyan Contribution To Solution-Focused Therapy, Stephanie Freeman

Journal of Solution Focused Practices

This theoretical paper explores the possibility of combining principles of solution-focused therapy with theories of learning and development by the psychologist Lev Vygotsky, whose thinking led to the development of Cultural-Historical Activity Theory. The similarities and complementaries between these traditions merit attention. Further, SFT has been characterized as an eclectic and constantly evolving approach, the theoretical and philosophical foundations of which are somewhat scattered. Hence, the article attempts to redefine the philosophical and theoretical location of SFT through a “Vygotskyan and CHAT-informed” lens. Since the emphasis in SFT seems to be on the identification and detailed description of the client’s …


The Co-Regulatory Effects Of Emotionally Focused Therapy, Julia Conroy Jul 2021

The Co-Regulatory Effects Of Emotionally Focused Therapy, Julia Conroy

Graduate Theses and Dissertations

Mental health literature emphasizes the necessity of expanding emotional regulation to improve symptomology of a variety of mental health disorders. Coregulatory experiences have been shown to expand individual emotional regulation and are more likely in relationships with secure attachment. Emotionally Focused Therapy (EFT) is focused on developing secure attachment between partners. This study examined the coregulatory effects of EFT with a single couple over the course of couples’ counseling. The participating couple received eight couples’ counseling sessions from a clinician who is a certified EFT trainer, supervisor, and therapist while having their heart rate, electrodermal activity, and skin temperature taken …


Child-Centered Play Therapy’S Impact On Externalized Behaviors Of Children Who Have Experienced Trauma: A Single-Case Research Design, Timothy "T.J." Schoonover Jul 2021

Child-Centered Play Therapy’S Impact On Externalized Behaviors Of Children Who Have Experienced Trauma: A Single-Case Research Design, Timothy "T.J." Schoonover

Graduate Theses and Dissertations

Adverse childhood experiences (ACEs) are defined as exposure to emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, loss of a parent, domestic violence, family member with addiction, family member with depression or mental illness, and family member incarcerated (Felitti et al., 1998). ACEs have been studied for many years and have shown to have long term negative health and social-emotional outcomes and costs the world over $1 trillion a year (Bellis et al., 2019; Felitti et al., 1998; Hughes et al., 2017). Due to the emotional, physical, and dollar amount cost to not addressing the impact of ACEs …


What Are We Missing?: A Comparison Of Experiences Of Race-Based Trauma By Black Americans And Black Jamaicans, Bianca R. Augustine Jul 2021

What Are We Missing?: A Comparison Of Experiences Of Race-Based Trauma By Black Americans And Black Jamaicans, Bianca R. Augustine

Counseling & Human Services Theses & Dissertations

Current literature explains that events resulting from instances of white supremacy and racism are traumatizing for Black individuals (Phillips, 2020). Prior literature illuminates the impact of racism and resulting race-based trauma on Black individuals but is lacking regarding the lived experiences of race-based trauma in Black individuals in the U.S. and Black individuals from Jamaica. The goal of this study was to fill a gap in current literature by providing counselors and counselor educators with information regarding the experiences of Black clients to better inform multicultural, trauma-informed counseling practices and counselor education pedagogy. This study explored the experiences of race-based …


The Role Of Athletic Identity In General Mental Health And Alcohol-Related Help-Seeking Intentions Of College Students, Michael Grant Young Jul 2021

The Role Of Athletic Identity In General Mental Health And Alcohol-Related Help-Seeking Intentions Of College Students, Michael Grant Young

Psychology Theses & Dissertations

Young adults are vulnerable to a range of mental health concerns and tend to drink in high quantities and tend to not seek help for these concerns. Specifically, college students involved in athletics tend to have low help-seeking rates—though help-seeking research for this population is relatively limited. Athletic identity (i.e., identification with the athlete role) is a relevant construct for examining this population, however little is known about its association with help-seeking beliefs and ideas. This study examines: (1) the association between athletic identity and help-seeking intentions for both mental health and alcohol use concerns, (2) the association between …


Telehealth Best Practice: A Call For Standards Of Care, Donna S. Sheperis, Arielle Smith Jun 2021

Telehealth Best Practice: A Call For Standards Of Care, Donna S. Sheperis, Arielle Smith

Journal of Technology in Counselor Education and Supervision

Teletherapy is an approach to working with clients that mental health providers have used in some form for years. However, the onset of COVID forced the provision of therapy into teletherapy almost exclusively for a period of time. Currently, mental health providers conducting therapy virtually are not required to be trained in telehealth and are operating without consistent uniform standards of practice. This manuscript pulls from the current literature and guidelines across counseling, psychology, psychiatry, family therapy, and social work to provide a Proposed Standards of Practice for Telehealth. Such standards benefit mental health counselor by grounding practice in common …


Consensual Qualitative Analysis Of Self-Criticizing Using The Two-Chair Technique, Júlia Halamová, Alžbeta Dvoranová, Slávka Zlúkyová, Viktória Vráblová Jun 2021

Consensual Qualitative Analysis Of Self-Criticizing Using The Two-Chair Technique, Júlia Halamová, Alžbeta Dvoranová, Slávka Zlúkyová, Viktória Vráblová

The Qualitative Report

Level of self-criticism has a significant impact on people’s psychopathology because severe self-criticism activates the sympathetic nervous system, and that further stimulates the physiological and psychological stress response which lead to impairment of mental health and wellbeing (Singer & Klimecki, 2014). Therefore, self-criticism is widely studied, but authors use mainly quantitative approaches which allow generalisation of knowledge but do not allow in-depth insights into the phenomenon. Hence our research aim was to identify the kinds of statements individuals utter when self-criticizing using the two-chair dialogue technique which enable to expose inward dialogues people lead with their self-critical parts. Out of …


Failure To Report: The Detrimental Effects Following Sexual Assault, Lindsey R. Osborne Jun 2021

Failure To Report: The Detrimental Effects Following Sexual Assault, Lindsey R. Osborne

Intuition: The BYU Undergraduate Journal of Psychology

Sexual assault is a prominent issue in society, yet many people remain unaware of the serious effects following sexual assault. Victims who report to legal authorities tend to experience disbelief and blame because of the prevalence of rape myths. Due to the severity of the trauma, hormones released by the brain hinder proper brain functioning and can cause a little-known evolutionary response termed tonic immobility (TI). The psychological outcome of sexual assault commonly results in or worsens several psychological conditions, including depression, anxiety, PTSD, and drug and alcohol abuse. Guilt, self-blame, and adverse emotions are accelerated with negative interactions while …


Teachers’ Perceptions Of Teacher–Child Relationships, Student Behavior, And Classroom Management, Szu-Yu Chen, Natalya A. Lindo, Sarah Blalock, Dina Yousef, Latoya Smith, Kara Hurt-Avila Jun 2021

Teachers’ Perceptions Of Teacher–Child Relationships, Student Behavior, And Classroom Management, Szu-Yu Chen, Natalya A. Lindo, Sarah Blalock, Dina Yousef, Latoya Smith, Kara Hurt-Avila

Journal of Educational Research and Practice

Children’s relationships with their teachers are a potential resource for enhancing developmental and academic outcomes. The effects of positive or negative teacher–child relationships can be either beneficial or detrimental to students’ academic progress, behaviors, and emotions. In the current study, we utilized a qualitative research design to examine 18 pre-kindergarten to fourth-grade teachers’ perceptions of teacher–child relationships, student behavior, and classroom management. Analysis of in-depth interviews yielded five major themes: (a) beliefs in children, (b) teaching strategies, (c) acknowledging individual differences, (d) challenges, and (e) relationships. Findings of this study have the potential to inform in-service training regarding relationship-building skills …


Children As Mischievous Spirits: Legitimizing Child Cruelty And Filicide In Contemporary Africa, Chima Agazue Jun 2021

Children As Mischievous Spirits: Legitimizing Child Cruelty And Filicide In Contemporary Africa, Chima Agazue

Dignity: A Journal of Analysis of Exploitation and Violence

The belief that certain humans are spiritual entities and the belief that some people are spiritually possessed can be found across histories and cultures. While these individuals are not always viewed in the negative or treated inhumanely, cases abound whereby degrading and inhumane treatments are meted out to some of them. In the African continent, certain groups of people, particularly children are linked to certain mischievous spirits due to their unusual appearance, aberrant behavior, disability, chronic illness, psychopathology or exceptional ability. Some are also suspected and consequently mistreated due to events surrounding their birth. Such children are known by different …


Black Men’S Perception Of Their Father-Son Relationship, Shaakira E. Jones Jun 2021

Black Men’S Perception Of Their Father-Son Relationship, Shaakira E. Jones

Dissertations

The purpose of this study is to investigate the perceptions that Black men have of their relationships with their fathers, specifically, adult sons’ retrospective perceptions of their fathers’/father figures’ involvement and nurturance during childhood, and their current emotional availability. The aim is also to explore whether perceptions of their fathers predict Black men’s current psychological well-being. The following measures are used: (a) a demographic questionnaire, (b) the Nurturant Fathering Scale (NFS, Finley & Schwartz, 2004; Williams & Finley, 1997), (c) the Father Involvement Scale (FIS, Finley & Schwartz, 2004), (d) the Lum Emotional Availability of Parenting Scale (LEAP; Lum & …


The Relationship Between Masculinity, Race, And Type Of Sport On Attitudes Toward Help Seeking In Retired Male College Athletes, Michael Filiaci Jun 2021

The Relationship Between Masculinity, Race, And Type Of Sport On Attitudes Toward Help Seeking In Retired Male College Athletes, Michael Filiaci

Seton Hall University Dissertations and Theses (ETDs)

Despite an increased risk of developing mental health difficulties, retired male college athletes are significantly less likely to seek mental health treatment than the general population. Results from previous studies suggest that the type of sport, race, and masculinity level of an athlete may contribute to more negative perceptions of help seeking. The purpose of this study was to fill gaps in the extant literature, raise awareness of stress associated with retirement from sport, and help identify those who may be most at risk for developing mental illness. An analysis of covariance (ANCOVA) was performed to measure the differences in …


Spiritual Well-Being - A Proactive Resilience Component: Exploring Its Relationship With Practices, Themes, And Other Psychological Well-Being Factors During The Covid-19 Pandemic In Cism-Trained First Responders, Justine Jaeger, Harvey J. Burnett Jr., Kristen R. Witzel Jun 2021

Spiritual Well-Being - A Proactive Resilience Component: Exploring Its Relationship With Practices, Themes, And Other Psychological Well-Being Factors During The Covid-19 Pandemic In Cism-Trained First Responders, Justine Jaeger, Harvey J. Burnett Jr., Kristen R. Witzel

Faculty Publications

Research suggests spiritual resilience may ameliorate the negative effects of exposure to traumatic events among disaster mental health first responders. Our study examined the relationship between spiritual wellness and associated resilience factors among four groups of first responders (law enforcement, fire services, emergency medical services and 911 dispatchers) trained in Critical Incident Stress Management (CISM) during a global pandemic. Utilizing a mixed methods-survey with transcendental phenomenological design, data was collected from 107 participants with membership in the International Critical Incident Stress Foundation (ICISF) or the Michigan Crisis Response Association (MCRA). Participants completed the Connor-Davidson Resilience Scale, Spiritual Well-Being Scale-Shortened Version, …


Incorporating Religion Into Therapy To Better Treat Depression, Jacob Tubbs May 2021

Incorporating Religion Into Therapy To Better Treat Depression, Jacob Tubbs

Intuition: The BYU Undergraduate Journal of Psychology

Depression is one of the most prevalent mental disorders. Cognitive behavioral therapy (CBT) is a common treatment option for depression. Often, CBT is only effective at masking the symptoms of depression without helping the person overcome depression altogether; thus, it may benefit CBT patients if alternative therapies are combined with CBT. Incorporating the patient’s religion into therapy is an alternative that may help many people. A large percentage of Americans are still religious or spiritual. This literature review discusses methods of building a personalized version of CBT that incorporates the patient’s religion, or religiously integrated CBT (RCBT), and the effects …


Exposure To Nature: An Underutilized Component Of Student Mental Health, Jeremy S. Bekker May 2021

Exposure To Nature: An Underutilized Component Of Student Mental Health, Jeremy S. Bekker

Intuition: The BYU Undergraduate Journal of Psychology

Nature-exposure interventions on university campuses may serve as an effective addition to overburdened counseling and student support centers. Nature-exposure interventions can work as a preventative health measure on campuses, which can be used adjacently with existing health resources. This paper outlines the potential benefits of nature exposure for students’ physical health, mental well-being, and academic success. Previous research has demonstrated that nature exposure may help reduce cognitive load, decrease negative psychological symptoms, increase psychological coping ability, and lead to better physical health. Many campuses already contain green spaces, defined as any part of an environment that is predominately made of …


Divining Structural Factors Related To Intervention Success Or Failure: Cultural Sexism Versus Other Macro-Level Factors, Blair T. Johnson, Christine M. Curley May 2021

Divining Structural Factors Related To Intervention Success Or Failure: Cultural Sexism Versus Other Macro-Level Factors, Blair T. Johnson, Christine M. Curley

CHIP Documents

This article provides commentary on a spatial meta-analysis published by Price and colleagues (2021); it provides valuable preliminary evidence that a dimension of cultural sexism can countervail efforts for psychotherapy to succeed in samples that focus on girls aged four to 18. Our own study reveals cultural sexism to be markedly associated with at least three macro-level factors: cultural tightness, historical slaveholding (and by implication racism), and sex education inclusiveness. The fact that cultural sexism can be so well predicted by these factors is additional evidence that cultural sexism is real, yet it also suggests caution in interpreting these effects …


Making Meaning Of The Family's Immigrant Experience, Distress, And Help-Seeking: A Critical Inquiry Of Mental Health Support For Second-Generation Korean Americans, Kristin Kim-Martin May 2021

Making Meaning Of The Family's Immigrant Experience, Distress, And Help-Seeking: A Critical Inquiry Of Mental Health Support For Second-Generation Korean Americans, Kristin Kim-Martin

Seton Hall University Dissertations and Theses (ETDs)

The Korean American community is a predominantly immigrant population with a long history of historical and cultural trauma, including the continued losses, hardships, and violence endured through the immigration process, that continues to impact the well-being and functioning of individuals and families today. Second-generation Korean Americans play critical roles in establishing and maintaining the livelihoods and security of their immigrant families; however, they have been underrepresented and under-researched within the literature on immigration and its effects on the mental health and help-seeking patterns of this population. Although there is strong evidence for the influence of culture in the intergenerational patterns …


The Ripple Effect: ‘Training The Trainer’ On The Impact Of Body Image Through A Dance/Movement Therapy Technique, Marina Gearhart May 2021

The Ripple Effect: ‘Training The Trainer’ On The Impact Of Body Image Through A Dance/Movement Therapy Technique, Marina Gearhart

Expressive Therapies Capstone Theses

This thesis describes the capstone project which was a psychoeducation and experiential workshop for fitness trainers. The workshop investigated the impact trainers’ work may have on the body image of their clients through a dance/movement therapy (DMT) technique. The aim was to enhance the trainers’ sensitivity around body image issues of their clients and to create a space for vulnerable movement conversation that may in turn lead to better mental health advocacy for their clients within the scope of ethical practice. The participants of the workshop were six white female identifying trainers ranging from 24 to 35 years of age. …


Community Art For Rebuilding College Communities Following The Covid-19 Pandemic: A Literature Review, Amber Haney May 2021

Community Art For Rebuilding College Communities Following The Covid-19 Pandemic: A Literature Review, Amber Haney

Expressive Therapies Capstone Theses

This paper is an examination of arts-based community engagement projects as a way to creatively engage, support, and endorse healing in college communities. This paper was written with consideration for potential long-term impacts on college students, individually and collectively, as a result of the COVID-19 pandemic. Throughout this paper, college student mental health trends in the United States are addressed and existing community engagement projects that center around community, healing, and resilience are examined. This paper argues that art therapy practices that are meant to advance societal healing can occur outside of the traditional, clinical individual or group therapy session …


Using Paper Theatres As An Expressive Arts Therapy Method: Activating Imaginal Worlds In Community Arts Practice, Silvina S. Ibanez May 2021

Using Paper Theatres As An Expressive Arts Therapy Method: Activating Imaginal Worlds In Community Arts Practice, Silvina S. Ibanez

Expressive Therapies Capstone Theses

Paper theatres are an artistic form that became widely popular in 19th century Europe. Also known as toy theatre and model theatre, a paper theatre has a small build-your-own proscenium and pre-cut paper characters that can be manipulated. Different styles of paper theatre can be found in several cultures.

In contemporary art, the use of paper theatres in several modalities led to an exploration of whether such theatres also could be used as an art therapy method. Research was conducted into expressive art therapy principles, Jungian perspectives, and recent studies in neurosciences. The studies included in the literature review confirmed …


Exploring The Therapeutic Relationship As A Central Focus Through Expressive Arts Therapy In Oncology, Akshata Parekh May 2021

Exploring The Therapeutic Relationship As A Central Focus Through Expressive Arts Therapy In Oncology, Akshata Parekh

Expressive Therapies Capstone Theses

The treatment for cancer can be physically, mentally, emotionally and socially challenging. These treatments have side effects like physical body pain, hair loss, changes in weight, energy, nausea and more. These physical changes impact the social, mental and emotional well-being of the patient and makes this journey of the life-threating prognosis of cancer very tough to confront. Expressive arts therapy provides a safe space for the patients to address their mental health concerns as a result of this treatment. The Capstone Thesis Project explored expressive arts therapy interventions with 95 patients through single or multiple sessions while going through their …


The Effectiveness Of Art Therapy As A Treatment Modality In Improving Quality Of Life For Adults With Chronic Pain, Kayley Nelson May 2021

The Effectiveness Of Art Therapy As A Treatment Modality In Improving Quality Of Life For Adults With Chronic Pain, Kayley Nelson

Expressive Therapies Capstone Theses

The efficacy of art therapy is explored in the context of improving the quality of life and mental health of individuals experiencing chronic pain. The exploration and examination of previous research on chronic pain and art therapy have led to various interconnected themes that tie together the needs of this population with the healing aspects of this treatment method. Through gathering data on both the negative impact of chronic pain and the healing aspects of art therapy and exploring research on chronic pain art therapy groups already in action, it can be deduced that future research may further illuminate the …


Making Room: Addressing The Counter-Therapeutic Nature Of Psychiatric Hospitalization Through Containment- Based Group Expressive Therapy, Max Sandor Copans May 2021

Making Room: Addressing The Counter-Therapeutic Nature Of Psychiatric Hospitalization Through Containment- Based Group Expressive Therapy, Max Sandor Copans

Expressive Therapies Capstone Theses

The process of hospitalization and the environment of a typical psychiatric hospital is often counter-therapeutic. To challenge this problem, clinicians may introduce the concept of psychological containment. To elaborate, being hospitalized anywhere can be disorienting, frightening and even traumatic. This problem is only further exacerbated in psychiatric hospitals where patients may be disorganized, manic, or struggling with psychosis. Furthermore, psychological containment is essentially the ability for psychiatric patients to prevent their intense emotions from effecting others negatively, and to act with resiliency when other patients are unable to contain their own disruptive behaviors. This paper utilizes both an initial literature …


Language As The Medium: A Literature Review. Harnessing The Prolific Power Of Dramatic Language As A Therapeutic Tool In Drama Therapy, Edward Freeman May 2021

Language As The Medium: A Literature Review. Harnessing The Prolific Power Of Dramatic Language As A Therapeutic Tool In Drama Therapy, Edward Freeman

Expressive Therapies Capstone Theses

Language in and of the theatre, with its palate of variegated writing styles and playwrights from throughout time, has the potential to be harnessed, focused, and systematized for use as a therapeutic tool within drama therapy – the field’s artistic medium. Drama therapy could benefit from having a specific medium germane to its artform which has the potential to provide practitioners with a common resource and means of communication, assessment, diagnosis, and treatment planning, as well as align the field with other creative arts therapies. Language encompasses all forms of human communication – speaking, writing, signing, gesturing, expressing facially – …


Bringing The Body Into Art Therapy: The Use Of Touch And Body Awareness In Creative Healing, Janna Corsetti May 2021

Bringing The Body Into Art Therapy: The Use Of Touch And Body Awareness In Creative Healing, Janna Corsetti

Expressive Therapies Capstone Theses

The focus on the use of healing touch and body awareness in art therapy is critically lacking. Despite the research supporting the use of body-oriented techniques in clinical therapy, there is little research related to this use specifically in art therapy. Research reveals that healing touch and body awareness can be instrumental in healing trauma, if done with the proper training and boundaries in place. The first form of attachment and comfort for children is that of touch. Therefore, it is imperative to acknowledge the power of touch and body awareness when healing from traumatic experiences. The purpose of this …


Studio Expressive Arts Therapy: Towards A Classroom Method That Incorporates Art And Music, Michael Greenberg May 2021

Studio Expressive Arts Therapy: Towards A Classroom Method That Incorporates Art And Music, Michael Greenberg

Expressive Therapies Capstone Theses

This thesis explored the ways in which expressive arts therapy (ExAT) could be incorporated into a small therapeutic high school’s visual arts program. Through the development and implementation of a method, intermodal exchange between visual art and music was integrated into both the school’s art program and its group counseling offerings. Informed by a literature review of studio art therapy (SAT) as related to ExAT, three different interventions were used to fit within the frameworks of the high school’s offerings. The first intervention focused on making music with a few students within art classes while the rest of the class …


Art Therapy Provides Relief To New And Expecting Mothers, Dailie Jeffs May 2021

Art Therapy Provides Relief To New And Expecting Mothers, Dailie Jeffs

Expressive Therapies Capstone Theses

Throughout pregnancy, during childbirth, and after childbirth, new and expecting mothers often experience a great amount of anxiety and depressive symptoms that can be classified into three divisions: prenatal anxiety, fear of childbirth, and postpartum depression. Often these symptoms are overlooked and unresolved due to their short time span and being specifically linked to childbirth. However, these symptoms cause a lesser quality of life for the mother that can highly impact the mother and her newborn short-term and long-term. Art therapy techniques, explained by the Expressive Therapy’s Continuum, have proved beneficial in the aid of alleviating depression and anxiety symptoms …


Self-Compassion Integrated Art Therapy For Mothers During A Pandemic, Shannon Dover May 2021

Self-Compassion Integrated Art Therapy For Mothers During A Pandemic, Shannon Dover

Expressive Therapies Capstone Theses

This thesis reviews literature related to parental mental health and the novel coronavirus (COVID-19). COVID-19 is a collective trauma in which individuals experience the trauma differently depending on race, gender, and class. Women’s experience of living during COVID-19 related to changes in the workplace, caretaking, and more. The pandemic influenced parents and notably mothers with increased stress, depression, grief, and anxiety. The practice of self-compassion reduces shame and self-criticism which are common experiences during parenting and trauma. Self-compassion and art therapy can aid in resiliency and make living during COVID-19 more comfortable. With a literature review, results yield the following …


Exploring Tactile Art-Making With Deafblind Students And Their Families: An Opportunity For Creative Play, Alice Rodgers May 2021

Exploring Tactile Art-Making With Deafblind Students And Their Families: An Opportunity For Creative Play, Alice Rodgers

Expressive Therapies Capstone Theses

The impact of a deafblind diagnosis on an individual’s mental health and the well-being of the family involved can be profound. However, current research and available literature for the mental health treatment and therapy practices of deafblind persons and their families is limited (Kyzar et al., 2016; “WFDB Global Report 2018,” n.d.). This thesis used the Leeds Family Psychology and Therapy Service principles (Leeds FPTS) and the Expressive Therapies Continuum with established deafblind teaching strategies to facilitate an original arts-based community project entitled: “Things We Like.” This project provided an opportunity for deafblind students (ages three to 22) and their …