Ph.D., Antioch University, 2016, Leadership and Change

Opioid dependence has reached epidemic levels in the United States and around the world. With the increased prescribing of opioid pharmaceuticals and the influx of inexpensive heroin, the health care cost to society has topped $72.5 billion annually (Murphy et al., 2016). Opioid overdose deaths have now surpassed motor vehicle deaths and have tripled since 1990. In some age groups opioid overdose is the leading cause of death. This study seeks to analyze the only field that directly treats this primary brain disease: medication assisted treatment for opioid dependence. The three primary participants in this partnership include: (a) doctors and allied medical providers; (b) substance abuse counselors known in Washington State as Chemical Dependency Professionals (CDPs); and (c) clients affected by opioid dependence. Together they combine medical approaches and psychosocial counseling with clients to attain the goal of recovery. Attitudes and beliefs of these three groups of individuals vary, as do their views toward the medications currently being utilized in the treatment field. This study measures these differences and discusses the implications for clients, medical providers, and CDPs. It was hypothesized that differences in opinions across the three groups about medication assisted treatment, length of time clients should be on medications, and recovery limit positive outcomes. Data were collected via survey from more than 250 clients being treated for opioid dependency and from over 200 professionals (medical and counseling). Descriptive and comparative ANOVA and t-test statistics were used in the analysis. Results indicate that there remain large differences in beliefs and attitudes among the medical providers, CDPs, and clients on key issues related to medication assisted treatment. The gap appears to be especially evident when comparing the two professional groups who treat clients with opioid use disorder. CDPs and medical providers are working from a dif (open full item for complete abstract)

Committee: Carol Baron PhD (Committee Chair); Jon Wergin PhD (Committee Member); Stacy Rasmus PhD (Committee Member); Adam Kartman MD (Committee Member); Monica Skewes PhD (Other) Subjects: Counseling Psychology; Medicine; Pharmaceuticals

Psy. D., Antioch University, 2015, Antioch Seattle: Clinical Psychology

Little research has examined the role that loneliness and perceived stigmatization play in the decision to seek mental health services among older adults enrolled in opiate substitution treatment. Researchers studying this at-risk population have called for more studies to examine services that can be implemented within current opiate substitution treatment settings. This study advances research in the field by utilizing standardized self-report measures to examine the relationship between loneliness, perceived stigmatization, and the impact of said variables on the utilization of available mental health services among older adults enrolled in opiate substitution treatment programs. Ninety-four 50-71-year-old adults from an opiate substitution treatment program completed self-report measures querying age, degree of perceived stigmatization, perception of loneliness, and engagement in mental health services. Results indicated that participants who reported feeling greater loneliness and perceived stigmatization were more likely to utilize available mental health services, not supporting the primary hypothesis; however, identifying that participants' experiencing greater difficulty were willing to seek supportive services. A significant relationship was identified between loneliness and perceived stigmatization, supporting a secondary hypothesis regarding the impact of compounding factors experienced by older adults in opiate substitution treatment. This study demonstrated the importance of the availability of mental health services for older adults in opiate substitution treatment settings, particularly targeting those experiencing a higher degree of loneliness and perceived stigmatization. Mental health services may help to alleviate the burden of the complex interaction of substance abuse and aging. The electronic version of this dissertation is at OhioLink ETD Center, www.ohiolink.edu/etd

Committee: Alejandra Suarez Ph.D. (Committee Chair); Bill Huesler Psy.D. (Committee Member); Douglas M. Kerr Ph.D. (Committee Member) Subjects: Aging; Behavioral Psychology; Clinical Psychology; Cognitive Psychology; Ethics; Families and Family Life; Health Care; Health Care Management; Psychology; Public Health; Quantitative Psychology; Rehabilitation; Therapy

Doctor of Philosophy, University of Toledo, 2012, Counselor Education

There is a great deal of literature to suggest that experiencing traumatic events in childhood often leads to problematic outcomes in adulthood. Not all individuals who experience such trauma, however, arrive at the same end point. The concept of resilience has been promoted as one of the ways in which individuals experiencing similar life events can end up with very different results. This study sought to clarify the complex relationship between adverse childhood events, resilience, and substance dependence in a college student sample. This researcher surveyed 143 first-year college students in a university orientation class. While this researcher did identify a relationship between trauma and substance dependence in this sample, not all findings were in support of the research questions. Despite the mixed results of this study, the researcher did identify several notable implications based on this study‘s findings, as well as a number of suggestions for future research.

Committee: John Laux (Committee Chair); Christopher Roseman (Committee Member); Nick Piazza (Committee Member); Jennifer Reynolds (Committee Member) Subjects: Counseling Education