Doctor of Psychology (Psy.D.), Xavier University, 2021, Psychology

Formal and informal caregivers experience both negative and positive aspects of caregiving, such as burnout and compassion satisfaction. However, the existing literature primarily focuses on the experiences of family caregivers and nurses, but neglects nursing assistants. This study examined the relationships among personality, burnout, compassion satisfaction, work engagement, and job satisfaction in a sample of certified nursing assistants (CNAs) employed in healthcare settings. Additionally, this study compared CNA data collected prior to and during the COVID-19 pandemic. Participants completed self-report surveys measuring burnout, compassion satisfaction, personality factors, work engagement, job satisfaction, intent to quit, and demographics. Results indicated significant positive relationships between compassion satisfaction and agreeableness and extraversion, as well as between burnout and neuroticism. Significant negative relationships were found between burnout and agreeableness and extraversion, as well as between compassion satisfaction and neuroticism. Work engagement and job satisfaction were not found to moderate these relationships. CNAs who participated prior to the COVID-19 pandemic reported lower burnout and higher compassion satisfaction compared to CNAs who participated during the pandemic. However, there were no differences in job satisfaction or intent to quit. The current study provided novel information about CNA personality, burnout, compassion satisfaction, and levels of job satisfaction and work engagement. The findings may be useful in developing interventions for CNAs to bolster compassion satisfaction and decrease burnout to potentially reduce turnover rates.

Committee: Renee Zucchero Ph.D. (Committee Chair); McCarren Heather Ph.D. (Committee Member); Nagy Mark Ph.D. (Committee Member) Subjects: Nursing; Occupational Psychology; Personality; Psychology; Public Health

Doctor of Philosophy, The Ohio State University, 2024, Educational Studies

Each year in the United States, an estimated 57.8 million adults and 7.7 million children experience mental health issues with far-reaching implications (National Alliance on Mental Illness [NAMI], 2023). Despite our increased awareness in the aftermath of the COVID-19 pandemic, which both exposed and exacerbated the problem, access to services remains severely limited for 163 million Americans living in Mental Health Professional Shortage Areas (NAMI, 2023). There is an insufficient supply of mental health providers in America, and an additional 8,251 practitioners are needed immediately to adequately meet the needs of the people (Health Resource & Services Administration [HRSA], 2023b). However, this deficit will not be resolved soon, as nearly half of mental health practitioners currently report intentions to leave their employment (Centers for Disease Control [CDC], 2023). Furthermore, resolving the shortage will require more than hiring additional mental health professionals (HRSA, 2023b). Compared to the larger workforce, mental health providers have a higher risk of experiencing detrimental occupational outcomes (Cocker & Joss, 2016; Ledoux, 2015; Ondrejkova & Halamova, 2022; Sinclair et al., 2017; Sorenson et al., 2016). Burnout, one of the occupational harms associated with the unique demands of care work, is a driving force in the provider retention problem (CDC, 2023; Hoge et al., 2007; Morse et al., 2012). Although there is a direct link between burnout and a lack of organizational support (Schaufeli & Greenglass, 2001), there is a lack of research examining systemic causal factors. Most existing studies neglect to explore links between work characteristics and employee well-being and are restricted to investigating individual traits as contributors (CDC, 2023). The present study confronts the gap in the literature through a systemic exploratory analysis. This quantitative study examined the link between workplace environments and mental health (open full item for complete abstract)

Committee: Darcy Haag Granello (Committee Chair); Paul Granello (Committee Member); Noelle Arnold (Committee Member) Subjects: Behavioral Sciences; Behaviorial Sciences; Clinical Psychology; Counseling Education; Counseling Psychology; Health Care; Health Care Management; Medical Ethics; Mental Health; Occupational Health; Occupational Psychology; Organization Theory; Organizational Behavior; Psychology; Psychotherapy; Public Health; Public Health Education; Systems Design; Therapy

Doctor of Philosophy (PhD), Ohio University, 2024, Counselor Education (Education)

The need for mental health resources in universities has seen a rise after the pandemic. Students have encountered various issues related to the transition and adjustment from online to in-person classes. Additionally, students in general have been known to have issues related to stressors of transitioning into adulthood and navigating their new life and relationships. This calls for increasing awareness amongst college counselors, counseling supervisors, and counselor educators to understand these issues and work towards combating the upcoming challenges that students face. A lot of these issues arise from students being harsh to themselves for not being able to accomplish as much as some of their peers. Constant comparison with others leads to feelings of guilt and shame towards oneself which in turn leads to a negative view of self along with symptoms of depression, and anxiety. A lot of these issues can be reduced by understanding and applying the concepts of self-compassion. Hence, it is important for college counselors, counseling supervisors, and counselor educators to be able to teach self-compassion techniques to their clients and students. While self-compassion can help students to accept themselves for who they are, it can also help them to understand how others share similar experiences. This can assist students to feel less isolated and more connected to their peers, which could also lead to newer friendships and connections. Feeling connected to others could lead to better experiences in college while preparing the students for a successful transition to adulthood. For college counselors, counseling supervisors, and counselor educators, practicing self-compassion themselves could lead to lower chances of burnout and a better understanding of boundaries. Through this study, I accomplished three objectives: (1) explored the relationship between self-compassion and flourishing, and satisfaction with life in undergraduate students, (2) explored the relatio (open full item for complete abstract)

Committee: Christine Bhat (Committee Chair); Gordon Brooks (Committee Member); Bilal Urkmez (Committee Member); Yegan Pillay (Committee Member) Subjects: Counseling Education; Mental Health; Psychotherapy; School Counseling; Teaching; Therapy

DNP, Kent State University, 2024, College of Nursing

Background: Due to the nature of their work, psychiatric nurses at Northwest Ohio Psychiatric Hospital (NOPH) encounter traumatic and emotionally exhausting situations almost every day. This exposure increases work-related stress, trauma, and vulnerability to compassion fatigue (CF) and burnout. CF and burnout can result in emotional and physical fatigue that affects one's ability to care for others. One can increase resilience and compassion satisfaction (CS) by identifying CF's early indications and symptoms and mastering efficient self-care techniques. Aim: This Doctor of Nursing Practice (DNP) project aims to bring awareness to psychiatric nurses at NOPH about CF and burnout and educate them on ways to improve resiliency and compassion satisfaction as professional nurses. PICOT: How do psychiatric nurses at NOPH (P) who are at increased risk for CF benefit from a webinar-based educational intervention (I) to identify and reduce symptoms of CF and improve compassion satisfaction (O) one month after intervention (T) compared to pre-intervention (C)? Design: Psychiatric nurses completed Professional Quality of Life surveys (ProQOL 5) (Stamm, 2010) before and one month after an educational intervention designed to teach about CF and self-care strategies. Comparisons of ProQOL scores, which measure compassion satisfaction and CF (burnout and secondary trauma scores), determined if an educational intervention effectively improved CS and reduced CF (significance level at p<0.05). Implementation Plan/Procedure: Psychiatric nurses received a one-hour educational intervention on CF via their work email. The educational intervention's contents included TED talks, PowerPoint presentations on the extent of the CF problem, common symptoms, and outcomes, and resources to combat CF, such as mindfulness. Nurses were given pre- and post-intervention ProQOL 5 along with a demographic survey. Surveys were administered pre-intervention and one month after inte (open full item for complete abstract)

Committee: Andrea Warner-Stidham Ph.D., MSN, RN (Committee Chair); Debra Cifani DNP, RN (Committee Member); James Tudhope DNP, PMHNP-BS, NPD-BC (Committee Member) Subjects: Nursing; Occupational Health

Bachelor of Science, Walsh University, 2022, Honors

The work of forensic nursing requires its nurses to display large amounts of compassion and empathy for their patients, who are victims of violent crimes. The forensic nurse's personal mental health and well-being can be negatively impacted by the extraneous use of empathy and compassion. Multiple gaps within the research were identified when detailing the specifics of both the positive and negative effects the role of forensic nursing has on its nurses' mental well-being. A mixed methods research approach was conducted to investigate the prevalence and impact of compassion fatigue/burnout, secondary traumatic stress, and compassion satisfaction amongst forensic nurses. A survey of practicing forensic nurses within the United States, recruited from the International Association of Forensic Nurses, was conducted to collect both qualitative and quantitative data. The survey consisted of basic screening/inclusion criteria questions, demographic information, the Professional Quality of Life questionnaire created by Dr. Beth Stamm, and five short extended response questions. nu

Committee: Mary Cook (Advisor); Nina Rytwinski (Committee Co-Chair); Jennifer Clevinger (Committee Co-Chair); Tammie Davis (Other) Subjects: Nursing

Doctor of Healthcare Administration (D.H.A.), Franklin University, 2022, Health Programs

The overarching objective of this study was to investigate the impact of individual psychological flexibility (PF) based on three fundamental constructs: secondary trauma, compassion fatigue, and burnout experienced by healthcare workers during the COVID-19 pandemic. Data were gathered from healthcare workers in the United States in ambulatory community health centers. Participants were drawn from public databases of demographic information, professional and social platforms such as LinkedIn, licensing and professional listservs, and healthcare organization associations. Data sources included online self-report questionnaires using the AAQ-II and ProQOL. An analysis was conducted to determine if a relationship exists between PF and compassion fatigue (CF), secondary traumatic stress (STS), and burnout. Furthermore, data were reviewed and compiled for healthcare leaders, consultants, policymakers, and other relevant stakeholders to analyze the benefit of developing psychological flexibility as a tool to promote emotional and psychological wellness and resiliency in their staff and organizations.

Committee: Cheryl Chance (Committee Chair); Jesse Florang (Committee Member); Gail Frankle (Committee Member) Subjects: Health Care; Health Care Management; Public Health

Doctor of Philosophy (PhD), Ohio University, 2022, Higher Education (Education)

This study explored the Professional Quality of Life in behavioral intervention team members at community colleges through the subcategories of compassion satisfaction and compassion fatigue. Although major tragedies are rare at colleges and universities, the emotional toll that behavioral intervention team members experience through listening to student stories and creating appropriate interventions can be taxing on their Professional Quality of Life. Stamm (2010) founded the Professional Quality of Life scale which measures how those in helping professions experience compassion satisfaction and compassion fatigue through the work they do. Student affairs professionals have not commonly been studied regarding compassion satisfaction and compassion fatigue, and this study aimed to navigate these experiences in behavioral intervention members. There were a variety of themes that came from this qualitative study. The first theme was that behavioral intervention members found their work challenging, but very rewarding. Most of the participants found that graduation was the ultimate celebration because it meant that the interventions for the students had successfully led to completion of their degree. Another theme is that support from fellow team members, as well as friends and family was important to the members keeping a positive Professional Quality of Life. Participants also shared that working for community colleges has allowed them to keep a good work-life balance. Another theme is that participants were growing professionally which helped their professional quality of life. There was also a common theme of the fear of missing important information that would impact a student's behavior that could possibly lead to tragedy. Implications for this study include preparing new student affairs professionals for working in community colleges, as the experience can be vastly different than that of four-year institutions. Preparing student affairs professionals in h (open full item for complete abstract)

Committee: Laura Harrison (Committee Chair) Subjects: Education; Higher Education

Doctor of Philosophy (PhD), Ohio University, 2021, Higher Education (Education)

Compassion satisfaction and compassion fatigue are best described as the good stuff and the bad stuff that comes from our emotional engagement with those who are suffering (Stamm, 2010). The literature on compassion satisfaction and compassion fatigue in higher education is minimal and limited to studies pertaining student affairs practitioners and nursing educators (Bernstein-Chernoff, 2016; Gardner, 2015; Hoy & Ngyuen, 2020, Raimondi, 2019; Stoves, 2014). This is problematic because the consequences of compassion fatigue and the benefits of compassion satisfaction are minimally understood while the client population, students, continues to exhibit increased and sustained mental wellbeing struggles (ACHANCHA, 2017; Eisenberg et al., 2007). This dissertation is a qualitative research study that investigated the ways tenure track faculty members experience compassion fatigue, compassion satisfaction, and the consequences of those experiences because of working with students. Using professional quality of life theory and appreciative inquiry as theoretical frameworks, this research found that students were a driving force of compassion satisfaction and that the faculty work environments are strong sources of burnout. Implications based on these findings were discussed to address the nature of the faculty work experience both to leverage the positive attributes from working with students and the negative aspects of the faculty work context.

Committee: Laura Harrison (Committee Chair) Subjects: Higher Education

Psy. D., Antioch University, 2020, Antioch New England: Clinical Psychology

This dissertation explored the impact of spending time in nature on therapist levels of compassion fatigue and compassion satisfaction for office- and nature-based therapists. While the study mainly focused on office-based therapists, a sample of nature-based therapists were included for exploratory purposes as they constitute a unique niche of mental health workers who combine traditional talk therapy methods and the healing properties of nature. The literature is reviewed within an ecopsychology frame, key terms are defined, and nature's impact on mental health and wellbeing is explored. One hundred fifty participants (124 office-based, 26 nature-based) were included in this study. They completed the Professional Quality of Life scale, which examined levels of compassion fatigue and compassion satisfaction, as well as a series of demographic questions. They were also asked about the amount of time they spend outside, and how they like to use that time. Utilizing Spearman's correlation, there was a significant negative correlation between time spent in nature and compassion fatigue for office-based therapists. There was no relationship between compassion satisfaction and time in nature for office-based therapists. Similarly, there was no significant relationship between compassion fatigue and compassion satisfaction between the office- and nature-based groups. Post-hoc analyses were conducted to explore additional findings, such as the relationship between geography and time in nature. The results of this study contribute to the literature on the positive impact of spending time in nature on wellbeing, as well as the potential benefit of spending time in nature as a self-care strategy for therapists.

Committee: Martha Straus PhD (Committee Chair); George Tremblay PhD (Committee Member); William Hafford PsyD (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, Case Western Reserve University, 2019, Management

Healthcare systems worldwide are challenged with caring for patients with chronic conditions. As of 2014, at least 60% of Americans have at least one chronic condition, with diabetes being among the top five chronic conditions. Although medical management is utilized for glucose control, the majority of diabetes management involves self-care, imposing physical and psychological demands. As a result, there is an underappreciation of the patients' actual workload and burden by providers. Although patients emphasize the importance of interpersonal relationships as a critical component of quality care, there is often incongruence between the goals of providers and the patients. This study aims to identify factors related to interpersonal interactions that influence behavioral change and chronic disease outcomes by exploring the dynamics of the patient-provider relationship. This is a three-part exploratory mixed methods study. In Study 1, thirty Type 2 Diabetic (T2DM) participants were interviewed to explore the social interactions that facilitate behavioral change. Findings showed that positive interpersonal interactions, social relationships, and the ability to cope during disease setbacks or situational events influenced sustained behavioral change. These findings informed measures for Study 2. In Study 2, a quantitative study surveying 423 T2DM participants examined the attributes that influence chronic disease outcomes. Findings revealed coping ability to positively fully mediate the effect of compassion on self-management and treatment satisfaction. Further, coping ability fully mediated the effect of optimism on self-management and treatment satisfaction. Providers enhanced self-management adherence and treatment satisfaction by helping their patients cope with the burdens of diabetes by communicating with compassion and optimism. In Study 3, 422 T2DM participants were surveyed to explore how the patients' perceptions of relationship quality influence c (open full item for complete abstract)

Committee: Yunmei Wang Ph.D. (Committee Chair); David Aron M.D. (Committee Member); Richard Boland Ph.D (Committee Member); Philip Cola Ph.D (Committee Member) Subjects: Health Care; Health Care Management

Doctor of Philosophy, University of Akron, 2016, Counseling Psychology

A counselor's ability to manage his or her emotions is central to connecting with the client and working through the client's distressing issues (Hill, 2009; Rogers, 1975; Skovholt, 2005). Despite its centrality to the counseling process, and thus counselor professional development and competency, counselor emotion management has been minimally researched. Counseling work can result in burnout or compassion fatigue (CF; Figley, 2002; Kahn, 1993; Lim, Kim, Kim, Yang, & Lee, 2010), as well as compassion satisfaction (CS; Killian, 2008; Stamm, 2006, 2009). By drawing on emotional labor research (Hochschild, 1983), the current study examined emotion management variables of: deep acting (DA, engendering emotions within oneself); surface acting (SA, feigning or suppressing emotions); and authentically-expressed emotions (AEE) in addition to emotional dissonance in two forms – as it relates to professional requirements (emotion-rule dissonance, or ERD; Morris & Feldman, 1996; Rafaeli & Sutton, 1987), or as the discord between that expressed externally and internally felt (emotion-display dissonance, or EDD; Cote, 2005; Hochschild, 1983) in relation to the above outcomes. Positive and negative affectivity (PA, NA) were examined as antecedents to the above variables. Structural Equation Modeling found that alternate measurement structures and structural model better fit the data than what was proposed. Specifically, direct and indirect relationships were found between PA and some emotion management and outcome variables, while NA was predictive only of some outcomes. Study implications, limitations, and suggestions for future research are reviewed.

Committee: Amber Hewitt Ph.D. (Committee Chair) Subjects: Counseling Psychology; Psychobiology

Doctor of Philosophy (PhD), Ohio University, 2016, Counselor Education (Education)

Research shows that stress in the workplace can contribute to negative physical and mental health outcomes among workers in a variety of settings, while the personality disposition of Hardiness can serve as a protective factor against those outcomes. Existing literature on human services professionals shows that Perceived Work Stress and Hardiness can predict Professional Quality of Life, which includes the positive outcome of Compassion Satisfaction and the negative outcomes of Burnout and Secondary Traumatic Stress (Stamm, 2010). The purpose of the current study was to determine whether Perceived Work Stress and the Hardiness components of Control, Commitment, and Challenge predict Compassion Satisfaction, Burnout, and Secondary Traumatic Stress among Emergency Services and Assessment (ES) clinicians in the Commonwealth of Virginia. ES clinicians conduct prescreening assessments for involuntary psychiatric hospitalizations and are exposed to unique work stressors. A secondary aim of the current study was to determine if there are interactions among the variables that better explain the relationships. Findings indicated that Perceived Work Stress and Hardiness are significant predictors of Professional Quality of Life for ES clinicians, but not all components of Hardiness made significant contributions to each regression model. The Hardiness component of Commitment did not significantly predict Secondary Traumatic Stress. The Hardiness component of Challenge did not significantly predict any of the outcome variables. Perceived Work Stress, Control, and Commitment accounted for 58.3% of the variance in Compassion Satisfaction. Perceived Work Stress, Control, and Commitment accounted for 65.2% of the variance in Burnout. Perceived Work Stress and Control accounted for 31.2% of the variance in Secondary Traumatic Stress. No interaction effects were detected among the predictor variables that better explained the relationships in the regression models for (open full item for complete abstract)

Committee: Christine Bhat (Committee Chair); Yegan Pillay (Committee Member); Tom Davis (Committee Member); Dianne Gut (Committee Member) Subjects: Counseling Education; Counseling Psychology; Occupational Psychology

Doctor of Philosophy, The Ohio State University, 2010, EDU Physical Activity and Educational Services

This qualitative study was conducted to identify perceptions and emerging concepts related to compassion in mental health counseling. In addition, this study examines diverse counselor perceptions and attitudes toward compassion and the impact of “being” a compassionate counselor. The construct of compassion has been empirically studied in many helping professions; however, most research has focused on counselors working with trauma victims in medical settings and large scale disasters. The sample comprised 16 mental health counselors (i.e., 13 females and 3 males). These counselors are licensed professionals working in the state of Ohio. Three major categories were identified and ten subthemes emerged from the analysis of the data: (a) client population, (b) work environment, and (c) coping mechanisms. Based on the findings practical recommendations are offered to mental health counselors, supervisors, as well as counselor educators.

Committee: James Moore III (Advisor); Kenneth Yeager (Committee Member); Michael Casto (Committee Member) Subjects: Mental Health

Doctor of Philosophy, University of Akron, 2009, Counselor Education and Supervision

One hundred sixty-four professional counselors completed an on-line survey that included the PRO-QOL (Professional Quality of Life Scale) and the SCS (Self-Compassion Scale). Participants also completed a demographic questionnaire that included length of meditation practice and other self-care practices. Results of a MANCOVA revealed that the meditation practice group (N=62) reported significantly higher levels self-compassion, while showing lower levels of burnout than their non-meditating peers (N=102) when controlling for Social Desirability. Further, the current study found that measures of self-compassion were positively associated with measures of compassion satisfaction (r=0.387, p=0.01) and negatively associated with measures of burnout (r= -0.525, p=0.01) and compassion fatigue (r=-0.452, p=0.01). These results are congruent with the promising research that has been conducted on the relatively new construct of self-compassion, suggesting its utility and value to the growing fields of positive psychology and professional wellness. In addition, post hoc analyses (ANCOVA) revealed that self-care time was found to have a significant impact on compassion satisfaction, suggesting that individuals who practice more than 5 hours of self-care per week have higher levels of compassion satisfaction than their colleagues who reported less self-care time. Limitations included a convenience sample of participants (recruited from state associations and professional list serves) and a fairly stringent definition of meditation practice (at least 60 minutes per week, at least 6 months of practice). Implications for training and practice, which includes the responsibility of training programs to include formal instruction in self-care practices, are presented along with recommendations for future research.

Committee: Patricia Parr PhD (Advisor) Subjects: Teacher Education

PHD, Kent State University, 2013, College of Education, Health and Human Services / School of Lifespan Development and Educational Sciences

The present study examined the relationship between compassion fatigue, burnout, compassion satisfaction, and self-care among counselors and counselors-in-training. Additionally, the current study investigated if recent life changes, age, sex, race, years of experience, education level, and work/internship setting impacted counselors' and counselors'-in-training self-reports of compassion fatigue, burnout, compassion satisfaction, and self-care. A total of 253 counselors and counselors-in-training were surveyed through a professional conference, internship classes, and email listservs. Variables were measured through the use of a demographic questionnaire, the Professional Quality of Life Scale (ProQOL 5), the Self-Care Assessment Worksheet (SCAW), and the Recent Life Changes Questionnaire (RLCQ). Pearson-product moment correlations, analysis of variances (ANOVAs), and t-tests were utilized to determine potential relationships between variables. Results indicated that recent life changes impact both burnout and compassion fatigue. Compassion satisfaction appeared to influence burnout, but not compassion fatigue. Results also determined that burnout and compassion fatigue are positively correlated with each other. When examining the demographic variables, results revealed that women experience higher levels of compassion fatigue than men. Burnout was found to be higher for participants who are working or interning in agency and school settings than those in private practices or hospitals. Participants in agency and school settings were also found to be associated with lower amounts of self-care than those in private practices. Nonstudent agency workers were determined to have higher amounts of compassion satisfaction with age and increased engagement in psychological self-care activities. However, self-care was negatively correlated with compassion satisfaction for participants in school settings.

Committee: Jane A. Cox Ph.D. (Advisor); Steve Rainey Ph.D. (Advisor); Kelly Cichy Ph.D. (Committee Member) Subjects: Counseling Education