Doctor of Healthcare Administration (D.H.A.), Franklin University, 2023, Health Programs

The Crisis Intervention Team (CIT) program is a partnership of law enforcement agencies, the behavioral healthcare system, emergency departments (EDs), advocacy groups, and other stakeholders in a geographic region. People in the community who experience a crisis related to a behavioral health (BH) condition often encounter police officers, and the CIT program offers guidance on the safe handling of those situations that ideally ends with a connection to treatment. In the United States, crisis BH resources are often unavailable, and it is common for officers to resolve the situation by initiating an ED visit, which is not associated with positive health outcomes for the patient. The aim of this study is to test the implications of Structural Functional Theory (SFT) in one CIT program. SFT suggests that imbalanced systems lead to the inappropriate reliance on other systems. The analysis of crisis events may provide insight into potential BH system improvements that align with the goals of the CIT program. One research question aims to find predictors of each disposition option available to LE officers in the CIT program. Findings in this study are drawn from the quantitative analysis of 594 CIT encounters over a 3-year period. The results of the multinomial logistic regression models indicate that adolescents and young adults experience suicide-related crises more often than other types of crises, and the most likely outcome is an ED visit. Findings suggest that the local system could benefit from improvements in BH resources, especially in crisis situations.

Committee: Gail Frankle (Committee Chair); Jesse Florang (Committee Member); Dail Fields (Committee Member) Subjects: Health Care Management

Doctor of Nursing Practice, Mount St. Joseph University , 2020, Department of Nursing

Hospital medical surgical units are experiencing an increase in aggression from patients resulting in increased injuries to health care team members nationally and locally. On one local medical surgical unit, incident reports were made on 10 violent patient occurrences within a two year time period. Leadership recognized the need to provide team members education for mitigating aggressive behaviors. A literature review was conducted to examine interventions effective in managing aggressive or disruptive patients. Effective communication techniques and mitigation strategies have been demonstrated to decrease patient aggression, increase team member confidence levels in managing patient aggression, and to decrease team member injuries. The DNP project focused on four voluntary education sessions in a week period on a local medical surgical unit to teach team members on de-escalation techniques, therapeutic communication, mindful awareness, dementia care tips, and knowing when to exit. A confidence scale instrument was used before the education, immediately after the education, and 30 days post education. In addition, injuries to health care team members from patients was reviewed and analyzed from before and after the project to measure effectiveness of the education sessions. The results of the DNP project did support the evidence that education classes on mitigating disruptive patient behaviors increased team members' confidence level scores immediately after the education and the confidence level scores sustained in 30 days. The team member injuries from patients also decreased. The findings indicate a need to educate other medical surgical units, and to further disseminate through national conferences.

Committee: Nancy Hinzman Dr (Advisor) Subjects: Nursing

Doctor of Philosophy, University of Akron, 2019, Counseling Psychology

Suicide is the tenth leading cause of death in the United States (McIntosh & Drapeau, 2018). Mental illness is prevalent among suicide deaths (Cavanaugh et al., 2003) and psychologists can expect to have clients with increased suicide risk during their training or career (Dexter-Mazza & Freeman, 2003; Kleespies, Penk, & Forsyth, 1993), it is vital that students training to be health service psychologists, including clinical psychology, counseling psychology, and school psychology (APA, 2018), be competent in providing clinical care to individuals with increased suicide risk. Competency incorporates “knowledge, skills, attitudes, and personal qualities” essential to clinical practice (Albanese et al., 2008). Although suicide is an important topic, only two studies have directly examined clinical skill with suicidal clients by graduate students (Mackelprang et al., 2014; Neimeyer & Bonnelle, 1997). There have been many calls to further emphasize clinical preparation related to suicide assessment and management (SAM; Neimeyer, 2000; Rudd et al., 2008; Westefeld et al., 2000), particularly because many students receive little training related to suicide at the internship level or beyond (Schmitz et al., 2012). The current study examined the experience, training, and competency of 140 health service psychology graduate students prior to internship, using a measure of skill (Suicide Intervention Response Inventory [SIRI-2]; Neimeyer & Bonnelle, 1997), attitudes, knowledge (Attitudes Towards Suicide Scale [ATTS]; Salander Renberg & Jacobsson, 2003), and a self-rating of clinical suicide competency (Suicide Competency Assessment Form [SCAF]; Cramer et al., 2013). These measures were compared examining a number of personal qualities identified in previous research as potentially affecting skill, attitudes, or knowledge related to suicide. Findings indicate nearly all graduate students were providing clinical services to clients with suicidal thoughts or attempts prior to (open full item for complete abstract)

Committee: Ingrid Weigold Ph.D. (Advisor); Bernard Jesiolowski Ph.D. (Committee Member); Suzette Speight Ph.D. (Committee Member); Charles Waehler Ph.D. (Committee Member); Alan Kornspan Ed.D. (Committee Member) Subjects: Clinical Psychology; Counseling Psychology; Psychology

Doctor of Philosophy, University of Toledo, 2019, Counselor Education

Law enforcement officers experience significant effects on their physical and mental health because of their employment. These effects frequently go untreated due to the stigma related to having mental health needs and attending treatment. Often, law enforcement culture perpetuates stigma. Addressing stigma and culture are barriers to treatment engagement frequently left unaddressed. Without understanding this link, even the most effective treatment will be left unattended. Thus,making prioritizing treatment engagement essential for addressing law enforcement officer's mental health. The current study aimed to increase understanding of how the Crisis Intervention Team training impacted law enforcement officer's help-seeking behaviors. This training is designed to decrease the stigma of law enforcement officers in working with individuals with mental illness in the community. An Exploratory Single Case Study, Embedded design (SCSED) was utilized to gain an understanding of how participation in one community CIT training affected law enforcement officers' help-seeking behaviors.The study included 11 participants including LEO training participants, LEO training facilitators, and mental health provider training facilitators. Findings indicated that the CIT program did not influence participant LEO help-seeking behavior. However it did increase their comfort and knowledge in reaching out to their peers regarding their peer's mental health.

Committee: John Laux (Committee Chair); Madeline Clark (Committee Member); Christopher Roseman (Committee Member); Kasey Tucker-Gail (Committee Member) Subjects: Counseling Education

Doctor of Philosophy, The Ohio State University, 1979, Graduate School

Committee: Not Provided (Other) Subjects: Psychology

Doctor of Philosophy, The Ohio State University, 1976, Graduate School

Committee: Not Provided (Other) Subjects: Sociology

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

PhD, University of Cincinnati, 2003, Nursing : Doctoral Program in Nursing

The purpose of this quasi-experimental study was to examine the effect of a nonviolent crisis intervention program on the perceived self-efficacy of community mental health center staff. The research was guided by Social Cognitive Theory, using the construct of self-efficacy, which is belief in one's capabilities (Bandura, 1986). Crisis intervention self-efficacy, along with seven other variables believed to influence crisis intervention self-efficacy were investigated: anxiety arousal, avoidant behavior, interpersonal self-efficacy, participant behavior, perceived risk, personal vulnerability, and risk discernment. The sample was non-randomized and consisted of 90 multidisciplinary mental health staff conveniently selected from two community mental health centers. The experimental group (n. = 56) received The Nonviolent Crisis Intervention® training program targeted toward managing potentially violent clients; the control group (n = 34) received no training. Data were collected using self-administered questionnaires immediately prior to the training, at the conclusion of the training, and six months later. The ANOVA showed there was a significant main effect for group (F [1,80] = 0.16, p < 0 .01, h =.15) and for time (F [1,80] = 10.17, p < .01. h=.11). Subjects who participated in the training demonstrated greater self-efficacy when compared to the subjects who did not have the training, and subjects who participated in the training increased their self-efficacy mean scores over time. Path analysis revealed a causal structure with interpersonal self-efficacy, risk discernment, and anxiety impacting personal vulnerability that mediated perceived risk, ultimately influencing crisis intervention self-efficacy. The results suggest community mental health staff that received the non-violent crisis training professed greater confidence in their ability to manage potentially violent clients. Perceived risk and interpersonal self-efficacy appear to directly influence crisi (open full item for complete abstract)

Committee: Dr. Evelyn Fitzwater (Advisor) Subjects:

Master of Arts (MA), Ohio University, 2011, Sociology (Arts and Sciences)

Drawing on data collected through a qualitative approach, this study explores the interactional processes involved in informing definitions of mental illness and mental distress between CIT officers and mental health professionals. CIT officers build empathy towards individuals in mental distress while mental health professionals assign individual responsibility for criminal acts. Subsequently, particular responsive strategies are imposed to mitigate the crisis. Lastly, attention is then turned to how these public service professionals negotiate definitions of severity and mental illness in attempt to impose a one-sided mitigating response to the crisis. Consistent with other previous research surrounding public service professionals and social problems, this study reveals the contextual, interactional and structural processes involved in how CIT officers and mental health professionals define, respond to, and negotiate mental illness.

Committee: Ursula A. Castellano PhD (Committee Chair); Leon Anderson PhD (Committee Member); John Gilliom PhD (Committee Member) Subjects: Criminology; Mental Health; Public Administration; Sociology

BA, Kent State University, 2013, College of Arts and Sciences / Department of Modern and Classical Language Studies

Whereas the 'Parti socialiste' is today a permanent fixture in the French party system, and has regularly been elected to government having even produced an elected president (Francois Mitterrand from 1981-1995), the PCF has not experienced the same level of longevity or electoral success. Indeed, the party has been in steady decline since the late 1970s, but remarkably has not disappeared (this is the hook that snagged my interest). One key question which arises concerns is whether or not the contemporary PCF continues to exert any real influence at all in a political system which has worked to the favor of larger, more centrist parties, with broad-based appeal. Does the PCF now exist more as an outdated ideological tradition than as a political entity with any realistic chance to bring about substantive change in a society in which capitalism is (reluctantly) embraced and firmly entrenched? This project provides a historical overview of some key moments in the PCF's existence, and also examines its ideological underpinnings, taking into account of any identifiable shifts in position over time. The investigation analyzes the PCF's current positions on a series of contemporary political, economic and social questions, such as the European Economic Crisis and the French military intervention in Mali, in order to provide some answers to these questions.

Committee: Matthew Kemp PhD (Advisor) Subjects: European History; Foreign Language; Political Science