Ph.D., Antioch University, 2023, Leadership and Change

This study examined the perspectives of master-level clinical mental health providers and members of leadership at a Community Mental Health Center (CMHC) in New Hampshire, to understand clinician and leadership perspectives as to why master-level providers choose to continue working at CMHCs. Most prior research on turnover in such organizations has focused on why so many leave their positions, however this study instead focuses on factors related to the decision to stay at a specific CMHC in an urban area of New Hampshire. A single case study method was utilized to focus on masters-level mental health care providers with additional interviews with leadership at the CMHC. Some of the findings that will be explored is what draws providers to community mental health centers, the importance of connections with colleagues and leadership, and aspects of why master-level providers stay. The study contributes to the understanding of clinician retention in community mental health centers and provides recommendations for master-level providers, CMHC leadership, and clinical mental health educators. Some of the overarching themes that surface from the data were around why clinicians remain in the CMHC, the reasons why providers do the work they do each day, the draw to CMHC, and reasons why people master-level providers consider leaving a CMHC. Connections with leadership and supervisor were very important in why clinicians want to stay at the CMHC. Licensure contracts were also an area that was explored in this research. Clinicians and members of leadership provided their perspective on licensure contracts and the implementation of the contracts. This dissertation is available in open access at AURA (https://aura.antioch.edu/) and OhioLINK ETD Center (https://etd.ohiolink.edu).

Committee: Harriet Schwartz PhD (Committee Chair); J. Beth Mabry PhD (Committee Member); William Gunn PhD (Committee Member) Subjects: Mental Health; Psychology; Public Health

Specialist in Education, Miami University, 2021, Educational Psychology

Over the last decade, mental health recognition and diagnoses for children, adolescents, and adults has increased. The need for mental health related services in schools is high, however there are many identified barriers to students receiving these services. Common barriers identified in literature included both structural (e.g. insurance, communication) and perceptual (e.g. stigma, discrimination) barriers. The current study was a local mixed methods evaluation of secondary school professionals' perceptions of barriers to mental health related services in schools. School referral process and pre-collected barrier data was also examined. Both structural (e.g., insurance, caregivers) and perceptual (e.g., stigma, language/culture) barriers were indicated in the results in addition to suggestions to overcome barriers. Study limitations and implications for practice will be discussed.

Committee: Kristy Brann Dr. (Advisor); Anthony James Dr. (Committee Member); Sharon Custer Dr. (Committee Member) Subjects: Educational Psychology

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2018, Higher Education Administration

The purpose of this phenomenological study was to understand the experiences of midlevel student affairs professionals who navigated a mental health condition as a new professional and remained in the field. New professionals' attrition and retention concerns continue to warrant further exploration through research. Research is lacking on new professionals group was those with a mental health condition. Mental illness is prevalent in our society, and as evident in this study, professionals do negotiate their mental illness as professionals in the field. I interviewed nine midlevel student affairs professionals from across the United States. Each of the professionals worked at a variety of institutions and within many functional areas in student affairs during their first five years in the field. I lead eighteen interviews with nine participants. In addition to the interviews, all of the participants responded to one journal prompt. To mask the identities of my participants, the professionals selected pseudonyms and I used these names throughout my manuscript. The participants shared their experiences comprising five main themes: (1) coping with mental health conditions, (2) student affairs competence and mental health, (3) influential relationships, (4) disclosure, and (5) organizational influences. Three primary findings emerged following the analysis of the experiences and the review of the literature. Participants experienced fear of discrimination. They shared about negotiating the personal nature of the experiences and their own self-advocacy. Lastly, the professionals' community was instrumental in connecting to their retention. With these themes and findings, I developed implications for practice and future research. Implications for practice include a proposed paradigm shift in our organizations; the important role of supervisors, administrators, and colleagues; the use of a universal design model; and the value of structures to support those with (open full item for complete abstract)

Committee: Maureen Wilson (Advisor); Michael Coomes (Committee Member); Neal Jesse (Committee Member); Hyun Kyoung Ro (Committee Member) Subjects: Adult Education; Counseling Education; Counseling Psychology; Education; Educational Psychology; Health; Higher Education; Higher Education Administration; Mental Health; Occupational Health; Psychology

Doctor of Philosophy, University of Toledo, 2009, Health Education

This study assessed the perceptions and practices of mental health professionals at university counseling centers regarding their provision of guidance on the health effects of religious/ spiritual involvement. The membership of the Association for University and College Counseling Center Directors was used to identify a national cross-section of university counseling centers. One licensed psychologist, professional counselor, or social worker from each counseling center was selected to survey (N = 623). A valid and reliable survey instrument was developed, and a three-wave postal mailing procedure was used to maximize the return rate.A total of 306 university counseling professionals (58%) responded. They agreed that religious/spiritual involvement has a positive influence on the health and well-being of college students (77%), but were unsure or disagreed (66%) that university counseling professionals should advise clients as such. Approximately one-third (31%) had never seriously thought about doing so. The respondents were predominantly (52%) "unsure" that guidance on the health effects of religious/spiritual involvement would result in lower health risks; however, nearly half (48%) indicated that such guidance would promote recovery among their clients. Although slightly more than half (54%) of the responding university counseling professionals discussed the salutary influence of religiosity/ spirituality with the majority of their clients (e.g., provides a means of coping with stress, offers social support, contributes to a sense of well-being), relatively few (21%) discussed the physical health effects of religious/spiritual involvement. The most frequently endorsed perceived barrier was that discussions of religiosity/spirituality and health "should occur only with clients who indicate that religion/spirituality is important to them" (67%). A plurality (35%) of the respondents had received no formal training in this area. Respondents who had received informa (open full item for complete abstract)

Committee: Joseph Dake Ph.D., MPH (Committee Chair); James Price Ph.D., MPH (Committee Member); Timothy Jordan Ph.D. (Committee Member); Jeanne Funk-Brockmyer Ph.D., ABPP (Committee Member) Subjects: Mental Health; Psychology; Psychotherapy; Public Health

Doctor of Psychology (Psy.D.), Xavier University, 2024, Psychology

Burnout is a syndrome consisting of emotional exhaustion from one's work, personal life, and/or client-specific content (Kristensen et al., 2005). Mental health professionals (MHPs) experience burnout more frequently when there is an increase in their frequency of patient contact, and inpatient working MHPs tend to experience higher rates of burnout compared to their outpatient working peers (Rupert & Morgan, 2005). The dramatic rise in demand for mental health treatment following the onset of the COVID-19 pandemic for depression, anxiety, and suicidality (Ganesan et al., 2021) suggests that MHPs working in inpatient settings are experiencing higher rates of burnout in the post-COVID crisis era. This study examined whether patient contact frequency, contact with patients in crisis (i.e., acute patient contact frequency), and MHPs' use of adaptive and maladaptive coping skills would influence burnout rates among MHPs working in inpatient settings. Sixty licensed MHPs working in correctional facilities, psychiatric hospitals, state hospitals, and substance use clinics completed self-report surveys measuring frequency of patient contact, burnout, and methods of coping. Results showed that patient contact frequency did not significantly predict burnout rates on the Copenhagen Burnout Inventory (CBI). Thus, the proposed mediation analysis was not conducted to determine if acute patient contact frequency statistically explained the relationship between patient contact frequency and CBI scores. In addition, adaptive coping skill use (i.e., emotional support, positive reframing) was not significantly predictive of burnout scores on the CBI, while maladaptive coping skill use (i.e., substance use, denial) was significantly predictive of higher levels of burnout. Finally, 37% of MHPs in this study were at a moderate or high level of burnout, indicating that emotional exhaustion is common among inpatient working MHPs. These results suggest that although patient contact is not (open full item for complete abstract)

Committee: Jennifer Phillips Ph.D. (Advisor); Heather McCarren Ph.D. (Committee Member); Kathleen Hart Ph.D., ABPP (Committee Member) Subjects: Mental Health; Psychology

Doctor of Philosophy, University of Akron, 2020, Counselor Education and Supervision

Prior research has suggested that non-suicidal self-injury (NSSI) among inmates has been on the rise within the prison setting, which implies that this population is in need of attention, particularly from mental health professionals. Attitudes towards inmates who have displayed NSSI are often negative, including among mental health professionals, suggesting that NSSI among inmates is often a form of manipulation to obtain a secondary gain. Negative attitudes towards NSSI are thought to produce adverse treatment outcomes, as well as increase NSSI itself. Counselor empathy and counselor self-efficacy (CSE) can also affect NSSI outcomes. The present study investigated whether empathy or CSE was associated with mental health professionals' attitudes toward jail and prison inmates who have displayed NSSI. 81 licensed mental health professionals employed in a jail or prison setting completed the Attitudes Towards Prisoners Who Self-Harm Scale (APSH), the Toronto Empathy Questionnaire, the Session Management Self-Efficacy subscale (CASES-SM), and a demographic questionnaire. Results from a standard multiple regression analysis revealed that both counselor empathy and CSE had a positive statistically significant relationship with APSH scores. The results of the current study have the potential to shed light on ways in which mental health treatment in jails and prisons need improvement, as well as the necessary steps needed in order to promote positive outcomes within the practice of correctional mental health professionals, as well as improving the lives of jail and prison inmates. Implications for mental health practice, mental health trainees, mental health educators, and future research are discussed.

Committee: Robert Schwartz (Committee Chair); Varunee Faii Sangganjanavanich (Committee Member); Julie Lenyk (Committee Member); Yue Dang (Committee Member); Seungbum Lee (Committee Member) Subjects: Behavioral Sciences; Counseling Education; Counseling Psychology; Mental Health; Psychotherapy

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2015, Psychology/Clinical

Although research has been done on social stigma and its effects on individuals in marginalized groups, relatively little is known about the effects of secondary stigma for those people who are associated with stigmatized individuals, such as mental health professionals. Using a sample of 196 mental health professionals who work with sexual offenders (64 sexual offender counselors), serious mental illness (64 case managers), and college students (68 college counselors), the present research examined mental health professionals' experience of secondary stigma, personal growth, professional burnout, and job choice regret as a function of working with clients. The mixed-method research design includes a qualitative analysis of mental health professionals' descriptions of secondary stigma and the impact of their work on their professional and personal lives. The psychometric properties of the newly developed measure, the Mental Health Professionals Secondary Stigma Scale (MHPSSS) were also evaluated. Findings suggest that sex offender counselors reported experiencing more secondary stigma and depersonalization than case managers and college counselors. Case managers reported higher levels of personal growth followed by college counselors and sexual offender counselors. All three samples of mental health professionals identified positive and negative aspects of their work. Implications of findings for research and clinical practice are discussed.

Committee: Catherine Stein (Advisor); Michael Zickar (Committee Member); Dryw Dworsky (Committee Member); Laura Sanchez (Committee Member) Subjects: Clinical Psychology; Psychology

Ph.D., Antioch University, 2014, Antioch New England: Marriage and Family Therapy

This dissertation consists of two articles focusing on foreign language interpreters in mental health. The first article is a literature review examining the existing research on mental health professionals working with foreign language interpreters while conducting therapy with refugee clients. After excluding articles that were not research studies and those that focused on physicians rather than therapists, 19 articles fit the search criteria. The majority of the articles that did not fall into the research category focused on recommendations and protocols for treatment. Those that did fit within the criteria were categorized into 5 main themes. Those themes were: effectiveness research, emotional influences, therapeutic alliance, role of the interpreter, and therapists' experiences of interpreter roles. The second article explored the interpreters' and therapists' perceptions of the triadic and dyadic relationships within the therapist-interpreter-refugee client system. A systemic lens was adopted to directly examine the question of how interpreters and therapists working with refugee clients experience the relationships among interpreters, therapists, and refugee clients in therapy. Three interpreters and three therapists were interviewed and four themes and nine subthemes emerged, all centered around a triadic relationship between the therapist, interpreter and client. This study revealed a circular process within the triadic system in which all of the members of the system influenced one another. It also revealed a reciprocal process in which both the therapist and the interpreter's perception of the other member's relationship with the client influenced the individual's feelings of effectiveness in therapy.

Committee: Walter Lowe Ph.D (Committee Chair); Aimee Burke Valeras Ph.D (Committee Member); Megan Murphy Ph.D (Committee Member); Catherine Lounsbury Ed.D. (Other) Subjects: Counseling Psychology; English As A Second Language; Minority and Ethnic Groups

EdD, University of Cincinnati, 2002, Education : Counselor Education

Sexual abuse is a painful experience for victims and survivors. The rate of sexual abuse prevalence varies from study to study (6% to 62%, Finkelhor, 1990), but all indicate that a significant number of children will have long-term symptoms. A literature review was conducted to identify the symptoms reported most frequently. The prevalent symptoms identified included: anger, anxiety, depression, fears/ fearfulness, hope-/helplessness, loneliness/isolation, low self-esteem, post-traumatic stress disorder, relationship difficulties, sexual problems, shame/guilt, suicidal ideations/ self-destructive behaviors, trust difficulties. Published group plans were reviewed to compare the long-term symptoms identified in the literature review with the focus of published clinicians. The focus of this study was to check the perceptions of mental health professionals working with survivors. Most research studies examined symptoms reported by survivors (e.g., Bell & Belicki, 1988; Finkelhor, 1990), but have neglected the perceptions of professionals who conduct groups. Some professionals have produced literature based on their clinical work (e.g., Gil, 1990; Courtois, 1988) but these studies did not corroborate this information using other group leaders. Thirty female mental health professionals were surveyed. The participants reported being licensed or certified mental health professionals or job-trained workers who conduct female survivor groups. Data were collected through conferences and networking. Years of experience ranged from less than one year to more than 12 years. One out of five of the individuals surveyed report that they consider themselves to be an expert; while 30% of the individuals surveyed report conducting groups because of a job requirement. Mental health professionals listed the top three symptoms observed when conducting groups – depression, low self-esteem and trust difficulties. Another section of the survey requested that participants rate the symptoms id (open full item for complete abstract)

Committee: Dr. Ellen Cook (Advisor) Subjects: Psychology, General

Doctor of Philosophy (PhD), Ohio University, 2003, Curriculum and Instruction (Education)

The retention of mental health professionals stands as a major problem in rural areas. Although a number of studies have examined the retention of rural allied health professionals and physicians, few, if any, have looked specifically at rural mental health providers. Two major contributing factors cited in the literature are (1) isolation of practitioners (both personal and geographic) and (2) lack of educational activities for professional development and continuing education. One solution suggested in the literature is the use of technology to address the needs of rural practitioners such as isolation, little or no access to experts and consultants, lack of peer support, and difficulty obtaining education and career development programs. This study examined(1) technology use and expertise in relationship to job satisfaction and (2) the difference in job satisfaction between mental health providers who state that they plan to remain in rural practice and those who plan to leave within two years. Three hundred and twenty rural mental health providers in southeast Ohio were surveyed, of which 163 returned usable surveys. The study did find a significant, but weak, relationship between technology use and expertise and job satisfaction, but no significant difference in job satisfaction between those who plan to stay and those who plan to leave their rural practice within the next two years. The study found that, despite the fact that over 90% of respondents have access to both a computer and the Internet, they are not using them to communicate with friends or peers nor are they accessing professional resources and educational programs via the internet or other distance technology. Two other factors emerged that influence job satisfaction, household income and years in rural practice, neither of them cited as significant contributors in the retention literature. This study raises questions about the use of technology as a tool to improve job satisfaction and thus reten (open full item for complete abstract)

Committee: Sandra Turner (Advisor) Subjects:

Psy. D., Antioch University, 2012, Antioch Santa Barbara: Clinical Psychology

Objective: To determine whether the presence of an ADHD-PI label influenced adult perceptions of a female adolescent's social competence. Method: Forty four primary and secondary teachers and 54 mental health professionals rated their perceptions based on a vignette that included or did not include the label ADHD-PI. Results: The ADHD-PI labeled vignettes elicited more negative perceptions of the child's social acceptance and ability to make close friends. Also, mental health professionals rated the girl as more socially accepted, regardless of diagnosis. There were no other significant main effects and there were no significant interaction effects. Conclusion: The presence of an ADHD-PI label has a significant influence on how the child is perceived by caregivers, and teachers are more likely to have less positive perceptions of adolescents with attention differences than do mental health professionals in certain domains. The electronic version of the dissertation is accessible at the Ohiolink ETD center http://www.ohiolink.edu/etd.

Committee: Salvador Trevino PhD (Committee Chair); Sharleen O'Brien PsyD (Committee Co-Chair); Stephen Hinshaw PhD (Advisor); Betsy Bates Freed PsyD (Committee Member) Subjects: Clinical Psychology; Mental Health; Psychology; Quantitative Psychology; Social Psychology; Social Research

Psy. D., Antioch University, 2009, Antioch Santa Barbara: Clinical Psychology

Studies conducted in previous decades have examined attitudes toward and perceptions of voluntarily childless men and women. Participants in these studies were usually comprised of high school, college, and university students. The results showed that, compared to those who were parents, voluntarily childless men and women were mostly perceived in a less favorable light. This study sought to investigate how voluntarily childless heterosexual couples are currently viewed and whether attitudes toward the voluntarily childless have changed since the earlier research was conducted. Participants in this study consisted of individuals who were practicing in the field of mental health and who might encounter voluntarily childless couples as clients. The collected data was analyzed, and areas of statistical significance were examined. Compared to the previous studies among student participants that indicated either more negative perceptions of the voluntarily childless, or very little or no bias at all, the current study's findings suggest that mental health professionals have more positive perceptions of individuals who choose to be childfree. Results were utilized to formulate recommendations for further research.

Committee: Juliet Rohde-Brown PhD (Committee Chair); Catherine Radecki-Bush PhD (Committee Member); Katherine Burrelsman PsyD (Committee Member); Heidi Zetzer PhD (Committee Member) Subjects: Families and Family Life; Personal Relationships; Psychology