Ph.D., Antioch University, 2024, Antioch Seattle: Counselor Education & Supervision

The purpose of this study is to understand how mental health counselors in private practice conceptualize, approach, and manage productivity, including key strategies and best practices employed through a qualitative study of lived experience. Inclusion criteria for participant eligibility included being a licensed counselor with a degree from a CACREP-accredited counseling program, working primarily in a private practice setting, and with primarily adult clients. Nineteen participants (N = 19) met these criteria and were included in the study. A thematic analysis was utilized by a team of researchers, which resulted in seven primary themes. The primary themes relate to the meaning of productivity in private counseling practice, thoughts and feelings about productivity, process of productivity, goals and values for productivity, productivity challenges and barriers, resource management, and best practices related to productivity. Ultimately, given the diversity of counselor thoughts, feelings, and perspectives on productivity unearthed in the study—ranging from antipathy to struggle to beneficial embrace, as well as the seeming discomfort of talking about the phenomen —it is recommended dedicated attention, fresh discussion, and further research on the topic be pursued.

Committee: Stephanie Thorson-Olesen (Committee Chair); Amanda Falkers (Committee Member); Colin Ward (Committee Member) Subjects: Counseling Education; Counseling Psychology; Mental Health; Psychology; Psychotherapy

Psy. D., Antioch University, 2015, Antioch New England: Clinical Psychology

There are too few mental health providers to meet the needs of residents of rural communities. Rural inhabitants often present for treatment with severe symptoms, high risk for suicide, comorbid chronic health conditions, and socioeconomic stressors. It is difficult to recruit psychologists to rural communities due to limited training in rural psychology, financial barriers to sustaining a practice, frequent ethical dilemmas posed by small towns, and limited cultural amenities. While there is a significant amount of scholarly literature describing the needs of this population and the challenges of maintaining a practice in such geographic regions, there is scarce literature on solutions to these problems. This study addressed this gap in the literature by exploring possible solutions for recruitment and retention of rural doctoral-level psychologists. Forty-eight psychologists practicing in towns with a population of 5,000 or fewer across the United States responded to mailed surveys inquiring about their background information, the factors which contributed to their initiation of and maintenance of a career in rural psychology, and their recommendations for improving recruitment and retention. Most participants worked in private practice providing individual psychotherapy and/or evaluation with adults despite having minimal training in rural mental health during graduate school. The most frequently listed reasons participants had chosen and maintained a rural practice were: a preference for a rural lifestyle, a desire to be close to family and friends, and the population. The most frequently reported suggestions for increasing the number of rural psychologists included: improved financial incentives, highlight the benefits of rural practice (e.g., limited competition, meaningful work), highlight the appeal of a rural lifestyle, and create a professional network of rural providers. Professional incentives such as owning a private practice, meaningful experi (open full item for complete abstract)

Committee: Susan Hawes Ph.D. (Committee Chair); James Fauth Ph.D. (Committee Member); Gina Pasquale Psy.D. (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, Case Western Reserve University, 1993, Social Welfare

As health care costs have increased, so too have the number of restrictions placed by insurers on reimbursement for mental health services. With the growth in vendorship for social workers, those in the mental health field are increasingly confronted with the challenge of how to provide appropriate services within the parameters of what will be reimbursed by the third party. These sometimes oppositional forces create a number of philosophical, clinical and moral predicaments. Such dilemmas are likely to be most acutely felt by social workers in private practice, for whom clinical decisions have direct personal fiscal ramifications. Decision making under the pressure of such competing values can be most easily understood using concepts and terminology derived from the field of ethics. In order to better understand these phenomena and their prevalence, an exploratory study was conducted using a sample of 540 social workers randomly selected from a clinical register. Subjects were sent a nine page, 53-item questionnaire which contained questions on demographic and practice characteristics, experiences with third party payors, the perceived impact of the third party, the actual effect on practice decisions and actions, and the amount of quandary experienced when deviating from legal, ethical, or clinical norms. Phone interviews expanding on the survey were conducted with a subset of respondents. As a result of the survey and interview findings, it appears that involvement with third parties varies, and the payor's effect on practice is related to the level and type of restrictions employed. Practice effects were found in the clientele selected for treatment, the diagnoses assigned, the length, frequency, and modality of treatment, and the collateral services rendered. Practitioners also evidenced ethical and personal dilemmas as a result of reconciling practice decisions with third party parameters. These findings hold significant implications for policy development, so (open full item for complete abstract)

Committee: Wallace Gingerich (Advisor) Subjects:

Doctor of Musical Arts (DMA), Bowling Green State University, 2013, Contemporary Music

It is commonly understood that the foundation of private instrumental studies at the collegiate level is one, hour-long, teacher-guided private lesson per week followed by self-guided student practice until the next lesson. This model allows a teacher to tailor instruction to fit a student's particular needs, however, because the majority of a student's time with an instrument is during self-guided practice, there are unique challenges that must be addressed. Students must recognize key concepts from a private lesson, know how to produce desired results technically, devise a strategy that will solidify key concepts in familiar and novel domains, and demonstrate their success in the next week's lesson. However, the processes involved in skill acquisition transcend domain and have been studied both in musical and non-musical contexts. In this research I will observe and compare the behaviors of students during private lessons with students' behaviors during subsequent self-guided practice sessions. The purpose of this study is to: 1. Determine if there is a measureable difference in student behavior during a private lesson and during a self-guided practice session. 2. Identify factors that mediate differences, if present. 3. Determine if accumulated lessons affect self-guided student practice. 4. Provide insight as to why different behaviors occur by comparing the findings from each student. A series of three private lessons and three subsequent student practice sessions from three students were video taped and analyzed, and after all video data were collected, an exit interview was conducted with each student participant. Descriptive statistics from each private lesson were compared with descriptive statistics from each self-guided practice session, and responses from the student exit interview were used to add additional insight to this comparison. It was found that there are measureable differences between student behavior during a private les (open full item for complete abstract)

Committee: Kevin Schempf (Advisor); Elaine Colprit (Committee Member); Laura Melton (Committee Member); Steven Boone (Committee Member) Subjects: Music; Music Education