Stigma toward individuals with eating disorders is common and well-documented. Individuals with eating disorders regularly report experiencing stigma associated with perceptions that they are to blame for their illness, that their illness is trivial compared to other conditions, or that they are engaging in disordered behavior to gain attention. These stigmatizing attitudes toward eating disorders are also reported by the general public and healthcare professionals, including those who treat eating disorders. Treatment of these illnesses at all levels of care often include paternalistic approaches such as coercion and compulsion that can have both adverse and advantageous consequences. While there are ethical, clinical, and legal justifications for these treatment approaches, this study provides a novel exploration of the relationships between stigma toward individuals with eating disorders and coercive and compulsive treatment. This was accomplished using a survey methodology to assess the attitudes and treatment practices of treatment providers across the United States. The results of this study suggest that there is no significant relationship between treatment providers' attitudes toward individuals with eating disorders and coercive or compulsive treatment methods. Implications for clinical practice and future research are discussed and center on the need for additional inquiry to better understand the complexities of these two variables in light of the ongoing debate concerning the risks and v benefits of coercive and compulsive treatment. This dissertation is available open access at AURA, http://aura.antioch.edu and Ohio Link ETD Center, https://etd.ohiolink.edu

This study utilized Primary Care Provider (PCP) perspectives to unveil major barriers to prescribing buprenorphine to youth (ages 16-25) with opioid use disorder (OUD). Semi-structured interviews were conducted with seven PCPs recruited through convenience and snowball sampling. Interviews were conducted and recorded via Zoom video conferencing. Transcripts were generated and analyzed for themes using a Constructivist Grounded Theory (CGT) approach. The CGT of the present study describes four major barriers that limit PCP prescription of buprenorphine to youth: 1) PCPs Feel Overwhelmed, 2) PCPs Feel Ill Equipped to Treat Youth Patients with OUD, 3) PCPs Hold and Observe Stigma toward Patients with OUD—Especially Youth, and 4) Structural and Systemic Barriers. Each major barrier consists of related subcategories and sub-subcategories. Findings offer stakeholders suggestions for targeting individual, relational, clinical, and systemic level changes to increase primary care access to buprenorphine for youth ages 16-25.

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)

The purpose of this paper was to develop a continuing education program to teach sex offender-specific treatment providers (SOSTP) in the community how to appropriately assess, treat and manage adults with severe mental illness who are also sex offenders (SMISOs) in an outpatient setting. This paper begins with an overview of the most relevant literature associated with the treatment of sex offenders and a presentation of some of the current programs developed to treat sex offenders with severe and persistent mental illnesses. This review also outlines the paucity of resources and the need for SOSTPs to receive expanded training to better serve the specialized and challenging needs of the SMISO population. Next, methods are used to develop a 7-hour continuing education training curriculum for SOSTPs aimed at increasing assessment and treatment skills of those working with adult men with severe and persistent mental illnesses who have also been convicted of sexual offenses. The results section provides a written overview of the final curriculum, the details of which are attached in the appendix. Lastly, a discussion follows to explore the limitations and potential uses of this project and the developed training.

This study investigated how treatment providers working with juvenile sexual offenders perceive treatment effectiveness of current treatment modalities for juvenile female sexual offenders. According to the Federal Bureau of Investigation statistics from 2008, juvenile offenders, particularly juvenile female sexual offenders, are rising in numbers (FBI, 2009). The majority of the research regarding juvenile sexual offenders has focused on adolescent males and little is known about whether treatment for juvenile offenders, generally without differentiation between genders, are working for female sexual offenders. The female juvenile sex offender is under identified, inadequately studied, and underserved. This study aimed at gaining information about treatment providers' perceived effectiveness of common treatment modalities on juvenile female sex offenders. Sixty-four helping professionals who work with sex offenders in the Midwest region participated in this study. The results indicated that, out of 55 treatment modalities for sex offenders, 23 treatment modalities were in the range of effective to mostly effective; 12 were in the range of somewhat effective to effective; and 12 were in the somewhat effective category; and 8 treatment modalities, all being in the Pharmacological Methods, were in the not effective to somewhat range. For the 35 treatment modalities in the range from somewhat effective to mostly effective, Communication Skills, Assertiveness Training, Psychodrama, Individual Counseling and EMDR were found to be perceived as more effective treatment modalities for juvenile female offenders compared to juvenile male offenders. Anger Management, Social Skills, Fantasy Work, Assault Cycle and Journaling were perceived to be effective for juvenile male offenders. However, 29 out of 55 treatment modalities (52.73%) were found to be perceived as equally effective to either female or male offenders. It is also found that none of the treatment modalities in th (open full item for complete abstract)