Master of Arts (MA), Bowling Green State University, 2023, Mental Health and School Counseling

Human trafficking is a significant crime and human rights violation that impacts more than 27.6 million individuals globally and is incredibly complex in nature (U.S. Department of State, 2023). Survivors are subjected to extreme conditions of abuse, neglect, and coercion leading to the need for competent and compassionate service providers and community support efforts (Kenny et. al, 2022). Service providers working with survivors of human trafficking are exposed to traumatic stories and events daily putting them at high risk for developing symptoms of vicarious trauma (Cohen & Collens, 2013). Due to the nature of their work, it is important to identify protective factors and methods of self-care for service providers that can prevent or reduce the impact of vicarious trauma. The goal of this study was to determine the effectiveness of trauma-informed yoga on the symptoms of vicarious trauma felt by service providers working with survivors of human trafficking.

Committee: Jared Rose Ph.D. (Committee Chair); Ellise Raghavan Ph.D. (Committee Member) Subjects: Mental Health; Therapy

Master of Science, The Ohio State University, 2024, Genetic Counseling

Background: Vascular Ehlers-Danlos syndrome (vEDS) is a life-threatening connective tissue disorder caused by pathogenic variants in the COL3A1 gene. Patients can experience aortic or arterial dissections and hollow organ rupture. While it is rare, affecting between 1/50,000 and 1/200,000 people, support organizations exist. The goal of this study is to determine what information would be helpful for support organizations of the vEDS community to prioritize programming regarding mental health support and how the social aspect of support organizations impacts mental health. Methods: People with vEDS and their first-degree family members, including spouses/partners, were surveyed about their mental health, traumatic experiences -including vicarious trauma -, and support organization participation. An electronic survey was administered, which included the STOP-D, OSSS-3, demographic questions, and questions regarding support organization participation, priorities, exposure to trauma, what materials they would like a support organization to provide regarding grief/trauma, and preferred ways of receiving information. Results: One hundred forty-three people participated. Statistically significant relationships were found between experiencing trauma and vicarious trauma (p=0.002) and having access to a provider who listens and confidence in a provider's knowledge of vEDS (p=0.001). Ninety five percent of those who reported vicarious trauma also reported experiencing at least one traumatic event. There was no association found between vicarious trauma and subtype of experienced trauma, or between vicarious trauma and support group participation. Although not statistically significant, high stress was reported for both people with vEDS (65%) and their unaffected family members (60%). Participants also wanted a variety of materials or programs from a support organization, including peer support, individual and group therapy, information on advanced directives, and 24/ (open full item for complete abstract)

Committee: Gretchen MacCarrick (Advisor); Kristen Carpenter (Committee Member); Elizabeth Jordan (Committee Chair) Subjects: Genetics; Mental Health

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

This study explored the experiences of African American mental health clinicians' during the intersecting crises of the Black mental health crisis, the highly publicized racial tension tied to extrajudicial violence and over-policing of Black Americans, and the COVID-19 pandemic. The pandemic started a global crisis that affected millions of people's physical and mental health and overall well-being. Shared trauma explores the duality of mental health clinicians' personal and professional experiences. Grounded in critical race theory and models of trauma, this study explores Black mental health clinicians' lived experiences and lessons. This is an interpretive phenomenological study with narrative interviews of 10 mental health clinicians who provided services to at least 50% Black clientele before the advent of COVID-19. The study explored how Black mental health clinicians providing mental health care fared, personally and professionally, during COVID-19 and with racial upheaval: How did they adapt their lives and practices? What did they learn personally and professionally during these crises? Data were collected in individual qualitative interviews and analyzed using Saldana's first-cycle and second-cycle thematic coding model. Themes that emerged were (a) anxiety and fear regarding the unknown of COVID-19; (b) anger towards the continued racism and over-policing and killing of the Black community; (c) the importance physical activity and therapy as a clinician as means of self-care (d) connection to others to help with emotional support and the isolation of COVID-19; (e) transitioning to telehealth from in-office clinical services; (f) increase in demand of services, and (g) increase in demand for the expertise of Black clinicians, specifically. Understanding the lived experiences of Black mental health clinicians during these crises informs future practices of clinicians by teaching how to optimize health and well-being for self-care and not (open full item for complete abstract)

Committee: J. Beth Mabry Ph.D. (Committee Chair); Fayth Parks Ph.D. (Committee Member); Ameena Kemavor Ph.D. (Committee Member) Subjects: African Americans; Black Studies; Clinical Psychology; Counseling Education; Counseling Psychology; Health Care; Mental Health; Psychotherapy; Social Work

Master of Arts in Psychology, Cleveland State University, 2021, College of Sciences and Health Professions

Mental health clinicians often work with clients who have been through significant trauma, and clinicians face risks of traumatization themselves through exposure to the traumatic stories of clients. This indirect traumatization is known as vicarious trauma (VT), and research has shown this to be related to burnout in mental health workers. Mental health clinicians must find a delicate balance between work and family roles, and the present study aimed to determine how this work interference with family (WIF) can explain the relationship between VT and burnout, and how support from the organization can ameliorate the negative effects of VT on the balance between work and family. Questionnaire responses were anonymously collected and analyzed from 110 mental health professionals working in mental health organizations sampled from several counties around Ohio. Analyses of the responses supported the hypotheses that WIF explains the relationship between VT and burnout, but perceived organizational support (POS) does not moderate the relationship VT and WIF, therefore rejecting those hypotheses. On this basis, it is recommended that mental health organizations educate employees on balancing work and family roles and provide adequate resources such as paid time off to help clinicians avoid burnout. Further research is needed to determine if POS is more effective at preventing VT than addressing it.

Committee: Michael Horvath (Advisor); Kenneth Vail (Committee Member); Elizabeth Goncy (Committee Member); Michael Horvath (Committee Chair) Subjects: Psychology

Doctor of Philosophy (PhD), Ohio University, 2018, Counselor Education (Education)

The purpose of this qualitative study is to explore the lived experiences of rural rope and rappel rescue workers. This research uses a phenomenological case study approach to look at meaning associated with the experience of rescue-based work for first responders. Furthermore, the research seeks to improve understanding on the impact of rescue work to rescue workers' personal and work life as well as reactions and coping to providing emergency services. An extensive literature review was conducted on important components of first response and rescue work. Topics of interest to the research include development of meaning, resilience, adverse experiences and trauma, quality of life, and coping. Careers of first response associated with this study were also reviewed from the literature, such as law enforcement, firefighters, and paramedics. A gap in the literature was identified as a lack of research related to the individual factors of first responders and a need for improved programs of care. This research study reviewed the lived experiences of 12 rural rescue workers who participate in the Rope Rescue Team at a state park in Ohio. The Rope Rescue Team provides emergency, first response services to victims of cliff falls which require the use of rope and rappel techniques to gain access to the victim. Each of the 12 participants in the study shared their experiences in semi-structured interviews with questions aimed at understanding the impact of rescue work on personal and work life as well as reactions and coping to providing emergency services. In addition, journal entries and an archive of historical information on the team was collected for more detailed information related to experiences. The phenomenological research method utilized for this study provided rich, detailed information on participants' experiences in rescue work. The significance of this study was to fill the current gap in literature by exploring concepts associated with the exper (open full item for complete abstract)

Committee: Yegan Pillay (Advisor); Mona Robinson (Committee Member); Cornelia Patterson (Committee Member); Dwan Robinson (Committee Member) Subjects: Clinical Psychology; Cognitive Therapy; Counseling Education; Counseling Psychology; Psychology; Social Work; Therapy

Psy. D., Antioch University, 2015, Antioch Seattle: Clinical Psychology

Program evaluation method was utilized to examine the relationship between vicarious rauma (VT) and organizational policies and practices. VT and secondary traumatic stress (STS) refer to the impact of hearing explicit accounts of people being directly traumatized. Indirect exposure to a traumatic events can cause traumatic stress and changes in the person's way of experiencing the self and the world. The focus of this evaluation was developed collaboratively with the Clinical Director of Monarch Children's Justice and Advocacy Center (MCJAC), the site of the program evaluation. The question of study was How effectively is MCJAC addressing vicarious trauma in staff, volunteers, and multi-disciplinary team members? MCJAC provides free services to victims of childhood sexual abuse and their families through forensic interviewing, psychotherapy, and family advocacy programs. Additionally, MCJAC houses and facilitates multidisciplinary team (MDT) meetings (a case consult group of Child Advocacy Center partners, such as law enforcement, medical examiners, etc.). The purpose of this program evaluation included identifying current levels of VT/STS distress and cognitive changes in current staff, volunteers, and MDT members; and exploring the participants' perceptions and experiences of how MCJAC addressed VT. The evaluator conducted four interviews, developed and administered a qualitative and quantitative measure unique to this site, and administered the Trauma and Attachment Belief Scale (TABS) (Pearlman, 2003) and the Secondary Traumatic Stress Scale (STSS) (Bride, Robinson, Yegidis, & Figley, 2004) to 16 participants. The quantitative results indicated low to average levels of VT/STS in participants. Qualitative data revealed more VT symptoms and both negative and positive impacts of working with the families. This program evaluation found most of the participants experienced most of the practices and the MCJAC culture as intended. Participants reflected trust, respect (open full item for complete abstract)

Committee: William Heusler PsyD (Committee Chair); Elin Bjorling PhD (Committee Member); Tyson Bailey PsyD (Committee Member) Subjects: Clinical Psychology; Occupational Psychology; Organizational Behavior; Psychology

Psy. D., Antioch University, 2015, Antioch Seattle: Clinical Psychology

The purpose of this study was to examine the present state of compassion fatigue (CF) education in APA-accredited clinical and counseling doctoral level training programs. It also sought to identify the number of training programs that require CF training or offer it as optional, attempted to discern the type of setting in which it is taught (class, supervision, etc.), as well as identified some of the reasons why it may not have been included (cost, time, interest, etc.) in programs without CF training. A researcher-developed survey was designed and consisted of a mixture of yes/no and multiple choice questions. Program chairs in 287 programs served as representatives of their programs and were invited to participate in this study. Participants included 69 program chairs from APA-accredited clinical and counseling programs that met study criteria. Descriptive and inferential statistics were used to analyze the data. In response to the first question of “Does your program offer any form of compassion fatigue prevention training,” the majority of participants (75.4%) indicated that they did not have any formal CF prevention training though several indicated that CF training likely occurs in spontaneous class and supervision discussions. In response to the question “if no CF training exists, why not,” the majority of participants sited “other” (58.5%) or “lack of time” (34%). The results and interpretations are explained; contributions to the current literature, implications, and limitations are discussed; and recommendations for future research are provided. The electronic version of this dissertation is at Ohiolink ETD Center, www.ohiolink.edu.

Committee: Suzanne Engelberg Ph.D. (Committee Chair); Colin Ward Ph.D. (Committee Member); Kelly Brown Ph.D. (Committee Member) Subjects: Behavioral Sciences; Clinical Psychology; Continuing Education; Counseling Education; Counseling Psychology; Ethics; Psychology

Ph.D., Antioch University, 2022, Antioch New England: Marriage and Family Therapy

Attorneys who specialize in family practice may experience significant rates of mood disorders and substance reliance. Law schools typically do not provide supportive coursework or mentoring to help students learn to manage their feelings and those of crisis-impacted clients. Lawyers may well consider that understanding emotional needs and providing emotional support does not fall within their codes of practice. Societal stigma may prevent family attorneys and their clients from seeking therapy. Small-town attorneys may be particularly vulnerable to professional stress and safety concerns. The purpose of this study was to explore and understand the lived experiences of family attorneys practicing in small towns. Semi-structured interviews of five family attorneys practicing in small towns in New England revealed professional and personal challenges related to compassion fatigue, vicarious trauma, and burnout, as well as safety concerns for themselves, their associates, and their families. Some reported resistance to therapy due to stigma or unfamiliarity with the process, though all validated therapy as a tool for distressed clients. Future research could identify ways in which couple/family therapists and family attorneys can collaborate to effectively and comprehensively meet the needs of clients who are experiencing challenging life transitions, and to support the ongoing emotional health needs of lawyers.

Committee: Lucille Byno PhD (Committee Chair); Denzel Jones PhD (Committee Member); Althea Lloyd JD (Committee Member) Subjects: Counseling Psychology; Families and Family Life; Law

Psy. D., Antioch University, 2022, Antioch Seattle: Clinical Psychology

Evidence suggests that clinical psychology trainees may be vulnerable to stress, vicarious traumatization, secondary traumatic stress, compassion fatigue, and burnout. Research also indicates that engaging in self-care may help to protect clinical psychology trainees against those experiences and enhance their well-being. However, best available research suggests self-care education is not consistently incorporated into clinical psychology training or prioritized by program directors. This study provided a systematic review of existing literature on self-care for clinical psychology trainees, utilizing reflexive thematic analysis to identify the essential skills, knowledge, and attitudes of self-care which should be taught to trainees, and how to operationalize self-care education in clinical psychology training programs. The objective was to facilitate the incorporation of self-care education into clinical psychology training by identifying what self-care education should address, and how to integrate it into training. In so doing, it was hoped that psychology training programs might increase access to self-care education for trainees, thus increasing trainees' well-being and professional competence and decreasing the likelihood of ethical lapses, impairment, PPC, and compassion stress injuries. Reflexive thematic analysis yielded detailed findings. Essential self-care knowledge themes included the hazards of practicing psychology and an overview of self-care. Essential self-care skills themes included: self-awareness/self-monitoring; self-assessment, utilize support; cognitive strategies, mindfulness, balance/boundaries; physical self-care; spirituality/religion; and create and implement a self-care plan. Themes for essential self-care attitudes included openness/transparency; self-compassion; and gratitude. Themes on operationalizing self-care education included personal practice models for teaching self-care and recommendatio (open full item for complete abstract)

Committee: Mark C. Russell PhD, ABPP (Committee Chair); Astrid Pujari MD, ABIHM (Committee Chair); Christopher L. Heffner PsyD, PhD (Committee Member) Subjects: Clinical Psychology; Education; Mental Health; Psychology; Teaching

Doctor of Philosophy (PhD), Ohio University, 2009, Counselor Education (Education)

The purpose of this quantitative study was to explore the relationship between compassion fatigue and empathy in professional counselors. The sample of 371 participants was surveyed using the Basic Empathy Scale (Jolliffe & Farrington, 2005), the Professional Quality of Life Scale (Stamm, 1995) and the Impact of Events Scale (Horowitz, Wilner, & Alvarez, 1979). A demographics questionnaire was utilized to gather data on race, gender, age, type of licensure, number of years licensed, clients information, work settings, and personal and professional experience with Posttraumatic Stress Disorder.The data was analyzed using descriptive statistics, regression analysis, MANOVA procedures, and supplemental analyses. The results of the regression analysis found that compassion fatigue accounts for 4.8% of the variance in empathy scores as measured by their designated surveys. The results of the MANOVA found that the research participants' compassion fatigue and empathy scores were not different based on years of experience as a professional counselor. The supplemental analyses included further regression and MANOVA analyses. The supplemental regression analysis found that it is possible to construct a prediction model using a regression analysis that explains 6.6% of the variance in empathy scores. The supplemental MANOVA constructed percentile rankings based on years of experience in order to further investigate the role of experience in the variance of compassion fatigue and empathy scores. The results found the counselors' compassion fatigue and empathy scores were not significantly different based on experience as grouped by the percentile rankings. Discussions of the research instruments, data analysis procedures, recommendations, study implications, and directions for future research are presented.

Committee: Mona Robinson PhD (Committee Chair); Gregory Janson PhD (Committee Member); Yegan Pillay PhD (Committee Member); Gordon Brooks PhD (Committee Member) Subjects: Mental Health; Psychology; Social Psychology

Doctor of Philosophy (PhD), Ohio University, 2008, Counselor Education (Education)

The purpose of this study was to determine if therapist levels (therapists who treat sexual offenders, sexual abuse victims, and general population clients) differ in terms of therapists overall perceptions of permissive parent-child sexual boundaries and therapists altered perceptions of self, others, and adaptation to the world as a result of vicarious trauma. Participants in this study consisted of graduate level therapists holding membership in one of three professional organizations: (a) Association for Treatment of Sexual Abusers (ATSA), (b) American Professional Society on the Abuse of Children (APSAC), (c) American Mental Health Counselors Association (AMHCA). Data were collected using four instruments: (a) Trauma and Attachment Belief Scale (TABS; Pearlman, 2003), (b) Secondary Traumatic Stress Scale (STSS; Bride, 1999), and (c) Permissiveness of Parent- Child Sexual Boundary Scale (PPCSBS), and (d) demographic questionnaire. The multivariate analysis of variance (MANOVA) was used to analyze the data. Significant differences in the levels of therapists were found based upon professional organization membership. However, examination of the effect size (.05) found the differences between the therapist levels to be quite small and unimpressive. ATSA members reported significant differences in increased disrupted cognitive schemas (as measured by TABS) compared to APSAC members and AMHCA members. ATSA members scored significantly higher on the TABS subscales for Other-Safety, Other-Trust, and Other-Esteem. AMHCA members reported significant differences in permissive parent-child sexual boundaries behaviors (as measured by PPCSBS) compared to APSAC and ATSA members. AMHCA members reported sexual boundary behaviors to be appropriate for only younger age children, while the APSAC and ATSA members reported sexual boundary behaviors to be appropriate for both younger age and slightly older age children. No significant differences in the levels of therapists were fo (open full item for complete abstract)

Committee: Patricia Beamish PhD (Advisor); George Johanson PhD (Committee Member); Janson Gregory PhD (Committee Member); Tracy Leinbaugh PhD (Committee Member) Subjects: Education