The American Counseling Association recently adopted standards of competency for counselors working with lesbian, gay, and bisexual (LGB) clients (Logan & Barret, 2005). Concurrently, the Council for Accreditation of Counseling and Related Educational Programs (CACREP) revised standards to require social and cultural diversity competencies, including LGB counseling competency, to be interwoven throughout counselor education curriculum (CACREP, 2009). Yet the ways that counselor educators are including these initiatives are unknown. Additionally, the factors that improve counselor competency with LGB clients are also unknown. Therefore, the purpose of the study was to examine counselors' self-perceived competency when counseling lesbian, gay, and bisexual clients and identify variables that are related to and predictive of LGB counseling competence. The quantitative study included 479 members of a southeastern state's professional counseling association including school counselors, community-based counselors, counselor educators, and counseling students. The assessment included an Information Questionnaire to collect data regarding personal and professional background, a Religiosity Index (Lippman et al., 2005; Statistics Canada, 2006), Spiritual Transcendence Index – Modified (adapted from Seidlitz et al., 2002), the Marlowe-Crowne Social Desirability Scale - Short Form C (Reynolds, 1982), and the Sexual Orientation Counselor Competency Scale (Bidell, 2005). Among results, counselors felt least competent in their skills with LGB clients, compared to knowledge and attitudes subscales. An ANOVA revealed that counselor educators perceived themselves as significantly more LGB-competent than counselors in other practice settings did. School counselors also reported significantly lower levels of LGB counseling competence than community counselors. Multiple regression analysis revealed that religiosity inversely predicted LGB competence whereas spirituality had a positive predictive relationship with LGB competence. Finally, there was a marked deficit in training experiences involving LGB issues for counselors in the sample. Implications of the findings suggest a need to increase experiential components of counselor training to strengthen counselors' skills with LGB clients, as well as improve the self-efficacy of school counselors in their work with LGB students. A unique finding to the study involved counselor spirituality as a positive predictor of LGB competence, perhaps indicating higher levels of compassion and connectedness to others despite differences; future studies should investigate this relationship further. / Ph. D.

A number of studies have examined how counselor educators can facilitate counselor development of multicultural competence within the context of graduate counseling programs (e.g., Chu-Lien Chao, 2012; Constantine, 2001; Constantine, Juby, and Liang, 2001; Dickson and Jepsen, 2007; Sodowsky et al., 1998). Much less research has focused on counselor development occurring in students' personal lives, yet some evidence has shown that students report the impact of extracurricular experiences on counselor development (Coleman, 2006; Furr and Carroll, 2003; Rønnestad and Skovholt, 2003). Many qualitative studies have demonstrated positive effects of cultural immersion experiences, yet much less research in this area has utilized the quantitative measures related to cultural awareness. Few studies have also examined the effects of living among a different culture instead of visiting a different culture short term. After a thorough review of the literature on cultural immersion experiences, this study was designed to fill the gap that presently exists in quantitative findings exploring differences in multicultural competence and universal-diverse orientation, which is an awareness and accepting attitude for those who come from diverse backgrounds. The sample for the study consisted of students experiencing cultural immersion by means of relocation for their graduate training program. Additional analysis examined how universal-diverse orientation and duration of graduate training predicted multicultural competence scores. The results were not significant showing any differences in either multicultural competence or universal-diverse orientation scores based on cultural immersion. Similarly, no differences were found for either of these variables based on amount of multicultural training either. One finding that was statistically significant was a strong, positive correlation, as well as predictive ability, between universal-diverse orientation and multicultural knowledge and awareness. Implications of the findings could be applicable to clinicians and counselor education programs. By fostering more universal-diverse orientation, counselor educators could work towards increasing multicultural competence as well. This study was found to have some limitations, primarily a small sample size for quantitative analysis. These results do have implications for future research to continue studying multicultural competence, universal-diverse orientation, and cultural immersion. / Doctor of Philosophy / Much research has examined how people who train mental health professionals can facilitate counselor development of multicultural competence, an awareness for cultural differences and an ability to work with people from many cultural backgrounds. Much less research has focused on counselor development occurring in students’ personal lives, yet some evidence has shown that students report the impact of events in their personal lives on counselor development. Many studies have demonstrated positive effects of cultural immersion experiences, in which participants immerse themselves in a different culture for a time period. A few studies have also examined the effects of living among a different culture instead of visiting a different culture short term. After a thorough review of the literature on cultural immersion experiences, this study was designed to research how living among a diverse culture could result in differences in multicultural competence and universal-diverse orientation, which is an awareness and accepting attitude for those who come from diverse backgrounds. The study focused on students who moved to live in a different culture as part of their graduate training program in a counseling related field. The researcher also explored the relationship between universal-diverse orientation and multicultural competence scores. The results were not significant showing any differences in either multicultural competence or universal-diverse orientation scores based on whether or not participants had experienced cultural immersion. Similarly, no differences were found based on amount of multicultural training either. One finding that was significant was a strong relationship between universal-diverse orientation and multicultural knowledge and awareness. Implications of the findings could be applicable to counselors and counselor education programs. By fostering more universal-diverse orientation, counselor educators could work towards increasing multicultural competence as well. This study was found to have some limitations, primarily having few participants take the study’s survey. These results do have implications for future research to continue studying multicultural competence, universal-diverse orientation, and cultural immersion.

In the counseling profession, clinical supervision is utilized to facilitate the personal and professional development of counselors in training (Bernard and Goodyear, 2014). Within this supervisory relationship, supervisors must adhere to the 2015 ACA Code of Ethics, which describes the need for infusing cultural competence into both counseling and supervision practices. This emphasis is warranted; as the population of the United States is growing more diverse and cultural sensitivity in counseling will be needed in order to best serve clients. Both qualitative and quantitative research in various allied fields and settings suggest that supervisor cultural competence positively impacts the supervision working alliance (i.e., Ladany, Brittan-Powell and Pannu, 1997; Ancis and Marshall, 2010; Wong, Wong and Ishiyama, 2013). However, research conducted from the perspective of supervisors working in community settings is limited. This study sampled 78 community supervisors to address the dearth in the counselor education literature concerning the relationships between supervisor cultural competence and the working alliance. Results indicated an overall positively correlated relationship between supervisor multicultural competence and the working alliance. Additionally, the results suggested that supervisor cultural knowledge and supervisor cultural skills are the greatest predictors of a strong working alliance, while supervisor multicultural relationship and supervisor multicultural awareness accounted for some additional variance. The results support the trend away from a competency-based model of cultural sensitivity and attention in counseling and toward a model of cultural humility. / Ph. D.

Background: Nursing competencies are important for quality of care, patient safety, and identifying gaps in knowledge and skills. Patient harm has been linked to a lack of competency and insufficient policy and procedures. Purpose: The purpose of this quality improvement project was to achieve standardization of nursing competencies within nurse-led clinics. Aims: The aims of this project were to validate select competency days and determine the satisfaction of the competency days by the participants. The second aim of this project was to develop an electronic tracking form. A third aim was to develop and present a policy and procedure for competency assessment for approval. Methods: Two competency days were held in February of 2024. A Google form was created to aid in the tracking of competencies. Validation methods were return demonstration and post-tests. At the end of the check-offs, participants completed a 5-point Likert scale satisfaction survey. Findings: Six nurses (n=6) participated in the competency days. Based on the satisfaction survey, all participants (n=6) found the competency day beneficial and promoted confidence in performing nursing skills. Conclusion and nursing implications: All participants found the competency day beneficial. The competency policy and procedures are currently under development. Once developed, the policy, procedure, and tracking form will be reviewed by the director of quality compliance, clinical directors, and chief nursing officer for approval and implementation in all nurse-led clinics within the organization.

A large body of research has examined if early psychopathology symptoms predict continued social difficulties into adolescence; however, few studies have examined whether early social competence predict which children will develop and maintain psychopathology symptoms across childhood and adolescence. Utilizing the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development dataset, this study included a multi-method assessment of social competence in preschoolers and examined whether these social competency measures predicted internalizing and externalizing psychopathology symptom trajectories throughout childhood and adolescence. Additionally, it examined whether social competency measures predicted narrowband measures of attention-deficit/hyperactivity disorder, oppositional defiant disorder, depression, and psychopathy in 3rd - 9th grade. Exploratory factory analyses could not identify underlying factors among the social competency measures; as such, these were examined individually. Two to four classes were identified using Growth Mixture Modeling for parent- and teacher-reported internalizing and externalizing trajectories. Generally, children who had worse preschool social competence were more likely to be in the various moderate and high psychopathology symptom trajectory classes. Some measures of social competency were predictive of parent and teacher-reported ADHD and ODD and self-reported psychopathy, with differing relations for males and females; no measures were predictive of self-reported depression. This study has important implications with regard to early identification of and intervention for at-risk youth. Identifying these youth during the preschool years can result in improved developmental trajectories and significantly decreased societal costs. / M.S. / A large amount of research has looked to see if early atypical mental or behavioral symptoms (known as psychopathology symptoms) predict continued social difficulties into adolescence; however, only a few studies have looked at whether early social skills and performance (social competence) predict which children will develop and continue to show psychopathology symptoms across childhood and adolescence. Using the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development dataset, this study included multiple ways to assess social competence in preschoolers and wanted to see if these measures predicted psychopathology symptoms over time as the child grows up. Additionally, it looked to see whether social competency measures predicted symptoms of attention-deficit/hyperactivity disorder, oppositional defiant disorder, depression, and psychopathy in 3rd - 9th grade. Generally, after running analyses on the data, children who had worse preschool social competence were more likely to have moderate and high psychopathology symptoms over time. Some measures of social competency were shown to be related to parent and teacher-reported ADHD and ODD and self-reported psychopathy, with different connections for males and females; no measures were connected to self-reported depression. This study has important possibilities when looking at early recognition of and treatment for at-risk youth. Finding these youth during the preschool years can lead to better paths over time.

Yes / Adopting a Service-Dominant Logic lens, recent research within industrial marketing contexts increasingly recognizes the role of operant resources in value co-creation. Incumbent within operant resources is actor competence. Despite this, an investigation into the role of actor competence in value co-creating processes is scant and the competence literature, in general, has tended to concentrate on specialized knowledge and skills based interpretations that potentially restrict our understanding of the construct. To address this gap, this research adopts a phenomenological approach to explore perceived behavioral attributes of competent actors. Findings confirm two broad behaviorally based conceptualizations of competence: 1) extra-role behavior demonstrated through organizational citizenship behavior, and 2) in-role behavior demonstrated through understanding of work, and engagement behavior. To this end, the contribution of this research is twofold. First and from a theoretical perspective, it offers empirical insights into a relational based framework of competency within industrial marketing contexts. Second, and from a pragmatic perspective, this framework may aid managers in developing a broader understanding of actor competence and how such competencies may be enhanced within the workplace to optimize value co-creation.

There is a need to make measureable improvements to the global competency of engineering students that will enable them to work more effectively with overseas colleagues. However, there are few assessment tools that offer clear guidance on which types of global exposure (coursework, virtual collaboration, or education abroad) provide substantial benefit. Additionally, with the increasing reliance on teams to solve problems in both industry and academia, there is a need to ensure high-performance and inventiveness. This thesis addresses these two challenges by 1) developing a new assessment tool for gauging global competency and evaluating a commercially-available tool, and 2) validating and simplifying Wilde's teamology method for assembling better teams. The newly developed Global Competence Survey (GCS) is a quick and effective tool that is able to delineate between student groups based upon duration of education abroad. In its current form, the GCS works by assessing student knowledge of key facts about USA and Germany, and their ability to recognize cultural images. This first attempt shows statistically significant differences between domestic, three-month abroad, and year-long abroad students in these critical areas. Additionally, the teamology method was confirmed empirically by analyzing the performance of two-person global research teams assembled using traditional selection criteria. This analysis shows that teams with greater personality diversity exhibit far higher performance and stronger cohesion. When coupled with functional role requirements, teamology provides an opportunity to dramatically enhance the team performance and cohesion of an available talent pool. / Master of Science

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No / To develop a culturally sensitive occupation-based health promotion intervention for older Hispanic adults who live alone. Methods: We used a mixed method design for the content validation of the intervention and the Ecological Validity Model (EVM) to culturally center the intervention. In the quantitative phase, aging experts as well as community members from two activity centers for the elderly in Puerto Rico completed a content validity ratio exercise. In the qualitative phase, we conducted three focus groups with these participants. Data analysis included content validity ratio and a directed content analysis. Results: This resulted in a working version of the intervention protocol addressing the eight dimensions of the EVM. Conclusions: The EVM can be used to culturally center preventive interventions to other ethnic minority groups to augment the external validity and cultural competence of interventions. Future research must test the feasibility of this new intervention. / This publication was supported by National Institute of Health (NIH), National Institute of Minority Health and Health Disparities (NIMHD), Clinical Research Education and Career Development (CRECD) [R25RR017589] in collaboration with Puerto Rico Clinical and Translational Research Consortium (PRCTRC) [8U54 MD 007587-03] and the National Center for Research Resources (NCRR) [8U54RR026139-01A1]. The second author was supported by the National Institute of Drug Abuse (NIDA) (1K02DA035122-01A1). Its content is solely the responsibility of the authors and do not necessarily represent the official views of the NIH, NIMHD, or NCRR.

Yes / Objectives: A novel model of resilience was tested in caregivers of people with mild-to-moderate dementia and was extended to explore whether including self-efficacy, optimism, and self-esteem improved its predictive value. Design: Cross-sectional. Setting: Data from the IDEAL cohort were used. Participants: The study comprised 1222 caregivers of people with dementia. Measurements: A composite resilience score was calculated from five measures. Multivariable regressions were used to investigate factors associated with resilience. Results: Greater resilience was associated with being older, being male, and caregiving for older people with dementia. Greater resilience was also observed when people with dementia had fewer functional difficulties and/or fewer neuropsychiatric symptoms, there was a stronger dyadic relationship, and the caregiver had fewer social restrictions, less neuroticism, and greater perceived competence. Surprisingly, caregiver self-efficacy, optimism, and self-esteem were unrelated to resilience. Conclusion: Caregivers of people with mild-to-moderate dementia generally scored well for resilience. Resilience was associated with both the personal characteristics of caregivers and level of care need among people with dementia. Future work is needed to determine whether the caregivers in this cohort appeared resilient because the care recipients had relatively low care needs and consequently placed fewer demands on caregiver well-being than would be the case where dementia is more advanced. / Economic and Social Research Council (ESRC) and the National Institute for Health and Care Research (NIHR) through grant ES/L001853/2. Alzheimer's Society, grant number 348, AS-PR2-16-001.