<p> Coordinating care is of particular concern in Alaska due to expansive geography, difficulty of travel, and often limited behavioral health care resources. This study explored how individual, organizational, and systemic factors influence clinicians' use of video teleconferencing to conduct "live" discharge plans from urban psychiatric facilities to rural communities. </p><p> Semi-structured key informant interviews were conducted, in person and by telephone, with urban clinical staff (n = 10), urban administrative staff (<i>n</i> = 6), and rural outpatient staff (<i>n</i> = 14). Two researchers analyzed the transcribed interviews in a recursive manner using a grounded theory methodology. </p><p> Participants described infrequent, but generally positive experiences with live discharge planning: connecting patients to providers, temporarily joining treatment teams, evaluating patients for appropriate placement, engaging patients in their own care, addressing medication issues, and coordinating with family and village resources. Providers recommended hiring interns or dedicated staff, installing equipment "on unit," or using wireless tablets. Rural participants ascribed a greater value to emergency psychiatric consultations at admissions than coordination at discharge. </p><p> Continued selective use of live discharge plans is indicated with patient length of stay being an important consideration in determining feasibility. Future implementation should involve dedicated resources and use video teleconferencing to formally enhance other transitional services. Once issues of organizational readiness are addressed, a Knowledge-Attitudes-Behavior framework may be useful for managing providers' underuse. Future research could evaluate rural, village-based intensive case management supported by consultation with the psychiatric hospital via video teleconferencing.</p>

<p> This study examines the role of the intuitive function in addiction recovery. Addictive behaviors create an internal state dominated by imbalanced instinctual drives. The psychological manifestations are obsessive thoughts, anxiety, depression, guilt, shame, and a sense of isolation. This research explored how subtle unconscious influences like the intuitive function have a role in shifting this treacherous internal state. Intuition is a prominent spectrum function which bridges the unconscious and conscious by providing unexpected knowledge of unknown origins when none is consciously available, assesses potential of situations, and imparts understanding of how and when to carry out instinctual action (Jung, 1971/1976, 1948/1981a).</p><p> Field research was conducted through a qualitative, intuitive, phenomenological methodology. Twelve participants in recovery from alcoholism were asked through conversational interviews about their experience of intuition in sobriety. The participants claimed intuition initiated, sustained, and enhanced their sobriety. They were able to distinguish the intuitive function from the amplified state of need, obsessive thought, and angst. They reported synchronicities, dreams and intuitive influences were instrumental in the decision to stop drinking. In longer term recovery, the intuitive function was perceived when helping others, solving problems, learning self-care, and enhanced intuition was described as one of the biggest gifts of sobriety.</p><p> This research contributes to the field of psychotherapy by discovering the important role of the intuitive function in addiction recovery. Recognizing and helping patients cultivate intuition facilitates the apprehension of addictive behaviors. Working with unconscious functions such as intuition helps those considering sobriety, as well as those in sobriety, to establish a relationship with their unconscious other than one based on addictive patterns. Developing the intuitive function in recovery establishes a conscious relationship to the primary process beyond impulsivity and curbs instinctual impulsivity. </p>

<p>This thesis explores the potential for soul-making in the prison violence-prevention program known as GRIP&mdash;an acronym for Guiding Rage into Power. The author utilizes hermeneutic methodology to explore the meaning and evolution of the concept of soul-making within the literature of depth psychology. Using heuristic methodology, the author then analyzes what he perceived to be a profound demonstration of soul-making among the members of the GRIP prison group he cofacilitated. The findings indicate that by combining a downward move into the underworld of emotional woundedness and psychopathology with a vertical orientation that includes contact with ego-transcendent archetypal energies, the inmates participating in the GRIP program had an opportunity for deep healing and genuine soul-making. </p>

<p> This phenomenological study explored how cancer impacted female patients or survivors while striving for personal work-life balance. Since female cancer patients and survivors encounter unique stressors, challenges, and experiences related to their cancer journey, this study examined the narratives of 10 women identified as having cancer and a comparison group matched on age via random sample for the birth year. The 20 narratives were a subset of the larger Weber (2011) sample collected by Digital Women's Project research team. The foundational theoretical framework is provided by Giele's (2008) life story method, which analyzed narratives through the lenses of identity, relationship style, drive and motivation, and adaptive styles of women.</p><p> However, this study focused on the following two themes: drive and motivation and adaptive style. The personal experiences of the ten diverse women, who received a cancer diagnosis (Group A), described ways that cancer changed their lives. The comparative sample of women without cancer diagnoses (Group B) were also analyzed along these themes. The findings reveal the differences between Group A and B with their outlook, lifestyles, and how work-life balance was navigated. Successful strategies of navigating work-life balance for the two groups were explored: faith, support systems, healthy lifestyle, resources, therapy, and hobbies.</p>

<p> The purpose of this project was to locate a potential funding source and write a grant to provide home-based mental health services to Latino older adults for Beach Cities Health District, in Redondo Beach, California, the host agency for this program. An extensive literature review was conducted to investigate the best way to provide non-traditional therapeutic services to older adults. The Archstone Foundation was chosen as the most appropriate funding source. </p><p> The population of Latino older adults is expected to grow significantly in the coming years. Many in this population suffer from depression but fail to access services due to language barriers and other obstacles. This program was developed to improve knowledge of depression and improve coping skills, as well as reduce symptoms of depression. </p><p> If funded, this program could provide social workers an opportunity to bridge the gap the need for and the receipt of mental health services among older Latinos. Submission of the grant was not a requirement for the thesis project.</p>

<p> Schools currently do not have a well-designed and well-implemented prevention model to help students reduce their feelings of stress. This mixed methods study examined the relationship between practice of mindfulness, perceived stress, and student achievement among 165 seventh-grade students at a college preparatory high school. Using previously tested survey instruments Perceived Stress Scale (PSS) and Childhood and Adolescent Mindfulness Measure (CAMM), the researcher trained, implemented, and tested the impact of a simple mindfulness practice universally as prevention model. Although the t-test did not detect an impact on the stress levels, which could be attributed to the limited time range of 12 weeks for the implementation of intervention, multiple regression analysis predicted mindfulness practice as a strong indicator of reduction in stress among the seventh-grade students. The qualitative analysis indicated a theme of situational awareness among the students who practiced mindfulness that led to regulation of their stress.</p>

<p> The purpose of the present study was to explore the associations between level of internalized homophobia, experiences of heterosexism, and gender with endorsement of type of humor (self-enhancing, affiliative, self-defeating, and aggressive) used as a coping skill among sexual minority participants. A survey was created and administered online, and participants were recruited by word of mouth, emails, and online postings on Facebook and craigslist. The sample consisted of 146 participants who identified as a sexual minority (i.e. Gay, Lesbian, or Bisexual), with ages ranging from 18 to 70 years. Results indicated a positive direct correlation between participants' level of internalized homophobia and endorsement of self-defeating humor. Results also indicated a positive direct correlation between participants' experiences of heterosexism and endorsement of self-defeating humor. Results indicated no significant correlations among level of internalized homophobia, experiences of heterosexism, and endorsement of aggressive, affiliative, or self-enhancing humor types. In regard to gender and humor type, men in the sample endorsed greater levels of aggressive humor than women in the sample. Results indicated no significant difference between men and women for self-defeating humor. Future research should continue to explore sexual minorities' use of humor. Implications of the present study suggest that clinicians be alert to and explore consequences of utilizing self-defeating and aggressive humor, especially for sexual minorities with more experiences of heterosexism, higher levels of internalized homophobia, and men using aggressive humor. Additionally, adaptive coping skills, such as affiliative and self-enhancing humor, should be encouraged to promote well-being. </p>

<p> PRN psychotropic medication administration is a common practice used by psychiatric RNs in acute inpatient mental health settings to manage anxiety and agitation in patients, and as a result, there are high incidences of PRN psychotropic medication administration (Mugoya &amp; Kampfe, 2010). There is limited documentation indicating that therapeutic non-pharmacological interventions are utilized prior to PRN psychotropic medication administration (Curtis et al., 2007). The purpose of this scholarly project was to determine what non-pharmacological interventions are used by mental health RNs prior to or in lieu of administering PRN psychotropic medication to manage anxiety and agitation in adult psychiatric hospitalized patients. Another aim of this project was to determine what factors influence mental health RNs' decisions to administer PRN psychotropic medications. A descriptive study was conducted. Two survey-type self-reporting tools were used. Twenty RNs completed Nursing Surveys. Thirteen RNs completed both Nursing Surveys and Nursing Intervention Tracking Forms. Findings from this study revealed that non-pharmacological interventions successfully resolved problems over 1/3 of the time and may prevent the use of PRN psychotropic medications. In cases where PRN psychotropic medication was not administered, distraction was the non-pharmacological intervention most often used. The most common factor influencing RNs' decisions to administer PRN psychotropic medications was a high level of anxiety persistent after non-pharmacological interventions were used. This study reinforces the importance of RNs using non-pharmacological interventions to manage patients exhibiting signs or symptoms of anxiety or agitation.</p>

<p> Holocaust survivors are a diminishing population, yet they share a wealth of knowledge, and their vast experiences, life stories, and perspective are relevant now and for future generations. The goal of this exploratory study was to elicit information about posttraumatic growth among Holocaust survivors and the factors that may come into play. The questions focused on the time before, during, and after the war. This study is about a positive change an individual may experience as a result of a traumatic event, posttraumatic growth, a term coined by Tedeschi and Calhoun. A total of 13 people (7 females and 6 males) were interviewed for this qualitative study. All of the subjects identified with suffering from PTSD at one point in their lives, and 10 (77%) indicated that posttraumatic growth has been prevalent, mainly in domains of greater sense of personal strength and more profound appreciation of life. </p>

Patients with schizophrenia exhibit considerable variability in therapeutic and metabolic (i.e. weight gain) responses to clozapine, an atypical antipsychotic medication. We treated the C57BL/6J and A/J inbred mouse strains with clozapine for 21 days to assess weight gain and behavioral response variations in two models of drug response in schizophrenia (prepulse inhibition and amphetamine-induced hyperlocomotion). If detected, between-strain differences may be partially due to genetic factors that can be subsequently mapped using quantitative genetic approaches. / Clozapine increased prepulse inhibition and decreased amphetamine-induced hyperlocomotion after three days of treatment in both the C57BL/6J and A/J strains. These effects were not observed after 21 days. Clozapine did not induce significant weight gain in either strain. Since these strains do not respond to clozapine treatment differently, the identification of more suitable strains for further genetic analyses of response variations may be warranted.