<p> Research shows that there has been a significant increase in mental health issues within the college student population. Applying recovery-oriented principles as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA) may be an effective approach to creating and adapting mental health resources for college students. In the current study, literature on the following was reviewed: (a) the college culture, (b) the prevalence of mental health issues for college students, and (c) recovery-oriented principles. Then, a critical analysis of the literature was conducted based upon the following recovery-oriented principles: (a) encouraging a holistic approach, (b) self-responsibility and self-empowerment, (c) strengths-based practice, (d) cultural sensitivity), and (e) family support. Findings indicate that holistic resources highlight individual needs and creativity; programs that encourage self-responsibility underscore the importance of self-screenings; strengths-based approaches are centered around building self-esteem and increasing positive emotions; culturally sensitive resources are often group-oriented and acknowledge multiple facets of diversity, and programming that promotes family support emphasizes psychoeducation and stigma reduction. Based upon the integration of these findings, adaptations of current efforts on campus to promote these principles, as well as new ideas, are provided.</p>

<p>This dissertation provides readers with a general framework for understanding drug addiction from a Winnicottian perspective that can help clinicians to better understand and work with clients who struggle with drug addiction. The underlying purpose of developing such a framework is not to formulate a ?master theory? that is applicable to all cases of addiction or that claims to encompass all of the myriad facets of addiction?such an endeavor would prove impossible, reductionistic, and hubristic. Rather, this dissertation uses Winnicott?s theories to identify and explore emotional, psychological, interpersonal, and developmental components of addictive processes that are present in some?but not all?cases of addiction. Although etiological factors play a prominent role in this dissertation, I argue that a Winnicottian approach can help clinicians to work with clients regardless of how much is known about their pasts and illustrate that a Winnicottian perspective need not be reductionisitc. I developed this model by applying the insights gleaned from primary and secondary literature to a case study. More specifically, I analyze the case utilizing three especially prominent themes in Winnicott?s theory: being, aggression, and creativity. Doing so enabled me to conclude the following regarding addiction: From a Winnicottian perspective, an individual?s relationships with drugs of abuse are both interpersonal and regressive in nature and are founded upon the need to experience the personal aliveness that accompanies the actualization of one or more developmental potentials.

<p> A traumatic and life-altering event, such as sexual assault, can adversely affect a survivor&rsquo;s psychological well-being. In conjunction with an individual&rsquo;s natural resources, religious and/or spiritual resources can provide additional and critical support as the realities of the Interpersonal trauma come to fruition. However, many mental health professionals do not feel comfortable or prepared to include spiritual or religious issues, within the therapeutic relationship. The objective of this research study was to examine the connection between a female sexual assault victim&rsquo;s perceived God-image, attachment to a perceived God-image, and her experienced psychological distress, when processing Interpersonal trauma. This study employed Bowlby&rsquo;s attachment theory and Rizzuto&rsquo;s God-image theory. A convenience, nonprobability sample of 132 women, 18 years or older, who had experienced a sexual assault (but not within the past two years), completed a demographic questionnaire, Froese and Bader&rsquo;s God Questionnaire, and Lovibond and Lovibond&rsquo;s Depression Anxiety Stress Scale (DASS-21). Data was analyzed using a MANOVA. The data concluded a lack of significant difference between the participant&rsquo;s perceived God image, her attachment to a God-image, and her selfreported levels of psychological distress due to the traumatic, Interpersonal experience. In the future, qualitatively analyzing this population would further explore valid themes and personal perspectives on the relationship between perceived God-image, an individual&rsquo;s attachment to a God-image, and her experienced psychological distress, which may further be used to inform mental health professionals on the most conducive treatment for sexual assault survivors. </p>

Adults with intellectual disabilities in the UK are more likely to be obese than their non-disabled peers and are at risk of experiencing serious medical conditions such as heart disease, stroke and Type 2 diabetes. UK weight management guidance recommends multi-component weight management interventions, tailored for different population groups. The aim of this thesis was to explore how evidence-based multi-component weight management interventions can be tailored for adults with intellectual disabilities who are obese. The thesis comprised three phases. Phase One included an integrative review of evidence-based multi-component weight management interventions for adults with intellectual disabilities; an exploration of theories used to underpin weight management interventions for this population; and a mapping exercise to investigate the extent of weight management service provision for adults with, and without, intellectual disabilities. The review found emerging evidence to suggest that multi-component weight management interventions can be tailored and are effective for adults with intellectual disabilities. However, the review identified few studies (n=5) and none of the identified studies explored this population’s views and experiences of such interventions. Phase One also found gaps in underpinning theories and insufficient service provision for this population. Phase Two comprised three studies to explore participants’ views and experiences of the barriers and facilitators to weight management for adults with intellectual disabilities. These studies included a qualitative study involving interviews with 14 health care practitioners; a co-produced focus group qualitative study involving 19 adults with intellectual disabilities and 8 of their carers; and a survey involving 19 carers and support workers. Thematic analysis of participants’ responses highlighted their frustrations with several barriers including a lack of accessible healthy lifestyle information, a lack of resources, a lack of reasonable adjustments, inconsistencies in caring support, unmet training needs for carers and support workers, and socio-economic and environmental barriers. Facilitators included the provision of clear and accessible healthy lifestyle information, provision of resources, consistent caring support, reasonable adjustments, and training for carers, support workers and health care practitioners. Phase Three involved a synthesis of findings from Phases One and Two. The overall findings imply that it is inequitable support and barriers associated with complex systems-related issues, rather than poor lifestyle choices or a lack of motivation, which inhibits this population from managing their weight if they want to. A whole systems approach is needed to address the systems-related issues and barriers experienced by this population, rather than a sole reliance on non-evidence-based weight management interventions (such as diet-only or exercise-only interventions) focused primarily on individual behaviour change to achieve short-term weight loss. The thesis has implications for research, policy and practice. It presents a whole systems approach and a logic model outlining the types of systems-related activities needed at several levels to overcome identified barriers and to contribute to reductions in the inequities and inequalities experienced by adults with intellectual disabilities who want to manage their weight.

<p> Conventional studies of veterans&rsquo; longitudinal mental health approach the topic through the post-traumatic stress disorder (PTSD) lens. This qualitative study shifts the focus from a PTSD psychosomatic-centric approach to a psycho-spiritual examination of the sequela of war in the veteran psyche: this approach has been named in recent literature, <i>moral injury</i>. Utilizing a methodological approach situated in the philological region of hermeneutics, a Reductionist dialectic was selected. This study illustrates that the quotidian war poetry read by this researcher exhibits psycho-spiritual moral injury. The relevant emergent themes of the study include: (a) the function of memory, of not-forgetting, (b) the psychological torment of psychic dismemberment, (c) the acknowledgment of suffering in archetypal salt, and (d) the not-forgetting component of psychic re-memberment necessary for resolving moral injury. Reorienting the focus from PTSD to moral injury, this study finds critical implications to helping war veterans with their sequela of war. For instance, conventional treatments for PTSD such as prolonged exposure (PE) or cognitive behavior therapy (CBT), while effective for treating the co-morbid symptoms of PTSD, do not address the profound insights which can be gleaned from re-examination of the phenomena in terms of moral injury. Most importantly, moral injury as a psycho-spiritual dilemma is something for which the veteran must embrace primacy in seeking resolution, working outside of the typical evidenced-based therapies. This comports with the alchemists who cautioned: Only by working with intense focus on self-transformation can the lapis philosophorum be achieved. </p><p>

<p> Contacting one&rsquo;s values and engaging in behavior consistent with those values, referred to as valuing, is associated with improved physical and mental health (Nygren et al., 2005), increases in quality of life (Plumb &amp; Hayes, 2008), and increases in overall well-being (Reker et al., 1987), among many other positive outcomes. But those areas of life that are valued tend to elicit unwanted, negatively evaluated experiences, often resulting in experiential avoidance (Michelson et al., 2001). Experiential avoidance has been associated with the etiology and maintenance of many psychological struggles, particularly anxiety-related struggles (Kashdan et al., 2006; Eifert &amp; Forsyth, 2007; Hayes et al., 1999; Hayes et al., 1996). Given that anxiety is a negatively-evaluated experience that is often avoided, exploring the relationships between anxiety, experiential avoidance, and valuing appeared needed. The current study examines the relationships between anxiety, experiential avoidance, and valuing with college students using both retrospective assessments through initial questionnaires and immediate assessments through the use of ecological momentary assessment. As predicted, results indicated a significant positive relationship between anxiety and experiential avoidance. Results also indicated a negative relationship between experiential avoidance and valuing. Further, anxiety disrupted progress toward values the most when experiential avoidance was high while anxiety and experiential avoidance both independently facilitated more perceived obstacles toward values. Implications for future studies using of multiple methods of assessment, including ecological momentary assessment, along with a multidimensional conceptualization of valuing, are discussed.</p>

Thesis (Ph. D.)--Victoria University of Technology, 2005. / Includes bibliographical references.

Thesis (PH.D.) -- Syracuse University, 2006 / "Publication number AAT 3251786."

<p> This dissertation investigates the mental health needs of the growing Somali population in Minneapolis and St. Paul, Minnesota by examining clinicians&rsquo; views of the challenges they experience conducting mental health assessments for Somali clients. The research describes the development of a multicultural competence model and recent attempts to improve multicultural competence in assessment and treatment strategies. Specific emphasis is placed on the foundation of current theories supporting diagnoses and treatment issues through a review of current literature on cultural aspects of Somali mental health conceptualization. The researcher conducted semi-structured interviews with eight mental health providers who have worked with Somalis, seeking information for how clinicians handle culturally-specific challenges during the assessment process. Results suggest best practice for assessing Somali clients ought to involve the use of trained full-time interpreters. It is also beneficial for clinicians to be aware of the differences in mental health and illness conceptualization between Somali and Western cultures. Findings show strong support for establishing a trusting triadic relationship with the clinician, client, and interpreter. Using slow-engagement practice, indirect open-ended questions, predicated on previous relationship, will improve rapport and obtain desired information. Results from this study have informed the development of a culturally sensitive diagnostic protocol, providing guidance on how to collect information in a manner that helps ease the Somali client into the assessment process. The culturally sensitive form, described in Appendix F, must be used in conjunction with the education of all parties. This research has implications for those seeking to conduct culturally sensitive assessment and treatment by reducing incongruent cultural practices and promoting culturally competent service for Somalis.</p>

<p> The research literature suggests that contingency management protocols are a useful approach in suboxone/buprenorphine treatment. However, there is a lack of data on its rate of use amongst service providers in Massachusetts. This study sought to survey the practices of service providers of suboxone/buprenorphine clients in Massachusetts. An online survey, questioning providers on their demographics, criteria for adherence to their treatment program, views and use of rewards, and views and use of punishments was developed and distributed to service providers. Fifty-four participants provided sufficient data to analyze. Descriptive statistics revealed that most participants were in the medical field, with a large number of participants having nursing degrees and nursing positions. Three criteria for treatment adherence were popular amongst service providers: &ldquo;Adherence to a suboxone/buprenorphine prescription, attendance at mandatory meetings, and abstinence&rdquo; (37%), followed by &ldquo;Adherence to a suboxone/buprenorphine prescription&mdash;decrease in substance use&rdquo; (24.1%), and &ldquo;Adherence to a suboxone/buprenorphine prescription and attendance at mandatory meetings&mdash;decrease in substance use&rdquo; (14.8%). Less than half of participants utilized rewards (38.9%). The most popular rewards used were &ldquo;<i>Reduction in frequency of supervision</i>&rdquo; (66.7%) and &ldquo;<i>Reduction in frequency of dispensing</i>&rdquo; (61.9%). Punishment use was more popular amongst participants (63%), and was viewed as significantly more effective than rewards. The most popular punishments were &ldquo;<i>Referral for additional services </i>&rdquo; (91.2%), &ldquo;<i>Increase in frequency of supervision </i>&rdquo; (85.3%), and &ldquo;<i>Discharge from the program</i>&rdquo; (70.6%). The most frequently cited factors that influenced the use of reward and punishment systems involved treatment engagement and use of illicit drugs. Future research in the field should focus on developing a standard approach towards contingency management use in suboxone/buprenorphine programs. For studies seeking to emulate the current research, drawing a larger population of participants will help develop greater likelihood of detecting significant relationships amongst variables.</p><p>