Thesis (M.S.)--Colorado State University, 1985. / Typescript (photocopy). eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves [37]-39).

Thesis (M.A.)--Central Connecticut State University, 2000. / Thesis advisor: Charles Mate-Kole. " ... in partial fulfillment of the requirements for the degree of Master of Arts [in Psychology]." Includes bibliographical references (leaves 41-45).

<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>

<p> The dynamic mental health landscape has placed undue strain on hospitals, providers, and the community at large, resulting in gross inequities in access to care for underserved populations. This business plan proposes the establishment of a Los Angeles area non-profit community mental health clinic, embedded with a mission to accept adult patients suffering from co-occurring mental health and chronic medical conditions, regardless of insurance status and ability to pay. Under the Patient Centered Medical Home model, the aim of the Clinic will be to treat patients holistically by incorporating an interdisciplinary team of clinicians to ensure optimal health outcomes. While this plan acknowledges the challenges in serving indigent populations, the Clinic will contract with Medi-Cal and commit to continuous fundraising efforts to remain financially sustainable in order to improve the health of vulnerable Angelenos.</p>

<p> Severely mentally ill adults are a historically underserved population that tends to be highly resistant to taking psychiatric medications. Although medications generally help to decrease the severity of symptoms and lower risk of relapse/hospital readmission, they also negatively impact sense of self and identity, and lead to unwanted side effects. Non adherence frequently leads to involuntary hospitalizations, where a medication adherence intervention is needed. In order to make a case for a medication adherence intervention, regression analyses were conducted on an inpatient psychiatric sample of 178 adults diagnosed with severe mental illnesses in order to determine predictive relationships between symptom severity upon admission, frequency of hospital readmission, medication adherence/non-adherence, and length of hospital stay (LOS). Results yielded insignificant findings, which is informative and even compelling due to medications being considered the gold standard in inpatient psychiatric care. Results were limited by medication adherence being measured dichotomously, and confounds related to ethnicity, family involvement, and substance abuse. Post-hoc analyses yielded significant relationships between pretest symptom severity and length of stay, as well as significance between medication non-adherence and elevations on the symptoms: Conceptual Disorganization, Grandiosity, Suspiciousness, and Motor Retardation, which indirectly support concerns about severely mentally ill adults not taking medications due to concerns related to autonomy and distrust of providers. Implications and future research and practice are also discussed.</p>

<p> Children who show signs of depression are at greater risk of having depression as adults as well as developing comorbid conditions. A multi-tiered system of support (MTSS) approach is currently the best evidence-based method for addressing behavioral and mental health concerns in a school setting. At this time, few research-based interventions exist that adequately address internalizing behaviors such as those associated with depression. <i> Strong Kids</i> is an evidence-based social-emotional learning curriculum that can be used at both the universal and secondary levels of prevention. It is designed to address internalizing behaviors; however, it has only been tested as one chronological series of lessons. This makes immediate response to a student&rsquo;s need &ndash; a hallmark of secondary prevention in MTSS &ndash; challenging because the Strong Kids program can take a minimum of 6 weeks for delivery. The current single-case design research evaluated the delivery of <i>Strong Kids</i> in an elementary school on a continuously rotating 4-week basis, such that students referred for the intervention began at the beginning of any given week and continued to receive the intervention until all lessons were received. Three hypotheses were tested: (a) Students at risk for developing depressive disorders would show reduced risk of depression following the <i>Strong Kids</i> intervention; (b) this intervention would be effective for students regardless of the lesson on which they begin the intervention; and, (c) any differential effects among students beginning the intervention during different weeks would be small and not reach the level of clinical significance. The obtained findings and implications for school practices are discussed.</p>

<p> The expansion of the parity law for mental health benefits under the Patient Protection Affordable Care Act (PPACA) along with the increased mental and/or behavioral health issue among American youth has established a need for various health services to mitigate the mental and/or behavioral health problem. The L.A. Children&rsquo;s Music Therapy Center, LLC, will be established to provide music therapy as an alternative or complementary form of medicine for individuals that are under 17 years of age with mental and/or behavioral health disorders. Additional regulations under the PPACA may potentially increase the use of mental health services and clinical evidence has shown that music therapy has resulted in improved health outcomes for various disorders. L.A. Children&rsquo;s Music Therapy Center, LLC, will focus on providing music therapy services within Los Angeles County for private clients in the community as well as contracting services for private and group organizations.</p>

<p> Nursing students often harbor negative stereotypes and feel unknowledgeable and unprepared to work with mentally ill people. In addition, nursing students rarely choose the psychiatric specialty as a career option. A quantitative quasi-experimental study was conducted to examine nursing student feelings about engaging those with behavioral health problems. Over 300 nursing students in eight Bachelor of Science in Nursing professional nursing programs were surveyed on the first and last day of their program&rsquo;s psychiatric mental health nursing course (the independent variable). A valid and reliable survey instrument was used to collect nursing student responses characterizing attitudes, impressions of knowledge and preparedness, and career interests relative to psychiatric nursing. This work was supported by the theoretical tenants of Labeling Theory, Benner&rsquo;s Model, and Peplau&rsquo;s Theory on Interpersonal Relations. Statistical Package for Social Sciences software was used for exploration of the data. Data examination included descriptive analysis and paired <i> t</i> tests of four component subscales identified by the survey tool authors which were associated with the research questions and research hypotheses in this study. The results indicated nursing students manifest negative attitudes and a moderate sense of knowledge of and preparedness for interacting with the mentally ill. In addition, nursing students had a low interest in behavioral health as a career path. However, significant improvements in all of these factors except the latter were observed at the end of the psychiatric mental health nursing course. Nurse educators may use the information generated from this project to modify psychiatric nursing courses for fostering improvement in student feelings about the mental health specialty.</p>

<p> Traumatic birth is a term used to describe a wide-range of negative physical and mental birthing events and outcomes. An estimated one-third of women perceive mental trauma during birth. Aside from deterioration of maternal mental health, the effects of perceived traumatic birth can be observed in the entire family. Although research shows the relationship of traumatic birth to mental health, the majority has focused on European or European-American women. The profound psychological impact of birth trauma has been passed off as common to all women without considering culture, race, or context. Little is known about birth trauma experiences of Mexican immigrant women. Since Mexican immigrants comprise the largest ethnic-minority group in the United States attention to perceived traumatic birth on their health status is clear. </p><p> The purpose of this dissertation research was to describe and understand the impact of a perceived traumatic birth, the range of responses produced, and the life course context in which it occurs in Latina immigrants from Mexico. </p><p> Although recruitment took place in a low-income community-based health center in Fresno, California, most interviews were conducted in the participants&rsquo; homes. In addition to field observation and photography, twenty-one interviews were conducted with seven Mexican immigrant mothers who provided first-person accounts of their perceived traumatic births and the life course context in which it occurred. Facilitated by a certified Spanish interpreter, all interviews were recorded, transcribed verbatim and analyzed via an iterative grounded theory process. </p><p> The results suggest that, in addition to the birth event, for these Mexican immigrant mothers, the process contributing to perceived traumatic birth is embedded in the profound adversity of their unique life context. The burden of crossing a militarized border, the fear of deportation, and lack of trust, mandates a self-protective silence that obscures both the adversity they endure and the resulting maladaptive psychological responses. Consequently, for Mexican immigrant mothers, undocumented status, adversity, mistrust, and the self-mandated silence that surrounds it, may be major factors affecting not only their perceived traumatic births, but their overall health. Findings inform further research, practice, and policy related to the unique needs of Mexican immigrant mothers. </p>

The thesis grew out of the recognition that there is a dearth of information on the users of mental health services. It set out to describe the characteristics of users across a range of health settings and to consider the role of such characteristics in the mental health referral process. The early phases of this research project were strongly influenced by a model of the referral process developed by Goldberg & Huxley (1980). They conceptualized users of health care existing on 5 levels ranging from people living in the community to users in hospital. Hypothetical filters are said to operate between each level to govern who is referred on to the next level of services. This research project borrowed the notion of filters and their arrangement of services in a referral sequence. However, the focus of this research is on the characteristics of users, and not the detail of the filters per se. What is described is the effect of the referral process not the mechanism. This thesis also moves substantially beyond the five settings in the Goldberg & Huxley model to produce a uniquely comprehensive analysis of the users of all the main mental health care providers in one health district. The research project uses a wholly quantitative methodology. The challenge has been to design a range of compatible survey forms to collect data in seven separate study settings, to collate information on over one thousand one hundred users, to describe the user profiles in each study and to develop a comparative analysis of users across a range of settings. The emphasis throughout has been to align the research with contemporary developments in health care policy, and as the project has progressed, to make a practical contribution to the important debate about information systems in mental health service planning. The thesis has been divided into four parts. Part I introduces and sets the context of the research, and describes the methodology. In seven chapters, Part II of the thesis reports the .findings of each of the seven study settings. Part III of the thesis reports the demographic and utilization characteristics comparatively across all the study settings. The conclusions of the thesis are reported in Part IV of the thesis, where the theoretical, research and policy implications are discussed.The research project makes a contribution to knowledge on 4levels. Firstly, it identifies and describes the characteristics and the typical profiles of mental health service users in a range of study settings, in one area. Secondly, it identifies the differences between users in each study setting. Thirdly, it identifies the overlap in use of one service and another. It is argued that the findings have profound implications for both developing a clearer picture of the referral processes and for highlighting for planners, producers, and providers possible complementary or inefficient service utilization patterns. On the fourth and macro level, this research project has developed a revised model of mental health service referral routes. This model provides a framework for further investigation, and has potential as a planning tool in and beyond the geographical boundaries of the current study area.