Little is systematically known about the collective health and well-being of Virginia American Indian people. This study sought to explore the meaning of health and healing among Virginia American Indian people in the context of a reservation-based, non-federally funded health clinic. Using an emergent approach to qualitative research grounded in a constructivist inquiry paradigm and guided by Indigenous research principles, a total of 24 in-depth, semi-structured interviews were conducted with 17 American Indian service-users of the Clinic. Through an inductive thematic analysis of participant stories, a framework for understanding responsive and responsible health and healing was derived. The framework includes seven dimensions: spirituality, physical processes, mental and emotional processes, social relationships, access to resources, contextual factors, and the interconnection among the dimensions. Personal and collective identity was a significant element woven through the dimensions. From the stories told by participants, health seems to be a continuum and healing seems to be a cycle. With constant motion in each of the dimensions, health has to do with sustained engagement in healing processes that continually seek to bring about functional balance in one’s whole health system. Ill health has to do with when a change in any one of the dimensions overtakes one’s ability to bring about a functional balance in the whole health system. The framework is context-dependent, true for the people who participated in the study at the time of the study.

Lyric analysis is one of the most commonly used music therapy interventions with the mental health population, yet there is a gap in the research literature regarding song selection. The primary purpose of this study was to determine distinguishing linguistic characteristics of song lyrics most commonly used for lyric analysis with mental health consumers, as measured by LIWC2015 software. A secondary purpose was to provide an updated song list resource for music therapists and music therapy students working with the mental health population. The researcher emailed a survey to 6,757 board-certified music therapists, 316 of whom completed the survey. Respondents contributed 700 different songs that they deemed most effective for lyric analysis with mental health consumers. The researcher used the LIWC2015 software to analyze the 48 songs that were listed by five or more music therapists. Song lyrics contained linguistic indicators of self-focused attention, present-focused attention, poor social relationships, and high cognitive processing. Lyrics were written in an informal, personal, and authentic style. Some lyrics were more emotionally positive, while others were more emotionally negative. While results must be interpreted with caution, it may be helpful to consider linguistic elements when choosing songs for lyric analysis with mental health consumers.

Posttraumatic stress disorder (PTSD) is a psychiatric condition affecting approximately 8% of the adult U.S. population with rates twice as high in women than men. Increasingly, evidence has suggested a close relationship between PTSD and increased risk of metabolic diseases. However, the literature on PTSD and metabolic disease risk factors has been limited by the lack of investigation of the potential influence of race on this relation. The current study examined the possible effect of race on the relation between PTSD and metabolic risk. Data for this study were provided from sample of that included 50 African American women and 39 Caucasian women, 56.2% and 43.8% respectively. Results support the importance of race in the relationship between PTSD and metabolic disease risk factors. Future research would benefit from analysis of cultural factors to explain how race might influence the course of metabolic disease risk and development in women with PTSD.

Greenwald, McGhee, and Schwartz (1998) developed the Implicit Association Test (IAT), a measure of mental associations between target pairs and positive or negative attributes. Highly associative categories yield faster responses than the reverse mental associations, which is thought to reflect implicit attitudes toward stereotypes. The present study investigated the effect of ethnic group on one’s implicit attitudes toward aging and gender stereotypes by comparing two groups of older adults, Asian Americans and Caucasian Americans, that likely hold different culture values. Past qualitative studies have established the existence of mental health stigma in Asian American populations, including negative Asian American perceptions of aging, but have not yet established a quantitative measure of this phenomenon. The age-attitude and gender-science IATs were administered to 20 Asian American and 20 Caucasian American older adults in the Southern California region. The results from the age-attitude IAT found that Asian American older adults demonstrated higher implicit bias toward aging, evidenced by faster responses to the category pairings associating “old” + “bad” and “young” + “good”. In contrast, performance on the gender-science IAT was similar for both groups, showing no strong bias toward gender stereotypes. Potential implications on the wellbeing of older adults, as stereotype threat and other forms of bias are already established harmful constructs in the population, are discussed.

Objective: The goal of this study was to conduct a systematic review of the relationship between mental health, discrimination, and self-esteem among college students. To further explore this concept, focus group interviews were conducted as a follow up. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a total of five existing literatures was systematically analyzed. Data analytic tables were used to collect information on population and study characteristics for the first part. The focus groups were transcribed verbatim and results were thematically analyzed to identify emergent constructs. Results: There is a substantial relationship between mental health and discrimination among college students, especially within minority groups. There was a difference in self-esteem within the Asian population when utilizing family support, which affected these students’ psychological distress in regards to perceived racial discrimination. Discrimination was associated with physiological distress within the Latino population, and African Americans obtained the highest mean perceived stigma. Focus group results were confirmed similar trends. Students of African American, Asian, and Latino groups shared the same discriminatory experiences when being of darker skin color. For example, a student said, “One time during class we were choosing groups and I heard people say that the Saudi Arabs are lazy and only cheat.” “It made me feel so iv low.” “No one asked me to be in their groups.” As such, it can be seen that such discriminatory acts can negatively impact students’ self-esteem. Conclusion: The results of the study highlight the need for more public health initiative to address mental health and discrimination among college students and how it affects their self-esteem negatively, especially within minority populations.

The movement to increase the number of group home programs for the mentally retarded/developmentally disabled is present in the state of Oregon. The Boundary Street group home, located in Portland, was established as a result of this movement. As a rather typical group home program, it is subject to many of the program concerns and evaluation needs experienced by similar services. This point represents the ultimate reason for this paper. The primary purpose will be to develop a program evaluation system that will be appropriate and beneficial in meeting the evaluation needs of the Boundary Street group home. Because the Boundary Street group home is similar in principle and design to other group homes in Oregon, a second purpose of this project will be to develop an evaluation system that can be beneficial to other programs.

The Community Mental Health Act of 1963 launched the deinstitutionalization movement, whereby individuals with serious mental illnesses were released from psychiatric hospitals and began living and receiving mental health care in the community (Carling, 1995). However, these actions have not necessarily integrated those individuals into all aspects of community life (Dewees, Pulice, & McCormick, 1996). This is unfortunate because people with serious mental illnesses frequently report that community integration is not only important to them, but that it also aids in reducing symptoms and promoting recovery (Townley, 2015). Although past research suggests that receiving mental health care in the community has a positive impact on symptom management, the influence of other community factors (e.g., sense of community, community participation) has yet to be fully explored (Segal, Silverman, & Temkin, 2010). Furthermore, there is lack of understanding as to how these community factors influence other aspects of recovery, such as mental and physical health. As such, the goal of the current study is to better understand the association between community participation and recovery by investigating sense of community as a potential mediating factor between community participation, psychological distress, mental health, and physical health. Data were collected from 300 adults with serious mental illnesses utilizing community mental health services in the United States. Results indicated that sense of community partially mediated the association between community participation and mental health, as well as psychological distress, and fully mediated the association between community participation and physical health. Implications include contributing to the current knowledge base about the role of community factors in recovery and informing future interventions aimed at promoting community integration of adults with serious mental illnesses.

Although 1 in 5 Americans will experience a mental illness at some point, each year people with mental illnesses continue to face high levels of stigmatization and discrimination at work. Recognizing this, many organizational researchers and practitioners have sought to improve workplaces for employees with mental illness through a variety of organizational interventions. Unfortunately, few interventions are thoroughly evaluated. One barrier to evaluating such interventions is the lack of a theoretically meaningful measure of workplace mental illness stigma. In this dissertation, I proposed to develop and evaluate such a measure (the W-MISS) based on Jones, Farina, Hastorf, Markus, Miller, and Scott's (1984) six-dimension stigma framework (i.e., concealability, course, disruptiveness, aesthetics, origin, and peril). To do so, I used Hinkin's (1998) approach: Phase 1) item generation was completed by 8 subject matter experts; Phase 2) content validity evidence was provided by 47 adults with management experience and 7 subject matter experts; Phase 3) exploratory factor analysis was conducted based on responses from 300 adults with management experience; Phase 4) confirmatory factor analysis was conducted based on responses from 200 adults with management experience; Phase 5) convergent and discriminant validity evidence was provided by 101 adults with management experience; and Phase 6) predictive validity evidence with regard to hiring discrimination was provided by 365 adults with management experience. Overall, the results supported the hypothesized factorial structure, convergent and discriminant validity, and predictive utility of the W-MISS. Findings provide empirical support for Jones et al.'s (1984) theoretical stigma framework in a workplace context for mental illness and represent the first comprehensive measure development drawing on these dimensions for any stigmatized identity in a workplace context. Further, results demonstrate the potential for scholarly and practical utility of such a measure.

Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disease that attacks the motor system and contributes to a range of cognitive and behavioral impairments (e.g., behavioral and emotional disinhibition, planning and problem solving difficulties, impulsivity, attention, and personality change). This executive dysfunction may contribute to selfregulatory impairment across several domains, including cognitive skills, thought processes, emotion regulation, interpersonal skills, and physiology, that may be crucial to the quality of life (QOL), or well being, of patients and their caregivers. Given the relentless course and prognosis of ALS, palliative treatments for ALS should target the full range of self-regulatory deficits. Thirty-seven patient-caregiver pairs completed questionnaires regarding the patients’ ability to regulate emotions, social behavior, and thought patterns. Patients also completed neuropsychological measures of executive functions and provided measures of glycosylated hemoglobin (A1c) and heart rate variability (HRV). Results suggest that SR and EF deficits exist on a continuum in ALS, such that some patients evidence adequate or superior ability to self-regulate while others evidence deficits. Patient- caregiver agreement about patients’ selfregulatory capacity across domains was generally weak to moderate. Patients perceived themselves to have less capacity for global regulation than caregivers perceived them to have, patients perceived less dyadic cohesion than caregivers, and patients perceived themselves to ruminate more than caregivers indicated. Overall, caregivers tended to perceive a more pervasive pattern of deficits compared to patients. Additionally, measures of SR and EF were not strongly inter-correlated in general, challenging the idea that SR in different domains depends on a common resource. Accordingly, correlations among measures of theoretically similar constructs (i.e., EF and SR) were small to moderate in magnitude and non-significant. With regard to physiological functioning, when patients had better regulated glucose (A1c), patients and caregivers perceived better global regulation. A similar pattern emerged with patient ratings, with higher baseline HRV linked to less emotional lability. Last, mixed results were obtained when predicting patient and caregiver QOL. Less rumination, less dyadic cohesion and more social anxiety were associated with higher QOL for patients. Caregivers’ QOL was not significantly related to their perceptions of patients’ self-regulatory capacity in any area.

The purpose of this study is to develop an interpretative understanding of how discursive therapists’ linguistic actions enhance the couple alliance. Additionally, this study includes an exploration of whether these models hold up to a common factors conversation in the practice of couples therapy. The couple alliance is the central relationship in couples therapy. Previous research suggests that therapists’ actions might have an effect on enhancing this alliance by creating a dyadic orientation. In postmodern/discursive models of practice, therapists’ actions have gone mostly unexplored, leaving therapists with little understanding of what is done in the process of couples therapy that enhances the couple alliance and creates a dyadic orientation. Results from a Conversation Analysis of couple’s cases in Narrative Therapy, Solution-Focused Brief Therapy, and Collaborative Language Therapy suggest the linguistic actions of discursive therapists appear mostly congruent with the claims they make regarding couples therapy. These actions may produce an enhanced couple alliance based on the empirically supported characteristics of a strong couple alliance. Findings also support model-dependent common factors of discursive couples therapy. In all three approaches the couple alliance appears to be enhanced by: (a) developing a symmetrical structure of the dialogue, (b) developing a contextual understanding of the self and the partner, (c) expanding the changes to the larger system, and (d) using thematic summaries. These findings have implications for practice and training in discursive couples therapy. Recommendations for future research include utilizing deductive reasoning in outcome studies to explore the effectiveness of a discursive couples therapy common factors approach to enhance the couple alliance.