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The U.S. Army has undergone extreme transformation to meet new national security needs of the nation due to the Global War on Terror (GWOT). In order to meet the needs of Soldiers and families exposed to increased stressors, the Army behavioral health system has undergone much transformation as well. The Army Social Work Care Manger Program (CMP) is one program recently developed to enhance Army behavioral health services to this population. It provides care for Soldiers and their families who experience psychological or interpersonal difficulties throughout the deployment cycle. This study investigates the ability of this new program to create effective services throughout several locations across the Army. More specifically, the study evaluates the extent to which the CMP has been implemented as intended, reaches the target population and accomplishes the intended tasks. Soldier survey data, multiple Care Manager (CM) activity reports, interviews and focus groups were analyzed in a triangulated methodology. CMPs studied were found to reach the target population and address target issues across installations; however, senior enlisted as well as white male Soldiers appeared to be exposed to trauma at higher rates than they received treatment. Burnout, lowered health benefits, overtasking, and recommendations for program formalization through manuals were identified as areas of program development.

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Outreach is recommended as an intervention for racial and ethnic minorities who underutilize traditional mental health services (e.g., Brinson & Kottler, 1995). Yet, the availability of outreach services at university counseling centers for students of color has not been studied. In addition, no study has examined factors influencing the availability of outreach services for racial and ethnic minorities. The primary purpose of the current study was to investigate the availability of outreach for racial and ethnic minorities and how these services are influenced by institution size, staff size, institution type, accreditation, and organizational cultural competence. One hundred and fifty one counseling center directors completed an online survey. It was hypothesized that counseling centers’ organizational cultural competence would predict the availability of outreach services for racial and ethnic minorities beyond that of institution size, staff size, institution type, and accreditation. The results supported this hypothesis. Among the variables examined, organizational cultural competence was the greatest predictor of the availability of outreach for students of color. The results suggested that counseling centers with greater levels of organizational cultural competency also had a greater availability of outreach services for students of color. The implications of these findings for theory, research, and practice are discussed. / Department of Counseling Psychology and Guidance Services

Although the profession of occupational therapy had its origins in the treatment of the mentally ill, and was among the pioneers in developing community-based programs to meet the social and emotional needs of children, a study of 28 therapists practicing in the public schools revealed that these occupational therapists did not serve students with behavioral disorders unless they also exhibited a neurological disorder. The results of this study revealed that occupational therapy is not recognized by the educational sector as an essential related service for students with behavioral disorders. Occupational therapy is viewed as a modality much akin to physical therapy in which the focus is on motor skill development.

Programs providing interventions for early psychosis are becoming commonplace in the United States (US); however the terrain of existing services within programs remains undocumented. Unlike other countries, the US does not have a systematic approach to defining and treating this population. We examined program characteristics, clinical services, and treatment population parameters for early intervention programs across the US. A semi-structured telephone interview was conducted with program directors between July 2013 and April 2014. Content analysis was used to identify the presence or absence of 32 evidenced based practices recently recommended for early intervention programs (Addington, et al., 2013). Frequent client requests were identified and functional definitions of the population served were assessed. A total of 34 eligible programs were identified; 31 (91.2%) program representatives agreed to be interviewed. Of the 32 essential components, the most prevalent were individual psychoeducation and outcomes tracking; the least prevalent were outreach services and communication with inpatient units. The population was most frequently defined by age restrictions, and restrictions on the duration of psychosis. Emergent themes of client requests included functional and social recovery as well as help meeting practical needs. Findings have the ability to assist researchers and policy-makers in determining best practice models and creating measures of fidelity. This study provides critical feedback on services for the early psychosis population and identifies research to practice gaps and areas for improvement moving forward.

Indiana University-Purdue University Indianapolis (IUPUI) / This study investigates differences between Veterans and non-Veterans with severe mental illness (SMI) regarding perceptions of their illness, themselves, and treatment. I compare patient interviews (using the Indiana Psychiatric Illness Interview, IPII) of Veterans (N=20) and non-Veterans (N=26). Modified grounded theory and qualitative coding software Atlas-TI were used to develop codebooks for each group, and these were compared for differences. I examined differences in both code frequency and meaning. Statistically, more Veterans were male, employed, married, had higher income, and had higher education. Statistical differences in code frequency included: more Veterans discussing boredom, regret/guilt/loss, and wanting to be “normal.” More non-Veterans had codes of pessimism and religion/spirituality, wanting a different future, bringing up mental health, family, future: no change, life goals, and relapse. Key differences in narrative themes included: (1) Veterans’ “military mindset”/discussion of anger as part of mental illness, (2) non-Veterans’ focus on mental-illness, (3) differing attitudes regarding stigma, (4) active versus passive attitudes toward treatment, and (5) degree of optimism regarding the future. Differences are described and then potential relationships and interactions are proposed. Veterans appear to have several protective factors (i.e., finances, employment, marriage). Additionally, Veterans’ military-mindset seems to encourage greater stigma-resistance, and thereby also facilitate Veterans being more active and optimistic toward treatment and recovery. By contrast, non-Veteran focus on mental illness may be related to increased self-stigma, passive and pessimistic attitudes. I propose that Veteran identity can serve as an additional protective factor against stigma, pessimism, and passivity. Veteran-identity may also be a useful framework clinically, to help promote active approaches to treatment (e.g., “fighting symptoms”). Further, Veterans emphasized issues relating to anger as important and part of their mental health. It may be that Veterans are more comfortable discussing mental health in the language of “anger,” given stigma. Finally, findings suggest that helping individuals in both groups engage in meaningful, non-mental illness-related life activities may help shape self-perception, and thereby responses to stigma, attitudes toward treatment, and hope for the future.