Children go to school for approximately 32 hours each week of an academic year. Many children who are in need of mental health treatment do not get the services they need because of barriers such as lack of access and stigma. Teachers are one of the primary sources of referrals for children's mental health services, and they often make referrals based on their perceptions of their students' mental health needs. Although teachers are typically the primary source of referrals for mental health services, they usually do not have any specialized mental health training. The purpose of this study was to gain insight into the perceived needs of teachers' in Title I schools on what is needed to help their students with emotional and behavioral problems. This research study was framed by Bronfenbrenner's bioecological model, which provides one framework for research and practice of school-based mental health. Bronfenbrenner's theory explains the impact of a child's interrelations with classmates, peers, parents, community, and society upon his or her development, particularly his or her mental health. Data was collected from audiotaped face-to-face interviews with 12 Title I elementary teachers. The interviews were then transcribed, coded, and several themes were identified. Relevant themes included the school's role in mental health, the school's current plan to help children, quality of mental health services, barriers to services, supports at school for mental health; reasons for referrals, administration training and classes on mental health, behavioral management systems, and changes to classrooms that will benefit children with mental health problems. Teachers are on frontlines everyday with students and should have all the training that's needed to help their students be successful.

The perspective of the caregiver is vital to understanding the experiences of raising a child with autism, including the challenges faced in accessing services. The purpose of this qualitative, transcendental phenomenological study was to examine the lived experiences of primary caregivers raising a school-age child with autism and to bring about an understanding of the challenges faced in accessing services. Resiliency theory provided the conceptual framework for the study. Semi-structured, in-depth interviews were conducted with 11 participants raising a child with autism in the Washington, DC metropolitan area. Data were analyzed using Moustakas's descriptive approach. Results yielded 5 themes: overall experience, challenges, relationships, access to services, and stressors. Findings revealed effective ways to support caregivers through programs and services and highlighted the importance of supportive relationships and family connections. Implications for social change include opening conversations regarding the unique perspectives and needs of primary caregivers of children with autism, supporting awareness of the stressors associated in daily caregiving, and engaging in broader discussions regarding the importance of establishing supportive relationships among physicians, mental health providers, specialists, social workers and care managers in order to support the advocacy efforts of caregivers.

Self-disclosure is used by feminist, humanistic, client-centered, and a variety of other counselors to build therapeutic alliances with clients. However, little research has been conducted on counselors' perceptions of their preparedness to use self-disclosure. This exploratory multiple-case study used attachment theory as a framework to explore the perceptions of novice licensed professional counselors' preparedness to use self-disclosure. The 12 participants who participated in face-to-face interviews practiced as licensed professional counselors in Delaware, New Jersey, or Pennsylvania. The participants described how they learned, practiced, and used self-disclosure. After analyzing interview data through cycle coding and peer review, themes emerged showing participants' life experiences, clinical practices, education, and supervision as having prepared them to use self-disclosure. Participants perceived they were prepared to use self-disclosure through their educational experience but primarily learned to self-disclose through trial-and-error. Participants reported learning to self-disclose by taking a chance and practicing the self-disclosure skill with clients after receiving their license. Professional counselors, supervisors, and counselor educators who are the gatekeepers for future counselors may use the study's findings to improve understanding of and training in self-disclosure. The findings can be used to enhance the training of how to prepare counselors to use self-disclosure, therefore, minimizing harm to the clients. Learning more about training counselors to use a skill that is of use with or without intent is of significance to the field of mental health counseling.

Research has indicated that lesbian, gay, and/or bisexual (LGB) couples seek mental health counseling far more than heterosexual couples. Using identity development theory and family-of-choice frameworks, a review of the literature revealed that there are a multitude of considerations in working with LGB couples. The use of self-determination theory and social cognitive theory also uncovered many considerations for counselors and counselors-in-training. The purpose of the current study was to add to the lacking empirical data regarding counselors-in-training by exploring their experiences in working with LGB couples. More specifically, this study aimed to understand perceptions regarding the educational training and self-efficacy of heterosexual-identified counselors-in-training who work with LGB couples. Through the use of a phenomenological interview approach, a purposive sample of seven counselors-in-training shared their experiences of working with LGB couples as well as their perceptions of their education and self-efficacy during their postgraduate work. Data interpretation, through the use of coding and a discovery-oriented approach, uncovered 10 themes that counselors-in-training shared. While the overarching theme was that every couple is to be treated similarly, regardless of sexual orientation, there were also very definite issues that were specific to LGB couples. The study's findings and recommendations can benefit those in the mental health fields as well as educators to continue to work toward consistency in educational programs and accreditation standards. The application of these findings can aid in implementing social change that embrace student and client needs in both classroom settings and hands-on field experience.

A father's abandonment of his minor daughter can leave an indelible impression on her psyche -- one that can forever affect her intimate romantic relationships. The purpose of this qualitative phenomenological study was to explore where women who were abandoned by their fathers prior to the age of 18 are today as adults in terms of their intimate romantic relationships and how they develop and engage in these relationships. The research questions examined how a daughter being abandoned by her father prior to the age of 18 relates to where she is today in her adult intimate romantic relationships and what meanings participants attach to relationships and relationship satisfaction as a result of their childhood experiences. Theories of social constructionism and psychosocial development grounded the study. After a review of the literature, data were collected through screening questionnaires and semi-structured interviews with a purposeful sample of 8 women. Each interview was transcribed and the data examined for themes. Key findings indicated that the effect of a daughter being abandoned by her father prior to the age of 18 affects her adult intimate romantic relationships. Results also indicated the psychosocial stage at which she was abandoned affected how she viewed men in her adult relationships as it effects whether she builds trust or mistrust, autonomy or shame and doubt, initiative or guilt, industry or inferiority, identity or role confusion. When the stage is not met, the basic virtue of each stage (hope, will, purpose, competency, fidelity) may be lacking or lost. Positive social change is implicated through this collection of qualitative data that can inform practitioners and researchers, foster therapeutic treatment, and help shed light on and ameliorate the effects of the phenomenon of paternal abandonment of daughters prior to the age of 18.

Missed psychotherapy appointments inhibit mental health treatment, limit the availability of treatment to those waiting for care, and reduce clinician revenue. Previous research has revealed that the factors that predict missed appointments vary depending on the geographic location in which that research is conducted. There is not a complete understanding of the characteristics of people who miss appointments in a rural context. This study used information from 281 client records to examine the predictive relationships among missed appointments and the distance traveled to the clinic, mental health diagnosis, age, and gender at a rural outpatient mental health clinic. The purpose of this research was to identify the factors that significantly predicted if clients missed 30% or more scheduled psychotherapy appointments. The health belief model was used as the framework. Logistic regression analysis revealed that clients with a diagnosis of depression, bipolar disorder, or anxiety were more likely to miss 30% or more appointments. The distance traveled to the clinic did not predict missed appointments. This finding deviates from results in previous literature which found that long travel distances increase the likelihood of missed appointments. This could be due to the geographic region or how the client records were selected in this study. This study can have a positive impact by informing rural mental health clinics of factors that may predict the likelihood of missed appointments. Clinics could then use the information to develop empirically-supported retention interventions. Retention interventions could promote social change by increasing appointment attendance, which could improve overall patient care and reduce health care waste accrued by missed appointments.

Legislative advocacy efforts are increasingly becoming part of a counselor's professional identity, yet scholarly literature lacks studies about experiences of counseling students involved in legislative advocacy for the counseling profession. The purpose of this study was to gain an understanding of the meaning counseling students ascribe to their involvement in legislative advocacy for the counseling profession. Astin's student involvement theory was the conceptual framework utilized to explore the lived experiences of counseling graduate students and recent graduates who participated in a 4-day long American Counseling Association Institute for Leadership Training on legislative advocacy and leadership or in professional legislative advocacy at the state level. Convenient and snowball sampling yielded 8 participants who engaged in semistructured interviews. Using interpretative phenomenological analysis, the data were analyzed to identify essential themes. Thematic analysis was conducted by hand using literature-based codes and lean coding as well as NVivo software. Themes included awareness, faculty mentor, involvement, incorporating legislative advocacy into the curriculum, lack of confidence, student learning and personal development, legislative culture, motivation, student obstacles to professional legislative advocacy, and problems in working with other professions. Findings may be useful for counselor educators seeking to integrate professional legislative advocacy into the counseling curriculum. Implementing a professional legislative advocacy approach into the counseling curriculum might contribute to counselor students' developing a propensity for leadership, advocacy, and professional legislative advocacy beyond graduation.

Burnout is a psychological syndrome caused by occupational stress, which often manifests in mental health professionals who experience demanding and emotionally charged relationships with clients. Guided by the equity theory, this study examined the relationship between spiritual transcendence and burnout in psychologists and social workers who work with severely mentally ill patients after accounting for specific personality traits. Constructs were measured via the Spiritual Transcendence scale (STS), Maslach Burnout inventory (MBI), and the NEO-Five Factor Inventory (NEO-FFI). Sixty eight psychologists and social workers were selected from psychiatric hospitals, community centers, and private practice in Nevada to participate in the study. A quantitative approach using hierarchical regression was used for statistical analysis. The results suggest that, after controlling for the NEO-FFI scales, STS was not significantly related to burnout. The results also suggest that, as the personality factor of neuroticism increases, burnout rates also increase and as the personality factors of extraversion and agreeableness increase, burnout tends to decrease. The social change implication of this research is identifying personality factors that contribute to, or are protective factors of, burnout. For example, individuals who score high on neuroticism scales can be aware of their susceptibility to burnout, and those with high scores on agreeableness and extraversion can be conscientious of those factors and potentially put protective factors in place. These findings are beneficial to employers of mental health professionals, program developers, and mental health professionals themselves.

The current study was designed to further examine the effects of verbal reward and punishment on task performance of schizophrenics. The relationship of need for approval of schizophrenics (as measured by the M-C SDS) to performance and to reward and punishment was also examined. Verbal reward and punishment along with need for approval served as independent variables. Task performance was the dependent variable. The following major questions were asked: Does verbal reward and punishment significantly influence performance of schizophrenics? How is the personality construct, need for approval, related to performance of tasks by schizophrenics? Is there a significant interaction between verbal reward and punishment and need for approval in schizophrenics?

This thesis attempted to examine stressors associated with the psychiatric technician profession and levels of burnout amongst them. This was accomplished through the use of a survey which included demographic data, the Maslach Burnout Inventory Human Services Survey (MBI‑HSS), an adaptation of the Nursing Stress Scale (NSS) and a self‑care assessment tool. A total of three research questions were examined statistically including levels of burnout on subcategories (personal accomplishment, emotional exhaustion and depersonalization), most common stressors identified by psychiatric technicians and percentage of participants who utilized therapy to cope with work related stress. The survey was made available via survey monkey and posted on the website for the California Association of Psychiatric Technicians website and via links posted on Union Chapter social media pages. A total of 123 Psychiatric Technicians participated in the study. Results indicated high levels of emotional exhaustion, depersonalization and personal accomplishment among psychiatric technicians. Results indicate that extended work hours and staffing minimums were significant issues impacting union members. Also significant among participants, was high level of difficulty attending work due to work related stress during the last three months. For future research, it is recommended that similar studies of psychiatric technicians be conducted to provide further insight into burnout, how it happens and how to avoid it.