Anxiety is a common and often stigmatized condition. Destigmatizing mental disorders can positively impact people’s interaction and communication with others and can prompt conversations in which people share their experiences with mental health, leading to improved societal understanding and perception. My design solution tackles behavioral symptoms of anxiety, specifically two conditions that fall under obsessive-compulsive behavior: Dermatillomania and Trichotillomania. By redesigning women’s jewelry to specialized accessories, my intention is for these objects to help destigmatize these conditions and relieve symptoms of maladaptive behaviors and hurtful impulses. By redirecting these irresistible urges to an external artifact, the objects are designed to help the user tactfully and harmlessly manage symptoms while at the same time satisfying the user’s impulse.

Psychiatric genetics is a basic science field that has potential for practical application and effective translation. To date, translational frameworks utilized by this field have been linear (e.g., sequential) in nature, focusing on molecular genetic information. It is proposed that non-linear (e.g., socio-ecological) frameworks are a better way to immediately translate non-molecular genetic information. This dissertation explored the translation of psychiatric genetic information in two ways. First, a survey was sent to academic stakeholders to assess the state of the science regarding the translation of genetic information to the clinical care of mental health disorders. Findings from this indicate a translation-genetic competence gap whereby genetic knowledge reinforces linear frameworks and genetic competence is needed to achieve effective translation in this content area. Second, a new risk factor model for social anxiety was created that incorporated genetic, environmental, and neurophysiological risk factors (behavioral inhibition, parental bonding, emotion reactivity). Findings indicate that genetic etiology is more informative knowledge that can influence risk factor models and possibly prevention and intervention efforts for social anxiety. Overall this dissertation paves the way for examining the translational capacity of psychiatric genetics in a clinical setting. It constitutes the first examination of barriers to and a potential solution for the most effective translation of psychiatric genetic information.

Adolescent self-harm is a growing epidemic in the United States with thousands of adolescent children being treated in hospitals every year. Despite awareness that self-harm impacts the family unit, little attention has been given to the full impact that self-harm has on parents. Due to this lack of knowledge, counselor educators and supervisors are not equipped to train counselors to work with parents of self-harming adolescent children leaving counselors feeling unprepared to work with parents. The purpose of this phenomenological study was to explore the lived experiences of parents who have self-harming adolescent children. Family systems theory was used to explore the concept that self-harm impacts the entire family system. The key research question for this study was: What are the lived experiences of parents of self-harming adolescent children? Six participants were interviewed using a semi structured design. The interviews were transcribed, coded, and analyzed using Pietkiweicz and Smith's 3 stage analysis process. Six main themes emerged from the data: (a) reaction to behavior, (b) change in self, (c) change in parenting style, (d) impact on relationships, (e) change in perception of mental health issues, and (f) support systems. The results of the study confirmed that parents have strong emotional responses to the self-harm and consequently adjusted their parenting styles. The outcomes of this study have the potential to impact positive social change by informing changes in counseling curriculum, training programs, and the level of support and services counselors provide when working with parents of a self-harming adolescent child.

The United States is experiencing a severe shortage of Emergency Medical Service (EMS) paramedics. The job outlook for paramedics (EMT-P) for the years 2012-2022 is predicted to increase by 23%-33%, which is much faster than the 4% average increase of other first-response professions. The average tenure of paramedics is less than 4 years. There is a significant gap in the literature concerning paramedic personality traits and tenure. The primary objective of the current study is to provide empirical data on the personality traits possessed by long-term paramedics (5+ years), and compare them to those with shorter tenure (< 5 years). Using Allport's Trait Theory, I predicted that personality would affect paramedic longevity. The 6 personality traits tested were warmth, reasoning, emotional stability, liveliness, social boldness and openness to change. A socio-demographic questionnaire, determined the length of their EMS career, while the 16PF® Assessment, tested their personality traits. Using t tests, Mann-Whitney U tests, and a set of regression analyses, data were examined to determine if length of career and personality traits predicted paramedic tenure. The research sample consisted of long term paramedics and former paramedics. The results showed that of the 6 personality traits, only warmth was a significant predictor of paramedic tenure. A logistic regression showed for every additional point in warmth, the odds of leaving EMS prior to 5 years increased by a factor of 2.77. This study provides support for positive social change by helping EMS to learn how to increase recruitment and tenure. It also helps by advising EMS agencies to attend to the mental and emotional health of their paramedics by being aware of the level of their warmth personality trait.

Female veterans' combat exposure to trauma places them at risk for developing posttraumatic stress disorder (PTSD), which has consequences for healthful reintegration to family and civilian life. Previous research found that wives who provide continuous care to male veterans with PTSD experience symptoms of psychological distress; however, little research has been conducted on the influence of female veterans' PTSD on their intimate male partners' (IMPs) psychological well-being. A multivariate correlational design was used to examine the influence of female veteran PTSD on psychological distress and relationship quality in IMPs. The couples' adaption to traumatic stress model was used as the theoretical framework. The research questions examined (a) the difference between female veterans with and without PTSD on the length of time in the relationship, combat experience, the total number of deployments, and IMP psychological distress and (b) the influence of female veterans' combat experience, PTSD, and IMP psychological distress on relationship quality. A sample of 71 IMPs between the ages of 18 and 65 provided survey research data on the variables of interest. Psychological distress, number of partner deployments, and length of time in relationship discriminated significantly between IMPS whose partners were diagnosed with PTSD, not diagnosed, or did not know about the PTSD diagnosis. The regression results revealed that the psychological distress of IMPs and the number of partner deployments positively predicted relationship quality. Attention to female veterans and their families can contribute to increased retention of female service members in the Army and successful integration into family and civilian life.

Anxiety, depression, and substance use disorders are some of the frequently occurring mental illnesses among Canadian children and adolescents that can result in debilitating short and long terms outcomes. The rise in readmission rates for recipients of mental illness in Saskatchewan, coupled with the high incidences of suicide-related deaths, necessitates a patient outcome evaluation for predictors of readmission to youth counseling services among adolescents. The purpose of this secondary data analysis study was to explore the associations between anxiety, depression, substance use disorder, individual counseling, family counseling, group counseling, and the outcome of readmission within 1 year following discharge from youth counseling programs. Age, gender, and socioeconomic status were tested for interactions between the independent and dependent variables. The social ecological model of health behavior was used in understanding the study findings. Data from the Saskatoon Health Region Addiction and Mental Health Information System database were used for chi-square and multiple binary logistic regression analyses. Findings showed a statistically significant association between anxiety and readmission (p = 0.046, odds ratio =. 707). The association for anxiety was modified by age (p = 0.038). Depression showed a strong association with readmission (p = 0.001, odds ratio = 1.722) even after examining for effect modification. Additional prospective cohort studies over a long period of time are needed for at risk youth. The potential positive social change impact of this study is better outcome and overall quality of life of program participants; both of which can be achieved through investments in resources to reduce readmission to youth community counseling program.

Workplace violence is a persistent problem in health care, and incidence rates have increased over the years. Traditional reporting systems, relying mostly on paper formats, are inadequate for developing effective predictive models for intervention and reducing acts of violence by patients to staff. The purpose of the development and deployment of the psychiatric emergency response team (PERT) was to provide effective intervention within the MIAHTAPS (Altered Mental status, Irritability, Agitation, History of Violence, Threatening, Attacking Objects, Pacing, and Staring) behavior prediction tool to reduce the severity and rates of violence in a hospital setting. Lewin's change theory was used to implement the necessary cultural change for effective deployment of PERT and MIAHTAPS. MIAHTAPS, with PERT as an integral component, was used by the primary nurse on admission and during every care shift to assess patients' potential for violence. Pre- and post- intervention assessments were completed to determine the effectiveness of the intervention. Quantitative and open-ended question responses from 200 nurse participants, who completed the 2 online surveys, were analyzed using descriptive and frequency distributions. Findings from the project showed that nurses could identify patient potential for violence and recognize how to diffuse situations effectively 34% of the time, compared to 14% before PERT. A post-implementation survey showed that 75% of the nurses found the MIAHTAPS and PERT system useful and easy to use. Having an easy-to-use tool that helps to identify potential for violence will help hospital and other workplace staff to develop and implement preventive interventions and as a result promote positive social change.

Marijuana is the most frequently used illegal substance in the United States and is most widely used among young people aged 12 to 21 years. Accurate screening and monitored issuance of medical cannabis recommendations have been shown to decrease abuse rates of the substance, create fewer deaths from opiates, reduce crime rates, reduce marijuana use in youths, decrease car crash deaths, and lessen prevalence of suicide in young men. The purpose of this project was to explore whether multiple screening methods for depression and anxiety in patients who seek medical cannabis referrals for anxiety and depression would improve screening and cannabis referral accuracy. A comprehensive review of the literature was conducted, and 2 screening tools were identified. The tools identified were the Zung self-rating anxiety scale and the Diagnostic and Statistical Manual of Mental Disorders 5 scale. The medical director at the project site reviewed the tools and approved them. These tools were then included in an education program for 12 staff members and providers with a pretest given to the participants prior to the staff education program. A posttest was then administered to the same group after the staff education program was completed and the new screening measures implemented. Results showed that referrals for cannabis were at 85% before the 2-step screening process was implemented; referrals for cannabis decreased to 60% with implementation of the dual screening method, suggesting increased accuracy in screening for depression and anxiety for cannabis referrals. This project might promote positive social change by increasing accuracy for cannabis referrals and reducing the risk of cannabis abuse.

Psychosocial support from family is important in outpatient treatment programs for individuals with depressive disorder. The purpose of this phenomenological study was to explore the lived experiences and perceptions of parents of patients with depressive disorder regarding intensive outpatient treatment. The research question was what are the experiences and perceptions of parents of patients with depression regarding their role as caretakers in intensive outpatient treatment? The conceptual framework was a biopsychosocial framework and family systems theory. Content analysis was used to analyze data provided from interviews with parent participants (n = 8). Many participants reported high levels of involvement with various forms of support. They maintained positive relations with professionals, were involved in patient socialization, and facilitated adherence to patients' treatment plans. The results of this study indicated that family caregivers experienced ambivalent emotions toward their roles and patients. Findings also indicated experiences of exhaustion, strong emotions about the burden of having to support the patient, and concern for their own and the rest of the family's well-being. Future researchers should study these aspects further. Researchers, clinical practitioners, and policy makers must increase efforts to support those who help family members suffering from depression to intensify the search for effective ways to reduce the toll on those caregivers. Because of these findings, researchers could expand literature to illuminate the decisions and practices of psychotherapists, leading to improvements in intensive treatment programs for both patients and their caretakers. This study impacts social change by providing insights to aid policy makers in ensuring that outpatients receive the best treatment program available and that their primary caretakers are psychologically prepared and healthy.

Social workers have no clear professional guidelines about the application of culturally competent mental health service delivery. Without culturally competent mental health service delivery, clients from diverse cultures do not access needed mental health services and they experience less effective therapy treatment outcomes and overall disparity of service delivery throughout the therapeutic process. The purpose of this descriptive case study was to better understand how community-based social workers are delivering culturally competent services to clients. The theoretical framework for the study was multiculturalism and the primary research questions addressed how associate clinical social workers who provide in-home mental health services in Los Angeles deliver culturally competent services to their clients. Through 8 interviews with associate clinical social workers, this descriptive case study revealed that without clear direction on what culturally competent services are, or how to deliver them, social workers are using a combination of personal experience and personal culture, educational and practice knowledge, and in some cases no attention to culture, to meet the mental health needs of their clients. This study emphasized the need for an industry wide understanding of the term cultural competency, so it could serve as the frame of reference by which practice professional skill level could be assessed, practice protocols measured, and could lead to social change through greater access to counseling services for clients.