The focus of this hermeneutic phenomenological, qualitative study was to gather an in-depth understanding of the lived experiences of male batterers participating in a standardized Duluth-model batterers' treatment group. The study had three main goals: (a) to understand the experience of male batterers participating in a standardized male batterers' treatment program, (b) to improve the treatment being provided to male batterers, and (c) to improve services to those impacted by domestic violence. Results from previous studies indicated that treatment for male batterers is ineffective and inconsistent and that the treatment provided, regardless of framework or modality, has little or no effect on recidivism. This study advances understanding of male-batterer treatment by exploring treatment from the perspective of those who receive it. The study included 9 men currently participating in a Duluth model batterer's treatment program in Minot, North Dakota. From the study results, 3 overall themes emerged: (a) overall group experience, (b) facilitators, and (c) Duluth model. Results indicated that the current delivery of the treatment is not effective for batterers. Findings suggested that the facilitators played an essential role in the treatment program. Findings further suggested that participants believed the Duluth model could be an effective treatment modality for batterers. Study findings may inform a more responsive and comprehensive treatment modality for male batterers. Such an intervention may improve service delivery for both batterers and victims as well as improve recidivism. These changes may result in positive social change for not only families caught in the cycle of violence but also for every sector of society.

Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl'€™s five stream confluence policy process theory and Lipsky's street level bureaucracy theory provided the foundation to explore the perceptions of the CHWs about their integration into the behavioral health care system; the problems, policies, processes, and programs that impacted their ability to be integrated into the behavioral health team; and their function as a street level bureaucrat to facilitate their integration. A deductive iterative coding approach was used, culminating in the identification of the following 6 themes: health system utilization of CHW behavioral health integration, official policy recognition of the CHW profession, accountability for CHW integration, CHW practice support, integrated health care team management of physical and mental health and behavior, and building the CHW profession. The social change implications of this study are that CHWs'€™ integration into the broadly defined, integrated, physical and mental behavioral health team can support having a more cost-effective way toward having healthy people and communities because they link the community to health and social services and advocate for quality care.

Cultural awareness is an ethical standard in the social work profession and, as the diversity in the United States continues to grow, it is a social work practice problem when cultural awareness is not implemented in mental health settings. The National Association of Social Workers revised the cultural awareness standards to include cultural humility and intersectionality as practice indicators. The purpose of this action research study was to examine how clinical social workers demonstrated cultural humility and intersectionality in mental health settings. Person-centered theory guided this study and a total of 17 clinical social workers in New Mexico participated in in-depth interviews to give examples of clinical practice behaviors that demonstrated cultural humility and intersectionality. Thematic analysis was used to identify common themes, which included (a) genuine interest in the client's culture, (b) therapist congruence, (c) unconditional positive regard, and (d) empathic understanding. The implications of this study for social work practice and social change are that findings could contribute to improved cultural awareness in mental health settings and decrease mental health disparities among minorities. Recommendations include creating continuing education, mentoring minority college students on their career path in mental health, and developing a mental health business model that integrates cultural awareness.

The cost of domestic and intimate partner violence (DIPV) exceeded $8 billion annually on a national level, and North Carolina spent $307 million on DIPV and DIPV-related mental health care. Studies have shown a correlation between DIPV, mental illness, and substance abuse. North Carolina was found to have higher than normal risk factors for DIPV. In response, the Centers for Disease Control and Prevention partnered with the North Carolina Coalition Against Domestic Violence (NCCADV) to develop the NCCADV 10-year primary prevention plan. This study investigated clinicians' perceptions of the effectiveness of the plan. Phenomenological thought served as the conceptual framework. A purposive sample of 10 clinicians who worked in the region with DIPV clients in the preceding 12 months responded to semistructured interview questions that investigated their perceptions of whether the 10-year plan had a positive influence on victims and if the plan could potentially impact victims' future mental health and substance use behaviors. Interview data were transcribed, open coded, and thematically analyzed with the aid of qualitative software. Study results indicated that these clinicians believed the plan did not impact DIPV clients' current behaviors and was unlikely to have a future impact. A policy recommendation in the form of a position paper resulted from the findings, which recommended the use of mass media that encompass old and new technologies to promote primary prevention efforts by stakeholders and practitioners for the general public. This study has implications for positive social change in that it may provide knowledge to clinicians and stakeholders at the study site that aids them in understanding and preventing DIPV, in addition to promoting an overall increase in public awareness of the negative effects of DIPV.

In 2014, Washoe County Department of Social Services in Nevada, licensed only 50 of 400 parents who applied to foster children. Lack of long-term effective foster parents creates instability within the system. Significant concern over increased numbers of children entering foster care and a decreased number of qualified foster care applicants continues. The Casey Foster Family Assessment (CFFA), a comprehensive assessment of key traits of effective foster parents may further enhance the fostering application process. The identified CFFA subscales most predictive of future foster parent effectiveness, may help WCDSS more effectively identify applicants likely to provide long-term stable homes for children. Local licensed foster parents and their case managers were recruited to complete the CFFA, and Effective Foster Parent Survey (EFPS). Using the Ecology theory of Bronfenbrenner and Belsky as a foundation, a series of Pearson bivariate correlations were conducted using the CFFA and EFPS scores and a regression analysis was conducted to determine the results. Results showed foster parents (N=35) with a high level of dedication, sufficient time, higher perceived degree of responsibility then the agency, and willing to foster children of differing racial, religious, cultural, or sexual identity backgrounds were viewed by their case managers as being highly effective. Identifying effective skills, and providing support and training to foster parents, may increase the likelihood that a child will stay in one home instead of moving repeatedly, reducing mental health risks of foster children. Three significant correlates were identified: positive parent-child interaction, participation in spiritual activities and attendance at agency training, set a foundation for continued research in additional effective foster parent skills and how to assess for these qualities in incoming applicants.

This cross-sectional quantitative study was conducted to assess the presence of muscle dysmorphia (MD) and a drive for muscularity (DFM) in 1,039 personal trainers using the Muscle Dysmorphia Inventory (MDI) and the Drive for Muscularity Scale (DMS). Muscle dysmorphia is considered a subtype of body dysmorphic disorder that can be exacerbated by an intense DFM, which may in turn lead to negative psychobehavioral outcomes. Because personal trainers are an unresearched population with regard to these 2 constructs, a multidisciplinary framework was used to ground the present research study. Independent variables were structured using a biopsychosocial foundation where the biological dimension was operationalized through the Body Comparison Scale, the psychological dimension through the Symptom Checklist-90-Revised, and the social dimension through the Sociocultural Attitudes Towards Appearance Questionnaire-4. Kendall's tau-b revealed that general appearance concerns, muscle concerns, and somatic features were positively related to both MD and a DFM. A DFM and MD were significantly, positively correlated with internalization of thin ideals, muscular/athletic ideals, family and peer pressures, but not media pressures. All psychological variables were significantly, positively related to MD and a DFM. The DMS was able to significantly predict scores on the MDI using hierarchal multiple regression. Trainers who displayed MD and DFM symptoms did so with little disparity between the sexes. Trainers are in a unique position of instruction as well as guidance, and therefore a better understanding of how MD presents in this specific fitness arena may impact not only personal trainers, but also their clients through increased body image disturbance awareness as well as provide a new population of interest for future MD research.

A National Survey indicated that 1.6 million adolescents in the U.S. were arrested in 2010 and 1.5 million in 2011 for erratic aggressive behaviors, thus showing a decline from the 2.18 million adolescent arrests in 2007. Residential facilities in the state of Pennsylvania offer a group intervention called Aggression Replacement Training (ART) to help adjudicated adolescents regain control of erratic behaviors. The purpose of this study was to examine the extent to which level of group participation in ART and certain demographic factors (age, gender, ethnicity, family socioeconomic status, parental involvement, and education) predict decreased aggression and increased anger control among these youth. Cognitive theory and change theory were used to guide this causal-comparative investigation. The overarching research question was, does a youth's level of ART group participation (i.e., attentive, inattentive, and resistant) result in a subsequent reduction in risk assessment as measured by post Aggression Questionnaire score differences. Data were collected for the period of 2011-2014 from archival records from 5 residential facilities (n = 160) in Pennsylvania and were statistically analyzed. Findings from an analysis of variance indicate that ART group participation predict decreased erratic aggressive behaviors and increased anger control among adolescents. Findings from multiple regression analyses indicate that parental involvement predicts attentive participation level, whereas ART group participation, gender, and parental involvement predicted a reduction in risk assessment. Study findings may assist other treatment facilities and affiliated agencies in the U.S. with developing and implementing effective interventions for youth who exhibit erratic aggressive behaviors.

Evidence-based practice (EBP) in mental health was initiated in the United States due to state legislation. The EBP implementation process is complex due to multiple factors related to organizational culture. Mental health agencies implementing EBP processes can expect significant personnel changes due to higher turnover rates, which may have a negative effect on the quality of services. The purpose of this study was to investigate the relationship between providers' attitudes toward the adoption of EBPs and organizational culture. The theoretical framework for this study was organizational culture theory and the Denison organizational culture model. This correlational and predictive study examined the relationship between the domains behind 112 provider attitudes as measured by the Evidence-Based Practice Attitude Scale and the multiple traits of organizational culture as measured by the Denison Organizational Culture Survey. A Pearson correlation was conducted in order to determine whether there were significant relationships prior to conducing a standard multiple regression and a stepwise multiple regression analysis. This study found a significant relationship between the mission trait and general provider attitudes and between the involvement trait and organizational support. The stepwise regression analysis found the mission trait to be a predictor of general provider attitudes. The standard regression analysis found the involvement trait to be a predictor of organizational support. Having this new insight could help managers make adjustments that may help providers be receptive to EBP adoption and ultimately may help in decreasing an organization's turnover. A more stable work environment may be conducive to the provision of higher quality services, leading to social change.

Acts of lone extremism are on the rise, yet little is known about who commits these acts. Research in this area has failed to delineate by extremist subtype. This has led to the misconception these acts and actors present with such variance psychosocially that they cannot be predicted. The purpose of this research was to assess whether statistically significant relationships exist between lone extremist subtypes on the psychosocial variables of mental illness, substance use, and having radicalized friends or family members. The conceptual framework for this study was De La Corte's psychosocial principles of terrorism, which addressed the social and political influences of terrorism with the complex psychosocial constructs that may exist. The Profiles of Individual Radicalization in the United States was chosen as the dataset and includes de-identified individual-level information on 1,865 extremists. The research questions that guided this study sought to determine if significant differences exist between 4 lone extremist subtypes across 4 psychosocial variables. Crosstabulation analysis and multiple chi-square tests for independence were used to test the relationship between categorical variables. Statistically significant relationships were found among each lone extremist subtype and having radicalized family members and friends (p=.00). In terms of mental illness, far left extremists were the only extremist subtype that yielded a significant relationship (p=.00). Also, a significant relationship was found between substance use and far right (p=.00), far left (p=.01), and single issue (p=.04) extremists. In terms of social change, this research presented support for studying lone extremism by subtype and also provided a foundation towards constructing a predictive model.

Mental illness and substance use disorders have been determined to be leading predictors for recidivism among criminal offenders in the United States who are released to community supervision. Women make up an increasing in percentage of this criminal justice population; however, few studies have explored the role that gender plays in determining men and women's recidivism. Offender's education, employment, and peer association have also been reported to be predictors increasing the likelihood of recidivism among criminal offenders. This study was designed to determine if gender, mental illness, substance use disorder, employment, education, and peer association predicted recidivism. Differential association theory and gender pathways theory provided the theoretical framework for this study for examining archival data obtained from the Court Services and Offender Supervision Agency AUTO Screener and Supervision Management Automated Record Tracking System. Multiple logistic regression analysis showed that substance use disorder significantly predicted recidivism, while employment decreased the likelihood of recidivism. This study did not find a significant interaction between mental illness and substance use disorder or mental illness only. Additionally, neither gender, education, nor peer association were found to be associated with recidivism. This study promotes social change by highlighting the increasing need for services for offenders and identifying the complex factors that impact recidivism. The findings from this study will be helpful to criminal justice agencies for developing programs that address the need of SUD and employment for offenders to reduce the likelihood of recidivism and increase public safety.