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The Amish are commonly known for horse-and-buggies, simple clothing, and refusal to use electricity. Less commonly known is their rate of mental illness, which is significantly lower than the non-Amish population. The literature that points to lower depression and anxiety among the Amish does not adequately explain what elements of their lifestyle contribute to this phenomenon. Depression and anxiety are a widespread problem in the United States, increasing the importance of understanding a lifestyle that can reduce these issues. The purpose of this study was to explore the Amish way of life through the words of its members. The three research questions that drove this investigation inquired how the Amish conceptualize mental illness, if and how they seek help for mental stress, and what elements of their lifestyle may protect them from higher rates of depression and anxiety. This qualitative study employed social constructionism as the conceptual framework and positive psychology as the theoretical foundation. Data collection employed a purposeful, maximum variation sample and consisted of 14 in depth, semi-structured, face-to-face interviews. Data analysis employed phenomenological techniques as outlined by Moustakas. Elements of the Amish lifestyle contributing to positive mental health include the increasing availability of Amish focused treatment centers, bishops who encourage mental health treatment, family ties, social bonds, work ethic, and the most significant to the Amish: their faith. This study contributes to positive social change by discovering elements of Amish life that may be practical to the non-Amish. If non-Amish find positive meaning from the elements of Amish life, it may lead to lower rates of depression and anxiety.

Counseling students report a lack of competence in spiritual and religious integration (SRI). As such, counselor educators and supervisors (CES) and students want to understand how to develop SRI competence. Although past research highlighted SRI dialogue in training, the problem is that no clear understanding exists about the role of faculty supervisor SRI on perceived student competence. The supervision models used to inform the study included the integrated developmental model, discrimination model, and spirituality in supervision model (SACRED). The purpose of this study was to determine if master’s-level graduate counseling students’ perception of their faculty supervisors’ SRI practices predicted students perceived spiritual competence when considering attendance in faith-based and non-faith-based institutions accredited by the Council for Accreditation of Counseling and Related Education Programs (CACREP). A review of existing literature supported the use of a quantitative, cross-sectional design. An online survey was distributed to students (n=59) in master’s level CACREP counseling programs currently in field experience to measure perceived SRI in supervision and perceived SRI competence. A multiple linear regression revealed there was a statistically significant predictive relationship between supervisor SRI and perceived student competence as measured by the Spiritual and Religious Competence Assessment and the Spiritual Issues in Supervision Scale. These results inform CES about the importance of SRI and students’ ability to work with clients’ spiritual and religious beliefs. On this basis, it is recommended that supervisors focus on SRI in supervision. Future research should focus on additional factors related to SRI competence during counselor training.

More than ten million American adults live with a serious mental illness (SMI). Given the deinstitutionalization of psychiatric facilities, caregivers and family members are often needed to care for these individuals. Due to SMI individuals’ extensive needs, caregivers frequently face unique challenges and experiences. Although research has been conducted on caring for individuals with SMI, less information exists about the experiences of rural caregivers of SMI individuals. The purpose of this study was to fill this gap in research by exploring the lived experiences of caregivers of SMI individuals in rural areas with the intention of understanding this population’s unique needs. The research questions focused on the experiences and stressors of caregivers of SMI individuals in a rural community. The frameworks were critical theory and Bowen’s family systems theory. A qualitative phenomenological design study was used employing semi-structured interviews with 4 participants who are caregivers of SMI individuals in a rural New York area. Data from the interviews were coded and analyzed using thematic analysis. Four themes emerged: impact on relationships, thoughts and feelings, impact on caregivers’ well-being, and rural mental health in this area. The potential impact for social change includes the dissemination of information to rural clinicians to assist caregivers with needed support and offer a framework for future curricula.

Diagnosing post-traumatic stress disorder (PTSD) is challenging and is currently, diagnosis through self-administered checklists. Because a diagnosis of PTSD can open up significant benefits to compensation, education, and medical care, people can tailor their responses to the checklist to help ensure a diagnosis of PTSD. The purpose of the study was to examine the utility of the quantitative electroencephalograph for diagnosing PTSD. Frequency and presence of biomarkers and alpha brain wave symmetry in the frontal and parietal lobes were examined. Research questions involved examining the presence of alpha wave imbalance across the frontal lobe and between the right and left parietal lobes. A secondary data analysis was conducted using data from 108 subjects; these data included records from those with and without a PTSD diagnosis. The results of logistic regression showed that 63% of the clients diagnosed with PTSD were correctly identified and between 7% and 8% of the variance in PTSD was accounted for by frontal lobe asymmetry. The parietal lobe imbalance correctly classified PTSD in 59% of the patients and it identified 3.5–4.9% of the variance, suggesting that asymmetry in the frontal and parietal lobes should not be used as the primary method for diagnosing PTSD. Implications for social change include identifying an objective diagnostic tool that can potentially decrease the possibility of inaccurate diagnoses based on self-reported symptoms. This could lead to eliminating some of the shame and embarrassment veterans and first responders feel toward seeking help for PTSD.

Implementation of a Protocol to Improve Quality and Use of Existing Crisis Safety Plan Kaitlynn Earls, Dr. Jo-Ann Marrs, Dr. Judy Rice, Dr. Beth Schreiner. College of Nursing, East Tennessee State University. Crisis safety plans are an important tool for decreasing suicide attempts if a crisis situation arises. Pre-implementation data found that only approximately 20% of clients with schizophrenia/schizoaffective disorder in medication services only had a up to date crisis safety plan in place. The purpose of this quality improvement project is to implement and evaluate a protocol to increase the use of an already established crisis safety plan in the outpatient setting within the electronic medical record. Aim is to increase imitating and updating crisis safety plans for clients with schizophrenia/schizoaffective disorder. Participants include clerical and nursing and providers. Target population are patients diagnosed with schizophrenia/schizoaffective disorder with appointments in medication services clinic. Clerical staff will identify those in the target population who do not have updated safety plan. Those without an updated plan will meet with the LPN and/or nurse practitioner who will document it in the electronic medical record. Outcome goal of 75% or more would be completed by the end of the 12 week implementation period, with approximately 45 of 60 safety plans will be up to date by the end of the implementation period. Preliminary findings include an increase in recognition of absent safety plans, as well as more awareness about the importance of crisis safety plans among staff.

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