Addictions and Rehabilitation Studies

Permanent URI for this collection

http://hdl.handle.net/10342/115

Browse

Now showing 1 - 20 of 39

Open Access
Counselors’ Attitudes Toward Sex Trafficking: A Quantitative, National Analysis
(East Carolina University, 2022-06-03) Pritchard, Kenn S; Toriello, Paul J; Leierer, Stephen J; Atherton, William L; Kane, Melinda D; Addictions and Rehab Studies
For more than 20 years, the pervasive problem of sex trafficking has garnered increasing attention in research, advocacy, and legislation. The cumulative research focuses on the trafficking of women and girls based on the less frequent trafficking of men and boys. Recent research has conceptualized multidimensional attitudes toward the sex trafficking of women and girls. The purpose of this current study is to extend the existing research by comparing counselors’ sex trafficking attitudes for any influence from the gender of the survivor or the gender of the counselor. Two forms of the Sex Trafficking Attitudes Scale (STAS) measured attitudes toward the sex trafficking of females and the sex trafficking of males. Stratified sampling provided the means to compare the STAS scores between male and female counselors. The population of this current study included counseling students enrolled in CACREP accredited graduate programs. Inadequate survey responses did not indicate random sampling of participants. The nonprobability sample included 83 participants. A 2 x 2 factorial MANOVA provided the answers to the research questions. Statistical significance was found where a counselor’s gender influenced the STAS subscales of Leaving, F (1,79) = 150.51, p = .004, ηp2 = .10, and Empathy, F (1,79) = 36.75, p = .039, ηp2 = .05. Influences on Knowledge, Awareness, Paternalism, and Efficacy were non-significant. Influences from a survivor’s gender and a survivor’s gender with dependence on a counselor’s gender were non-significant. Findings support that a counselor’s gender significantly influences their attitudes towards people being able to leave sex trafficking and their empathic reactions to sex trafficking. Findings also demonstrate that counselors’ paternalistic attitudes toward helping survivors were borderline favorable and similar for female and male counselors. These findings have implications for counseling practice, supervision, education, and future research.
Open Access
An Augmented Counseling Approach on Fear of Crime and Self-Efficacy in Older Adults
(East Carolina University, 2022-07-28) Sanders, Meg Perry; Murray, Nicholas P; Toriello, Paul; Leierer, Stephen; Sherman, Susan G; Addictions and Rehab Studies
Fear of crime research notes two strong predictors of fear are fear of crime and perceived risk of victimization. Adults 65 years of age and older report a higher fear of crime than younger age groups. The effects of fear of crime on older adults can be long-lasting and have a notable impact on their mental, emotional, and physical wellbeing (National Center for Victims of Crimes, 2012; Tan and Haining, 2016; Rivara et al., 2019; Serfaty et al., 2016; Serfaty et al., 2021; Sheppard et al., 2021; Victims of Crime, 2019). Fear of crime models denotes a reciprocal nature to fear of crime impacting an individual's thoughts, behaviors, and actions (Rader et al., 2007; Rader, 2010; Rader, 2017). Social Cognitive Theory’s triadic causation model further declares personal factors influencing an individual's behavior, environment, and vice versa (Bandura, 1989). One of the ways to promote positive behavioral change is by raising a person's perceived self-efficacy (Bandura, 1986; Bandura, 1990; Bandura, 2004). Raising an older adult's self-efficacy beliefs on successfully thwarting or dealing with an unsafe situation can be vital to countering fear of crime. Psychoeducation group counseling and self-defense training are common treatment modalities used to raise a person's self-efficacy in addressing fear of crime (Clark, 1998; Helgeson, Lepore, and Eton, 2006; Ozer & Bandura, 1990; Sanders & Murray, 2018). Both treatment approaches are often used separately to manage an individual's fear of crime. The present study compared an augmented group intervention (i.e., psychoeducation group counseling and self-defense training) to a non-augmented (i.e., 4psychoeducation group-only) group intervention on self-efficacy and fear of crime. A total of 34 older adults with a mean age of 68.21 years, primarily female, married or widowed, and retired, participated in the study. Participants were randomly assigned to an augmented or non-augmented group and provided the intervention remotely online, once a week for six weeks. Participants were measured on perceived self-efficacy, fear of crime, and perceived risk of crime pre and post the study. Participants in the augmented intervention were also measured on self-defense proficiency (i.e., pre and post-study). Participants were also asked to complete a weekly check-in survey and a satisfaction and technology questionnaire post the study. An RM ANOVA analysis revealed that the augmented and non-augmented groups increased perceived self-efficacy from engaging in the six study. An RM ANOVA also showed that the augmented group decreased in total fear of crime while the non-augmented group increased in fear. A simple linear regression showed that perceived self-efficacy did not predict total fear of crime. However, a regression analysis revealed self-defense self-efficacy was a predictor of total fear of crime for the augmented group. A paired-samples t-test showed the augmented group’s self-defense proficiency in skill increased over time from engaging in the six-week study. Participants of both groups reported high to moderately-high satisfaction with the study design, remote online approach, and use of technology. Participants also indicated that participation in the study positively impacted their views of safety and self-defense. Future research would benefit from providing a similar study in person, developing instruments specific to measuring older adults’ self-efficacy and fear of crime, and examining messages and message sources on fear of crime.
Open Access
An Augmented Counseling Approach on Fear of Crime and Self-Efficacy in Older Adults
(East Carolina University, 2022-07-28) Sanders, Margaret Perry; Murray, Nicholas P; Addictions and Rehabilitation Studies
Fear of crime research notes two strong predictors of fear are fear of crime and perceived risk of victimization. Adults 65 years of age and older report a higher fear of crime than younger age groups. The effects of fear of crime on older adults can be long-lasting and have a notable impact on their mental, emotional, and physical wellbeing (National Center for Victims of Crimes, 2012; Tan and Haining, 2016; Rivara et al., 2019; Serfaty et al., 2016; Serfaty et al., 2021; Sheppard et al., 2021; Victims of Crime, 2019). Fear of crime models denotes a reciprocal nature to fear of crime impacting an individual's thoughts, behaviors, and actions (Rader et al., 2007; Rader, 2010; Rader, 2017). Social Cognitive Theory's triadic causation model further declares personal factors influencing an individual's behavior, environment, and vice versa (Bandura, 1989). One of the ways to promote positive behavioral change is by raising a person's perceived self-efficacy (Bandura, 1986; Bandura, 1990; Bandura, 2004). Raising an older adult's self-efficacy beliefs on successfully thwarting or dealing with an unsafe situation can be vital to countering fear of crime. Psychoeducation group counseling and self-defense training are common treatment modalities used to raise a person's self-efficacy in addressing fear of crime (Clark, 1998; Helgeson, Lepore, and Eton, 2006; Ozer & Bandura, 1990; Sanders & Murray, 2018). Both treatment approaches are often used separately to manage an individual's fear of crime. The present study compared an augmented group intervention (i.e., psychoeducation group counseling and self-defense training) to a non-augmented (i.e., psychoeducation group-only) group intervention on self-efficacy and fear of crime. A total of 34 older adults with a mean age of 68.21 years, primarily female, married or widowed, and retired, participated in the study. Participants were randomly assigned to an augmented or non-augmented group and provided the intervention remotely online, once a week for six weeks. Participants were measured on perceived self-efficacy, fear of crime, and perceived risk of crime pre and post the study. Participants in the augmented intervention were also measured on self-defense proficiency (i.e., pre and post-study). Participants were also asked to complete a weekly check-in survey and a satisfaction and technology questionnaire post the study. An RM ANOVA analysis revealed that the augmented and non-augmented groups increased perceived self-efficacy from engaging in the six study. An RM ANOVA also showed that the augmented group decreased in total fear of crime while the non-augmented group increased in fear. A simple linear regression showed that perceived self-efficacy did not predict total fear of crime. However, a regression analysis revealed self-defense self-efficacy was a predictor of total fear of crime for the augmented group. A paired-samples t-test showed the augmented group's self-defense proficiency in skill increased over time from engaging in the six-week study. Participants of both groups reported high to moderately-high satisfaction with the study design, remote online approach, and use of technology. Participants also indicated that participation in the study positively impacted their views of safety and self-defense. Future research would benefit from providing a similar study in person, developing instruments specific to measuring older adults' self-efficacy and fear of crime, and examining messages and message sources on fear of crime.
Open Access
Counselors’ Attitudes Toward Sex Trafficking: A Quantitative, National Analysis
(East Carolina University, 2022-06-03) Pritchard, Kenneth S; Toriello, Paul; Leierer, Stephen J; Atherton, William Leigh; Kane, Melinda D; Addictions and Rehabilitation Studies
For more than 20 years, the pervasive problem of sex trafficking has garnered increasing attention in research, advocacy, and legislation. The cumulative research focuses on the trafficking of women and girls based on the less frequent trafficking of men and boys. Recent research has conceptualized multidimensional attitudes toward the sex trafficking of women and girls. The purpose of this current study is to extend the existing research by comparing counselors' sex trafficking attitudes for any influence from the gender of the survivor or the gender of the counselor. Two forms of the Sex Trafficking Attitudes Scale (STAS) measured attitudes toward the sex trafficking of females and the sex trafficking of males. Stratified sampling provided the means to compare the STAS scores between male and female counselors. The population of this current study included counseling students enrolled in CACREP accredited graduate programs. Inadequate survey responses did not indicate random sampling of participants. The nonprobability sample included 83 participants. A 2 x 2 factorial MANOVA provided the answers to the research questions. Statistical significance was found where a counselor's gender influenced the STAS subscales of Leaving, F (1,79) = 150.51, p = .004, [eta]p2 = .10, and Empathy, F (1,79) = 36.75, p = .039, [eta]p2 = .05. Influences on Knowledge, Awareness, Paternalism, and Efficacy were non-significant. Influences from a survivor's gender and a survivor's gender with dependence on a counselor's gender were non-significant. Findings support that a counselor's gender significantly influences their attitudes towards people being able to leave sex trafficking and their empathic reactions to sex trafficking. Findings also demonstrate that counselors' paternalistic attitudes toward helping survivors were borderline favorable and similar for female and male counselors. These findings have implications for counseling practice, supervision, education, and future research.
Open Access
The Effect of Brief Sex Offender Training on the Graduate Counseling Students’ Scores on the Discrete Emotions Questionnaire and Working Alliance Inventory
(East Carolina University, 2022-04-26) Britton, Kendrick; Leierer, Stephen; Addictions and Rehabilitation Studies
Clinicians who treat sex offenders commonly struggle with the tension between conceptualizing them as rehabilitative or instinctively predatory. On the one hand, there is the well-intended goal of forming an alliance with the offender and helping them develop into more functional human beings. On the other, counselors experience common emotional reactions such as anger, disgust, and even fear of sex offenders that negatively impact their perceptions and attitudes. Forensic clinicians are trained to treat sex offenders; however, with the continuing trend of treating more sex offenders in the community rather than in the prison system, some community clinicians will inevitably counsel sex offenders after they are released into the general public. Despite the presence of comorbid and treatable psychiatric symptoms, the disturbing crimes committed by sex offenders can make them morally intolerable to some counselors. In these circumstances, there is little guidance to help clinicians carry out their treatment duties competently and ethically. Participants in this study were graduate counseling students. The graduate counseling students were divided into two groups and asked to examine and evaluate a Tier I sex offense. Next, the participants completed the DEQ, which documents the participant's emotional reaction to the offense. Afterward, they completed the WAI-SRT as a pretest that assessed their confidence in establishing a relationship with the offender. A 45-minute sex offender training intervention (independent variable) was given to one group and no training to the other. After the training, each group examined and evaluated a Tier III sex offense. The DEQ and WAI-SRT post-tests (dependent variables) were given to each group to compare the change over time between the training-treatment and the no training-control groups.
Restricted
The Efficacy of an Evidence-Based Biofeedback Intervention to Reduce Anxiety in College Students
(East Carolina University, 2021-05-03) Saul, Amelia Day; Fish, Matthew T.; Addictions and Rehabilitation Studies
This study employed a randomized control repeated measures design to determine the effectiveness of a 2-week paced breathing intervention in reducing anxiety symptoms. I randomly assigned 35 healthy college students into the paced breathing group (n = 17) and the control group (n = 18). Participants completed the State-Trait Anxiety Inventory (STAI) and baseline heart rate variability (HRV) during Session-1 and Session-2. Participants in the paced breathing group were trained using HRV biofeedback training (HRV-BT) during both sessions and then practiced at home using a free smartphone application. At baseline, both groups had similar State Anxiety (S-Anxiety) scores and HRV, evidenced by the outcome standard deviation of the NN intervals (SDNN; a measure of HRV). Within-group analyses demonstrated a significant reduction in S-Anxiety for the paced breathing group during Session-1 (Time-1 vs. Time-2) and Session-2 (Time-3 vs. Time-4), p = 0.02 and p [less-than] 0.001, respectively; however, the control group did not. Between-group analyses comparing the paced breathing and control group at baseline (Time-1) to Session-2 (Time-3) did not reveal a significant S-Anxiety reduction; similarly, between-group changes for SDNN were not significant. Lastly, a moderated mediation model explored if the changes in S-Anxiety over time were influenced by participants' Trait Anxiety (T-Anxiety) scores at Time-1 for the participants randomly assigned to the paced breathing or control group. However, the results did not support the overall moderated mediation model using the index of moderated mediation. However, I found that participants with higher levels of T-anxiety at baseline had higher S-Anxiety after the 2-week intervention. In conclusion, the HRV-BT and paced breathing at home for 2 weeks participants significantly reduced short-term anxiety, but the long-term effects were not significant. Furthermore, interventions such as HRV-BT or paced breathing may be an effective coping mechanism for college students to reduce short-term anxiety symptoms.
Restricted
A Classification System for Instruments Frequently Found in Textbooks Used in Vocational Rehabilitation Counseling Education
(East Carolina University, 2021-04-15) Schuster, Ralf; Leierer, Stephen; Rowe, Dawn A; O'Brien, Kevin F; Sligar, Steve R; Addictions and Rehabilitation Studies
The dissertation describes the rationale and development of a classification system for instruments frequently found in textbooks used in vocational rehabilitation counseling education. Such a classification system does not yet exist but could provide benefits for vocational rehabilitation counseling educators. A system could enable consistent nomenclature for instruments and measurement domains, influence the use of assessment in vocational rehabilitation, enhance assessment practices, and stimulate research on instruments and clinical practice that uses instruments or draws from their results. A classification could also impact decisions on which instruments are selected and how they are used in education, thereby leading to potential changes in service outcomes. Sligar and Schuster (2020) coded instruments and their variables from seven graduate textbooks used in vocational rehabilitation counseling education. The limitations encountered and the data produced in this study formed the two main foundations for the present study. A qualitative meta-synthesis was conducted to synthesize and interpret this data. The k-means cluster analysis in Desktop Tableau yielded a non-hierarchical numerical cluster solution. In other words, a non-hierarchical cluster model fitted the data; a hierarchical model did not fit. The taxonomy that was constructed organized 84 instruments and 73 characteristics, and named 63 homogeneous instrument groups each representing one measurement domain. The taxonomy provides a resource for educators for identifying the instruments and domains used in rehabilitation counseling education, and as such, guiding them as to what instruments could be included in their teaching of courses. Future research could validate the instrument groups in the taxonomy and analyze all instruments covered in textbooks used in vocational rehabilitation counseling education.
Open Access
TRANSGENDER/GENDER NONBINARY STUDENTS WITH DISABILITIES: BEST PRACTICES FOR DISABILITY SUPPORT SERVICES PROVIDERS IN POSTSECONDARY EDUCATION
(East Carolina University, 2021-05-03) Cea, Dana M; Leierer, Stephen; Addictions and Rehabilitation Studies
There are approximately 26,600 students of public higher education in the United States of America who identify as transgender/gender nonbinary and have at least one disability. Research has focused on these two marginalized identities (i.e., gender identity, disability status) separately for college students, and there is sparse research regarding the experiences of students for whom these two identities intersect. This study addressed the gap in research by exploring which best practices used by disability support services (DSS) providers and administrators led to student academic success and elicited feedback on the best practices from these students. A survey of questions was created based upon previous research regarding the academic success of college students with disabilities and proposed best practices for supporting this group of students. Survey responses were received from recent students (n = 89) of public higher education who identified as transgender/gender nonbinary and had at least one disability. The results indicate that the majority of participants contacted disability support services at their public university or college. A relationship between contacting DSS providers and administrators and academic success was not found to be statistically significant. Additionally, the relationship between receiving accommodations from DSS providers and administrators and academic success was not found to be statistically significant. Further results demonstrated a significant association only between academic success and three practices: (1) DSS providers and administrators offering to connect students with career counseling or other vocational supports, (2) DSS providers and administrators ensuring participants' inclusion in campus activities and groups, and (3) DSS providers and administrators ensuring that school facilities are accessible for students. Finally, the best practice endorsed by the most participants was hiring staff who openly identify as having a disability. Qualitative responses from students indicated a need for responsiveness, advocacy, and accessibility from DSS providers and administrators. Limitations of this study include new instrumentation with a need for more validity and reliability information; a relatively small sample size with no demographic information gathered; and the effects of current events. Implications for DSS providers and administrators, counselor educators, and future research conclude the study.
Open Access
USING THE SOCIAL ECOLOGICAL MODEL AS A FRAMEWORK TO UNDERSTAND PSYCHOSOCIAL ENVIRONMENTAL VARIABLES THAT MEDIATE OR MODERATE NICOTINE ADDICTION
(East Carolina University, 2021-05-03) Scroggs, Lauren Bethune; Toriello, Paul; Addictions and Rehabilitation Studies
Despite increased awareness of the harms of cigarette smoking as well as improved prevention efforts, tobacco and smoking-related morbidity and mortality continue to be a leading cause of death and disability in the United States. This study used the Social Ecological Model (SEM) as a framework to explore four levels of influence on smoking behaviors. The SEM allows for an understanding of the complex and interactive effects of individual, relationship, community, and societal levels of influence that may contribute to behaviors like cigarette smoking. Understanding these effects may help clinicians, researchers, and educators to identify behavioral and community leverage points for health promotions within society. This study used archival data to explore the influence of several psychosocial environmental variables on cigarette smoking behaviors and uncover potentially causal (i.e., mediation) and relational (i.e., moderation) pathways present in the data. In the current study, negative binomial regression was utilized to explore whether specific psychosocial environmental variables at the different levels of influence outlined in the SEM act as mediators or moderators between participants' level of addiction to nicotine and their smoking cessation efforts in the last 12 months. Results indicated that mental health disorder status was a significant mediator and employment status, age at smoking initiation, history of a substance use disorder, and whether participants worked in a smoke-free environment each acted as moderators for the relationship between participants' level of addiction to nicotine and their number of quit attempts in the last year. These results have implications for understanding smoking behaviors and treating nicotine addiction. This analysis may be used to guide counselor education, smoking cessation interventions, and public policy as it relates to cigarette smoking and addiction.
Open Access
Examining the Effects of Casual Video Gameplay as an Intervention to Alleviate Symptoms of Depression on both Subjective and Objective Measures
(East Carolina University, 2020-12-02) Brown-Bochicchio, Christina M.; Toriello, Paul; Addictions and Rehabilitation Studies
Depression can be a debilitating illness that affects more than 300 million people worldwide. Although there are successful treatments for depression with pharmaceuticals and behavioral approaches such as psychotherapy, these approaches are often very costly and may carry a stigma of treatment for some individuals. The purpose of this dissertation study was to compare results of previously collected data that examine whether a prescribed regimen of casual videogame play (CVG) could reduce symptoms associated with depression. This dissertation specifically focused on comparing results of a study group and a comparison group on the self-report instrument, the Patient Health Questionnaire-9 (PHQ-9) as well as objectively measured changes in alpha wave, Electroencephalogram (EEG) data. Participants in the original study were screened for depression using the PHQ-9. There were a total of 57 participants who met the study inclusion criteria. Each participant that met the inclusion criteria was then randomized into either the comparison group (n=29) or the study group (n=28). Experimental group participants were prescribed to play one of three CVGs three times per week (with 24 hours between each session). This process occurred for 30 minutes each session, over a 1-month period. Comparison group participants reviewed the National Institute of Mental Health's webpage on depression during a pre-test and a post-test session. The participants in this group did not engage in any intervention over the one-month period of time between the pre-test and post-test sessions. A repeated-measures analysis of covariance (ANCOVA) was completed to examine three research questions between subjects at Time 1 and Time 3 to compare changes in depression symptoms on both subjective, self-report (PHQ-9) and objective alpha wave EEG measures. The CVGs used as the intervention factor were either Peggle, Bejeweled or Bookworm Adventure. Study analysis revealed significant decreases in depression symptoms reported in the study group on the PHQ-9 self-report scale. Results along the objective, EEG alpha wave scale revealed non-statistically significant changes. Potential reasons for the non-significant findings along with recommendations for future research are also discussed. Conclusions from this study found that a prescribed regimen of CVG may have potential as an intervention to help reduce symptoms of depression as measured on the PHQ-9 scale. Further research should consider examining intricacies of CVG play as a potential intervention to address symptoms related to depression. Findings also revealed that while EEG findings were not statistically significant, participants self-report responses were significant and may underscore the importance of individual's subjective feelings in the therapeutic process.
Open Access
Crisis in the Family: Counselor Anxiety and Self-Efficacy in Responding to Family Crises
(East Carolina University) DodgeEvans, J. Hillary; Toriello, Paul
Counselors are reporting their job duties include crisis response at a frequency of at least weekly. However, counselors have previously reported a lack of curriculum exposure to crisis response training. Unfortunately, there is a growing need for counselors to intervene with crises at the family level due to increases of children entering foster care and higher rates of mass causality events. This study will seek to assess counselor's anxiety and self-efficacy across licensure levels when responding to a family in crisis. Assessment of the counselor's anxiety and self-efficacy will be measured with the State-Anxiety Inventory (STAI) and the Counselor Self- Estimate Inventory (COSE). This study used nonprobability sampling to recruit 30 participants. The research questions were answered with three repeated-measures MANOVAs, and six univariate analyses. No statistical significance was found with respect to the COSE. Additionally, no significance was noted with respect to curriculum exposure and changes on the COSE or STAI. Statistical significance was found on the STAI in a three-way interaction [F (2, 26) = 7.31, p = .012, np 2 = .22] between licensure, years of experience, and changes over-time on the STAI.
Open Access
Exploring the Challenges of Elite African American Male Athletes at Predominately White Universities: Three Descriptive Case Studies
(East Carolina University, 2019-12-09) Outlaw, Kimberly R; Jackson, Mary S; Addictions and Rehabilitation Studies
In American society, sports participation is viewed through many lenses. With both college and professional teams, sports are popular entertainment that rivets millions of people and is discussed passionately. It is a major revenue-producing enterprise for universities, professional sports teams, and the communities that benefit in many ways from sports attendance. For many elite African American male student athletes growing up in low-income urban areas and without many job possibilities at home, sports provide a potential means to climb out of their current economic circumstances, support their families, and possibly earn millions of dollars and fame. For elite collegiate athletes particularly, sports bring scholarships and a pathway to college as well as a better career. The possibility of attending college would not be open to many of these students from poor urban areas without sports scholarships. This study seeks to gain insight into the challenges experienced by elite African American male athletes attending predominately White universities.
Open Access
Examining the Influence of Internalizing and Externalizing Maladjustment on Holland-based Vocational Interest Score Differentiation and Profile Elevation Among African American Mothers Receiving Welfare
(East Carolina University, 2019-07-22) McClanahan, Matthew L.; Leierer, Stephen; Addictions and Rehabilitation Studies
According to John L. Holland's (1985, 1997) theory of vocational interest types and work environments, counselors can learn whether a client is experiencing psychological maladjustment by attending to secondary constructs in vocational interest assessment. More specifically, Holland posited that low differentiation (i.e., degree of interest scale score variation) and low profile elevation (i.e., total number of endorsed items, or like responses, across all interest scales combined) are indicative of psychological maladjustment that warrants more intensive treatment or assessment. Counselors, too, are known to infer psychological maladjustment from low interest score differentiation and profile elevation (Gottfredson & Jones, 1993). However, findings are equivocal. Consequently, these interest assessment constructs are without a validated interpretation with respect to psychological maladjustment. This lack of an empirically substantiated interpretation for differentiation and profile elevation is potentially a product of methodological flaws or gaps in research that the current study aimed to address. The purpose of the current study was to examine the influence of the two primary disorder dimensions of psychological maladjustment (i.e., internalizing, externalizing) on vocational interest score differentiation and profile elevation among African American mothers receiving welfare. Towards this end, a quantitative, ex post facto research design was employed to analyze archival data on the vocational evaluation (VE) results of adult welfare recipients in North Carolina. More specifically, the sample consisted of African American mothers receiving welfare who were referred to the Navigate Counseling Clinic between 2012 and 2017. This population was targeted, in large part, because these mothers have been without the benefit of research that examines their vocational complexities through the prism of a career theory. Furthermore, psychological maladjustment is identified as being among the more prevalent barriers to employment that African American mothers receiving welfare experience (Danziger et al., 2000). Thus, findings from the current study served to enhance the interpretability of Holland's theoretical constructs, but also served to improve counseling-based services for a client group in need of proper career and mental health assistance. In this study, six research questions were developed for examining main and interaction effects of internalizing and externalizing maladjustment on interest score differentiation and profile elevation among the sample (N = 122). Research questions were addressed with a series of 2 X 2 analyses of variance (ANOVA) in which internalizing maladjustment and externalizing maladjustment were the independent grouping variables. These variables each had two levels for indicating the presence or absence of a probable disorder within the corresponding maladjustment dimension as measured by the Global Appraisal of Individual Needs- Short Screener (GAIN-SS; Dennis, Feeney, & Titus, 2013). In contrast, the continuous dependent variables were vocational interest score differentiation and profile elevation as measured using the O*NET Computerized Interest Profiler (CIP; Rounds et al., 1999). Consistent with standards in social science research, statistical significance was established with an alpha level of .05 (Heppner et al., 2008), and assumptions of the 2 X 2 ANOVA were tested. Results from addressing research questions indicated a statistically significant finding in a post hoc analysis wherein internalizing maladjustment had a direct main effect on vocational interest score differentiation. Exclusively non-significant findings were observed for the remaining research questions. In addition to addressing research questions, the study included an examination of O*NET CIP scale scores and primary RIASEC types. Furthermore, psychometric properties were investigated among the sample. All results from this study are discussed, including limitations, implications, and recommendations for future research.
Open Access
The Psychosocial Implications of Being Lesbian, Gay, and Bisexual Military Personnel in a Post Don't Ask, Don't Tell Era
(East Carolina University, 2018-04-24) Robinson-Thomas, Jeffrey Franklin; Toriello, Paul; Addictions and Rehabilitation Studies
Scholarly research on sexual minority military personnel was silenced until the United States (U.S.) Congress passed the Don't Ask, Don't Tell (DADT) Repeal Act of 2010. Not only did the repeal liberate lesbian, gay, and bisexual (LGB) military personnel from serving in silence, but also impelled military researchers to conduct studies pertaining to this population. However, research on LGB military personnel remains scant for counselors and other healthcare providers. Military personnel in the U.S. are experiencing unprecedented levels of alcohol and other substance use disorders, mental health disorders, and suicide. Speculating that LGB military personnel are at a greater risk for these psychosocial issues was reasonable, as research has indicated an increased risk of psychosocial factors for LGB civilians. This descriptive phenomenological study discovered new knowledge of LGB military personnel and veterans who were serving or had served post-DADT from all branches of the U.S. Military. This study employed Minority Stress theory and its model as a framework to explain psychosocial implications of having a minority sexual identity for LGB military personnel. The study's results are addressed, which include participants' sexual identity development and expression, military culture experienced by LGB military personnel, participants' lived experiences after the repeal of DADT, and the psychosocial implications associated with having a minority sexual identity.
Open Access
Biopsychosocial Barriers, Motivational Interviewing, and Antiretroviral Medication Adherence in Persons Living with HIV and AIDS
(East Carolina University, 2018-04-23) Hinton, Qu'Nesha S; Sias, Shari; Addictions and Rehabilitation Studies
Since the development of antiretroviral medications in the mid-1990s, treatment of human immunodeficiency virus (HIV) infection has improved steadily and HIV is now considered a manageable chronic condition with improved quality of life for those who are medically adherent. However, medication regimens typically require near perfect adherence to be effective and people living with HIV/AIDS (PLWHA) may experience a unique set of biopsychosocial barriers that limit or inhibit their ability to be medically adherent. The purpose of this study was to examine the influence of biopsychosocial factors and motivational interviewing on antiretroviral medication adherence in people living with HIV/AIDS (PLWHA). Specifically, this study explored how biopsychosocial barriers (i.e., physical health, mental health, substance use, housing, transportation, and employment concerns) and motivational interviewing predict antiretroviral medication adherence in PLWHA as measured by patients' CD4 count and HIV viral load. This study utilized archival data that was collected between July 2013 and July 2016 at the Brody School of Medicine HIV Clinic and captured patients' biopsychosocial barriers, CD4 count and HIV viral load. A stratified sample of 210 patients was drawn from the archival data for this study. Multiple logistic regression analysis showed that patients' CD4 count cut scores at intake made a significant contribution to the prediction of medication adherence as measured by PLWHA CD4 count cut scores at week 21, when controlling for patients' CD4 count cut scores at intake. Comparatively, results showed a statistical significance for the barrier substance use when examining antiretroviral medication adherence in PLWHA as measured by patients' HIV viral load cut scores at week 21. Further, a non-significant association between patients' CD4 cut scores at week 21 and patients' HIV viral load cut scores at week 21 in predicting antiretroviral medication adherence was found. The results of this study suggest that patients' starting CD4 count and substance use are important components that warrant further research for PLWHA. Further, this study has implications for healthcare professionals, counselors, and counselor educators related to substance use concerns for this specific population. Future research exploring substance use treatment and ARV medication adherence in PLWHA is suggested.
Open Access
The Effects of an Equine Assisted Learning Supervision Intervention on Counselors’-in-Training Performance Anxiety, Counseling Self-Efficacy, and Supervisory Working Alliance
(East Carolina University, 2017-12-12) Meola, Cheryl C; Sias, Shari; Addictions and Rehabilitation Studies
Due to the complexity of the counseling process, counselors-in-training often experience performance anxiety when entering the counseling profession. Research shows that higher counseling self-efficacy (the belief in oneself to perform counseling skills successfully) helps decrease performance anxiety. Further, a strong supervisory working alliance is the most effective intervention to increase counseling-self-efficacy. However, there are barriers to building a strong supervisory working alliance including high performance anxiety and low counseling self-efficacy as well as the dual nature of the supervisor's role as mentor and evaluator. This study introduces an equine assisted learning supervision intervention for counselors-in-training. This experiential learning intervention provides an opportunity for counselor self-exploration and growth in a non-evaluative, nonjudgmental, novel situation. The population of interest was counselors-in-training enrolled in CACREP counseling programs. The purposive sample included 20 students enrolled in a theories counseling course or a practicum skills course. The study used a quasi-experimental design where participants completed a Demographic Questionnaire, the Counseling Self-Estimate Inventory, the State-Trait Anxiety Inventory, and the Supervisory Working Alliance-Trainee Form. Participants were randomly selected to be in a treatment group, which received a one hour individual equine assisted learning supervision intervention or in the control group, which received class as usual. Six research questions examined the main effect of the EAL-S intervention on counseling self-efficacy, the main effect of the EAL-S intervention on performance anxiety, the relationship between counseling self-efficacy and performance anxiety, the correlation of the quality of supervisory working alliance with counseling self-efficacy, the correlation of the quality of the supervisory working alliance with performance anxiety, and the correlation of the supervisory working alliance with the effectiveness of the EAL-S intervention. A split-plot MANOVA was performed to analyze the first two questions and revealed a significant main effect of the EAL-S intervention on counseling self-efficacy. Non-significance was found in the main effect of the EAL-S intervention on performance anxiety. Pearson Product Moment Correlations were performed for the remaining questions. A significant positive correlation was found between counseling self-efficacy and performance anxiety. No significance was found in the correlation of the quality of the supervisory working alliance with counseling self-efficacy, performance anxiety, or the effectiveness of the EAL-S intervention. Findings support that a one hour EAL-S intervention can improve counselors'-in-training counseling self-efficacy and improve their tolerance for performance anxiety. These results have implications for counselors-in-training, supervisors, and counselor educators.
Open Access
Training Effects on Recovering Parents' Self-Efficacy to Identify Problems, Solutions and Resources to Prevent Internet Addiction in Youth
(East Carolina University, 2017-12-06) Schatz, Mary Therese; Leierer, Stephen; Addictions and Rehabilitation Studies
This study examined the effects of a 2-hour training on the self-efficacy of parents in recovery from substance use disorder to intercede in their children's Internet technology use in order to prevent future problems with Internet addiction (IA). Using a quasi-experimental pre-post-test/post-test design, 32 parents between the ages of 19-48 in a recovery center were assigned to receive the parent training or to participate in control-comparison group. Prior to the study, a Parental Self-Assessment Inventory (PSAI) was developed and field tested as a measure of Parental Self-Efficacy (PSE) to identify problems, solutions and resources supported in research to increase resiliency of children and adolescents to manage appropriately their technology use. During the study, The PSAI demonstrated internal consistency and was shown to be an effective measure of PSE to intervene effectively in youth Internet technology use. A doubly univariate analysis was conducted to determine whether there were significant PSAI outcomes between study participants. Significant multivariate effects were not found for main effect of group. However, significant multivariate effect with a large effect size was found for the main effect of time. Moreover, a statistically significant and large effect size was also found for the multivariate the training by group interaction. The parent training produced a significant positive effect on PSE of the study participants who attended the 2-hour training. Researchers, counselor educators, and clinicians could all benefit from considering these findings when addressing parenting issues for individuals in recovery.
Open Access
Alcohol Exposure While Serving in the United States Military
(East Carolina University, 2017-12-07) Agius, Marie; Sias, Shari; Addictions and Rehabilitation Studies
Over the past 30 years, alcohol use, misuse, and alcohol related problems have increased among military personnel. Researchers have tracked the rates of alcohol misuse and alcohol related problems among military personnel, but few have sought to understand alcohol exposure in the military. To fill this gap, the current study sought to understand the experience of alcohol exposure for active duty military personnel through a qualitative phenomenological design. Semi-structured interviews with participants were used to collect data. The grand tour question that guided this study was: How do active duty enlisted military personnel experience exposure to alcohol? Related sub-questions that directed the study included: 1. In what ways are active duty, enlisted military personnel exposed to alcohol during their enlistment period(s)? 2. How do active duty, enlisted military personnel describe their experiences with alcohol exposure? 3. In what ways, if any, does the military intrinsic and extrinsic cultures contribute to the use, misuse, and/or abuse of alcohol among active duty, enlisted military? Participant responses revealed three major themes that reflected their lived experiences of alcohol exposure during their military careers. These themes were drinking behaviors, military culture, and potential outcomes. Implications for counselor education, counseling service providers, military personnel, and future research are discussed.
Restricted
The Effects of Bullying Type and Special Education Status on the Evaluation and Referral of Students to Mental Health Counseling
(East Carolina University, 2017-04-28) Cain, Kristin M.; Leierer, Stephen; Campbell, Robert James; Goodwin, Lloyd R. Jr.; Chapin, Martha H.; Addictions and Rehabilitation Studies
The increased prevalence of school bullying over the last decade has gained the attention of the public as well as educational researchers. Many are concerned about the serious mental health consequences of bully victimization, such as depression, anxiety, and suicidal behaviors. Although students in special education are significantly more likely to experience bullying than non-special education students, little research has addressed the evaluation and decision-making process of school counselors, who are often charged with responding to bullying incidents in schools. In this study, 31 middle and high school counselors read vignettes of bullying incidents in which the bullying type and special education status of the students varied and then responded to questions on a modified Bully Attitudes Questionnaire. The results indicated that the bullying type significantly influenced the counselors' evaluation and decision-making process, but the special education status of the student did not. In addition, a significant interaction was found between bullying type (verbal) and education status (victim specified as a person who receives special education) when taking into account the seriousness of the bullying. The findings point to the need for more counselor training in recognizing and responding to relational bullying, in particular, and for more efforts to decrease mental health consequences for victims. This additional expertise may help school counselors build relationships with other stakeholders in the community, thus increasing the likelihood of referral of bullying victims to mental health counseling.
Open Access
Mental Health Professionals' Attitudes toward Clients with Antisocial Personality Disorder
(East Carolina University, 2017-04-19) Dunbar, Edward T., Jr.; Sias, Shari; Addictions and Rehabilitation Studies
Clients with personality disorder are treated throughout the United States' healthcare system. Research suggests that mental health professionals' attitudes' toward clients with personality disorders are poor. However, research specific to clients with antisocial personality disorder was lacking. The current study examined the influence of social learning factors (i.e., level of clinical contact and history of criminal victimization) on mental health professionals' attitudes toward clients with antisocial personality disorder. The population of study was Medicaid-approved providers. The purposive sample included 98 Medicaid-approved mental health providers in North Carolina. The study used an online survey design, and participants completed an author-developed Demographic Questionnaire and the Adapted-Attitudes toward Personality Disorders Questionnaire. Three research questions examined the main effects of level of clinical contact, history of criminal victimization, and interaction effects on mental health professionals' attitudes toward clients with antisocial personality disorder. A factorial MANOVA and follow-up univariate ANOVAs revealed a statistically significant main effect for level of clinical contact with clients with antisocial personality disorder on participants' attitudes scores as measured by the Adapted- Attitudes toward Personality Disorders Questionnaire. No main effect for history of criminal victimization nor interaction effect was detected. Findings support that the social learning factor of level of clinical contact significantly influences mental health professionals' attitudes toward clients with antisocial personality disorder. Findings hold implications for mental health professionals, mental health supervisors, mental health educators, and mental health researchers.