Matching Items (16)
Description
This study examined the role of substance use in the relationship between the working alliance and outcome symptomatology. In this study, two groups of participants were formed: the at risk for substance abuse (ARSA) group consisted of participants who indicated 'almost always,' 'frequently,' 'sometimes,' or 'rarely' on either of two items on the Outcome Questionnaire-45.2 (OQ-45.2) (i.e., the eye-opener item: "After heavy drinking, I need a drink the next morning to get going" and the annoyed item: "I feel annoyed by people who criticize my drinking (or drug use)"). The non-ARSA group consisted of participants who indicated 'never' on both of the eye-opener and annoyed screening items on the OQ-45.2. Data available from a counselor-training center for a client participant sample (n = 68) was used. As part of the usual counselor training center procedures, clients completed questionnaires after their weekly counseling session. The measures included the Working Alliance Inventory and the OQ-45.2. Results revealed no significant differences between the ARSA and non-ARSA groups in working alliance, total outcome symptomology, or in any of the three subscales of symptomatology. Working alliance was not found to be significant in predicting outcome symptomatology in this sample and no moderation effect of substance use on the relationship between working alliance and outcome symptomatology was found. This study was a start into the exploration of the role of substance use in the relationship between working alliance and outcome symptomatology in individual psychotherapy. Further research should be conducted to better understand substance use populations in individual psychotherapy.
ContributorsHachiya, Laura Y (Author) / Bernstein, Bianca (Thesis advisor) / Tran, Giac-Thao (Committee member) / Homer, Judith (Committee member) / Arizona State University (Publisher)
Created2013
Description
ABSTRACT Caregiving studies generally do not focus on the post-caregiving phase of care, or African Americans post-caregivers (AAPCGs). This mixed-methods study guided by the Transitions Theory, explored the experiences of 40 AAPCGs residing in Los Angeles, California and Phoenix, Arizona, whose loved ones died within the last 10 years. Data collection tools included individual interviews, demographic questionnaire, CES-D, Brief Cope, and Social Support. Findings present the specific aims of the study. Aim 1 dealt with the types, patterns and properties of post-caregiving transitions (PCT). Many AAPCGs experienced multiple, simultaneous transitions that continued to impact their lives many years after caregiving ends. Aim 2 dealt with factors that facilitate or inhibit healthy PCT. Facilitators include: Being satisfied with care provided; fulfilling death-bed promises; living out the legacy of the deceased; deep spiritual beliefs in God and support of family, friends and church. Inhibitors include: Experiencing a deep sense of loss, confusion, depression, loneliness, and guilt; physical challenges such as fatigue and exhaustion, breathing problems, dizziness, fainting, cognitive difficulties, pain, headaches, hypertension and insomnia; family conflicts, job or home loss that linger long after PCT. Aim 3 involves process indicators including: connectedness with family, friends, co-workers, church and God; returning to work or school. Coping strategies that helped AAPCGs include: productive ventures, family mementoes, reminiscing, new baby, or visiting cemetery. Appropriate coping led to outcome indicators of mastery such as new environment; making decisions; taking actions; readying oneself for another caregiving role; preparing for one's own life and death; or caring for self. Fluid integrative identities include: Sense of balance, peacefulness and joy, fulfillment, compassion; remembering without pain; or new identity. Implications for practice, policy, education and research include: Care providers and policy makers must ensure that AA caregivers receive adequate EOL and hospice information and support for adequate preparation of loved one's death. Geriatric educators must design and implement curricular programming that includes the post-caregiving phase as a very important phase of caregiving. Researchers should design culturally-congruent assessment tools or improve the checklist developed in this study to appropriately measure PCT; and also develop culturally-relevant interventions to facilitate healthy PCT.
ContributorsUme, Ebere Peace (Author) / Evans, Bronwynne C. (Thesis advisor) / Coon, David W. (Thesis advisor) / Keller, Colleen S (Committee member) / Arizona State University (Publisher)
Created2013
Description
The treatment of individuals with multiple chronic conditions represents the single largest driver of Medicare costs. The use of prescription drugs is a major component in the treatment/management of chronic disease in the United States. Medication nonadherence, however, is a common problem among older adults and leads to significant morbidity and mortality. Whereas, the problem of medication nonadherence has been a primary focus of research for the last thirty years, much is still unknown about which older adults are most at risk for medication nonadherence, as well as what are effective theory-based interventions to improve a person's medication self-management.
The purpose of this descriptive explanatory study was to better understand the self-management behavior, medication adherence, in a sample of frail urban older adults. The study used a combination of quantitative and qualitative methods to analyze data from a larger twelve-month study of a nurse care coordination intervention. Ryan and Sawin's (2009) Individual and Family Self-Management Theory served as the study's conceptual framework for identifying the context and processes involved in the older adults' medication self-management. Quantitative results found several individual- as well as family-level predictors for medication nonadherence. Qualitative analyses identified three overarching themes to describe the participants' struggles along the multistep process of medication adherence. Additionally, a cultural domain described the need for more information from participants to understand their nonadherence. Integration of the results further increased our understanding of medication-self management in these frail older adults, and offers direction for clinical practice and future research.
The purpose of this descriptive explanatory study was to better understand the self-management behavior, medication adherence, in a sample of frail urban older adults. The study used a combination of quantitative and qualitative methods to analyze data from a larger twelve-month study of a nurse care coordination intervention. Ryan and Sawin's (2009) Individual and Family Self-Management Theory served as the study's conceptual framework for identifying the context and processes involved in the older adults' medication self-management. Quantitative results found several individual- as well as family-level predictors for medication nonadherence. Qualitative analyses identified three overarching themes to describe the participants' struggles along the multistep process of medication adherence. Additionally, a cultural domain described the need for more information from participants to understand their nonadherence. Integration of the results further increased our understanding of medication-self management in these frail older adults, and offers direction for clinical practice and future research.
ContributorsO'Brien, Anne Marie (Author) / Marek, Karen D. (Thesis advisor) / Coon, David W. (Committee member) / Evans, Bronwynne C. (Committee member) / Arizona State University (Publisher)
Created2014
Description
The purpose of this study is to identify the needs of older adults with Alzheimer's disease (AD) and related dementias (ADRD) admitted to a rehabilitation setting where they are expected to physically and mentally function to their optimal level of health. To date, no studies have identified the needs and concerns of ADRD patients in rehabilitation settings. The Needs-Driven Dementia-Compromised Behavior (NDB) Model, the researcher's clinical experience, and the state of the current scientific literature will help guide the study. An exploratory qualitative research approach was employed to gather data and discover new information about the ADRD patient's needs and related behavioral outcomes. The qualitative findings on the discrepancies and similarities in perceptions of ADRD patient needs were obtained by examining formal and informal caregivers' perceptions. The researcher recruited registered nurses and certified nurse assistants (RNs and CNAs, formal) and family/friends (informal) who have provided care to patients in inpatient rehabilitation facilities to participate in focus groups and individualized focused interviews. The data were collated and analyzed using a thematic analysis approach. The overarching theme that developed as a result of this approach revealed discordant perceptions and expectations of ADRD patients' needs between the formal and informal caregivers with six subthemes: communication and information, family involvement, rehabilitation nurse philosophy, nursing care, belonging, and patient outcomes. The researcher provided recommendations to help support these needs. These findings will help guide the development of nurse-lead interventions for ADRD patients in a rehabilitation setting.
ContributorsAllen, Angela Marie (Author) / Coon, David W. (Thesis advisor) / McCarthy, Marianne (Committee member) / Uriri-Glover, Johannah (Committee member) / Arizona State University (Publisher)
Created2014
Description
Never married parents (NMPs) are a burgeoning population within the Family Court system. However, there is no empirical research on these parents' separation process, though the neighboring literature purports that NMPs are more at risk for negative child wellbeing outcomes than their divorcing counterparts. This study investigated child behavior problems in high conflict litigating never married families by assessing four salient issues collectively termed chaotic environment: economic strain, lack of social support for the parents, parental repartnering, and family relocation, which included parent changing residence and child changing schools. They were then compared to divorcing parents. It was hypothesized that NMPs would experience higher levels of chaotic environment, and subsequent increases in child behavior problems than divorcing parents, but that the relationship for NMPs and divorcing parents would be the same with each of the chaotic environment variables. This study found the contrary. NMPs only had significantly higher mean scores on lack of social support for fathers and marital status did not predict child behavior problems. Both economic strain and child changing schools predicted child behavior problems for both mothers and fathers. Two interaction effects with mothers were found, indicating that the more a never married mothers repartnered and/or changed her residence, the more behavior problems her child had, while divorcing mothers experiencing the converse effect.
ContributorsHita, Liza Cohen (Author) / Braver, Sanford (Thesis advisor) / Sandler, Irwin (Thesis advisor) / Bernstein, Bianca (Committee member) / Homer, Judith (Committee member) / Arizona State University (Publisher)
Created2011
Description
This study presents a structural model of coping with dating violence. The model integrates abuse frequency and solution attribution to determine a college woman's choice of coping strategy. Three hundred, twenty-four undergraduate women reported being targets of some physical abuse from a boyfriend and responded to questions regarding the abuse, their gender role beliefs, their solution attribution and the coping behaviors they executed. Though gender role beliefs and abuse severity were not significant predictors, solution attribution mediated between frequency of the abuse and coping. Abuse frequency had a positive effect on external solution attribution and external solution attribution had a positive effect on the level of use of active coping, utilization of social support, denial and acceptance.
ContributorsBapat, Mona (Author) / Tracey, Terence J.G. (Thesis advisor) / Bernstein, Bianca (Committee member) / Green, Samuel (Committee member) / Arizona State University (Publisher)
Created2011
Description
While the literature on caregivers of loved ones with Alzheimer's Disease and Related Disorders (ADRD) has continued to grow, the relationship of ethnicity and acculturation factors with regards to the coping strategies used by caregivers has not been extensively explored. The current study included participants from the Palo Alto site of the Resources for Enhancing Alzheimer's Caregiver Health (REACH) project. The study examined differences in coping strategies between 140 non-Hispanic White, 45 less acculturated Latina, and 61 more acculturated Latina caregivers. Univariate and Multivariate Analysis of Variance, as well as post hoc analyses, were conducted to determine the differences among the three groups. Results indicated less acculturated Latina caregivers employ more avoidant coping strategies compared to non-Hispanic White caregivers. However, no differences were found among the other groups in their use of avoidance coping. Moreover, there were no differences found in the use of social support seeking, count your blessings, problem focused, and blaming others coping among the three groups. These findings have important implications for the design of culturally relevant psychoeducational and therapeutic interventions aimed towards meeting the individual needs of these three populations. In addition, the findings expand on the understanding of maladaptive coping strategies that may be potentially exacerbating caregiver distress among Latina caregivers.
ContributorsFelix, Vitae (Author) / Arciniega, Guillermo M (Thesis advisor) / Robinson-Kurpius, Sharon (Committee member) / Coon, David W. (Committee member) / Arizona State University (Publisher)
Created2011
Description
The purpose of this study was to examine the association between characteristics of the symptomatology change curve (i.e., initial symptomatology, rate of change, curvature) and final treatment outcome. The sample consisted of community clients (N = 492) seen by 204 student therapists at a training clinic. A multilevel approach to account for therapist effects was followed. Linear, quadratic, and cubic trajectories of anxiety and depression symptomatology, as assessed by the Shorter Psychotherapy and Counseling Evaluation (sPaCE; Halstead, Leach, & Rust, 2007), were estimated. The multilevel quadratic trajectory best fit the data and depicted a descending curve (partial “U”-shaped). The quadratic growth parameters (intercept, slope, quadratic) were then used as predictors of both symptom change and reliable improvement in general symptomatology (pre- to post-treatment), as assessed by the Outcome Questionnaire-45.2 (OQ-45.2; Lambert, Hansen, Umpress, Lunen, Okiishi et al., 1996). The quadratic growth parameters of depression and anxiety showed predictive power for both symptom change and reliable improvement in general symptomatology. Patterns for two different successful outcomes (1-change in general symptomatology and 2-reliable improvement) were identified. For symptom change, successful outcomes followed a pattern of low initial levels of depression and anxiety, high initial rates of change (slope), and high (flattening after initial drop) curvature, and the pattern applied to both within- and between-therapist levels. For reliable improvement at within-therapist level, successful outcomes followed a pattern of high initial rate of change (slope) and high curvature. For reliable improvement at between-therapist level, successful outcomes were associated with a pattern of low initial levels of depression and anxiety. Implications for clinical practice are discussed.
ContributorsJimenez Arista, Laura E (Author) / Tracey, Terence (Thesis advisor) / Kinnier, Richard (Committee member) / Bernstein, Bianca (Committee member) / Randall, Ashley K. (Committee member) / Levy, Roy (Committee member) / Arizona State University (Publisher)
Created2018
Description
Using a sample of 931 undergraduate students, the current study examined the influential factors on undergraduate students' academic performance, satisfaction, and intentions to persist in their enrolled major. Specifically, the current study investigated the salience of interest-major match in predicting academic success. Interest-major match has been found to be one of the most influential determinants of academic and occupational success. However, support for this relationship has been equivocal and modest at best. The present study was designed to improve upon the current understanding of this relation by examining the moderating effect of gender and employing a longitudinal design to investigate the reciprocal relation between interest-major match and academic outcomes. Correlational results suggested that women reported greater interest-major match and results of the path analyses demonstrated a moderating effect of gender. Although a reciprocal relation was not supported, the findings indicated that a student’s level of academic satisfaction may influence the degree of fit between his or her interest and academic major. The results also highlight the tendency for students further along in their academic tenure to persist to graduation despite poor fit. Implications for educators and administrators are discussed.
ContributorsWilkins, Kerrie G (Author) / Tracey, Terence J. G. (Thesis advisor) / Bernstein, Bianca (Committee member) / Homer, Judith (Committee member) / Arizona State University (Publisher)
Created2016
Career decision ambiguity tolerance: a longitudinal examination of its relation to career indecision
Description
The current study investigated the dynamic interplay of career decision ambiguity tolerance and career indecision over three assessment times in a sample of college students (n=583). While the previous research has repeatedly shown an association of career decision ambiguity tolerance with career indecision, the direction of this association has not been adequately assessed with longitudinal investigation. It was hypothesized in this study that there is a reciprocal pattern of career decision ambiguity tolerance leading to subsequent career indecision and career indecision leading to subsequent career decision ambiguity tolerance. Using a cross-lagged panel design, this study found support for the reciprocal pattern that aversion with ambiguity led to increased negative experience, choice anxiety, and lack of readiness in career decision making, while negative experience, choice anxiety, and lack of readiness led to increased aversion with ambiguity as well. Additionally, this study revealed that choice anxiety and readiness for career decision making led to increased interests in new information. The key findings were discussed with respect to the theoretical and clinical implications for career counseling along with limitations and suggestions for future research.
ContributorsXu, Hui, Ph.D (Author) / Tracey, Terence J. G. (Thesis advisor) / Bernstein, Bianca (Committee member) / Dawes, Mary (Committee member) / Arizona State University (Publisher)
Created2017