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Black Males' Treatment Experiences in Mental Health Court: A Phenomenological Analysis
Mental health courts (MHCs) are part of an umbrella of specialty courts in which court officials, law enforcement, and treatment providers work together to seek alternative solutions to failed traditional approaches to justice. Researchers investigating MHCs indicated that the courts may be helpful in reducing recidivism and introducing offenders with mental health disorders to treatment services. I used the qualitative method of phenomenology to understand the experiences of young adult Black male clients' perceptions of mental health treatment in MHCs. Twelve participants ranged in age from 21-40 years. The research team identified three themes -- (a) helpful treatment factors, (b) relational growth, (c) treatment barriers – and five subthemes: (a) internal growth, (b) relational growth, (c) behavioral growth, (d) factors of marginalization, and (e) interpersonal barriers. Meaning pertaining to findings and implications for research and practice are discussed.
Child Centered Play Therapy with Children Exhibiting Aggressive Behaviors
Aggressive behaviors in childhood currently serve as the leading cause of counselor referrals within the United States. Children exhibiting maladaptive aggressive symptomology are at an increased risk for highly externalized and problematic behaviors across the lifespan. Emotional self-regulation and empathy are two constructs currently believed to be closely related to aggression, but a lack of research exploring these variables currently exists in the counseling literature. In this study I examined the effect of child-centered play therapy (CCPT), is a manualized, developmentally responsive, and nondirective intervention, on these variables. Participants were 71 students from four Title 1 elementary schools in the southwest U.S. referred by teachers for aggressive behavior (12 females, 59 males; age range 5-10 years with mean age 6.28. The sample consisted of 52.1% (n = 37) children identified as African American, 21.1% (n = 15) as Latina/Latino, 19.7% (n = 14) as Caucasian, and 7% as multiracial (n = 5). Participants were randomly assigned to 8 weeks of a twice-weekly CCPT experimental group (n = 36) or a waitlist control group (n = 35). Results of descriptive discriminant analyses (DDA) of the Social Emotional Assets and Resilience Scale and the Children’s Aggression Scale scores revealed that parents perceived children’s group membership in CCPT as significant and reasonably predictive of improvement in children’s aggression, self-regulation, and empathy. However, teachers did not perceive a statistically significant difference between the two groups with respect to these variables. These results suggest the relevancy of CCPT for parents in providing children with a developmentally responsive intervention to reduce aggressive behaviors and support their healthy development.
Child Parent Relationship Therapy: A Program Evaluation
For the past 40 years, one southwestern US university counseling program has sponsored two mental health training clinics in which master's and doctoral level students have learned to provide child parent relationship therapy (CPRT) services to community parents. In their training, students learn about the positive effects of CPRT, particularly on parental stress. To date, however, no program evaluation has been conducted at these clinics focusing specifically on parental stress outcomes after the completion of CPRT or to determine the demographics and characteristics of parents who pursue CPRT. The purpose of this study was to conduct such an evaluation of archival data spanning 7 years. Participants were 129 parents (70% female, 30% male; 80% Caucasian, 35% Hispanic/ Latino, 6% African American, and 4% Asian; 62% married, 9% separated, 16% divorced). Results from a t-test indicated a statistically significant decrease in self-reported parental stress, with a moderate effect size. Multiple regression revealed that women and those who attended with a co-parent reported greater stress reduction. This study confirmed the benefit of CPRT, provided by counselors-in-training, on reducing parental stress and indicated clientele for which and conditions in which those benefits might be optimized.
The Effects of Child Parent Relationship Therapy (CPRT) for Adoptive Families
Adoptive parents often struggle to understand and meet the social-emotional behavioral needs of their adopted child, particularly when the child's pre-adoption experience lacked a secure relationship with an attuned and responsive caregiver. This randomized controlled study, a replication of Carnes-Holt and Bratton's 2014 research, investigated the effects of child parent relationship therapy (CPRT) for adoptive families who reported attached-related concerns such as difficulties establishing a mutually satisfying parent-child relationship as well as concerns about the adopted child's behavior and parental stress. Participants were 49 adoptive parents (61% female; 7% couples; 86% European American, 6% Latino, 6% Asian, and 2% Black American) with adoptees between the ages of 2.5 to 9 (50% female; 35% European American, 22% Asian, 12% Latino, 10% Black American, and 21% Biracial or other). Eighty-four percent of children were adopted internationally or from the foster care system. Parents were randomly assigned to CPRT or treatment as usual (TAU). Results from 2 (group) by 2 (time) repeated measures ANOVAs indicated that compared to the TAU control group, parents who participated in CPRT reported statistically significant improvement in child behavior problems, parent-child relationship stress, and parental empathy, with a large treatment effects on all measures. Findings confirmed results from Carnes-Holt and Bratton's study and provided strong support for CPRT as a responsive intervention for adoptive parents and their children.
Group Activity Play Therapy for Preadolescents: Effects on Low Self-Esteem
Research shows that preadolescent females are more prone to negative self-perceptions than their male counterparts which places them at greater risk of developing mental health problems stemming from low self-image. The purpose of this randomized, controlled outcome study was to examine the effectiveness of group activity play therapy (GAPT) compared to an evidenced based social skills/self-esteem group. Participants were 29 fourth and fifth grade girls in two Title I schools in the southwest U.S. referred by teachers and school counselors as presenting with low self-esteem. Participants identified as 45% Latina, 38% Caucasian, 14% African American, and 3% Asian. Children were randomly assigned to either 16 sessions of GAPT (experimental group; n = 15) or 13 sessions of an evidenced based social skills/self-esteem group intervention (control group; n = 14). Results from a 2 (Group) by 3 (Times) repeated measures ANOVA indicated that, compared to the control group over time, the GAPT group reported statistically significant improvement in self-esteem with a moderate to large treatment effect. Teachers did not report a statistically significant difference between the two groups over time. However, teachers reported noteworthy improvement for children in both treatment groups, with generally stronger improvement for the GAPT group. Overall, results indicate that GAPT may be a promising school-based intervention for preadolescent females suffering with low self-esteem.
Human-Animal Relational Theory: A Constructivist-Grounded Theory Investigation
Constructs of human-animal relational theory (HART) were investigated to determine how those constructs manifested in animal-assisted therapy in counseling (AAT-C) from the perspectives of 6 participants (2 counselors, females, ages 28 and 32, both non-Hispanic and White; 2 clients, male and female, ages 55 and 23, respectively, both non-Hispanic and White; and, 2 therapy animals, canines, Labrador retriever and spaniel mix, ages 4 and 5, respectively). Using constructivist-grounded theory, a research team analyzed qualitative data from observations, interviews, and field notes. From the iterative process of multiphasic coding and constant comparison, these findings emerged: (a) consistency between Chandler's (in press) constructs and participants' experiences of AAT-C, (b) more meaningful therapeutic impacts for clients from client-initiated human-animal relational processes (HARPs) than counselor-initiated HARPs, (c) development of rich definitions and descriptions of Chandler's constructs, and (d) descriptions of interactive experiences of AAT-C and client resistance in the context of HART. Clinicians and educators in the field of AAT can apply the processes, practices, and principles from this study in their work to enhance positive therapeutic impacts for clients. As Chandler's constructs were supported in this study, AAT authors and researchers can solve a glaring problem of inconsistent terminology in the AAT literature by using those constructs in future studies and publications as operationalized nomenclature for standardized AAT interventions.
The Impact of Family Resilience Factors and Parent Gender on Stress Among Parents of Children with Autism
Parents of children with autism experience high degrees of stress. Research pertaining to the reduction of parental stress in families with a child with autism is needed. In this study, the relationship between family resilience, parent gender, and parental stress was examined. Seventy-one parents of young children with autism were surveyed. Regression and correlational analyses were performed. Results indicated that the vast majority of respondents reported significantly high levels of stress. Lower degrees of parental stress were correlated with higher degrees of family resilience. Family resiliency factors were significant contributors to the shared variance in parental stress. Mothers of children demonstrated higher levels of stress than fathers. Suggested explanations of these findings are presented and clinical and research implications are provided. The findings of this study provide evidence for the importance of facilitating family resilience for parents of children with autism and affirm differing stress levels between mothers and fathers.
The Impact of Psychotherapeutic Reiki on Anxiety and Mindfulness: A Single-Case Design
Reiki healing is one of several complementary and integrative therapies becoming increasingly prevalent in mental health counseling. It has been identified in the medical field for its usefulness in treating anxiety, depression, distress, and pain but has rarely been studied for its counseling impact on client wellness. I conducted single-case research to explore psychotherapeutic Reiki's (PR's) influence on adult clients' anxiety symptoms and perceived sense of mindfulness and provided analysis of data collected from two assessments administered weekly: the Adult Manifest Anxiety Scale-Adult and the Mindful Attention Awareness Scale. Three of the four participants demonstrated significant improvement in both anxiety and mindfulness over the course of the PR intervention. The study revealed potential therapeutic benefits for integrating PR with conventional talk therapy. Included in discussion of study results are clinical implications and importance, suggestions for future research, and limitations.
Individual and Group Child-Centered Play Therapy: Impact on Social-Emotional Competencies
A randomized controlled trial study was conducted to test the effectiveness of 16 sessions of the modalities of individual and group child-centered play therapy (CCPT) on improving social-emotional assets, including self-regulation/responsibility, social competence, and empathy. Participants were 56 students in four urban elementary schools in north central Texas, referred by teachers for disruptive or problematic behavior: 10 female and 46 male; ages 5 to 10 years with mean age 7.12; and 21 identifying as Hispanic, 17 as White, 8 as Multiracial, 1 as Asian, and 9 unspecified. Teachers and parents completed the Social and Emotional Assets and Resilience Scale (SEARS; Merrill, 2011) at pre- and post-treatment. With a significance criterion of p< .05, teacher reports provided no statistically significant results. However, parent reports indicated a statistically and practically significant interaction effect with a medium to large effect size, indicating a substantial improvement in children's scores from pre- to post-test attributed to group assignment. Mean differences indicated substantial gains in overall social-emotional assets, according to Total scores, in both individual and group treatment conditions as compared to the waitlist control group. Additionally, both individual and group play therapy was correlated with significant improvement with a large effect for the constructs of self-regulation/responsibility and social competence, with the group condition having a larger effect than the individual condition. Regarding empathy, neither modality resulted in significant improvement, though individual CCPT resulted practically in a large effect. These results indicate CCPT may provide a developmentally appropriate treatment for clinicians working with children in schools and in the community to foster their social and emotional competencies.
Master Therapists' Decision Making Process Concerning Adolescent Confidentiality: A Grounded Theory Approach
Ethical codes and laws provide counselors with guidance for how to approach confidentiality, but there is a gap in the literature surrounding counselors' process of decision-making when managing confidentiality with adolescent clients. This study explored the decision-making process of master therapists concerning adolescent clients. I conducted semi-structured interviews with peer identified master therapist (N=10), all of whom were licensed professional counselors with 15 or more years of counseling experience and whose case load contained 25% or more adolescent clients. Participants included seven females and three males; nine participants identified as Caucasian, and one participant identified as Hispanic. Participants ages ranged from 39-61. I analyzed the data, along with two research partner, according to Grounded Theory (GT) methodology. Through constant comparative analysis, a grounded theory emerged from the data in which participants converged understanding of client safety, relationships, clinical intuition in a process of integrated experience and consultation. With the exception of mandated reported and mortal danger, ethical guidelines and laws did not seem to factor into participants' decision making. Implications for counseling practice, preparation, and research are provided.
Social-Emotional Competencies of African American Children: Impact of Child-Centered Play Therapy
African American children experience risks due to heightened socio-environmental problems and responding to negative racial messages in their environments. Child Centered Play Therapy (CCPT) is one viable intervention for the development of social emotional competence among African American children to help mediate adverse conditions. I sought to explore the effects of CCPT on the social emotional competencies of African American children utilizing Social Emotional Assets and Resilience Scale-Parent & Teacher (SEARS-P; SEARS-T) reports. Thirty-seven African American participants with a mean age of 6.68 years were recruited from four suburban elementary schools in the southwest U.S. Twenty participants were randomly assigned to the intervention group receiving a mean of 13.3 CCPT sessions over 8 weeks, and 17 participants were assigned to the waitlist control group. Factorial ANOVA results indicated that parents reported statistically and practically significant improvement for children who participated in CCPT in overall social-emotional competencies. Follow-up analysis revealed statistical and practical improvement in children’s empathy, as well as practical improvement in self-regulation/responsibility and social competence. Teacher-reported results indicated practical but non-statistically significant improvement in overall social-emotional competencies for children who participated in CCPT, including statistical and practical improvement in children’s responsibility, as well as practical improvement in self-regulation, social competence, and empathy. Thus, CCPT showed promise as a culturally responsive treatment intervention to improve African American children’s social-emotional competencies
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