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Collaborative documentation in community behavioral health: The impact of shared record keeping of therapeutic alliance
Get PDFConcurrent collaborative documentation, or simply collaborative documentation, is a form of record keeping whereby the psychotherapist prepares progress notes in a transparent, collaborative manner with the client during the therapy session. In recent years, this emerging clinical record-keeping practice has been promoted as a partial solution to managing time and the copious volume of records mandated by stakeholders in public behavioral health and managed care settings where psychotherapy services are delivered. This is in contrast to the typical method of completing record keeping after the conclusion of the traditional psychotherapy session. Proponents of collaborative documentation reason that the practice saves time, increases clinician capacity to see more clients, and improves compliance with agency productivity and performance standards. Seemingly born out of quality improvement objectives, collaborative documentation does not offer a theoretical rationale for its use as a psychotherapy process tool, and given its embryonic state, there has been little opportunity to empirically demonstrate the mechanisms responsible for outcomes with its use.This research intended to examine the relationship between collaborative documentation and therapeutic alliance factors with the aim of understanding the strengths and limitations of using record keeping to improve outcomes in psychotherapy. Specifically, the relationship between collaborative documentation and the formation and maintenance of the therapeutic alliance was explored. Two community mental health agencies in Northern Arizona were selected to participate based on their documentation practices, and 60 client-therapist dyads at each agency were anticipated to participate at each agency. Participating clients completed the Working Alliance Inventory—Short Form Revised, a psychometrically reliable and valid instrument for measuring alliance. Regrettably, the desired sample size was not achieved and thus the planned statistical analysis was not possible. However, follow-up interviews revealed potential support for the use of collaborative documentation. For example, the practice appeared to improve trust through increased transparency, and created a platform for providing feedback to clients that prompted insights into behaviors and cognitions more quickly than before. Ultimately, therapist comfort level and skills appeared to influence the adoption of a collaborative documentation process. The methodological challenges, implications for collaborative documentation, and recommendations for future research will be discussed
Sustainable leadership: A case study examining perceptions of participants in a long-term, district-wide reform
Get PDFEach school year seems to bring new demands for change. As a result, today’s education leaders must address multiple challenges simultaneously, and often with limited resources. To address these challenges, leaders must create and implement meaningful changes, while allowing their organizations and those working in them to more effectively fulfill their purpose. Today’s education leaders must be skilled in the practices of sustainable leadership.Through this study, the researcher sought to build upon the work of Hargreaves and Fink (2004) to define further practical examples of sustainable leadership in the context of a large scale reform. This qualitative, intrinsic case study examined Reform Partnership Initiative (RPI), a unique reform partnership that merged the funding resources of the Ellis Center for Educational Excellence with the technical expertise of WestEd to create a model for public / private partnerships that could support school district transformation.Sixteen veteran educators who had been long-term participants in the RPI were selected to take part in this study. Participants in this study included members of the WestEd team, principals, and teachers who worked side by side during the six-year period while RPI was in place to design, implement and sustain meaningful, systemic reforms. Semi-structured, in-depth interviews were conducted one-on-one with each participant. During the interviews participants reflected on the goals and effectiveness of the RPI, the leaders they worked with, and their experiences with the implementation of seven specific reform elements. Participants also reflected on the changes in their own leadership that they experienced as a result of their leaders’ actions during the RPI.The researcher analyzed the perceptions that the participants shared in order to gather information about sustainable leadership practices. The researcher found that all participants in a reform have a leadership role, including principals as well as teachers and external partners. The researcher also found that people perceive the goals of a reform differently depending on their role and that those goals can become unclear when not shared among all stakeholders.The researcher concluded that sustainable leadership is evident when leaders: establish and communicate expectations about the reform, create opportunities for deep learning, are positive, appreciate, encourage and support people, make the reform practical in the present and connect it to the future, trust people to work with and make sense of the reform, and use data to inform people involved in the reform.The researcher also concluded that leaders can detract from sustainability when they: approach the reform element superficially, make people feel threatened, are absent, impact people’s use of time negatively, impact peoples’ wellness negatively, overwhelm people, fail to establish priorities, or undermine the people or the reform itself. Finally, the researcher established that the actions of reform leaders can impact how participants perceive themselves as leaders. When sustainable leadership is present, people feel trusted and empowered as leaders. They feel pushed to grow and learn. They also shift their focus from accountability to true, meaningful learning. In the absence of sustainable leadership, people can develop the sense that their leadership capacity is unfulfilled
The discovery and analysis of a new type of Wolf-Rayet star
Get PDFWe’ve recently completed searches for Wolf-Rayet (WR) stars in the Local Group galaxies including M31, M33, and the Magellanic Clouds using a combination of image subtraction techniques and photometry for candidate discovery and spectrophotometric follow-up for candidate confirmation. As part of these surveys, we’ve discovered a new type of WR star in the Large Magellanic Cloud (LMC). These stars have both strong emission lines as well as He II and Balmer absorption lines and spectroscopically resemble a WN3 and O3V binary pair. However, they are visually too faint to be WN3+O3V binaries. So far we have found nine of these WN3/O3s, making up ~6% of the population of LMC WRs. Using CMFGEN, a spectral modeling program, we have successfully modeled their spectra as single stars and have compared the physical parameters with those of more typical LMC WNs. Their temperatures are around 100,000 K, a bit hotter than average LMC WNs (by around 10,000 K), and abundances are what you would expect for a WR star in CNO equilibrium. However, most anomalous are their mass-loss rates which are more like that of an O-type star than a WN. While we are still learning more about their evolutionary status, their low mass-loss rates and wind velocities suggest that they are not products of homogeneous evolution. It is possible instead that these stars represent some sort of intermediate stage between O stars and WNs. There is some indication that there may be a metallicity dependence in their formation environment so we have recently started a survey searching for these WN3/O3s in M33, which has a strong metallicity gradient. By either confirming or denying their existence in other metallicity regimes we hope to gain further insight into their evolution
Relationships among economic factors and community college enrollment in Arizona
No full textThis study explored the extent to which economic variables relate to aggregate enrollment as well as enrollment by demographic subgroup in ten community college districts in the state of Arizona. The economic variables included in the study were in-county tuition and fees, state appropriations to the district, local appropriations to the district, maximum annual Pell Grant award amount, county unemployment rate, and county median household income. Correlation analysis and multiple regression analysis were used to explore the relationships between the independent variables and enrollment. The findings of the study indicated that community college enrollment in Arizona was related to county unemployment rate and to state appropriations to the district. The findings also showed that the economic variables with strongest correlations to enrollment were not necessarily the variables included in the best enrollment model. Additionally it was found that the relationships between aggregate enrollment and the economic variables in community college districts with similar characteristics were not the same. It was also concluded that studying the relationships between enrollment by demographic subgroups and each independent variable provided insight into some of the relationships found between aggregate enrollment and each independent variable in the three community college districts analyzed by demographic subgroup
Primed for action: The unique role of Greek life in bystander helping behaviors
Get PDFSexual assault has become an increasingly acknowledged problem on college campuses nationwide. Women are more likely to experience sexual violence during college than any other time in their life (Martin, Fisher, Warner, Krebs, and Lindquist, 2011). The chances increase tremendously for those women in a social sorority. Research has shown that women in Greek life are three times as likely to report sexual victimization than non-sorority members (Mohler-Kuo, Dowdall, Koss, and Wechsler, 2004). Additionally, Minow and Einolf (2009) found that 33 percent of sorority members reported they had experienced completed rape compared to 6 percent of non-sorority members. Many studies have examined sexual assault perpetration and victimization rates among Greek life members, but there is little research on those interested in Greek life and helping behaviors.With the recent policy changes, such as the Campus SaVE Act, requiring prevention programs, like bystander intervention programs, be implemented at all college campuses and universities it is important to evaluate the effectiveness of these prevention programs. The goal of the current research was to evaluate The Take a Stand! bystander intervention program training for incoming freshman interested in Greek life at a state university and evaluate whether the 35-minute training video would increase participants’ bystander efficacy and decrease the barriers to intervening.This study found that participants who completed the training were less likely to report a barrier to intervening due to a skill deficit compared to those who did not complete the training. However, there were no differences between the experimental and control groups, those who completed the training and those who did not, in the remaining four barriers: failure to notice, failure to identify the situation as high risk, failure to take intervention responsibility, and failure to intervene due to audience inhibition. Additionally, differences did not exist between those who completed the training and those who did not in perceived confidence to intervene (the bystander efficacy scale)
The ARM Model for Wellness of Counselors-in-Training Exposed to Trauma Case
Get PDFOver the past two decades, literature has discussed the negative consequences of working with trauma cases on counselors, which include disturbing feelings and thoughts, disrupted beliefs, and symptoms of post-traumatic stress disorder; these negative consequences have been defined as vicarious traumatization and other related terms. Researchers also identified factors contributing to vicarious traumatization, which include personal trauma history, workload, clinical experience and personal wellness. Particularly, novice counselors and counselors-in-training (CIT) have been recognized as a vulnerable population to vicarious traumatization, and an attention should be given to promoting wellness of CIT exposed to trauma cases. However, no article to date provides specific suggestions for faculty supervisors to promote the wellness of CIT during the practicum and internship. Therefore, the Assessment, Response, and Maintenance model proposed in this article aims to address this gap in literature and provide a novel contribution to the counseling profession more broadly. The model is an integrated one that adopts developmental and ecological concepts, and is mainly influenced by the Constructivist Self-Development Theory and the Wheel of Wellness. Practical examples are presented, and suggestions for future research are provided
Unconventional agriculture how farmer-to-farmer networks support sustainable communities: a study of the Sustainable Farming Association of Minnesota
Get PDFAs the public’s interest in local and sustainably-produced food continues to grow, farmer organizations throughout the country are working to develop and spread more sustainable methods of farming for producers. To better understand how these groups can promote alternatives to industrialized food systems, I conducted a study of the Sustainable Farming Association of Minnesota (SFA). SFA is farmer-led and encompasses a state-level organization along with nine geographic chapters across Minnesota. Their organizational structure serves as the framework of their “community network” through which they connect farmers and disseminate the wisdom of their sustainable farming communities. My study involved interviews with members of three local SFA chapters, observations of chapter activities, and an interview with SFA’s Network Coordinator. Through this research, I was able to observe how interdependent relationships between local SFA chapter members, as well as between local chapters and the state-level SFA, support sustainable agriculture within the state
Adaptive capacity of agriculture in Arizona's Verde Valley: situated resilience and climate change
Get PDFIndustrial agriculture, constructed and maintained through the human-nature divide, causes enormous environmental and social destruction. Because of its contributions to climate change, there is a dire need to understand and encourage the ability of alternative systems of more sustainable food production to adapt to changing conditions. By viewing agriculture as a social-ecological system (SES), I used a place-based resilience approach to study the adaptive capacity of non-industrial, individual growers in Arizona’s Verde Valley. Using a political ecology lens, in-depth interviews, and grounded theory, I developed an understanding of the characteristics and processes that influence climate change adaptation that emerge from the specific historical, cultural, and environmental conditions of this SES. Through coding and analysis, I found that opportunities and barriers for adaptation were deeply dependent on the processes and contexts of the agricultural system. Key elements of the growers’ adaptive capacities to climate change are climate change awareness and belief, alternative agricultural practices and ideologies, and larger structural barriers. Therefore, to create climate change-resilient agricultural systems, we must not only target individual beliefs and ideologies but also the systemic conditions they are embedded within
Mindfulness for Well-Being and Stress Management Among College Students
Get PDFCollege student pressures have been steadily increasing over the years, as has the rise in the use of college counseling centers by students who report stress (American College Health Association, 2016). This paper examines mindfulness interventions employed with healthy college students to understand the impact on stress levels in study participants. The term stress, as used in this paper, refers to student self-reported, subjective experience. The review is organized into three sections: (a) mindfulness program protocols; (b) personal practice of mindfulness in instructors; and (c) measures used across studies. This review revealed some common components found among interventions that may have impacted outcomes such as: the personal practice of mindfulness of instructors, additional meditation requirement outside of group, use of an assigned textbook, timeline and accountability measure completed by participants. In addition, some mindfulness techniques that were highlighted and found to be common across studies included: mindful breathing, sitting meditation, mindful attention, body scan meditation, loving kindness meditation, guided imagery, yoga self-compassion and gratitude. Recommendations are presented for developing and evaluating future mindfulness programs for students in college settings
Yoga and the Ability to Counteract Negative Effects of Stress and Trauma
Get PDFMany individuals today struggle with the effects of chronic stress, whether due to social and environmental factors or as a result of trauma embedded in their psychophysiology. Research has demonstrated that once an individual endures a traumatic event, there are undesirable changes that occur in the brain and body It is of the utmost importance that mental health counselors consider the relationship between the body and mind. The purpose of this paper is to describe the negative impact traumatic experiences and chronic stress has on the brain and body. Furthermore, the ways in which yoga practice can mitigate trauma symptoms and stress will be explored. Incorporating yoga as an adjunct to talk therapy has been found to lower stress levels while also working to repair biological mechanisms holding these ongoing stress patterns in place. Implications for mental health counselors will be discussed