Examining perceived levels of stress, burnout, and job satisfaction among play therapists

Work-related stress and burnout have become a popular topic for research studies over the course of many years. The COVID-19 pandemic has also highlighted the importance of monitoring stress and well-being for workers in a variety of fields. The purpose of the present study was to examine the relationship between perceived stress, burnout, and job satisfaction among play therapists. We found a strong correlation between perceived stress and burnout among sample participants. We also found a strong negative relationship between these variables and job satisfaction. Based on our findings, we recommend several strategies that supervisors can implement when working with counselors-in-training in order to prevent stress and burnout for this specific therapist population. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Coronavirus disease (COVID-19) associated anxiety, fear and preparedness among healthcare students at university teaching hospital in KSA

Purpose: The infectious pandemics are generally accompanied by an often-overlooked impact it has on the psychology of the masses. Healthcare students and workers are expected to develop significant levels of stress as compared to the general population. The significance of this study is to assess the depression, anxiety and stress faced by the healthcare students that may lead to unfavourable effects on learning and their overall psychological health. Methods: This assessment was done by means of an anonymous, online, closed-ended questionnaire. DASS-21 scale was the primary instrument used for this purpose. The responses were recorded on a 4-point Likert scale. Results: The study had more male students, majority were between 21 and 23 years of age, asymptomatic and almost equal proportion of students from the fraternity of dentistry, medicine, pharmacy and nursing. Dental and pharmacy students were associated with lower stress than medical students whereas nursing students experienced higher anxiety as compared to medical students. Close contact with confirmed COVID-19 cases experienced higher stress and anxiety. Daily patient exposure was associated with significantly higher stress anxiety and depression. Conclusion: Based on the observations of the present study, a support program for psychological training for these health care students should be introduced. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Public health nursing perspectives on resiliency during COVID-19

Public health nurses are leaving the workforce, and few studies exist that examine resiliency perspectives among this specialty, community-focused population of frontline nurses. The COVID-19 pandemic created an unprecedented era in public health worldwide. The researcher used a quantitative research design to explore public health nursing viewpoints on resiliency during the pandemic. The quantitative approach aids in understanding the complexities of nursing resilience and needs during the pandemic, implications for the development of supportive interventions, and public health policies for future programming. This study is significant in that it gives a platform to public health nurses on the frontline who have been overshadowed in previous studies. The study utilized an online Survey Monkey evaluation tool which included: the Mindful Self-Care Scale (33-Item), the Resilience Scale (14-Item), and a researcher-designed questionnaire (22-Item). Findings from the study include a positive correlation identified between public health nurse self-care practices and resilience, specifically self compassion and purpose. Age was the only demographic variable significant in relation to job satisfaction, specifically age group 31-45 years of age. A positive correlation was identified between Job Satisfaction and QOL Home and Work. Resiliency could not predict or explain public health nurse job satisfaction and/or risk for attrition. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Acute Stress among Nurses in Sweden during the COVID-19 Pandemic

Sweden was hit hard in the beginning of the COVID-19 pandemic with deaths per capita among the highest in Europe. The pandemic was a stressful time especially for healthcare workers caring for COVID-19 patients. Various studies have evaluated whether nurses caring for these patients had higher levels of acute stress, but typically with measures that either used older DSM-IV criteria for Acute Stress Disorder (ASD) or general measures of acute stress. We recruited an online sample (N = 101) of nurses in Sweden from COVID-19 specialized units (ICU), Emergency (ER), and other units (Other), and asked them to answer questionnaires retrospectively to the peak of infections in Sweden. We aimed to evaluate: 1) the psychometric properties of the translation of the Stanford Acute Stress Reaction Questionnaire-II (SASRQ-II, which follows DSM-5 criteria for ASD) into Swedish, 2) whether nurses in COVID-19 units had experienced more acute stress than nurses in other units, and 3) the extent of potential acute stress disorder. The SASRQ-II evidenced good construct, convergent and divergent validity, and good reliability. It showed that ICU nurses reported significantly more acute stress than the other two groups, a difference that could not be accounted for by demographic or other variables. A retrospective diagnosis of ASD using the SASRQ-II suggested that 60% of nurses might have fulfilled ASD criteria, but no differences across groups were found. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

The work of liberal health professionals in the COVID-19 pandemic context

As of March 2020, the COVID-19 pandemic made an important impact on work on a global scale. In the absence of a vaccine, the most adopted measures were social distance and preference for remote work. The present study sought to understand the meanings that eight health professionals attributed to their practices in this context. Meetings held with a dentist, a physician, an occupational therapist, a nurse, a psychologist, a physiotherapist, a speech therapist, and a nutritionist, were registered through comprehensive narratives. Three categories of results were found: 1) the meaning of work, 2) the option for liberal practice, and 3) the implications of the pandemic. It was possible to see how the effects of the pandemic were peculiarly experienced by each of the participants, in some cases making them reconsider the meaning of work in their lives. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Abstract (Portuguese) A partir de marco de 2020 a pandemia da COVID-19 gerou importantes impactos sobre o trabalho em escala mundial. Diante da inexistencia de uma vacina, as medidas mais adotadas foram o distanciamento social e preferencia pelo trabalho remoto. O presente estudo buscou compreender quais significados que oito profissionais liberais da area da saude estavam atribuindo aos seus oficios em meio a esse contexto. Foram realizados encontros dialogicos com um odontologo, um medico, uma terapeuta ocupacional, uma enfermeira, um psicologo, uma fisioterapeuta, uma fonoaudiologa e uma nutricionista registrados por meio de narrativas compreensivas. Tres categorias de resultados foram encontradas: 1) o significado do trabalho, 2) a opcao pela atuacao liberal e 3) as implicacoes da pandemia. Foi possivel constatar como os efeitos da pandemia foram sendo vividos de maneiras peculiares por cada um dos participantes e fazendo-os repensar, em alguns casos, o significado do trabalho em suas vidas. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Abstract (Spanish) A partir de marzo de 2020, la pandemia COVID-19 causo importantes impactos en el trabajo a escala global. A falta de una vacuna, las medidas mas adoptadas fueron la distancia social y la preferencia por el trabajo a distancia. El presente estudio busco comprender que significados atribuian ocho profesionales de la salud a su trabajo en este contexto. Se realizaron encuentros en los que se dialogo con un dentista, un medico, una terapeuta ocupacional, una enfermera, un psicologo, una fisioterapeuta, una logopeda y una nutricionista, registrados a traves de relatos exhaustivos Se encontraron tres categorias de resultados: 1) el significado del trabajo, 2) la opcion por la practica liberal y 3) las implicaciones de la pandemia. Se pudo comprobar como los efectos de la pandemia estaban siendo vividos de forma peculiar por cada uno de los participantes y les hacia replantearse, en algunos casos, el significado del trabajo en sus vidas. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Black American experiences in healthcare: Past, present, and (improving the) future

Black Americans presently and have historically faced disproportionately negative experiences in the U.S. healthcare system, as spotlighted by the COVID-19 pandemic. In my dissertation, I employ diverse methodologies, including quantitative analyses of nationally representative data, qualitative analyses of focus groups, and experimental methods aiming to understand and illuminate potential ways to address Black Americans' experiences of injustice in healthcare. The introduction (Chapter 1) builds upon previous research to illustrate a model which emphasizes the importance of individuals and systems (and the histories of individuals and systems) to better understand racial injustice in healthcare. In Chapter 2, I provide a narrative review of the present and historical experiences of Black Americans in the healthcare system. Next, in Chapter 3, across two studies (N=13,054), including a nationally representative sample of Black and White Americans during the COVID-19 pandemic, Black (relative to White) Americans reported less positive experiences in healthcare, which explained early COVID-19 vaccination hesitancy and lower medical system trust. Current knowledge of the Tuskegee Syphilis Study was not related significantly to medical trust or vaccination intention, however. In Chapter 4, qualitative data and thematic analysis were used to interrogate the quality of healthcare provider-Black patient interactions in a sample of 37 Black American women who had been diagnosed with breast cancer. In a community-academic collaboration, three focus groups were conducted across California. Results demonstrated that participants experienced discrimination, stereotyping, and hostility from healthcare providers and within the healthcare system which undermined their medical trust. Further, participants offered suggestions for improving the healthcare experiences of Black women diagnosed with breast cancer. A critical step toward dismantling racial injustice is acknowledging its existence. Thus, in Chapter 5, I tested specific ways to shift dominant group members' perceptions to recognize both individual and systemic racism and how to increase behavioral intentions to combat injustice in healthcare. Results from this online experiment conducted with 1853 adults suggested that when White Americans learned about critical Black history in healthcare (i.e., history of injustice) vs. celebratory Black history (i.e., history of achievement) or control information, they reported significantly more perspective-taking with Black Americans, which in turn predicted more individual and systemic racism recognition and support for anti-racist policies in healthcare. Ultimately, my dissertation studies highlight specific experiences of injustice that Black Americans face in healthcare and identifies a mechanism to increase White Americans' recognition of and support for addressing injustices toward Black Americans. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

An investigation of healthcare professionals' perspectives on the tasks of mental health counselors in hospital settings

With the global mental health implications reported by the spread of COVID 19 (Javed et al., 2020) and the amplified mental health illnesses reported by the State of Mental Health in America (Reinert et al., 2021), there is an increased need to address psychological and emotional health along with physical health. Mental Health Counselors (MHCs) can be the next professional body to support the multidisciplinary teams within hospital settings to complement holistic care focusing on physical and emotional well-being. Researchers have demonstrated addressing the psychological needs of patients from their first admissions to the hospital has significant positive implications on their recovery outcomes as well as psychological, social, and relational well-being post-discharge (Zhang et al., 2016;Ng et al., 2007;Schoultz et al., 2015;McCombie et al., 2016;Hatch et al., 2011). Research on the effects of therapeutic intervention has effectively prevented PTSD in the general population when provided in the first month after trauma exposure (Bryant et al., 2008). Therefore, early therapeutic interventions in hospital settings to identify emotional and psychological reactions (Weinert & Meller, 2007) before discharging patients can significantly impact patients' post-discharge mental health. However, since counseling is a new profession entering the medical field, role confusion within multidisciplinary teams appears to impact counselors' effective integration into healthcare as they provide counseling services to hospitalized patients. Therefore, in this study, I address the gap in the literature by exploring the perspectives and expectations of healthcare professionals on what MHCs do in hospital settings. This study was guided by a social constructivist paradigm utilizing an exploratory sequential mixed-methods design, concept mapping (Kane & Trochim, 2007). Healthcare professionals conceptualized MHCs' tasks in hospital settings to facilitate medical and mental health services and enhance patients' well-being in 104 statements grouped in 11 clusters forming three central regions. The three main regions include: "Overarching Roles and Responsibilities of MHCs in the Hospital Setting" (Region I) contained two clusters (i.e., 'Fundamental Roles and Responsibilities in the Hospital Setting', & 'Specific Roles and Responsibilities in Different Hospital Units') of MHCs' tasks, while "MHCs' Specific Roles in the Hospital Setting" (Region II) entailed four clusters (i.e., 'Building Relationship with Patients,' 'Assessing/Evaluating Patients' Mental Health Status', 'Assisting and Supporting patients with Physical, Psychological, and Social Challenges in Relations to their Medical Condition' & 'Educating Patients') and "MHC's Roles and Responsibilities as a Multidisciplinary Team Member" (Region III) hosted five clusters (i.e., 'Advocating for Patients in the Multidisciplinary Team', 'Mediating Communication Between Healthcare Professionals, Patients, and Families', 'Collaborating with Other Multidisciplinary Team Members on Patients' Care', 'Training Other Multidisciplinary Members on General Wellness and Mental Health' & 'Offering Trainings and Emotional Support to Other Multidisciplinary Team Members'). The top three higher-rated clusters as being most important for participants were cluster 7 'advocating for patients in the multidisciplinary team', cluster 5 'assisting and supporting patients with physical, psychological, and social challenges in relation to their medical condition,' and cluster 11 'offering training and emotional support to other multidisciplinary team members'. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The Palestinian health-care providers' perceptions, challenges and human rights-related concerns during the COVID-19 pandemic

Purpose: One of the most affected groups during the COVID-19 pandemic was health-care providers due to the direct and continuous exposure to the virus and a lack of sufficient medical equipment. Palestinian health-care providers were exposed to several challenges related to their work environment as they worked in war-like conditions;therefore, this study aims to explore health-care providers' perceptions, perspectives, challenges and human rights-related concerns during the COVID-19 Pandemic in Palestine. Design/methodology/approach: The sample comprised 30 health-care providers 26-35 years, who were purposively selected from among health-care providers in two Palestinian cities, Nablus and Tulkarm, located in the north of the West Bank. Thematic content analysis was applied to transcripts of interviews with the practitioners to identify key themes. Findings: The thematic content analysis showed that the pandemic and quarantine negatively affect the mental health outcomes, daily routine and social relations of health-care providers. The main challenges related to human rights violations and faced by the health-care providers include a lack of sufficient infrastructure, lack of medical equipment's and protective gear, military occupation and a shortage of health-care providers in general, especially those who practice in speciality fields such as neurology, oncology, pediatric surgery and clinical psychology. Practical implications: Further investigations are recommended to test different variables related to health-care providers' work during the COVID-19 pandemic. This paper also recommends conducting studies targeting Palestinian health-care providers' training and supervision services to improve their skills and resiliency in dealing with future crises. Originality/value: The present work is the first to examine health-care providers' perceptions, perspectives, challenges and human rights concerns during the COVID-19 pandemic in Palestine. This novel sample resides in a political and social environment characterized by high environmental stressors due to decades of military and political violence (e.g. militarization, poverty, lack of employment opportunities, cultural pressures, human rights violations, etc.) (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Loss and grief: Personal stories of doctors and other healthcare professionals

This collection of personal narratives is just that: stories intended to chronicle the journeys of a small number of health clinicians and other professionals who have been struck by personal illness and/or loss. What these stories do not assume is that there are answers to the universal experiences of loss and grief, courage, and survival implicit in the telling. While the past is gone, the meaning of it, however, is forever in flux, forever being worked and reworked in our conscious and unconscious minds. Each memory is a redoing of what it represents and brings forth within our sense of ourselves and in our relationships with one another. Grief challenges us physically, emotionally, and psychologically to recast the loss again and again. And, in recasting the past and the passage of time, refashioning memory to meet the needs of the moment in which the lost object and our response to it either helps us to move forward in our life or keeps us stuck, unable to engage with a future that requires acceptance of giving up the life lived before. The COVID pandemic further highlighted the internalization of expectations. Drilled into us in training is the "prime directive", the ethical responsibility of patient care and that one should deal with personal things on one's one time. The stories written in this collection were a draft perhaps unending versions telling of the experience. Some stories were written in one setting, others over many weeks or months as the writer lost and regained footing along the tale's trail. The shame, the sadness and weeping, the anger and guilt, and the shame of feeling relief of the pain and suffering for ourselves or those we love(d) and the "weakness" of not being able to manage it all echo through these stories. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Mental health providers' perspectives: The link between childhood trauma, juvenile delinquency and long-term effects

Juvenile delinquency is an ongoing problem in society and is detrimental as many delinquents have mental and behavioral health issues. Delinquency is costly to society, and it was found that many delinquents have a traumatic past or adverse childhood experiences. They include child abuse and neglect, loss, separation/divorce of parents, witnessing domestic violence, parents who struggle with mental health and/or drug and substance abuse, parents who have their own trauma, death of a loved one, natural disaster, or other tragedies that are linked to an increase in the likelihood of juvenile delinquency. In this study, the relationship between juvenile delinquency and trauma by the lived experiences of professionals who have worked with delinquents and at-risk youth was examined. The biopsychosocial model provided a theoretical framework for the study. Data were collected by interviewing 20 mental health professionals. The data were analyzed to determine common themes and patterns about professionals who work with at-risk youth. The 6 themes found during analysis were professionals' caseloads consisted of clients who have lived through trauma, vicarious trauma was common, professionals must adapt to the barriers that stem from working with the population, they faced many barriers working with at-risk youth, they wanted to be effective for their clients, they were interested in trainings to increase their effectiveness with clients, they found it was necessary for caregivers to be involved in treatment, and COVID-19 has impacted traumatized youth. This study can contribute to positive social change as professionals may be able to identify ways to intervene with at-risk youth to encourage normal social functioning. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Parent and healthcare provider beliefs about a chlamydia adolescent vaccine

Introduction: Chlamydia is the most common bacterial sexually transmitted infection (STI) worldwide and it disproportionally affects young people and those living in the Southern United States. If left untreated chlamydia infections can lead to complications such as infertility and pelvic inflammatory disease. Currently, chlamydia vaccines are being development. A successful chlamydia immunization program would require adolescents to be vaccinated before engagement in sexual activity and would require parental approval and recommendations from healthcare providers. Therefore, this project aims to explore parent and healthcare provider opinions about chlamydia vaccines to identify potential barriers and facilitators to uptake. Because the COVID-19 pandemic began while developing this project there was a great need to understand parent opinions about a vaccine for adolescents. Therefore, this study also incorporates beliefs about COVID-19 adolescent vaccines.Methods: Qualitative in-depth interviews were conducted with parents of adolescents and healthcare providers. Topics included chlamydia and COVID-19 awareness, opinions on whether a chlamydia vaccine should be developed, willingness to vaccinate adolescents, and vaccine characteristics including efficacy, cost, and boosters. Interviews were conducted and recorded on a web-conferencing platform. Transcripts were analyzed using a thematic analysis approach.Results: Between January and July 2021, interviews were completed with 21 parents and 22 healthcare providers. The first manuscript describes parents' attitudes about an adolescent chlamydia vaccine. The third manuscript describes healthcare provider opinions on chlamydia adolescent vaccines. The second manuscript describes parents' opinions about COVID-19 vaccines compared to HPV vaccines. Because both COVID-19 and HPV vaccines can prevent serious illness, it is important to identify how beliefs might differ between these vaccines and identify strategies that were successful in promoting uptake.Conclusion: The results from this study will help to improve knowledge about parent and healthcare provider opinions about adolescent vaccines and how to better promote vaccinations before vaccines are available and once, they are available to the public. For example, we found news coverage about COVID-19 and the benefits of vaccination helped to improve vaccine confidence among parents. Therefore, using media to disseminate chlamydia vaccine information could be beneficial and promote uptake. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Exploring mental health provider and consumer attitudes toward telehealth amidst COVID-19

This study explores the relationship between mental health provider and consumer attitudes toward telehealth to determine the extent to which attitudes toward telehealth are related to participant type (provider versus consumer). Additionally, several other factors, including training and experience with telehealth (for providers) as well as stigma and help-seeking behaviors (for consumers), are explored to determine the strength of the relationship between these variables and attitudes toward telehealth. The current study also explores the potential impact of COVID-19 on participants' attitudes toward telehealth. Hypotheses predicted that providers and consumers will report significantly different attitudes toward telehealth and that attitudes toward telehealth will be significant related to and predicted by both training and experience with telehealth (for providers) as well as stigma and help-seeking behaviors (for consumers). A series of statistical analyses, including a one-way between-subject analyses of variance and an independent sample t test, was conducted to determine if significant differences exist among these two groups. Additionally, correlational and regression analyses were conducted to explore the relationship between training and experience with telehealth (for providers);stigma and help-seeking behaviors (for consumers);and well as COVID-19 and attitudes toward telehealth (for all participants). (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Pandemic motherhood and the academy: A critical examination of the leisure-work dichotomy

In late 2017, a critical investigation of the impact of motherhood on perceptions of success in academia, specific to leisure scholars in the United States, was undertaken by the authors of this critical review. Results from this study indicated that leisure scholars who are also mothers experience a great deal of pressure to be productive educators and researchers. This stems from unrealistic work expectations, unsupportive colleagues, and workplace policies that are difficult to navigate. The impacts of these are exacerbated by the pandemic conditions caused by COVID-19 due to existing patriarchal structures in academia. Community mitigation efforts result in working mothers balancing multiple full-time responsibilities, including providing childcare and education for their children while struggling to complete their paid work. We asked our previous research participants to share how their work and family experiences have been affected by the COVID-19 pandemic conditions, specifically as it relates to performing simultaneously as both primary childcare providers and faculty members at their institutions. While necessary to address a global health emergency, transitioning to remote work has increased employment expectations for mothers employed in higher education. Leisure scientists reported that telecommuting has led to an unideal merger of their personal and professional spaces, disrupting any harmony that these mothers were working so tirelessly to achieve. Leaders in higher education must address this misguided "hurry up model" and lack of concern for their employees as both scholars and human beings that need leisure to ensure quality of life and wellbeing. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Mourning and restoration

During the endless days of March and April 2020, New York City experienced more than 20,000 COVID-19 deaths and was considered the "epicenter" of a new global pandemic. Nursing homes witnessed the virus's contagion at staggering rates, with elderly and debilitated patients coming in by the dozens, gasping for breath, scared they would die and never see their loved ones again. Our hospital and our lives were quickly transformed. The author spent most of his clinical effort during those months running a new eight-bed hospice unit in our hospital. The author then presents the story of a hospice patient, a fifty-nine-year-old Black male-to-female transgender homeless woman. She had been diagnosed with an aggressive squamous cell carcinoma. She underwent chemotherapy, radiation therapy, and surgery, including a diverting colectomy, leaving her with a permanent ostomy. She had several other medical problems-chronic kidney disease, heart disease, diabetes, major depression, and chronic lymphedema. Taking care in her last days of life was agonizing. The possibility to have spent more time getting to know her. To explore her world and navigate the challenges of her health and condition together. This is the privilege of the doctor-patient relationship. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

A multilevel perspective on the perceived effects of COVID-19 on nurses in China

Purpose: This study examines the effects of COVID-19 on individual, organizational and societal level as perceived by nurses in China. Design/methodology/approach: We draw on two qualitative studies consisting of 483 qualitative surveys and 28 in-depth interviews with nurses in China. Findings: The pandemic has enhanced the profile of the nursing profession in Chinese society and has led to an increase in recognition, respect and visibility of nurses. In addition, participants point to an improved workplace culture in which there is a strong sense of pride in the collective effort they put. Simultaneously, however, nurses reported how COVID-19 was perceived to be detrimental to their own psychological well-being, while also interfering with their work-life balance. Originality/value: The data reveal the paradoxal effects of COVID-19 on nurses in China. On societal and organizational level, the pandemic seems to have had a positive effect, while on individual level a range of perceived negative effects is identified. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Exploring the perspectives of older adults and health care providers on patient participation in transitional care from hospital to cardiac rehabilitation during the COVID-19 pandemic

Older adults who transition from hospital to cardiac rehabilitation settings often are vulnerable and at risk of experiencing adverse health care outcomes. Given the complexities of transitional care, it is crucial to engage older adults in the clinical decision-making process and to promote their active participation in their medical care. Older adults have unique ways of understanding their participation in the transitional care process. Gaining an in-depth understanding of their specific needs during this process can help inform clinical practice and interventions aiming to improve care for older adults living with cardiovascular disease. Focused ethnography methodology was used to explore the perspectives of older adults and health care providers on patient participation in transitional care from hospital to cardiac rehabilitation. The study also sought to identify and to gain a better and more in-depth understanding of the challenges and opportunities that shape participation for older adults during transitional care from hospital to cardiac rehabilitation. Semi-structured interviews were conducted with 15 older adults and 6 healthcare providers from cardiac rehabilitation and cardiology units. Additional methods included document analysis and reflexive journaling. Thematic analysis revealed six themes and fifteen subthemes. Themes included: Follow-up from Healthcare Provides, Interactions with Healthcare Providers, Support from Family Members, Information about Medical Care and Rehabilitation, Decision-Making and Participation, and Healthcare Journey during COVID-19. Older adults reported gaps in follow-up and insufficient spaces or opportunities for participation in decision-making. Healthcare provider's support was reported as essential for a smooth transition, particularly nurses' support. The COVID-19 pandemic was mostly reported as a major barrier for participants, especially in terms of delayed medical procedures and difficult hospitalization experiences. Some participants, particularly those who seek social connection, viewed technology and virtual care negatively. However, virtual care delivery also was reported as a fruitful strategy to engage older adults in their care and to overcome transportation barriers. The results of this study can help inform the implementation of strategies that will engage older adults more actively in their care, as they transition from hospital to cardiac rehabilitation settings. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Understanding mental health professionals' perspective of therapeutic alliance in working with unaccompanied children: A Grounded theory approach

The number and trends of unaccompanied children immigrating to the U.S. has drastically changed throughout the years and many are placed in shelters while they remain in the custody of the Office of Refugee Resettlement (ORR). Unaccompanied children subject to traumatic experiences in their country of origin or throughout their journey present with high levels of adverse mental health. Despite this, there is limited literature exploring the mental health concerns of unaccompanied children or the experiences of mental health professionals serving unaccompanied children specifically unaccompanied children in ORR care. This study aimed to understand the perception of mental health professionals of establishing therapeutic alliance with unaccompanied immigrant children in an ORR shelter. Grounded theory methods were utilized to identify elements vital to the process of building therapeutic alliance with unaccompanied immigrant children. In this qualitative study data was drawn for 6 participants providing mental health services to unaccompanied immigrant children in ORR shelters in South Texas. The pressing elements identified were, policy impacts treatment, boundaries, limitations due to setting, cultural competency, creating a safe environment and impacts of COVID-19. Understanding how these elements present themselves and how to address them in the process of developing therapeutic alliance is crucial. Future research should include a specific focus on building therapeutic alliance in other ORR settings. More work can be done to educate communities and other mental health professionals about the efforts and practices necessary in building therapeutic alliance with unaccompanied immigrant children and addressing their unique needs. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Mental health providers' responses to the COVID-19 pandemic

The COVID-19 pandemic resulted in closures, increased stressors, and a high need for mental health services. To provide continuity of care and meet the rising need for therapy, mental health providers rapidly transitioned to telehealth. This transition occurred with the support of policy changes and leniency in telehealth guidelines. A survey including participant and client demographic variables, readiness for telehealth, transition time, methods for telehealth practice, and therapist efficacy in-person and via telehealth was created in Qualtrics. It was completed by 79 mental health providers to provide insight into this transition and inform future practice. This study hypothesized that (1) there would be differences between mental health professionals and how they adapted to telehealth based on demographic factors;(2) those with prior training and experience would be better prepared for telehealth and adapt more quickly, (3) therapists would feel more efficacious in their in-person practice than over telehealth, and (4) those with prior training and experience with telehealth would report higher levels of therapist-efficacy. The first hypothesis was supported, and differences were found in training, telehealth platform use, data collection and storage, transition time, and readiness for telehealth across professions, type of facility, and years of experience. The second hypothesis was not supported as no significant predictors of transition time were found. The third hypothesis was supported and a large effect size was found indicating that therapists felt efficacious in both settings, but more efficacious in-person (t(78) = 7.29, P<.001, D = .854). Regarding the fourth hypothesis, client technology access was the only significant predictor of therapist-efficacy over telehealth. These findings have implications for clinical administration, graduate training, policy, and ethical considerations. First, clinicians can prepare themselves for future telehealth use by reviewing their consent process, technology, and data collection/storage strategies. Second, graduate programs can support future mental health providers by incorporating telehealth into their curricula. Third, policies regarding insurance reimbursement and initiatives targeting the digital gap may improve telehealth services and ensure more equitable access to healthcare. Finally, increased awareness of the risks of technology use and clarification of regulations regarding telehealth can protect both clients and clinicians. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Barriers and facilitators to the implementation of intensive treatments for PTSD: early lessons learned from the field

  This article addresses the barriers and facilitators associated with the implementation of PTSD Intensive Outpatient Programs (IOP) across three VHA Medical Centers. Each site developed programs that delivered EBPs in a massed or condensed format and relied on implementation science and the i-PARIHS model to help direct the innovation. Face-to-face, virtual, and combined platforms were used, demonstrating flexibility in design. While each site experienced unique challenges associated with local contextual factors, multiple themes emerged across sites that may help guide future IOP and massed EBP implementations. Common facilitators of the implementation process included: the availability or presence of a credible lead (i.e., champion) to guide the innovation, opportunities to consult with national or outside experts, strong team engagement, processes in place that allowed for ongoing review, clinic operations that are aligned with principles of PTSD specialty care (e.g., time-limited, evidence-based, utilization of measurement based care, willingness to treat complex cases), and leadership support. Alternately, shared barriers included limitations on available resources, options for provider coverage, early staff buy-in, and organizational factors. Solutions to address these barriers and recommendations for future direction are shared. [Author ]  

Loss and grief: Personal stories of doctors and other healthcare professionals

This collection of personal narratives is just that: stories intended to chronicle the journeys of a small number of health clinicians and other professionals who have been struck by personal illness and/or loss. What these stories do not assume is that there are answers to the universal experiences of loss and grief, courage, and survival implicit in the telling. While the past is gone, the meaning of it, however, is forever in flux, forever being worked and reworked in our conscious and unconscious minds. Each memory is a redoing of what it represents and brings forth within our sense of ourselves and in our relationships with one another. Grief challenges us physically, emotionally, and psychologically to recast the loss again and again. And, in recasting the past and the passage of time, refashioning memory to meet the needs of the moment in which the lost object and our response to it either helps us to move forward in our life or keeps us stuck, unable to engage with a future that requires acceptance of giving up the life lived before. The COVID pandemic further highlighted the internalization of expectations. Drilled into us in training is the "prime directive", the ethical responsibility of patient care and that one should deal with personal things on one's one time. The stories written in this collection were a draft perhaps unending versions telling of the experience. Some stories were written in one setting, others over many weeks or months as the writer lost and regained footing along the tale's trail. The shame, the sadness and weeping, the anger and guilt, and the shame of feeling relief of the pain and suffering for ourselves or those we love(d) and the "weakness" of not being able to manage it all echo through these stories. (PsycInfo Database Record (c) 2023 APA, all rights reserved)