Doctor of Social Work Capstone Reports

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Exploring the Provisions in Medical Social Work Settings for Those Living with Diabetes: A Systematic Review
(2022) Brunson, Amie D.; Davis, Curtis; McKinney, Robert; University of Alabama Tuscaloosa
Diabetes is a public health issue that constantly prompts social work practitioners to examine how to best serve those diagnosed. Social workers and other practitioners unfamiliar with the disease may think of a disease that is easily managed by checking one’s blood sugar and taking medications. Not many people imagine a disease that has the power to inflict extreme damage internally before manifesting in external signs and symptoms. Anyone is susceptible to this disease. Without the knowledge of proper treatment and access to resources on the part of practitioners, devastating consequences can arise for those with diabetes. Nowhere is this issue more prevalent than in communities of color and the underprivileged. Medicaid-eligible patients are particularly at-risk for higher rates of chronic diseases, while communities of color disproportionately suffer from higher rates of poorly controlled diabetes and remain at heightened risk for negative health outcomes. The following systematic review will include a detailed explanation of the disease process along with the devastating effects of untreated diabetes. Care coordination services will be evaluated to determine whether the implementation of those services decrease adverse health outcomes in diabetic patients. By systematically reviewing the literature, this study highlights the crucial need for interventions targeting social determinants of health factors that often affect communities of color and the underprivileged. Without those interventions to address those barriers, the benefits of care coordination services are minimal. are cancelled out. By considering the ways in which the disease has primarily been managed by medical professionals in the past, this will allow for an alternative view of managing the disease in the future.
Promoting Mental Health in the Workplace: Best Practices for Covid-19 and in the Future
(2022) Bolt, David; Ruggiano, Nicole; Lee, Lewis; University of Alabama Tuscaloosa
Introduction/Background: This was a descriptive survey research project on promoting employee mental health. This project used a survey that was created in Qualtrics to assess what mental health services are offered by employers as well as the perception of those services by employees. The findings were then used to recommend best practices that organizations can use to improve employee mental health. Methods: Data were collected through a Qualtrics survey that was distributed electronically via LinkedIn and professional/academic email listservs. Best practices for supporting employee mental health were researched using a literature review on the subject. There was a total of 203 validated responses. A convenience sampling approach was used which resulted in a non-statistically valid sample size. Descriptive statistics were generated using Microsoft Excel. Results: There was a total of 203 validated responses. The survey had many findings that involved employees’ knowledge of existing workplace-based mental health services offered by employers and the perception of those services by employees. A full report of the results is included as an appendix to this report. Discussion: The three main implications of this research are that employees view their employers as having a responsibility to address mental health, that employees desire an organizational and interpersonal approach to workplace mental health programs, and that organizations can use workplace mental health services as a tool to attract or retain employees. The findings from the survey were used to inform a discussion of best practices for promoting employee mental health. Limitations of this research project include that a non-parametric sample was recruited for the survey.
Considering Empathic Leadership’s Impact on the Retention of Social Work Employees
(2022) Davis, Cynthia J.; Davis, Curtis; Hall, Kotina L.; University of Alabama Tuscaloosa
Retention of social workers is a common issue that affects various organizations. Retention of social workers in child welfare, social service, and other human service agencies is a serious concern. The high turnover rate of professional workers poses a major challenge to child welfare agencies and to the social work field in general. Turnover rates range from 30 to 60 percent in a typical year. According to Srinika Jayaratne and Wayne Chess (1984), “39 percent of social workers in family services and 43 percent in community mental health are likely to leave their jobs within a year of starting.” This article utilizes information derived from a comprehensive literature review to present a conceptual training model of empathic leadership to remedy the overwhelming dilemma of retaining social work employees.
Virtual Opportunities: A Study in the Accessibility of Public Education for Homeless Youth
(2022) Creger, Cara; Cheatham, Leah; Ruggiano, Nicole; University of Alabama Tuscaloosa
The number of youths experiencing homelessness has increased over the last decade and has only been exacerbated due to impacts of the COVID-19 pandemic. Although overall rates of homelessness declined in the last decade, the numbers of homeless youth continued to increase. Much of the existing body of research related to homelessness fails to capture the experiences of homeless youth and their families, many of whom are excluded from mainstream relief efforts due to the classification of nighttime residence categories. The McKinney Vento Act is a federal program established and reauthorized to allow additional resources for homeless youth and their families to reduce barriers to academic achievement. Despite these resources, McKinney Ventoeligible youth experience poorer academic outcomes and attendance rates than their housed peers. One consistent challenge for this population is transience, and protocols aimed to address transience often leave families without support or access to academic instruction for weeks at a time. With the emergence of the COVID-19 pandemic, school districts were left to find solutions to new barriers for all students and implemented virtual learning opportunities on an unprecedented scale. This study examines how one school district’s approach to virtual learning resulted in new means to accessibility for this vulnerable population, despite high levels of transience. Through retrospective analysis of 191 de-identified student transcript records for 9th- 12th grade McKinney Vento youth from the 2018-2019, 2020-2021, and 2021-2022 school years, this project examined whether increased accessibility through virtual course opportunities would yield greater academic outcomes for McKinney Vento youth. Academic outcomes (measured as pass rates) were consistent with pre-COVID years. Despite national findings indicating significantly poorer academic outcomes for all students during this time, for MV youth to have fared consistently to prior years can be considered a successful outcome with possibilities for future implementation. Implications for practitioners, school social workers, and public-school faculty include greater congruence for MV youth remaining or achieving grade-level status, higher graduation rates, and reduced barriers to instruction.
There is No Time Like the Present: Conceptualizing a Radical Self-care Approach in Black Women Social Workers
(2022) King, Quinchele LeKesha; Davis, Curtis; Gresham, Kay; University of Alabama Tuscaloosa
Radical self-care is a self-care model that centers the health, wellness, and communal care of Black women. Radical self-care is rooted in self-determination, self-preservation, and self-restoration that nurtures the experiences of Black women. The theoretical lenses put forth in this paper show how interconnected COVID-19, Blackness, and Black womanhood in social work are all salient identities and experiences in need of radical self-care. Embedding radical self-care in the social work discourse is needed as it provides a method to broaden the well-being and retention of Black women social workers. It is imperative that social work organizations look at their policies and practices surrounding supporting self-care practices of Black women social workers as they are coping with racial trauma and navigating systems of oppression. In this paper I postulate how Black women social workers can take charge and ownership of their self-care needs and instill radical self-care practices in their marginalized clients through the proposed intervention of green therapy.
“Who Am I?” Utilizing a Systematic Review of the Literature to Explore Relevant Black Youth Identity Models for Social Work Practice
(2022) Jones, Vanessa Martin; Davis, Curtis; Hall, Kathryn; University of Alabama Tuscaloosa
The identity and wellbeing of Black adolescents is often explored in the context of racial development with emphasis on the deficits of the developing youth. Subjected to adultification, racism, and anti-blackness in the United States, Black youth face unique challenges that interventions and theories do not adequately account for. A systematic review was conducted to examine the available applicable models, interventions and theories to answer the following question: In what ways do interventions target the nurturance of Black identity and wellbeing? Several themes emerged including connectedness as a buffer for the developing youth, however, the nurturance of Black identity was not present. Assuming identity development is a monolithic and universal experience, literature fails to examine the complexities of intersecting identities for the developing Black youth.
Sexually Harmful Behaviors in Adolescents: A Comparative Assessment of Tools to Guide Comprehensive Intervention and Treatment
(2022) Baker, Carolyn E.; Cheatham, Leah; Davis, Curtis; University of Alabama Tuscaloosa
Introduction/Background: The purpose for this study is to examine the need for comprehensive assessments when working with youth who engage in sexually harmful behaviors. One of the most effective preventive measures for future engagement in sexually harmful behavior is engagement in treatment. Identifying individual treatment needs can help bolster treatment outcomes for youth. There has been a shift in working with this population, which includes a movement from identifying risk, to identifying treatment needs and strengths. With this shift the way in which youth are evaluated and assessed, also needs to shift, particularly when working with adjudicated youth in residential placements. This study examines the potential to implement new assessment tools to utilize as a part of the comprehensive sexually harmful behavior assessment. Methods: During a monthly workgroup meeting, participants completed three assessment tools, the J-SOAP II, J-RAT and the YNPS using a case study. The participants also completed a brief survey on their perceptions of the tools and had a focus group discussion focusing on their experiences with the three tools. Results: There were statistically significant differences found between both the J-SOAP and the J-RAT as well as the J-SOAP and the YNPS. The perceptions of the tools showed greater comfortability with the tool that was most familiar to the team. The focus group, looking at pros and cons of the different tools, allowed for an implementation that made sense for the agency. Discussion: The team determined at this current time, it made the most sense for the agency to begin using the YNPS in addition to the J-SOAP II. This was a decision that was felt most comfortable by the participants and The SHB Treatment Coordinator. The decision to not replace the J-SOAP, and instead utilize the YNPS in addition to the J-SOAP will also help get outside readers including courts and outside treatment providers more accustomed to the new tool.
Finding a Final Home: A Needs and Gaps Analysis of the Referral Process into Long-Term Care for Aging Veterans with a Mental Health Diagnosis
(2022) Lawlor, Kristen; Davis, Curtis; Ruggiano, Nicole; University of Alabama Tuscaloosa
Introduction/Background: This study aimed to improve the referral process for Veterans with mental health who are seeking long-term care support through the VA with a needs and gaps analysis. Hackman and Oldham’s theoretical framework served as a lens to gain insight into stakeholders of the process and explore the need for stakeholders to know the whole process to yield the most effective outcome. Methods: Survey, 9 structured interviews, Mental Health admission data collection Results: More than 45% of all clinical staff at Manchester Veterans Affairs Medical Center reported not feeling confident or only slightly confident on their knowledge of the Long-Term Care Referral Process while 71% reported not feeling confident or slightly confident on their knowledge of the PASRR as part of the referral process. Data Collection from Geriatric programs found all four programs had 35% or more Veterans e nrolled with a Mental Health diagnosis. There were five central themes found from interviews in data analysis; a lack of knowledge of the referral process, an increase in aging mental health Veterans, needed resources, COVID Impact and a need for more training. Discussion: A discovered lack of knowledge of the whole referral process amongst stakeholders is negatively impacting nursing home placements with an inconsistency in completing the PASRR which supports existing literature on a need for a standardization of the PASRR and an Interdisciplinary approach. This study introduced an approach to standardize the PASRR implementation and improve the effectiveness of the LTC referral process through Oldham & Hackman’s theoretical framework. While this was applied to the LTC referral process this approach can be generalized to other areas working to breakdown the compartmentalization of workflows. Manchester is one VA of 171 facilities. This study was limited to VA stakeholders and future research would benefit from community stakeholder insight.
Exploring Virtual Calming Rooms as an Intervention to Address the Mental Health Needs of Students
(2022) Gainey, Brittny; Davis, Curtis; Ruggiano, Nicole; University of Alabama Tuscaloosa
A Qualitative Content Analysis was conducted to determine prevalent themes in Virtual Calming Rooms in Virginia K-12 Schools. Given the inclusionary criteria, located in Virginia and connected to a K-12 school, eleven Virtual Calming Rooms were analyzed. Through this analysis six common themes were identified, and 18 content areas were coded. The results of this study suggest that Virtual Calming Rooms are a viable intervention to address the mental health needs of students. A thematic review of the literature exploring educational disparities stemming from the COVID-19 pandemic lockdown created foundational knowledge of the mental health crisis that children and adolescents experience(d) particularly those of school-age. This review was through the lens of the opportunity gap as it conceptualizes educational outcomes within students resources accessibility and attainability and exposure.
A Synthesis of Research Examining Culturally Specific Barriers Black Female Students Experience Following Incidents of Sexual Violence
(2022) Turner, LaSharia; Davis, Curtis; Rainer, Shawra; University of Alabama Tuscaloosa
This review examines the barriers experienced by Black female students following incidents of sexual violence. Research revealed that nondisclosure amongst college students is linked to the student feeling fear, embarrassment, doubt, uncertainties, and unfamiliarity of resources and services. In contrast, Black females experience additional barriers that impede their decision to report the incident formally. Research on Black female student's barriers after sexual assault revealed the following themes: experiences, cultural-specific barriers, support. This systemic review concludes by recommending colleges and universities to develop culturally grounded campus prevention initiatives for Black female students.
The Use of a Trauma-Informed Approach During the Integrative Field Seminar to Address Indirect Trauma with Social Work Students
(2022) Schiefelbein, Tina M.; Nelson-Gardell, Debra; Phelps, Carroll; University of Alabama Tuscaloosa
Both the National Association of Social Workers (NASW) and the Council on Social Work Education (CSWE) describe the use of self-care as a predominant practice skill for social work practitioners to provide competent, ethical behavior. Self-awareness underscores self-care, yet often neophyte social workers enter the field without this knowledge nor the recognition of the impact of personal trauma histories or the occupational hazard of indirect traumatic stress. Many studies have highlighted the impact of traumatic stress on students and practitioners, but few have focused on Latinx providers/students. The objective of the study was to test the efficacy of using a trauma-informed supervision approach taught during the seminar that runs in conjunction with field placement to mediate indirect traumatic stress. Students were from the University of Texas-Rio Grande Valley School of Social Work, a Hispanic Serving Institution (HSI). The researcher conducted a quasi-experimental quantitative study design that analyzed interval data (intervention group, n=20, control group n=17) to determine the efficacy of the intervention by gathering data from Secondary Trauma Stress Scale and the Professional Quality of Life Scale that were administered three times over the semester. The results from the study showed the effects of indirect trauma were mitigated for the second half of the semester for the intervention group but continued to increase for the control group. Implications for social work education point to the significance of implementing a trauma-informed supervision approach as one way to fill the practice skill gap for the use of self-care to decrease social work impairment.
Can a Schoolwide Advisory Program Reduce Discipline Referrals and Boost Feelings of School Connectedness?
(2022) Manning, Conor; McKinney, Robert; Ruggiano, Nicole; University of Alabama Tuscaloosa
Introduction/Background: School discipline procedures are harmful to students and programs that reduce the likelihood of suspension are important for students’ wellbeing. School connectedness is a known protective factor for students. This study explores the implementation of a schoolwide advisory program’s impact on discipline referrals and students’ feelings of school connectedness. Methods: Data were collected over the course of an entire school year and results were compared pre- and post-intervention. The intervention took place during the 2nd semester of the school year. School discipline data and survey data (Student Subjective Wellbeing Questionnaire [SSWQ]) were compared pre- and post-intervention. Results: Mean out-of-school suspension rates were reduced at statistically significant levels. Mean ISS rates increased. There was not a statistically significant change in mean SSWQ scores. Discussion: This might serve as foundational work that a schoolwide advisory program could use to help reduce rates of out-of-school suspension.
The Impact of Religious Trauma on the LGBTQ+ Community: A Systematic Review
(2022) Goodwin, Miranda; Ruggiano, Nicole; Payne, Nancy; University of Alabama Tuscaloosa
Religious and spiritual practices have shown to be an integral part of developing positive health and mental health outcomes for many individuals; however, evidence shows that this is not the case for most LGBTQ+ individuals. Adverse religious experiences can lead to religious trauma which has significant and profound impacts on spiritual and sexual identity development, mental health outcomes, and social and family support. Trauma-informed clinical interventions have shown significant reduction of poor mental health outcomes; however, the efficacy of these interventions are undetermined in response to religious trauma. The current study involved a systematic review to determine the impact of adverse religious experiences on mental health outcomes within the LGBTQ+ community and to examine the clinical outcomes and treatment of trauma related to negative religious experiences. Of 383 articles identified and screened, 17 articles met eligibility guidelines. The current review found that the majority of LGBTQ+ individuals faced adverse religious experiences manifested by microaggressions and abuse within a religious setting, rejection based on sexual identity, conflict between religious identity and sexual identity, and extent of rejection of religious practice throughout the lifespan. The impact on mental health included increased rates of depression, anxiety, internalized sexual stigma, suicidality, substance abuse, and high-risk sexual activity. The study also determined a significant lack of research conducted to determine the outcomes of clinical treatment of religious trauma within the LGBTQ+ community.
The Social Work Role in Higher Education: A Systematic Review
(2022) Naasko, Rachel T.; Jackson, Sebrena; Elliot, Willie; University of Alabama Tuscaloosa
Social workers apply social work knowledge and skills in various educational settings, including higher education. Although this career path is not widely recognized, social workers address the needs of students in higher education by providing mental health services, case management, program management, and outreach. This systematic review aims to explore the roles of social workers in higher education settings. This review includes empirical literature, articles written by students, and grey literature to demonstrate how the profession understands social work practice in higher education settings. The twenty-eight articles reviewed reflected six themes: the role of social work, field education, mental health, substance use, foster care, and diversity and inclusion. The results of this review support that further research is needed on the social work roles in higher education and that this setting is rich with field placement opportunities.
A Qualitative Inquiry into the Use of a Virtual Platform during a Crisis to Boost Social Work Competencies
(2022) Wilkes, Sherron; Davis, Curtis; Williams-Moss, Javonda; University of Alabama Tuscaloosa
Introduction/Background: In March 2020, the global pandemic known as COVID-19 and corona virus affected every aspect of a person’s lived experience including social workers. Social work practitioners were restricted from attending in-person conferences and workshops because of the global pandemic shutdown. Receiving this education is critical to the development of social workers. The aims of the study were twofold: (1). To understand the benefits and challenges experienced by attendees of a virtual series; and (2). To explore the experiences of attendees of a virtual series. Methods: This qualitative study was conducted between March 2021 and April 2022. Thirteen virtual learning series were offered to social workers in Alabama and beyond. These series included topics on current and emerging issues in social work education. After each virtual series, attendees received an email that included a self-administered 5-point Likert questionnaire via Qualtrics and CE contact verification form for 1.0 free contact hour. Results: Seven themes emerged from the thematically analyzed data. 634 respondents completed the questionnaire. 83% stated that they will be able to use this information in their work. The series on Self-care, Resilience and Healing in Social Work had the highest mean score (mean: 4.68) followed by Men in Social Work are Essential (mean:4.58). Discussion: Virtual learning offers intriguing opportunities for broadening and extending access to continuing education. These series must be accessible and equitable. Research suggests that there is little evidence to show that attending virtual learning series have any correlation to maintaining or improving the skills of a practicing professional.
Behavioral Health Needs and Barriers to Care Among Soldiers Who Report Past Year Sexual Harassment and/or Sexual Assault
(2023) Kunhavijit, Michael; Shah, Avani; Ruggiano, Nicole
Background: Sexual harassment and sexual assault (SH/SA) continue to be a problem in the military despite extensive efforts to mitigate incidents. The mental health needs of military SH/SA survivors are often unmet due to stigma, military cultural values related to self-reliance, and logistical barriers. This secondary analysis assessed data related to the prevalence of past-year SH/SA across demographics, identified the mental health needs among those who experienced it, and ascertained the perceived barriers to treatment among members of an Army brigade combat team (BCT).Methods: For this analysis, any affirmative response to either 1) past-year sexual harassment, and/or 2) past-year sexual assault was combined to create a past-year SH/SA indicator variable. Mental health outcomes included major depression, generalized anxiety, post-traumatic stress disorder, suicidal ideation, alcohol use, and insomnia. Perceived barriers to treatment outcomes included stigma, self-reliance, and logistical barriers. Descriptive statistics, chi-square, and logistical regression were used to report findings.Results: SH/SA incidents were concentrated among young (17-24) junior enlisted (E1-E4) female soldiers; SH/SA survivors reported psychological problems at a higher rate compared to non-victims (73% vs. 31%); and SH/SA survivors reported higher occurrences of stigma and barriers to care compared to non-victims.Conclusion:The results of this study were mixed. The SH/SA survivors that indicated psychological concerns reported higher rates of stigma and barriers to care but sought mental health care at higher rates than non-victims that indicated psychological concerns. The gap between SH/SA victimization and BH utilization needs improving as unmet BH needs can lead to a myriad of issues. Changing perspectives on self-reliance as it relates to coping with mental health problems is a way to address this gap. Leaders must emphasize that mental health care is a form of self-reliance, while military mental health professionals must implement effective self-care initiatives and promote available resources to aid soldiers in overcoming their mental health problems.
Eating Disorder Rates and Body Image Dissatisfaction Among College Females
(2023) Blair, Abigail Hogan; McKinney, Robert; Cheatham, Leah
The purpose of this study was to obtain further information on the rates of eating disorders among college-aged females and the possible sociocultural protective factors at play, especially those concerned with race and ethnicity. Participants included female undergraduate students at colleges and universities in the Southeast and Midwest portions of the United States who completed online surveys. The study remains ongoing, but implications to date are discussed.
Supporting Mental Health in the Classroom
(2023) Kerr, Angela M.; McKinney, Robert E. Jr.; Traylor, Amy C.
Today’s youth are facing a significant increase in mental health disorders, many of which are unable to receive the support and care they need due to various barriers (Ghandour et al., 2019; CDC, 2022. As a result, many have turned to schools to assist in promoting mental health and well-being. However, many teachers report lacking the training to efficiently address and support mental health issues in the classroom (Kratt, 2018). Numerous studies have identified programs that are effective at increasing a teacher’s ability to address mental health in the classroom. However, few studies examine the change in frequency of teachers intervening with students displaying challenging behaviors and/or mental health concerns. The aim of the current study is to examine the change in frequency of teachers addressing mental health in the classroom following a teacher-mental health collaboration training group. Teachers and staff members attended six training sessions, led by a mental health professional, focused on mental health and related topics. Pre and post tests were administered to evaluate the change in helping behaviors. Studies were needed to further assess the frequency in which teachers utilized newly learned skills and information to address mental health concerns in the classroom. While participants provided positive feedback for the group, data analyzed only identified one area, responding to a student in crisis, that met the criteria for a significant change. Small sample sizes and lack of a standardized tool to measure the frequency could serve as limitations for this study. Future research is needed to further explore the impacts of mental health-teacher groups on teachers' knowledge and ability to address mental health in the classroom as well as the impact to students’ well-being.
Foster Parent Factors Associated with Placement Stability: An Umbrella Review
(Journal of Public Child Welfare, 2023) Pixley, Jeanna; Cheatham, Leah; Smith, Brenda
Introduction/Background: This umbrella review summarizes empirical evidence of foster parent factors associated with placement stability. Methods: Joanna Briggs Institute protocol for umbrella reviews was applied in the narrative synthesis of data from four systematic reviews and one meta-analysis to isolate empirical evidence specifically related to foster parents and placement stability. Results: Sixteen foster parent factors associated with placement stability were identified. Twelve of the sixteen identified factors are related to social-emotional competencies (SEC). Discussion: Key limitations to the study include inconsistent operationalization of concepts related to placement types and outcomes in literature and methodological design which precludes examination of primary sources to resolve discrepancies in data reported across reviews. Recommendations include further exploration of the connection between SEC of foster parents and placement stability, more research regarding foster parent mental health, and increased focus on intersectionality of variables related to placement types and outcomes.
Outcomes of Continuing Education Programs for Social Workers’ Self-Efficacy towards Job Performance: A Systematic Review
(2023) Burrow, Aisha Monikee; McKinney, Bob; Lee, Lewis
The aim of this systematic review was to identify the outcomes of continuing education programs on social workers’ self-confidence towards job performance. This systematic review was guided by UNC’s Systematic Review Workbook and the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) 2020 Statement. The literature search was completed in July 2023. Databases searched included Academic Search Premier, MEDLINE, and SocINDEX. A total of 133 peer-reviewed journal articles published in 2011-2023 that evaluated outcomes of continuing education programs for social workers were identified. Covidence software was used to present and synthesize results. Two reviewers independently analyzed fulltexts and assessed quality and biases. Seven journal articles met the inclusion criteria. The fulltext review revealed five common outcomes: professional development, enhanced practice skills, increased knowledge, preliminary effectiveness, and increased self-confidence towards job tasks. Based on these findings, continuing education programs have some positive outcomes. However, there were no comparison groups or randomized control trials used in the included studies. None of the studies are generalizable due to biases and small sample populations. Therefore, this systematic review is a first step to gaining a greater understanding of continuing education programs’ utility, feasibility, and outcomes for social workers’ self-efficacy towards job performance.

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