Behavioral Health Practitioners Research Articles

Improved student outcomes: a unique, culturally relevant, and intensive behavioral health training program

ABSTRACT The behavioral health workforce shortage is pervasive across the United States. To address this need, it is important to establish effective and culturally relevant trainings for behavioral health practitioners. This study examines the results of a Health Resource Service Administration (HRSA) Behavioral Health Workforce Education and Training (BHWET) funded program intended to increase the qualified workforce meeting high need and demand. Over the four-year funding of the program, 119 Masters of Social Work students graduated from the social work program with specialized training. The program was successful providing innovative training focused on interdisciplinary collaboration, evidence-based practices, and culturally responsive services.

Interpersonal process features of collaboration between probation and behavioral health practitioners.

This study sought to identify and conceptualize the central interpersonal process features that comprise good collaboration between behavioral health practitioners (BHPs) and probation officers (POs). Eighteen POs and 21 BHPs from geographically adjacent jurisdictions in a Midwestern state each participated in one of six focus groups. Researchers systematically coded focus group transcripts for interpersonal collaborative themes using both inductive and deductive strategies. Seven core themes-shared values and beliefs, communication and information sharing, knowledge of the other, trust, respect, team-based decision making, and equitable contribution-were identified and coded for importance, as indexed by frequency, latent tone, and group consensus. An initial working operational definition of these constructs, based on practitioners' dialogue, is also provided. This study is one of the first to provide BHPs and POs who work with justice-involved people with prescriptive guidance about interpersonal actions and approaches that will best serve their professional collaborative efforts. Future research should examine whether these constructs hold across other samples and contexts and work to fully operationalize and measure these constructs and their importance for affecting various outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Teaching Note—Training MSW Students in Sector-Specific Macro Content: An Innovative Behavioral Health Leadership Initiative

ABSTRACT Social work education has responded to the heightened demand for graduates as competent behavioral health practitioners. However, the preparation of social work graduate students for transitioning into leadership roles in behavioral health settings is limited. To enhance graduate students’ macrolevel competencies, specifically in behavioral health, a social work graduate program and a Medicaid managed care organization partnered to pilot an innovative teaching initiative. This teaching note describes the initiative, provides an overview of the competencies, and highlights evaluation data and findings. Using a pretest–posttest design, paired sample t-tests were conducted. Mean differences between the pretest and posttest scores were statistically significant, and there was a moderate gain. This initiative is an innovative strategy for improving social work graduate students’ behavioral health leadership competencies.

Revisiting our approach to behavioral health referrals.

This system of matching referrals to behavioral health practitioners' historical effectiveness seeks to strengthen patient outcomes.

First responder perceptions of the system of care and people who use drugs: Spanning boundaries.

Addressing the beliefs of first responders about people who use drugsand the system of care with which they interact must be part and parcel to addressing the opioid crisis. Using a boundary spanning framework, we examine how first responders perceive community behavioral health. With qualitative methods, we asked: What are first responders' lived experiences on the frontlines of the opioid crisis? In sum, it is important to consider that there is a critical role that first responders could play in brokering services when they are not themselves behavioral health practitioners but are, importantly, boundary spanners.

Attitudes and perceptions about the use of long-acting injectable antipsychotics among behavioral health practitioners.

IntroductionLong-acting injectable antipsychotics (LAI-As) are important tools for the treatment of schizophrenia, yet they appear to be underutilized. This study will assess practitioner perceptions of LAI-As to elucidate reasons for underuse and uncover new avenues to increase appropriate use.MethodsAn anonymous electronic survey was developed and actively distributed to behavioral health care practitioners (MD, DO, PA, NP, PharmD, RN, LCSW). Independent t testing and linear regression analysis was used to assess for interactions between survey responses and individual factors.ResultsA total of 146 survey responses were collected from September 3, 2020 to March 17, 2021. On average, participants thought that LAI-As were slightly underutilized in practice. The mean estimated patient acceptance rate for LAI-A therapy was 38.6% ± 29.5% (range = 0%-100%). Participants who were <40 years of age and those with a psychiatric pharmacist at their practice site had significantly higher estimated acceptance rates. The highest-rated barriers to LAI-A use were related to negative patient attitudes, lack of patient education, and access issues (eg, transportation, cost). Respondent characteristics including age, gender identity, geographic location, practice setting, and the presence of a psychiatric pharmacist significantly influenced the perceived impact of these barriers.DiscussionBehavioral health practitioners generally believed that LAI-As were underused, and only one-third of their patients would be accepting of the therapy. Several barriers were perceived as frequently impacting LAI-A use, but these were reduced by the presence of a psychiatric pharmacist. Understanding practitioner perceptions can assist with increasing the use of LAI-As.

Essential components of care in a multidisciplinary headache center: Perspectives from headache neurology specialists.

Comprehensive headache care involves numerous specialties and components that have not been well documented or standardized. This study aimed to elicit best practices and characterize important elements of care to be provided in multidisciplinary headache centers. Qualitative, semi-structured telephone interviews with a purposive sample of headache neurology specialists from across the US, using open-ended questions. Interviews were recorded, transcribed, and coded. Coded data were further analyzed using immersion/crystallization techniques for final interpretation. Mean years providing headache care was 17.7 (SD=10.6). Twelve of the 13 participants held United Council for Neurologic Subspecialties headache certification. Six described their practice site as providing multidisciplinary headache care. Participants explained most of their patients had seen multiple doctors over many years, and had tried numerous unsuccessful treatments. They noted patients with chronic headache frequently present with comorbidities and become stigmatized. All participants asserted successful care depends on taking time to talk with and listen to patients, gain understanding, and earn trust. All participants believed multidisciplinary care is essential within a comprehensive headache center, along with staffing enough headache specialists, implementing detailed headache intake and follow-up protocols, and providing the newest medications, neuromodulation devices, botulinum toxin injections, monoclonal antibodies, nerve blocks and infusions, and treatment from a health psychologist. Other essential services for a headache center are other behavioral health practitioners providing cognitive behavioral therapy, mindfulness, biofeedback and pain management; and autonomic neurology, neuropsychology, vestibular audiology, sleep medicine, physical therapy, occupational therapy, exercise physiology, speech therapy, nutrition, complementary integrative health modalities, and highly trained support staff. While headache neurology specialists form the backbone of headache care, experts interviewed for this study maintained their specialty is just one of many types of care needed to adequately treat patients with chronic headache, and this is best provided in a comprehensive, multidisciplinary center.

Mitigating the Impact of Coronavirus Disease-2019 on Child and Family Behavioral Health: Suggested Policy Approaches

Mitigating the Impact of Coronavirus Disease-2019 on Child and Family Behavioral Health: Suggested Policy Approaches

Practitioner driven psychological resilience interventions in urban communities facing minority stress and public health emergencies

ABSTRACT Current uses and interpretations of psychological resilience by behavioral health practitioners are contextually blind to social and political issues requiring psychological resilience. This contextual blindness leads to inaccurate case conceptualizations, ineffective interventions, and microinvalidations in healthcare (MIH). This paper highlights the synergistic nature of micro and macro issues while outlining practical implications of infusing both perspectives into healthcare practice for Black women in an urban American city context.

COVID: 19 Pandemic and Mental Health Issues in America

In 2019, coronavirus, a respiratory virus emerged from a seafood market in Wuhan, China. Afterward, this virus spread to other countries. Currently, globally, about 661, 012 deaths have been reported as a result of COVID 19 infection as of July 2020. Adverse life experiences contributed to mental illness such as the trauma caused by the COVID-19 pandemic. Many adults reported worsened of mental health due to the pandemic. During the pandemic, many Americans are struggling with mental health challenges. This is an analytical review of the literature on the impact of COVID-19 on mental health. During the pandemic, common mental health issues included (a) quarantine, social distancing, and self-isolation; (b) community members and mental health; (c) grief and multiple losses; (d) parents, children, and mental health issues.(e) mental health conditions; and (f) COVID-19 infection and existing mental health complications. A collaborative effort is needed to address the trauma brought on by the pandemic. Enduring emotional distress and fear created by COVID-19 caused trauma in children and adults. The symptoms of trauma can manifest differently in children than in adults. In the future, many of these psychosocial and mental health consequences of the pandemic will have to be addressed by behavioral health practitioners. These mental health issues will continue when the pandemic has ceased. More research is needed on COVID-19 infection during and especially after the pandemic to address and lessen mental health problems.

Virtual Geriatric Education Preferences of Rural Social Workers

Older adults in rural communities need access to comprehensive healthcare services provided by practitioners equipped with geriatric knowledge and skills. The Geriatric Rural Extension of Expertise through Telegeriatric Service (GREETS) project goal is to use telemedicine and telehealth to expand geriatric service options to underserved Michigan regions. GREETS educational programs train health practitioners to provide geriatric care for vulnerable older adults. To determine gaps in geriatric competencies, the team conducted an online survey of health professionals including behavioral health practitioners. Respondents identified educational topics and preferred virtual delivery methods. Demographic information included respondent’s professional position, practice setting, and county. The respondents were asked to indicate level of educational need using a scale ranging from a low, medium, or high need. Fifty (47%) of 106 total responses were from social workers. We compared the percent of social workers to other practitioners’ responses in our analysis. Four topics emerged for both groups as medium or high educational needs: 1) transitional care when changing residential settings or post-hospitalization; 2) assisting family caregivers cope with caregiving responsibilities; 3) incorporating community-based services into care plans; and 4) and managing frail older adults. Social workers noted higher need than the other respondents for: 1) managing chronic pain; 2) managing care of patients with multiple chronic conditions; 3) having serious illness conversations; 4) diagnosing dementia; and 5) discussing advance care planning. Both social worker and other respondents indicated interactive case-based webinars; published tools, toolkits, tip sheets; and didactic webinars as their top three learning formats.

Interprofessional obesity treatment: An exploration of current literature and practice

It is unclear which professions, their roles, competencies, and necessary training, maximize the effectiveness of interprofessional non-surgical obesity treatment teams. This exploratory exercise was to gain an understanding of current literature and practice regarding adult interprofessional obesity treatment team practice. Synthesis of information from 87 articles and 9 websites identified through review of pertinent literature as well as qualitative analysis of transcripts from 15 one-on-one obesity treatment team member interviews. Teams vary in their make-up but most often include physicians, physician assistants, nurse practitioners, registered dietitian nutritionists, registered nurses, mental and behavioral health practitioners, and exercise specialists. The team leader sets the tone that can promote respectful exchange of opinions among team members. Decisions regarding which professions are represented on teams are driven by financial ability to support the provider's work. Well-functioning interprofessional teams are rare, possibly due to insufficient opportunities for training with well-functioning interprofessional obesity teams. Learning from other team members is believed to improve the patient experience and provider satisfaction. There are limited training opportunities for professionals to learn to function as members of obesity treatment teams. Few examples of well-functioning obesity treatment teams exist to act as role models and training sites. Some professions have competencies that could inform and develop profession-specific interprofessional training opportunities to prepare professionals to assume effective obesity treatment team roles. However, more work is needed to study how interprofessional obesity competencies and training, geared toward developing shared decision-making and shared goals, and could impact patient care and provider satisfaction. Furthermore, without adequate reimbursement for all the needed health professions to provide basic services to persons with obesity, expanding small programs will be an ongoing challenge.

Factors Associated With Children Diagnosed With Attention-Deficit/Hyperactivity Disorder and 30-Day Follow-up Care With Practitioners Among Medicaid Recipients in Georgia.

Background and Objectives:It is important that children prescribed attention-deficit/hyperactivity disorder (ADHD) medication get timely follow-up care. In 2018, only 44% of US Medicaid recipients attended a follow-up visit within 30 days of their first ADHD prescription. The objective of this study was to identify the member and practitioner-related predictors that were associated with children who were diagnosed with ADHD and had a follow-up visit within 30 days (initiation phase) of their first prescription of ADHD medication (Index Prescription Start Date, or IPSD).Methods:A cross-sectional study was conducted to identify the independent predictors of a follow-up visit within 30 days and 2 follow-up visits within 270 days after the initiation phase (continuation and maintenance phase, or C&M phase) for Medicaid recipients. Predictive factors examined included race, school age group, gender, geography of residence, Medicaid service region, newly diagnosed ADHD, hospital admission, emergency department (ED) visit, types of ADHD medication, other psychosocial or behavioral diagnoses, psychosocial or behavioral therapy, prescriber specialty, and school season.Results:There were 2369 members eligible for the initiation phase measure, of whom 330 members were eligible for the C&M phase measure. Multiple regression analysis found that unmet 30-day follow-up was significantly associated with African American children with an existing diagnosis of ADHD (adjusted odds ratio [AOR] = 2.13; 95% confidence interval [CI], 1.64-2.76), middle school-aged children (AOR = 1.49; 95% CI, 1.23-1.80), rural residence (AOR = 1.27; 95% CI, 1.05-1.55), no ED visit (AOR = 1.57; 95% CI, 1.16-2.12), no psychosocial or behavioral therapy prior to the IPSD (AOR = 2.30; 95% CI, 1.65-3.21), and primary care practitioners (AOR = 1.88; 95% CI, 1.45-2.44).Conclusion:Pediatrics was the most common specialty prescribing ADHD medications. Managed care organizations can focus intervention efforts to improve compliance with 30-day follow-up among Medicaid children by targeting the high-risk categories identified above. They can also focus on facilitating communication between behavioral health practitioners and pediatricians about several key points: (1) the importance of using behavioral health therapy prior to prescribing medication; (2) the importance of timely follow-up care; and (3) the importance of medication management in combination with behavioral health therapy.

Implementation of School-Based Behavioral Health Services Over Time: A Longitudinal, Multi-level Qualitative Study

Behavioral health practitioners recognize how critical the process of implementation is to the successful use of evidence-based practices. It is further recognized that implementation is a complex, time-consuming process and that successful implementation often occurs in stages. Capitalizing on a national evaluation examining the implementation of school-based behavioral health (SBBH) services, this project involved an analysis of qualitative interview data to assess the unique barriers and facilitators that arise across time and organizational levels in the implementation of SBBH services. Forty-eight semi-structured telephone interviews were analyzed across 3 years and two organizational levels in seven sites (n = 48). Qualitative analysis identified five major implementation facilitators including communication and collaboration, data utilization, leadership, planning, and training. Major barriers to implementation included systemic state/governmental barriers, workforce shortages, and funding issues. While there were small changes in the relative importance of these facilitators and barriers over time and by organizational level, the most salient barriers and facilitators remained important across all 3 years of the study. Differences across organizational levels included greater emphasis at local levels for facilitators such as training and leadership and a greater emphasis at state levels for state/governmental barriers. Results suggest that while the importance of given facilitators and barriers changes as implementation progresses, the major factors that contribute to implementation are likely to remain unchanged over time. Effective communication/collaboration among stakeholders remains a powerful facilitator across time, and systemic state/governmental barriers remain a potent barrier. Implications for increasing successful integration of behavioral health services in public school settings are discussed.

Polyvictimization and Substance Use Among Sexual Minority Cisgender Women

Background: Violent victimization and substance use are higher among sexual minority cisgender women (SMCW) than heterosexual cisgender women. Unknown, however, is how polyvictimization—experiencing multiple types of violent victimization—affects substance use among SMCW. Purpose/Objectives: This study explores the relationship between polyvictimization and substance use among a small sample of SMCW. Methods: An exploratory secondary data analysis was conducted on data from a convenience sample of 115 SMCW currently in relationships (70.4% lesbian, 73.9% non-Hispanic white) via a cross-sectional survey. Lifetime physical, sexual, and crime-related violent victimization were measured via the Trauma History Questionnaire. Past-year substance use was measured via the Drug Abuse Screening Test (DAST-10). Mann-Whitney U testing and linear regression modeling were used to examine differences in substance use by victimization status (victimized/non-victimized) and the association between polyvictimization and substance use. Results: Lifetime prevalence of violent victimization was high with 60.9% of the sample reporting at least one type of victimization: 10.4% experienced physical, 22.6% experienced sexual, and 22.6% experienced crime-related violent victimization. Substance use was significantly greater for victimized participants than non-victimized participants. Modeling showed that as violent victimization increased by one unit, substance use scores increased by .30 units. Conclusion/Importance: Preliminary evidence suggests that increase in violent victimization was associated with increased substance use among SMCW. Findings indicate a need for additional confirmatory research with more representative samples and longitudinal data. Behavioral health practitioners are urged to consider the implications of these findings and assess for past cumulative violence and current risk of substance use disorder, to appropriately facilitate treatment planning.

Functional Behavior Assessment Practices Used by Canadian Behavioral Health Practitioners

AbstractA proportion of children and adults in Canada are identified as having an intellectual or developmental disability (I/DD). Moreover, the prevalence of autism spectrum disorder (ASD) in Canadian children has increased substantially over the past decade. Research has shown that these populations have a greater likelihood to engage in severe destructive behavior such as self‐injury and aggression, which places them at risk for exposure to intrusive interventions and denial of services. Functional behavior assessment (FBA) is an assessment strategy that takes the environmental variables responsible for the development and maintenance of destructive behavior into consideration and has shown to be the most informative for developing effective treatments for destructive behavior. We conducted a nation‐wide survey that queried behavior‐analyst practitioners working in the I/DD and ASD service sectors about their beliefs and use of FBA in clinical practice. We compared the results of this survey with similar surveys conducted in the United States. The results indicated that most Canadian practitioners are conducting some type of FBA; however, many of these assessments are not comprehensive and missing important components of the assessment process. We discuss the implications of these findings, as well as the barriers to implementing FBA in practice.

Development and validation of a method to screen for co-morbid depression by non-behavioral health practitioners treating musculoskeletal pain.

BACKGROUND:Although diagnosis and treatment of depressive illness is outside the scope of practice for non-behavioral health practitioners such as occupational therapists, physical therapists, kinesiotherapists, and chiropractors, it frequently is comorbid with painful musculoskeletal disorders such as low back pain and it negatively affects outcomes, including return to work. As psychologically-informed practice becomes more widely implemented without the immediate availability of behavioral health practitioners, safe and effective methods to screen for and appropriately triage depressive illness by nonbehavioral health practitioners are necessary.OBJECTIVES:To demonstrate the efficacy and validity of a method employed by non-behavioral health practitioners to screen for and appropriately triage musculoskeletal pain patients who also are experiencing depressive illness.METHODS:As part of a previously-published psychometric research study conducted in a community-based musculoskeletal pain rehabilitation program, a method was developed for nonbehavioral health practitioners to screen for and appropriately triage patients for co-morbid depressive illness, thus providing the current opportunity to examine the effects of depressive illness on work outcomes. The first step in the two-step process involves a 22-item questionnaire, providing scores used in the second step to triage for outside consultation with behavioral health practitioners. This paper describes the screening method and its application in an observational study of the impact of depressive illness on work outcomes.RESULTS:Among 156 consecutive patients who were presenting with musculoskeletal pain disorders to an outpatient rehabilitation program, 22.3% also were identified to have co-morbid clinical depression. The screening process allowed all patients to continue in the rehabilitation program. Those who were already receiving behavioral health care were encouraged to inform care providers of their participation in the program. Those who were not receiving behavioral health care were successfully triaged to care outside of the clinic. Depressive illness was found to affect success in the program, confirming the validity of the screening process for outpatient rehabilitation program participants experiencing chronic pain.CONCLUSIONS:A simple and effective depression screening process that triages patients without interruption of musculoskeletal treatment can be employed by nonbehavioral health practitioners. Because return to work outcomes were found to be negatively affected by depressive illness, this approach has the potential to improve overall program efficacy.

Empowering Patients in Integrated Behavioral Health-Care Settings: A Narrative Approach to Medical Family Therapy

Integrated behavioral health care (IBHC) provides patient-centered care, which assures full considerations of patients’ needs and promotes patients having a voice in decisions about their own health care. In this article, we consider narrative therapy as an empowering, nonpathologizing, and collaborative approach for medical family therapists and behavioral health practitioners to better help patients, families, and health-care systems in IBHC settings. Clinical examples are provided for effectively utilizing narrative therapy in IBHC settings across various stages of treatment. Using narrative medical family therapy informed by cultural humility, therapists can empower patients, help them reauthor their story through the lens of their experience, and validate their worldviews.

Social Work and Suicide Prevention

Back to table of contents Previous article LettersFull AccessSocial Work and Suicide PreventionJoshua Levine, L.C.S.W., Leo Sher, M.D.Joshua LevineSearch for more papers by this author, L.C.S.W., Leo SherSearch for more papers by this author, M.D.Published Online:1 Jul 2019https://doi.org/10.1176/appi.ps.201900165AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail TO THE EDITOR: Since 2008, suicide has ranked as the 10th leading cause of death in the United States (1). The Centers for Disease Control and Prevention reported that nearly 45,000 U.S. citizens died by suicide in 2016, and suicide rates have increased by over 30% in half of the states since 1999 (1). The growing epidemic of suicide poses many challenges for suicide prevention efforts.Social workers are instrumental in suicide prevention in that they comprise one of the largest occupational groups of behavioral health practitioners in the United States (2). Most social workers will encounter at least one suicidal client in their career. A national survey of 598 social workers found that 92.8% of respondents had reported working with at least one suicidal client, and 78.1% had worked with at least one suicidal client in the past year (3).Social work research in the area of suicide prevention is limited. A systematic review on social work research literature found that “social work research articles made up only 0.2 per cent of the total articles published from 1980–2006 in social work journals” (4). Furthermore, less than 8% of these articles discussed effective evidence-based practice interventions that could be used with suicidal clients (4).A review of the literature identified several areas in which social work as a profession could improve in suicide prevention. First, master’s-level social work education programs need to modify their curricula toward educating about suicide prevention. The Social Work Education in Suicide Survey of 598 social workers found that 79% of respondents reported that they did not receive formal training on suicide in their master of social work (MSW) program, and 41% of respondents indicated that they did not take any classes that addressed suicide intervention or prevention (3). Moreover, a randomized intervention study of the Question, Persuade, and Refer suicide prevention gatekeeper training of 73 advanced-standing and second-year MSW students found that students scored an average of 5.64 out of a maximum score of 25 on their knowledge of suicide risk factors (5).In addition to modifying MSW education programs, prevention efforts should be focused on gatekeeper training programs. Gatekeepers are individuals within the community, such as social workers and teachers, who are trained to identify suicide risk factors. Prevention efforts should be directed toward training social workers to be effective gatekeepers, as well as having social workers educate the general public on suicide risk factors.Another area that could be further explored is postvention, or an intervention to support persons bereaved by suicide. Those bereaved by suicide have an elevated risk of suicide, and postvention could decrease suicidal behavior of these individuals. Maple et al. reported that social work researchers have published only three articles on postvention since 2003 (6).Future social work research on suicide prevention should expand on evidence-based practices in regard to screening and psychotherapeutic interventions.James J. Peters Veterans Affairs Medical Center, Bronx, New York (Levine, Sher); Columbia University School of Social Work, New York (Levine); Icahn School of Medicine at Mount Sinai, New York (Sher).Send correspondence to Mr. Levine ([email protected]).References1 Suicide Rising Across the US. Atlanta, Centers for Disease Control and Prevention, 2018. https://www.cdc.gov/vitalsigns/suicide/index.htmlGoogle Scholar2 Health Resources and Services Administration: National Projections of Supply and Demand for Selected Behavioral Health Practitioners: 2013–2025. Washington, DC, US Department of Health and Human Services, Nov 2016. https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/behavioral-health2013-2025.pdfGoogle Scholar3 Feldman BN, Freedenthal S: Social work education in suicide intervention and prevention: an unmet need? Suicide Life Threat Behav 2006; 36:467–480Crossref, Medline, Google Scholar4 Joe S, Niedermeier D: Preventing suicide: a neglected social work research agenda. Br J Soc Work 2006; 38:507–530Crossref, Medline, Google Scholar5 Osteen PJ, Jacobson JM, Sharpe TL: Suicide prevention in social work education: how prepared are social work students? J Soc Work Educ 2014; 50:349–364Crossref, Google Scholar6 Maple M, Pearce T, Sanford RL, et al.: The role of social work in suicide prevention, intervention, and postvention: a scoping review. Aust Soc Work 2017; 70:289–301Crossref, Google Scholar FiguresReferencesCited byDetailsCited bySocial work practice instructors’ preparedness and readiness to teach suicide content19 July 2022 | Social Work Education, Vol. 433Assessment of Some Social Factors Related to Suicidal Behaviors in Ilam, Iran, during 20181 March 2020 | journal of ilam university of medical sciences, Vol. 28, No. 1 Volume 70Issue 7 July 01, 2019Pages 638-638 Metrics KeywordsSuicide & self-destructive behaviorSocial work/psychiatricPDF download History Received 28 March 2019 Accepted 11 April 2019 Published online 1 July 2019 Published in print 1 July 2019

An exploration of posttraumatic growth, loneliness, depression, resilience, and social capital among survivors of Hurricane Katrina and the Deepwater Horizon Oil Spill.

The aim of this study was to examine the relationships among posttraumatic growth (PTG), loneliness, depression, psychological resilience, and social capital among survivors of Hurricane Katrina in 2005 and the Deepwater Horizon oil spill in 2010. The survey was administered to a spatially stratified, random sample of households in the three coastal counties of Mississippi. A total of 216 participants were included in this study who lived in close proximity to the Gulf of Mexico coastline during both disasters. Results from structural equation modeling analyses indicated that there was a significant and inverse relationship between PTG and loneliness. Conversely, a direct relationship was not found between PTG and depressive symptoms; instead, the results revealed an indirect relationship between PTG and depressive symptoms through loneliness. Social capital was related to loneliness only indirectly through PTG, while psychological resilience was related to loneliness both directly and indirectly through PTG. Understanding the relationships among these factors, particularly the importance of PTG, can provide insight into the long-term adaptation among those who have survived multiple disasters. Further, these findings may lead to nuanced methods for behavioral health practitioners in assessing and treating individuals with symptoms of depression in disaster-prone communities.