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Counseling Ohio Youth: What Their Parents Hope for in Mental Health Counseling Services in a County Identified As Appalachian

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Counseling Ohio Youth: What Their Parents Hope for in Mental Health Counseling Services in a County Identified As Appalachian COUNSELING OHIO YOUTH: WHAT THEIR PARENTS HOPE FOR IN MENTAL HEALTH COUNSELING SERVICES IN A COUNTY IDENTIFIED AS APPALACHIAN A dissertation submitted to the Kent State University College and Graduate School of Education, Health, and Human Services in partial fulfillment of the requirements for the degree of Doctor of Philosophy By Thomas Scott Newman December 2018 © Copyright, 2018 by Thomas Scott Newman All Rights Reserved ii A dissertation written by Thomas Scott Newman B.A., Malone College, 1984 M.S., Malone College, 1994 Ph.D., Kent State University, 2018 Approved by _____________________________, Co-director, Doctoral Dissertation Committee Jane A. Cox _____________________________, Co-director, Doctoral Dissertation Committee Jason McGlothlin _____________________________, Member, Doctoral Dissertation Committee Steven R. Brown Accepted by _____________________________, Director, School of Lifespan Development and Mary Dellmann-Jenkins Educational Sciences _____________________________, Dean, College of Education, Health and Human James C. Hannon Sciences iii NEWMAN, THOMAS SCOTT, Ph.D., December 2018 LIFESPAN DEVELOPMENT AND EDUCATIONAL SCIENCES COUNSELING OHIO YOUTH: WHAT THEIR PARENTS HOPE FOR IN MENTAL HEALTH COUNSELING SERVICES IN A COUNTY IDENTIFIED AS APPALACHIAN (155 pp.) Co-Directors of Dissertation: Jane A. Cox, Ph.D. Jason McGlothlin, Ph.D. This study utilized Q methodology to explore the hopes of parents in an Appalachian County in Ohio in relation to the mental health counseling treatment provided to their children. Twenty-six parents whose children received mental health counseling services in the identified county sorted 31 statements. The sorts were analyzed using and unrotated principle components analysis solution. Sorts loading on more than one factor were manually deflagged from the analysis resulting in three viewpoints being identified. Statements were also collected from parent participants during the sorting process. Analysis suggests parents in this Appalachian County have varied hopes for their children in mental health counseling services. These hopes simultaneously challenge and support some traditional beliefs about Appalachian residents highlight the continued need for mental health counseling professionals to invest effort in understanding the hopes of area parents. Implications for counselors and future research are discussed. ACKNOWLEDGMENTS This space is insufficient to begin thanking those responsible for supporting me throughout this process. I will do my best to highlight those who have been vital to who I was when I started and those who have helped shepherd my continued growth. First, my family. To my angel, my all, my other self, Stephanie, a fellow traveller who reinvigorated and cajoled me through all the starts and stops. I am looking forward to celebrating our completed programs together. This is yours as much as mine and I hope to find a way to match the aid you have already delivered to me. You changed my life. I owe an unaccountable debt to my parents, Sue, a mother and an educator, and John, a father who without almost any formal education remains the most intelligent and knowledgeable person I have met. You both suffered decades of an immature, unmotivated student. I eventually discovered what education was all about in college and have graduated several times since. I hope in some way you both are able to enjoy what your frustration and patience have earned. It still saddens me he won’t be sitting with Mom this time, but he’s still with us. My in-laws, Don, Joyce, Laura, Andy, Jen, and other extended family that ‘always’ believed I would finish, even when I was not so sure myself. The list would not be complete without the two furry mutts who kept my feet warm these many winters of writing. I owe a vast debt of gratitude to you all. My committee. I joked at the end of my oral defense I felt as though you had signed up for a 5k and discovered some way into the race it was a marathon and kept going. This process can make you feel moronic, lazy, crazy, and inattentive. You iv minimized many of those moments for me and directed me through. Dr. Jane Cox, Dr. Jason McGlothlin, and Dr. Steven Brown, thank you for doing much more than your jobs. To the numerous people in the county in which this study took place, you helped make an impossible task come to fruition. There are those who consider the region’s residents backward or standoffish. I have always found the opposite. Always open and pleasant, I have not worked with a county more devoted to pursuing the cutting edge to support their residents. I am thankful you allowed me to play some part in your efforts and hope this project offers information to support those efforts. A special note of appreciation goes to the parents who took time to help us better understand what their children need, the county providers who took time out of their day to make it easier for the parents to participate, and the administrators who trusted me enough to represent them to their families in need. I hope I did you justice. To my ‘Participant Whisperer’, you know who you are, your spirit didn’t just change the direction of this study but evidenced what genuine caring creates in a world in such desperate need of more. A small but growing group of folks were on my heart throughout this process and will continue to be. To my tenacious partner, Mary Beth, and our first additions Vanessa and Rachel, it has been incredible working in a practice where everyone is so committed to making a difference in the lives of others. It is so easy to maintain an intense level of caring when those around you are doing the same. Mary Beth and I always said we would only hire counselors better than we are and have lucked into two who were willing to clamber into our pirate ship and roll out the canons. This project represents the first step into our seriously studying how we help and how we fail, solely to do more of the v former and less of the latter. I look forward to setting the standard of what mental health counseling could be and apologize for the lumps we will take in getting there. It will be so worth it. I have been blessed from the beginning with varied informal supports in my life. Some transitory while others stick; some positive influences and some negative peers; some educated, others smart, and a couple who manage both. I cannot adequately communicate my appreciation for being cared for when broken, taken down a peg when overly arrogant, and challenged to be a better human than where I started. I intend to do my best to be worthy of all of your efforts and to pay it forward by encouraging others as you have encouraged me. I offer my most sincere Thank You! vi TABLE OF CONTENTS Page ACKNOWLEDGMENTS ................................................................................................. iv LIST OF FIGURES .............................................................................................................x LIST OF TABLES ............................................................................................................. xi CHAPTER I. INTRODUCTION AND LITERATURE REVIEW .....................................................1 Purpose and Rationale..............................................................................................5 Definitions................................................................................................................7 Review of the Literature ..........................................................................................9 Mental Health Counseling in Rural America .................................................10 Appalachia ......................................................................................................12 Culture ...................................................................................................13 Poverty ..................................................................................................17 Mental health services ...........................................................................18 Medical care ..........................................................................................22 Family structure in Appalachian culture ...............................................24 Appalachian Ohio ...........................................................................................25 The Appalachian region ........................................................................26 The study’s county ................................................................................28 Parental Involvement in Mental Health Counseling Services for Their Children ..........................................................................................................29 Children in mental health counseling ....................................................30 Parental influence on children’s mental health counseling ...................32 Addressing parental concerns in mental health counseling ..................35 Summary ................................................................................................................37 II. METHODOLOGY .......................................................................................................38 The Present Study ..................................................................................................39 Introduction to Phase I ....................................................................................41 Phase I: Statement collection for
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