Degree awarded: Ph.D. Social Work. The Catholic University of America

Assessing the Leadership and Management Skills ofSenior VA Social Work Leaders by Internal StakeholdersKristin Shanahan Day, Ph.DKarlynn BrintzenhofeSzoc, Ph.DLeading experts in the field of social work advocate that social workers become expert leaders and managers able to bring business acumen, congruent with social work values to the human service industry (Brilliant, 1986; Edwards, Cooke, & Reid, 1996; Franklin, 2001; Patti 2003; Rank & Hutchinson, 2000). Yet, no leadership or management content is required for Council on Social Work Education accreditation (2010); thus the adequacy of preparation for social work executives may be questioned. The purpose of this study is to explore the actual and preferred levels of leadership and management skills of Department of Veterans Affairs (VA) social work executives, as reported by the medical center director, the chief of staff, the social work executives and their social work subordinates. Specifically, are VA social work executives meeting the leadership and management expectations of their key internal stakeholders? This study used the VA's High Performance Development Model (HPDM) 360 Degree Assessment Scale to assess perceived levels of actual and preferred management and leadership competencies. An independent t-test was used to explore the level of preferred management skills by subscale; each subscale, systems thinking, technical skills, and flexibility/adaptability, was statistically significant in terms of differences in mean scores. For all three subscales, the medical center directors and the chiefs of staff mean scores for preferred level of management skills were significantly higher than for the social work executives and the social workers mean scores for preferred level of management skills. An independent t-test was used to consider the subscales comprising leadership skills; three subscales, customer service, personal mastery and organizational stewardship, were found to be statistically significant in terms of differences in mean scores between the two groups. Medical center directors and the chiefs of staff preferred higher levels of management and leadership skills than both the social work executives and the social workers. This is a call to action for the social work program at VHA. This study provides empirical support for the infusion of business and leadership theory and practice into social work education and practice.

Made available in DSpace on 2011-03-01T11:45:51Z (GMT). No. of bitstreams: 1 Day_cua_0043A_10152display.pdf: 965417 bytes, checksum: 5a24210455be062d494a42a242d12697 (MD5)

Degree awarded: Ph.D. Social Work. The Catholic University of America

Assessing the Leadership and Management Skills ofSenior VA Social Work Leaders by Internal StakeholdersKristin Shanahan Day, Ph.DKarlynn BrintzenhofeSzoc, Ph.DLeading experts in the field of social work advocate that social workers become expert leaders and managers able to bring business acumen, congruent with social work values to the human service industry (Brilliant, 1986; Edwards, Cooke, & Reid, 1996; Franklin, 2001; Patti 2003; Rank & Hutchinson, 2000). Yet, no leadership or management content is required for Council on Social Work Education accreditation (2010); thus the adequacy of preparation for social work executives may be questioned. The purpose of this study is to explore the actual and preferred levels of leadership and management skills of Department of Veterans Affairs (VA) social work executives, as reported by the medical center director, the chief of staff, the social work executives and their social work subordinates. Specifically, are VA social work executives meeting the leadership and management expectations of their key internal stakeholders? This study used the VA's High Performance Development Model (HPDM) 360 Degree Assessment Scale to assess perceived levels of actual and preferred management and leadership competencies. An independent t-test was used to explore the level of preferred management skills by subscale; each subscale, systems thinking, technical skills, and flexibility/adaptability, was statistically significant in terms of differences in mean scores. For all three subscales, the medical center directors and the chiefs of staff mean scores for preferred level of management skills were significantly higher than for the social work executives and the social workers mean scores for preferred level of management skills. An independent t-test was used to consider the subscales comprising leadership skills; three subscales, customer service, personal mastery and organizational stewardship, were found to be statistically significant in terms of differences in mean scores between the two groups. Medical center directors and the chiefs of staff preferred higher levels of management and leadership skills than both the social work executives and the social workers. This is a call to action for the social work program at VHA. This study provides empirical support for the infusion of business and leadership theory and practice into social work education and practice.

Made available in DSpace on 2011-03-01T11:45:51Z (GMT). No. of bitstreams: 1 Day_cua_0043A_10152display.pdf: 965417 bytes, checksum: 5a24210455be062d494a42a242d12697 (MD5)

Degree awarded: Ph.D. Social Work. The Catholic University of America

An Examination of Attachment Styles and Distress Among Parents Who Have Lost a Child to CancerPhilip M. Domingue, Ph.D.Director: Karlynn BrintzenhofeSzoc, Ph.D.This study of bereaved parents whose child died of cancer, investigated how retrospective insecure attachment and social support impact both the individual and the couple in dimensions of marital satisfaction, grief, and psychological distress. The impact of levels of discrepancy in retrospective attachment styles between spouses, on marital satisfaction, grief, psychological distress, and social support were examined. The study also explored the impact of insecure attachment and social support on grief oscillation (ref: Dual Processing Model of Grief) (DPM). The study utilized a cross- sectional correlational survey design. Couples bereaved in the last five years, still living together at diagnosis of deceased child, were invited to participate through support organizations such as Candlelighters in both the U.S. and Canada. The survey consisted of seven standardized tools: Retrospective Attachment Questionnaire (RAQ), Brief Symptom Inventory (BSI), Dyadic Adjustment Scale (DAS), Hogan Grief Reaction Checklist (HGRC), Texas Revised Inventory of Grief (TRIG), Inventory of Daily Widowed Life (IDWL), and Social Support Index (SSI)). Demographic data was also collected. The sample consisted of 86 individual and 32 couples. The data was analysed using SPSSS and multivariate analysis of three hypotheses were performed. Results showed mixed support for all three hypotheses. Insecure attachment was a stronger predictor of grief, than gender. Insecure attachment and social support were both predictors of psychological distress. Retrospective attachment style was not a significant predictor of marital satisfaction/distress however, the control variable gender and social support were. Discrepancy of anxious ambivalent attachment in the couple increased the level of social support. An interaction between discrepancy in disorganized attachment and gender impacted levels of grief. In terms of oscillation balance of grief insecure attachment was the only significant predictor with social support trending. This study supports aspect of the DPM, specifically the claim that attachment styles have an impact on individual and to some extent on couples grieving outcomes. The findings support the DPM concept of oscillation balance and that loss and resolution orientations are separate grieving tasks. Retrospective attachment was stronger predictor of grief than gender. Researchers and clinicians should consider retrospective attachment styles as an important variable in grief.

Made available in DSpace on 2011-02-24T20:46:15Z (GMT). No. of bitstreams: 1 Domingue_cua_0043A_10080display.pdf: 1667552 bytes, checksum: a873abae32867c5e73882e9d77b02537 (MD5)

Degree awarded: Ph.D. Social Work. The Catholic University of America

There is a significant lack of research on the long term effects of cancer treatment on sexuality and intimacy, specifically in those diagnosed as young adults (YA) (18 to 40 years old). Sexuality and intimacy are quality of life issues affected by cancer and its treatments, regardless of age, race, gender, or socioeconomic background. Sexual dissatisfaction, whether physical, psychological, or emotional, not only affects the person being treated for a disease, but also his/her partner and the overall relationship. Although there is substantial literature supporting the challenges in sexual function, fertility, and body image in persons with cancer, there is a significant lack of research on the long term effects of cancer treatment on sexuality and intimacy, specifically in those cancer survivors diagnosed as young adults who are two to five years post cancer diagnosis. Utilizing cognitive theory as the guide, this study sought to explore the differences in this researcher's conceptual model of the sexual self of young adult cancer survivors as compared to their healthy peers (those with no history of a cancer diagnosis). This exploratory study utilized a mixed-methods research design to study the sexual selves of young adult cancer survivors (diagnosed two to five years ago) and healthy peers. A total of 167 young adults participated in the online survey; 113 survivors and 54 healthy peers. The primary purpose of this study was to investigate this researcher's conceptual model of the sexual self, and the sexual self of YA cancer survivors; 2 - 5 years post diagnosis as compared to their healthy peers.Findings show that the sexual selves of young adult cancer survivors are indeed different than those of their peers, demonstrating lower sexual esteem, higher sexual distress, and lower sexual function. Additionally, qualitative data demonstrated that health care professionals are not sufficiently addressing the sexual health concerns of young adult survivors. The lack of information provided appeared to be interpreted as dismissive of the importance of their sexuality and sexual health needs. Further, quality of life was lower and psychological distress was higher when a more negative sexual self was present in the survivor.

Made available in DSpace on 2011-02-24T20:45:49Z (GMT). No. of bitstreams: 1 Bolte_cua_0043A_10082display.pdf: 1074546 bytes, checksum: edf517cf7746485511fb8a8544684246 (MD5)

Degree awarded: Ph.D. Social Work. The Catholic University of America

This dissertation can be viewed by CUA users only.

A public health approach to the harms that arise from alcohol misuse requires that alcohol problems be identified early and intervened with before serious social and medical consequences occur. An intervention directed at at-risk drinkers, known as alcohol brief intervention, has well established efficacy when delivered by physicians working in primary health care clinics and some hospital Emergency Departments. However, the adoption by physicians has not been widespread, due to a number of barriers including lack of physician time, skill, and knowledge about alcohol. An important question thereby arose as to whether other health professionals, including social workers, achieve the same positive patient outcomes as physicians when delivering the intervention. Using data from the largest effectiveness study of alcohol brief intervention in Emergency Departments (ED's) to date (Academic Emergency Department Screening, Brief Intervention, and Referral to Treatment Research Collaborative), changes in alcohol use from patients who were treated by physicians were compared to changes in those patients treated by non-physician health professionals. Participants in the current study (n=279) were drinking at levels above the National Institutes of Health limits. Patients were divided into two groups: 137 received the intervention from a physician and 142 received the intervention from a non-physician health professional. In addition to baseline data on demographic, education and health variables, measures on three quantity and frequency of alcohol use variables were collected at baseline and at 3-months post intervention. Results of an Analysis of Co-Varience that adjusted for differences in baseline drinking, indicated that controlling for gender, marital status, education level, and severity of addiction, the ED patients who received the alcohol brief intervention from trained non-physician health providers did as well as at 3-month follow-up on the three assessed outcomes of reduction in alcohol use as those patients who received the intervention from a physician. Findings suggest that non-physician health professionals who are trained in alcohol brief intervention be considered to provide the intervention, removing significant barriers to physician delivery that currently exist, and increasing opportunities for wide-spread implementation of this efficacious public health approach to reducing the harms of alcohol misuse.

Made available in DSpace on 2012-09-11T17:08:24Z (GMT). No. of bitstreams: 1 Murray_cua_0043A_10128display.pdf: 660002 bytes, checksum: eae0385f6b3adf66169618748e47ef4d (MD5)

Degree awarded: Ph.D. Liturgical Studies/Sacramental Theology. The Catholic University of America

Many liturgical theologians understand the Church's euchology as a primary source for theological reflection. This dissertation examines the Prayers Over the Gifts (super oblata) for Sundays in Ordinary Time in their liturgical context in the current Order of Mass as such a theological source. The study begins by examining the presentation of bread and wine and other gifts at the altar in early Eucharistic liturgies. It shows how a practical activity took on cultic and sacrificial connotations. This led to the increasing elaboration of the ritual actions and prayers associated with the presentation, with the super oblata appearing in the seventh century as the sole prayer of preparation for the Eucharistic prayer in the earliest sacramentaries of the western Church. The development of the preparation rite into the highly sacrificial Offertory in the Missale Romanum 1570 is followed. Here, the numerous offering prayers obscured the liturgical and theological import of the super oblata, which were now said silently. Next, in the revision of the Order of Mass following Vatican II the Offertory became the Presentation of the Gifts, in which the sacrificial elements were lessened and the super oblata recovered an approximation of their original significance. A study of some of the critiques of the current preparation rite and the role of the super oblata within it follows. The dissertation then proceeds to a detailed analysis of the thirty-four super oblata for Ordinary Time. It shows how the orations elucidate the role of the liturgical act of offering in the whole sacramental economy of the Eucharistic sacrifice and give particular expression to theological themes including grace, providence, Christology, soteriology, ecclesiology, sacramentality and eschatology. These liturgically founded notions can be applied in the construction of a comprehensive Eucharistic theology, which in turn can contribute to the ongoing development of systematic theology. Moreover, the theological content of the super oblata prayers can be employed in Eucharistic catecheses, mystagogy and homiletics. The prayers also provide language and imagery for further prayer and meditation, which can assist in the development of a spirituality and ethics of self-offering at both the ecclesial and personal level.

Made available in DSpace on 2012-09-11T17:13:06Z (GMT). No. of bitstreams: 1 Nursey_cua_0043A_10247display.pdf: 3546511 bytes, checksum: 55054b8b4b6d2a37951c7d0e031a4322 (MD5)

Degree awarded: Ph.D. Liturgical Studies/Sacramental Theology. The Catholic University of America

Many liturgical theologians understand the Church's euchology as a primary source for theological reflection. This dissertation examines the Prayers Over the Gifts (super oblata) for Sundays in Ordinary Time in their liturgical context in the current Order of Mass as such a theological source. The study begins by examining the presentation of bread and wine and other gifts at the altar in early Eucharistic liturgies. It shows how a practical activity took on cultic and sacrificial connotations. This led to the increasing elaboration of the ritual actions and prayers associated with the presentation, with the super oblata appearing in the seventh century as the sole prayer of preparation for the Eucharistic prayer in the earliest sacramentaries of the western Church. The development of the preparation rite into the highly sacrificial Offertory in the Missale Romanum 1570 is followed. Here, the numerous offering prayers obscured the liturgical and theological import of the super oblata, which were now said silently. Next, in the revision of the Order of Mass following Vatican II the Offertory became the Presentation of the Gifts, in which the sacrificial elements were lessened and the super oblata recovered an approximation of their original significance. A study of some of the critiques of the current preparation rite and the role of the super oblata within it follows. The dissertation then proceeds to a detailed analysis of the thirty-four super oblata for Ordinary Time. It shows how the orations elucidate the role of the liturgical act of offering in the whole sacramental economy of the Eucharistic sacrifice and give particular expression to theological themes including grace, providence, Christology, soteriology, ecclesiology, sacramentality and eschatology. These liturgically founded notions can be applied in the construction of a comprehensive Eucharistic theology, which in turn can contribute to the ongoing development of systematic theology. Moreover, the theological content of the super oblata prayers can be employed in Eucharistic catecheses, mystagogy and homiletics. The prayers also provide language and imagery for further prayer and meditation, which can assist in the development of a spirituality and ethics of self-offering at both the ecclesial and personal level.

Made available in DSpace on 2012-09-11T17:13:06Z (GMT). No. of bitstreams: 1 Nursey_cua_0043A_10247display.pdf: 3546511 bytes, checksum: 55054b8b4b6d2a37951c7d0e031a4322 (MD5)

Degree awarded: Ph.D. Social Work. The Catholic University of America

An Examination of Attachment Styles and Distress Among Parents Who Have Lost a Child to CancerPhilip M. Domingue, Ph.D.Director: Karlynn BrintzenhofeSzoc, Ph.D.This study of bereaved parents whose child died of cancer, investigated how retrospective insecure attachment and social support impact both the individual and the couple in dimensions of marital satisfaction, grief, and psychological distress. The impact of levels of discrepancy in retrospective attachment styles between spouses, on marital satisfaction, grief, psychological distress, and social support were examined. The study also explored the impact of insecure attachment and social support on grief oscillation (ref: Dual Processing Model of Grief) (DPM). The study utilized a cross- sectional correlational survey design. Couples bereaved in the last five years, still living together at diagnosis of deceased child, were invited to participate through support organizations such as Candlelighters in both the U.S. and Canada. The survey consisted of seven standardized tools: Retrospective Attachment Questionnaire (RAQ), Brief Symptom Inventory (BSI), Dyadic Adjustment Scale (DAS), Hogan Grief Reaction Checklist (HGRC), Texas Revised Inventory of Grief (TRIG), Inventory of Daily Widowed Life (IDWL), and Social Support Index (SSI)). Demographic data was also collected. The sample consisted of 86 individual and 32 couples. The data was analysed using SPSSS and multivariate analysis of three hypotheses were performed. Results showed mixed support for all three hypotheses. Insecure attachment was a stronger predictor of grief, than gender. Insecure attachment and social support were both predictors of psychological distress. Retrospective attachment style was not a significant predictor of marital satisfaction/distress however, the control variable gender and social support were. Discrepancy of anxious ambivalent attachment in the couple increased the level of social support. An interaction between discrepancy in disorganized attachment and gender impacted levels of grief. In terms of oscillation balance of grief insecure attachment was the only significant predictor with social support trending. This study supports aspect of the DPM, specifically the claim that attachment styles have an impact on individual and to some extent on couples grieving outcomes. The findings support the DPM concept of oscillation balance and that loss and resolution orientations are separate grieving tasks. Retrospective attachment was stronger predictor of grief than gender. Researchers and clinicians should consider retrospective attachment styles as an important variable in grief.

Made available in DSpace on 2011-02-24T20:46:15Z (GMT). No. of bitstreams: 1 Domingue_cua_0043A_10080display.pdf: 1667552 bytes, checksum: a873abae32867c5e73882e9d77b02537 (MD5)

Degree awarded: Ph.D. Social Work. The Catholic University of America

There is a significant lack of research on the long term effects of cancer treatment on sexuality and intimacy, specifically in those diagnosed as young adults (YA) (18 to 40 years old). Sexuality and intimacy are quality of life issues affected by cancer and its treatments, regardless of age, race, gender, or socioeconomic background. Sexual dissatisfaction, whether physical, psychological, or emotional, not only affects the person being treated for a disease, but also his/her partner and the overall relationship. Although there is substantial literature supporting the challenges in sexual function, fertility, and body image in persons with cancer, there is a significant lack of research on the long term effects of cancer treatment on sexuality and intimacy, specifically in those cancer survivors diagnosed as young adults who are two to five years post cancer diagnosis. Utilizing cognitive theory as the guide, this study sought to explore the differences in this researcher's conceptual model of the sexual self of young adult cancer survivors as compared to their healthy peers (those with no history of a cancer diagnosis). This exploratory study utilized a mixed-methods research design to study the sexual selves of young adult cancer survivors (diagnosed two to five years ago) and healthy peers. A total of 167 young adults participated in the online survey; 113 survivors and 54 healthy peers. The primary purpose of this study was to investigate this researcher's conceptual model of the sexual self, and the sexual self of YA cancer survivors; 2 - 5 years post diagnosis as compared to their healthy peers.Findings show that the sexual selves of young adult cancer survivors are indeed different than those of their peers, demonstrating lower sexual esteem, higher sexual distress, and lower sexual function. Additionally, qualitative data demonstrated that health care professionals are not sufficiently addressing the sexual health concerns of young adult survivors. The lack of information provided appeared to be interpreted as dismissive of the importance of their sexuality and sexual health needs. Further, quality of life was lower and psychological distress was higher when a more negative sexual self was present in the survivor.

Made available in DSpace on 2011-02-24T20:45:49Z (GMT). No. of bitstreams: 1 Bolte_cua_0043A_10082display.pdf: 1074546 bytes, checksum: edf517cf7746485511fb8a8544684246 (MD5)

Degree awarded: Ph.D. Social Work. The Catholic University of America

This dissertation can be viewed by CUA users only.

A public health approach to the harms that arise from alcohol misuse requires that alcohol problems be identified early and intervened with before serious social and medical consequences occur. An intervention directed at at-risk drinkers, known as alcohol brief intervention, has well established efficacy when delivered by physicians working in primary health care clinics and some hospital Emergency Departments. However, the adoption by physicians has not been widespread, due to a number of barriers including lack of physician time, skill, and knowledge about alcohol. An important question thereby arose as to whether other health professionals, including social workers, achieve the same positive patient outcomes as physicians when delivering the intervention. Using data from the largest effectiveness study of alcohol brief intervention in Emergency Departments (ED's) to date (Academic Emergency Department Screening, Brief Intervention, and Referral to Treatment Research Collaborative), changes in alcohol use from patients who were treated by physicians were compared to changes in those patients treated by non-physician health professionals. Participants in the current study (n=279) were drinking at levels above the National Institutes of Health limits. Patients were divided into two groups: 137 received the intervention from a physician and 142 received the intervention from a non-physician health professional. In addition to baseline data on demographic, education and health variables, measures on three quantity and frequency of alcohol use variables were collected at baseline and at 3-months post intervention. Results of an Analysis of Co-Varience that adjusted for differences in baseline drinking, indicated that controlling for gender, marital status, education level, and severity of addiction, the ED patients who received the alcohol brief intervention from trained non-physician health providers did as well as at 3-month follow-up on the three assessed outcomes of reduction in alcohol use as those patients who received the intervention from a physician. Findings suggest that non-physician health professionals who are trained in alcohol brief intervention be considered to provide the intervention, removing significant barriers to physician delivery that currently exist, and increasing opportunities for wide-spread implementation of this efficacious public health approach to reducing the harms of alcohol misuse.

Made available in DSpace on 2012-09-11T17:08:24Z (GMT). No. of bitstreams: 1 Murray_cua_0043A_10128display.pdf: 660002 bytes, checksum: eae0385f6b3adf66169618748e47ef4d (MD5)