Doctor of Philosophy in Counselling Psychology (PhD)
Improving Indigenous clients' access to mental health care services by exploring mental health provider bias and discrimination
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Since the events of September 11th 2001, Muslims have been under increased scrutiny experiencing discrimination, prejudice, and hate crimes. The consequences of this day have had a negative affect on Muslims and their communities’ mental health, making it imperative to ensure Muslims are able to access mental health professionals when needed. However, contemporary counselling and psychotherapy are still criticized for being Eurocentric, and research has shown that disparities in mental health services based on sociocultural variables have continued to persist. It has been noted that religion is an area that has not received much attention in the literature on mental health service disparities leading to a dearth in knowledge on how Eurocentric approaches impact Muslim clients. It is this broader context that highlights the pressing need to investigate the possibility of religious disparities and implicit bias in access to mental health services for Muslims. The goal of this study was to examine if there is possible implicit bias by counsellors and psychologists against Muslims who access counselling and psychotherapy services. An audit methodology utilizing emails examined the effects of clients’ perceived religion on counsellors and psychologists in Greater Vancouver in their openness to provide services. A total of 470 practitioners received an email either from a Muslim male or non-Muslim male potential client, requesting an appointment. The main analyses showed that perceived religion was not a statistically significant predictor of whether a response is received nor how receptive a practitioner will be. Exploratory analyses showed that perceived religion was associated with how long it takes practitioners to respond, with the Muslim man receiving statistically significant quicker responses, compared to the non-Muslim man. This study was the first Canadian study examining mental health services disparities using an audit methodology, as well as the first North American study examining mental health services disparities based on religion, which can help inform future research in this area.
Alcohol and other substance use disorders are a significant health and social issue in North America (World Health Organization [WHO], 2018). Previous research has found that individuals working to overcome an addiction often report feeling hopeless about their ability to secure employment or return to work in the future (Bauld et al., 2013). Hopefulness and a sense of human agency have been found to be important predictors of positive outcomes, including vocational ones, in a variety of domains for individuals with substance use disorders. Research findings suggest that the presence of hopefulness and being engaged in a meaningful activity, such as a job, are important factors for achieving positive outcomes for individuals with a significant problem with substance use (Ferrari et al., 2012). As such, it is essential to validly and reliably measure career competencies, based on hope and human agency, in clinical settings to provide direction for practitioners on how to effectively support this population. This study evaluated the psychometric properties of the Hope-Action-Inventory (HAI; Yoon, 2017) with a sample of 751 individuals who had ever had a problem with alcohol and other drugs. The HAI is based on Hope-Action Theory (Niles et al., 2019) and was developed to measure an individual’s level of Hope-Centered Career Competencies (i.e., Hope, Self-Reflection, Self-Clarity, Visioning, Goal Setting and Planning, Implementing, and Adapting). This study assessed the reliability of the HAI as well as the scale’s factor structure to explore whether the HAI can be justifiably used to assess career competencies in a problematic substance use population. The HAI was found to have adequate reliability with this previously uninvestigated clinical sample. Furthermore, hierarchical confirmatory factor analysis found that the previously proposed hierarchical seven-factor structure of the HAI fit the data well. These results provide support for the use of the HAI by professionals working with individuals who have ever experienced problematic substance use. Specifically, for the purpose of developing a better understanding about which career competencies clients may need to work on to improve their ability to navigate career development and exploration.
Compared to women, men experience many poorer health outcomes including having shorter lifespans, higher rates for all 15 leading causes of death, and greater risk of cancer and heart disease (Courtenay, 2000; Statistics Canada, 2005; Singh, Kochanek, & MacDorman, 1994; Viallancourt, 2010). College aged men experience additional challenges such as dropping out of school more often and engaging more frequently in risky behaviours compared to women (Courtenay, 2000; Oliffe, Galdas, Han, & Kelly, 2013). Research illustrates the adherence to traditional masculine norms contributing largely to men’s poorer life outcomes (Shen‐Miller, Isacco, Davies, St. Jean, Phan, 2013). Deficit models of psychology saturate the literature on men and masculinities to provide insights into men’s experiences and therapeutic interventions, but less attention has been given to the study of strengths and positive emotions. (Kiselica & Englar-Carlson, 2010). Further, research demonstrates the lack of engagement of college aged men when receiving psychotherapeutic interventions (Davies, Shen-Miller, & Isacco, 2010; Kiselica & Englar-Carlson, 2010). By using a positive psychology approach to develop clinical interventions, scholars have found increased engagement of college aged men in counselling (Davies et al., 2010; Kiselica & Englar-Carlson, 2010), but literature describing these approaches is largely theoretical. Following recommendations to build theory on men and masculinities using a positive psychology lens (Issaco, 2015) and noting the existence of a new but elusive concept of possible masculinities, the present study aimed to (a) construct a data-driven theory for explaining how college aged men envision their possible masculinities (i.e., what men want to be in the future), and (b) to contribute theory-driven suggestions for psychotherapeutic interventions for college aged men within a positive psychology framework. Using grounded theory methodology, the Envisioning Possible Masculinities Model (EPMM) emerged from analyzing eight focus groups with 49 college aged men. The EPMM describes the contextual factors and processes contributing to how college aged men envision their possible masculinities and summarizes two types of possible masculinities (i.e., internal and external). Results can be used to expand the theoretical understanding of college aged men, aid in the development of engaging clinical interventions, and improve the current conceptualization of possible masculinities.