When the opioid crisis re-introduced itself to the United States in 1975, individuals began advocating for change regarding treatment of various substance use disorders – something that the health care system was not prepared for or interested in. The creation of programs outside of the hospital setting in forms of detox centers, inpatient programs, and outpatient programs set the tone for discriminatory views and biases regarding SUD that have continued to be present for the past decades.

The purpose of this project is to examine mental health outcomes of discriminatory healthcare experiences and opioid use disorder through three different papers: the systematic literature review, the conceptual paper, and the practice application paper.

The systematic literature review presents an evidence-based analysis of the current knowledge regarding mental health outcomes of discriminatory healthcare experiences and opioid use disorder. It reviews literature related to the history of healthcare and opioid use disorder discrimination and various themes among past research findings and recommendations.

The conceptual paper identifies, explores, and analyzes relevant theories that can be used to address mental health outcomes of discriminatory healthcare experiences and opioid use disorder. It synthesizes knowledge, past change efforts, and presents new recommendations to fill gaps in research.

Lastly, the practice application paper uses synthesized knowledge and theories to solve this practice problem.

Suicide postvention is a growing terminology and practice in the mental health professions. Supervision practices are a key element of suicide postvention practices, in the field of social work there is an isolated group that does not have this important component of suicide postvention. Supportive supervision practices as described by the Association of Social Work Boards (ASWB) and the National Association of Social Workers (NASW) are one component that can be put in place to support those private practice social workers who currently lack this crucial component of suicide postvention.

This capstone project’s main aims are to (1) identify psychotherapy interventions in the literature that specifically addresses internalized homonegativity (IH) in lesbian, gay, and bisexual individuals (LGBI), (2) present a conceptual model integrating several therapeutic approaches to target the multifaceted nature of IH, and (3) adapt the conceptual model for individual psychotherapy. Specifically, the systematic literature review (SLR) explored the research question, “What psychotherapeutic interventions have been identified in the literature to address the internalized homonegativity (IH) of LGB adult individuals?” The goal of the SLR was to identify the therapeutic approaches that had been adopted for use with LGBI, targeting IH. The findings illustrate four main psychotherapy approaches, (1) psychodynamic psychotherapy, (2) gay-affirmative therapy, (3) person-centered therapy, and (4) cognitive therapy. The conceptual model outlines a new and novel approach to treating IH in LGBI, named the Internalized Psychotherapy Model for Internalized Homonegativty (IPM-IH). The IPM-IH systematically integrates interventions from each of the four therapy models. The practice application paper builds on the conceptual paper by detailing how the IPM-IH is applied to individual therapy. The IPM-IH for individual therapy with LGBI is a three-stage approach that systematically addresses the intrapsychic, cognitive, and interpersonal functions implicated in IH. The treatment model describes the (1) assessment, (2) treatment, and (3) evaluation stages of treatment. While each paper has a particular focus, the culmination of the three papers results in a novel approach to working with LGBI with internalized homonegative biases.

The United States Department of Veterans Affairs (VA) is the largest employer of master’s level social workers in the United States (Department of Veteran Affairs). Social Workers have been employed in the VA since 1926. The VA currently employs over 19,000 social workers nationally and because of this sheer scope in number requires critical approaches to ensuring that supervision in regard to administrative, educational, and supportive supervision are consistent across all locations.

Social work within the VA provides services to veterans that touch upon a myriad of programs including mental health, substance abuse, intimate partner violence, suicide prevention, geriatrics, primary care, homeless services, and caregiver support. The nature of the vast types of services that social workers provide in this system call for a unified approach to training and supporting supervisors responsible for the oversite to social work staff in cross sectioned areas, requiring a level of competent knowledge and expertise that spans across specialties.

Since the Covid 19 pandemic, staffing has suffered with a large exodus of healthcare providers including qualified social workers. The lack of resources and the staffing shortages have left social workers still working in the VA healthcare system with large caseloads, feelings of burnout and cross covering in areas outside their primary area of expertise. Supervisors in the system have often been quickly promoted to cover administrative responsibilities with little education, training or mentoring to prepare them for the role. The lack of adequate supervisory support is leading to the turnover rates and ultimately impacting patient care provided of these critical services from social work.

Organizational support for adequate and consistent supervision provided to social workers in the VA is critical to motivating and retaining staff in this growing resource constrained setting. Review of the research and current literature supports that the provision of quality supervision plays an integral role in reducing turn-over rates, burnout, overall job satisfaction and patient outcomes. The following review of the literature posits that the importance of consistent provision and oversite of supportive supervision to social workers in healthcare settings such as the VA is critical to retention efforts and patient outcomes.

Legislation has implemented laws that mandate that students who qualify for special education services have equal opportunities in the school environment. The Rehabilitation Act of 1973 and the Education for All Handicapped Children in 1975 ensured that all children receive free education and that institutions accommodate each child. However, they do not specify what accommodations. This is up to the individual's school district and what programs they offer. Some students who qualify for special education services are placed in self-contained classrooms; these students learn academics and life skills. Unfourtanky many of these classrooms are secluded from the general education environment and other students. This affects them socially. I propose mainstreaming self-contained students with general education students during exploratory classes. Inclusion benefits not only students in self-contained classrooms but students in the general education setting as well. Our educators aim to prepare students for life as best as possible. These students will only sometimes be in a secluded setting that fits their needs.

The presentation will explore the impact of burnout, trauma, and mental health barriers that child welfare workers endure while working. There is a lack of self-awareness for the barriers experienced, resulting in high turnover rates, stress, high caseloads, lack of support, and inconsistency providing adequate services to children and families within child welfare. There are a variety of interventions developed to support children within the child welfare, however there is a lack of support for providers within child welfare. Trauma-informed care initiatives have been successful addressing trauma and the barriers because of traumatic experiences. The capstone creates awareness to implementing trauma-informed care initiatives within child welfare agencies to promote greater well-being, retention, supportive environments, professional development, and self-care. Utilizing theoretical approaches such as strength-based, solution-focused, systems, and trauma-informed care are essential in implementing a practical solution within organizational leadership. Implementing policies, trainings, and leadership support will help to increase retention, create a safe environment, promote greater well-being, and eliminate barriers. Providing support to child welfare workers is essential to support their well-being and to ensure that adequate services are provided to children within child welfare.

The presentation will explore the impact of burnout, compassion fatigue, and lack of supervision within school social workers. In school social workers, research has been lacking, particularly in terms of burnout, compassion fatigue, self-care, and supervision. Taking care of yourself and implementing different interventions are important to eliminate other problematic stressors as a school social worker. There are a variety of interventions developed to support students which helps decrease burnout and compassion fatigue. This capstone will create awareness of different restorative practice interventions, self-care techniques, and ways to implement appropriate supervision to decrease burnout and compassion fatigue. It's important to provide a theoretical perspective, the strengths of using both approaches are their identification of the problem and the creation of a feeling of reliance. They look to enhance social and emotional awareness, support for all involved, and resources.

Trauma-informed care initiatives have been successful addressing trauma and the barriers because of traumatic experiences. The capstone creates awareness to implement trauma-informed care initiatives within child welfare agencies to promote greater well-being, retention, supportive environments, professional development, and self-care. Utilizing theoretical approaches such as strength-based, solution-focused, systems, and trauma-informed care are essential in implementing a practical solution within organizational leadership. Implementing policies, training, and leadership support will help to increase retention, create a safe environment, promote greater well-being, and eliminate barriers. Providing support to school social workers is essential to support their well-being and to ensure that adequate services are provided to students and the school community.

People are often drawn to helping professions because they have experienced some form of adversity in their lives. This presentation explores the concept of the "wounded healer" and how this manifest in social work practice. The presentation explores the concept of the “wounded healer” and theories that explain the reported high rates of adverse childhood experiences by helping professionals, particularly social workers. An examination of the Kentucky Board of Social Work (KYBSW) approved clinical supervision training required for licensed clinical social workers in pursuit of providing clinical supervisions. After a review of the current competencies of the KYBSW approved training, a curriculum and competencies will be explored by the presenter, that includes information regarding the disproportionate experiences of childhood adversity, ways to support certified social work practitioners, and ways to encourage open communication during supervision. With the use of clinical supervision, the negative implications of childhood adversity can be reduced. The purpose of this, is to enhance the integrity of social work practice, enhance clinical social work, and prevent impaired social work practice by raising awareness and supporting social workers.

Disproportionality in special education refers to the rate at which students from diverse backgrounds are placed into special education in comparison to their White peers. Disproportionality exists across public schools in America, and efforts to reduce disproportionality have been unsuccessful. Research suggests that black students and black students are rapidly qualifying into special education, receive harsher discipline methods, and are placed into self-contained special education programming at significantly higher rates than all their peers. Black students are twice as likely to qualify for special education under an emotional impairment, and three times more likely than their white peers to be identified as having an intellectual disability. Placing students in special education at monumental rates and misidentifying need is directly associated with negative outcomes, including greater involvement with the juvenile justice system and lesser access to higher education. Rooting practice in theory, this presentation will explore the perceived causes of disproportionality and align them with evidence-based solutions to create viable district-level change.