Racial Disparities in Posttraumatic Stress Disorder Treatment

Introduction

We all know that African Americans participated in every war in which the United States of America was involved. Their sufferings are not limited to their war struggle as they tend to suffer even when they return home. While African Americans make up for approximately 14% of the US population, they account for 17% of the overall number of US soldiers. The African American soldiers and veterans are exposed to numerous stressors that can be characterized by a rather high level of multi-layeredness and interconnection (Rosen et al. 355). Like numerous other American soldiers, African Americans may feel left and unsupported when they come back home from the battlefield. However, the issue is rather complex for Black veterans and soldiers because they experience stresses based on critical changes occurring in mental health and associated with institutional racism.

All these factors lead to the advent of a struggle regarding the inability to obtain necessary resources and gain support that is vital throughout the process of overcoming the pains of war (Kaczkurkin et al. 93). This is why clinicians have to understand that they have to deal with specific cultural experiences when treating African American veterans. This leads us to the hypothesis that the healthcare specialist has to be culturally competent to provide high-quality treatment to African American veterans. Within the framework of this submission, the author is going to discuss several components that may critically impact the complexity of psychological traumas received by African American soldiers and provide a conceptualized policy that will be expected to contribute to the changes in healthcare practices. This population necessitates essential clinical treatment, and specific assessment techniques have to be used (Mustillo and Kysar-Moon 330).

Moreover, the researcher realizes that there are quite a few ethnicity-specific reactions that may transpire during the veterans exposure to combat-related PTSD. This kind of ordeals may include the African American Psychic Trauma, for example. A thorough analysis of this topic will help the researcher to investigate the nature of African American vulnerabilities and come up with a brand new treatment plan that will also include a novel type of care delivery. Such evidence was presented by Tiet et al. who examined the status of minority veterans and then associated it with expectancies regarding the treatment of PTSD (317). This study was based on the information presented by the Department of Veteran Affairs (VA) and included several additional aspects such as components of the therapeutic alliance. The researchers asked veterans to complete surveys regarding the efficiency of PTSD residential treatment that they received (37%  minority respondents, 63%  white respondents) (Tiet et al. 319).

It was hypothesized by the researchers that minority status adversely impacted their therapeutic bond with the outpatient provider. At the same time, the authors of this research article stated that the expectancies for residential treatment also relied on the association with the former provider. Tiet et al. found out that higher expectancies could be positively associated with the concept of task agreement (instead of the previously mentioned therapeutic bond (319). The problem with their findings consisted in the fact that effect sizes were relatively small. To conclude, the researchers were not able to identify any critical differences in terms of VA PTSD residential treatment that would consider the ethnic minority status. According to the information obtained throughout the surveys, the investigators were able to point out the idea that other treatment settings should be involved in future research to investigate the issue of veterans with PTSD more comprehensively.

Another study on the topic of PTSD among African American veterans was conducted by Spoont et al. (419). They based their research project on the idea that PTSD can be associated with several physical and social deficiencies that are exclusively PTSD-related. Even though the VA does a lot to cover the expansion of mental health issues among African American veterans, they cannot provide sufficient care to the majority of those in need. Therefore, the clinical benefit cannot be achieved, and African American veterans keep on struggling (Spoont et al. 419). In addition to this inclusive hypothesis, the researchers decided to take into account the question of race differences when it came to premature mental health treatment. The investigators went even further and addressed the issue of differential access to healthcare services. To obtain the most accurate results, they took a sample of African American veterans who were recently diagnosed with PTSD (Spoont et al. 420).

The researchers waited for six months to complete a follow-up survey. The results of their investigation showed that minority veterans (Latino and African American) did not receive sufficient treatment throughout those six months (Spoont et al. 422). Nonetheless, African American veterans were also found to meet the effects of pharmacotherapy retention negatively. Race disparities related to treatment retention did not show any significant variation between White and African American veterans. Spoont et al. concluded by claiming that even in the VA, there are occasional disparities in terms of PTSD treatment. They advocated for a much more direct approach towards the patients treatment beliefs. Therefore, we have to conduct further research in the area to address the issue of treatment disparity properly and provide African American veterans with decent and fair PTSD treatment.

The issue with PTSD consists in the fact that more and more veterans are annually affected by this disorder. In perspective, treatment may be costing more than several billions of dollars because the country does not pay proper attention to the problem. Therefore, there is a need to advocate for critical changes in the current policy to help the VA get rid of race-associated disparities. Counseling Services of the organization also have to be improved  the VA does not even try to outsource these services yet, and the burden of derisory treatment resources remains undefeated. It is safe to say that without an applicable intervention, veterans with PTSD will be subject to abusing alcohol and other substances.

The evidence shows that they numb their pain using displaying hazardous or felonious behaviors (Koo et al. 12). Currently, fixing the short-term issues may lead to the advent of several complex long-term issues that will affect the whole ecology, not a single individual. African American veterans are mostly affected by PTSD because they showcase their non-adaptive coping mechanisms. Consequently, we have to find a solution that would let African American veterans have access to the necessary services and resources. Lee and Gabriele also mention that African American veterans are much more inclined to being exposed to traumas, obesity, and sleep problems (3). The VA did not pay enough attention to the question of posttraumatic stress, but there is a robust body of evidence that shows that the current policy has to be revised to provide better treatment plans for the minority veterans.

Policy Solution

This policy solution will be divided into several important points. First of all, there is a need to take into account the cultural eco-map and ethnically relevant readings. This policy stresses the importance of facilitating the development of simpler eco-maps and military-adjusted narratives. In this case, the policy relies on the idea that African American veterans may identify themselves more with their armed services family. The proposed action plan revolves around the idea that many African American veterans may have unresolved conflicts that transpired from the death of their military partners. The evidence discussed in the literature review section hints at the fact that there is a strict necessity to build new narratives to approach African American veterans culturally.

This policy change is justified by the fact that the new processes of cognitive synthesis may help African American veterans to integrate their traumatic past into the current existence. At the same time, this approach will help healthcare practitioners to decrease the strength of PTSD symptoms (this will be discussed in the next subsection of this proposal). The rationale for reworking the framework of passing down information consists is the difference between the traditional African American methods (storytelling and narratives) and those that are currently used by practitioners. The evidence shows that such clinical treatment plans may have a positive impact on African American veterans. Therefore, the idea that is covered in this policy relates to the concept that collaborative partnership increases the chances to come up with an appropriate treatment plan for African American veterans with PTSD.

The second part of this proposal is intended to disclose several recommendations for the practitioners. First of all, there is a stringent necessity to help PTSD practitioners to gain more insight into the question of the cultural identity of African American veterans. The problem here consists of the fact that they may be still exposed to the adverse influence of racism and the history enslavement. According to this policy proposal, practitioners should not disregard the fact that African American individuals are oppressed and battle against inequalities even in the modern world. Second, it is recommended to identify the strengths present in African American veterans to help them to build positive relationships with their families. Here, practitioners will have to emphasize the importance of finding the solution collaboratively. The third recommendation hints at the fact that African American veterans should be perceived as partners on several levels.

It may be reasonable to learn more about the everyday life of regular African American individuals to find more points of contact. Expanding on this topic, the new policy also suggests that practitioners should interact with veterans throughout each of the treatment stages. These stages include diagnosis, medication intake, and the overall treatment process. Clinical interaction with African American veterans can be subject to transference issues, so it has to be guided carefully. Overcoming this barrier is vital, and the policy suggests that African American veterans have to work on their PTSD in collaboration with the practitioners to achieve positive results. We should also consider the fact that the psychological traumas of African American veterans may be reflected in other family members. This may happen because typical African American families are in a state of interdependence. The policy intends to address PTSD as a disorder that causes a lack of affection and makes African American veterans too preoccupied with their traumas. Therefore, the possibility of internal family disintegration also has to be addressed by the renewed policy.

The third part of the proposal relates to the implementation of specific family therapies as they can also be helpful. This idea also has to be supported by an additional initiative  psychoeducation for the members of African American families with veterans. Nonetheless, this should not be the only improvement. It is also proposed to provide counseling services using the Army Community Services Program (ACS). The rationale behind this decision is an extensive number of services that can be adjusted to the needs of African American veterans with PTSD and their families. Also, this program can be implemented because it is available in several places and local communities fully support these initiatives. In perspective, the policy is willing to connect with the ACS because it provides relocation, deployment, and budgeting services for African American veterans.

Also, at this particular point, we may address the primary cultural issue associated with the African American population and soldiers/veterans in particular. There is a problem with the inability of the majority of clinicians to embrace a different archetype that outlines the African American community. The rationale for this particular decision consists of the idea that there are ways to conceptualize African American worldviews and develop an African-centered treatment framework that will be based on the strengths of this community. Within the framework of this policy, it is proposed to pay attention to the significance of family and collectivism, religion and spirituality, empathy, empowerment, and healing rituals. As it has been mentioned before, we have to focus on the African American culture and history to be able to develop a multi-dimensional treatment framework. To conclude, the author of this proposal believes that African American veterans with PTSD should be exposed to holistic treatment because of numerous spiritual aspects that are typical of this community.

The author of this proposal understands that religiosity and spirituality of African American veterans is one of the cornerstones of reforming the existing policy. Therefore, minority veterans with PTSD must be influenced by practitioners properly as there is no other method to cope with traumatic events. Without an in-depth understanding of the African-centered culture, there is no point in revising the current policy. All the PTSD practitioners dealing with African American veterans will have to possess knowledge in military culture. The author of this policy proposal is certain of the fact that clinicians have much better chances of building positive relationships with African American veterans if they are well-versed in the discipline of the armed services. This policy is compiled to promote the significance of military values that are highly appreciated by African American veterans. It may be safe to say that effective PTSD treatment can only take place into a culturally appropriate environment that respects the peculiarities of African American worldviews. To conclude, the development of a renewed policy can also be supported by the fact that African American veterans are less expected to approve PTSD treatment than their White counterparts. There is no way we can elaborate and implement a new policy without addressing the question of mental health stigma. This may be particularly beneficial when treating African American veterans with PTSD.

Policy Impact

It is expected that the epidemiological data reports will show a robust decline in the number of African American veterans with PTSD after the policy is implemented. Also, the researcher assumes that even the rates of PTSD prevalence will go even lower than expected. Nonetheless, there may still be some issues with providing appropriate treatment for veterans with severe functional impairment. One of the problems that may interfere with the successful implementation of the policy and spoil the positive impact of the latter is the willingness of quite a few veterans to exaggerate their symptoms for the sake of disability compensation. Regardless, the policy will deal with the cases where the reports on combat exposure change repeatedly and do not reflect the severity of PTSD correctly. The proposed policy will allow clinicians to perform a much more accurate clinical evaluation and provide services to the majority of African American veterans in need.

In perspective, this policy will exterminate the need to be watchful and validate veterans sincerity using additional check-ups and unnecessary interviews. One of the outcomes that are perceived as central is the ability to preserve effective and compassionate healthcare and maintain positive relationships with African American veterans. Statistically, African American veterans with PTSD do not commonly benefit from treatment if compared to other patients with this disorder. The researcher expects that the employment of the proposed policy will increase the overall number of African American veterans that are willing to complete psychotherapy and engage in posttreatment activities. It is also expected that the implementation of this policy within the VA framework will provide us with more evidence regarding clinical improvements in African American veterans with PTSD. This policy can be positively associated with a cognizant attempt to encourage African American veterans to participate in vocational rehabilitation.

The significance of this policy can be highlighted by the fact that currently, vocational rehabilitation is not available to the majority of African American VA associates with PTSD. This will help the researcher to replace the existing policy and implement only those evidence-based practices that are aligned with the rehabilitation principles mentioned in the previous subsection of the proposal. Most probably, African American veterans will be able to find a job after being exposed to the countertherapeutic practices of the past. The impact of the proposed policy will be perceived on working, social, and physical levels. More to say, the policy will strengthen the existing knowledge base regarding the African American community and the minority veterans with PTSD. The researcher expects to minimize the occurrence of cases where veterans with PTSD are merely seeking compensation and are not interested in being a part of clinical research or an evidence-based treatment plan. This recommendation was not taken into consideration before, but the author of this proposal believes that it makes no sense to ignore this population.

On a bigger scale, the implementation of the proposed policy will give clinicians the possibility to recruit applicants that are involved in the treatment process and not motivated solely by compensation. This will allow us to develop the existing PTSD interventions for African American veterans and help them overcome their combat trauma. It is also expected that they will closely collaborate with clinicians to investigate the under-researched aspects of PTSD. US veterans deserve to be treated appropriately, and this policy will change their status in the healthcare community. Moreover, appropriate rehabilitation services that are in line with the cultural specifics of African American veterans will positively impact their civilian life. The social expectations associated with this policy are rather high. In perspective, the proposed policy will eradicate the counterproductive practices from the radar of PTSD practitioners and provide the latter with more possibilities to save African American veterans from becoming psychiatrically disabled. Using this policy, the researcher expects to develop flexibility in the minority veterans, but they have to bear in mind that psychiatric problems may impact the process of recovery regardless of the chosen strategy. This is why resilience is pivotal, and the author of this policy proposal believes that the number of chronically ill African American veterans with PTSD will decrease significantly.

Therefore, the policy outlined within the framework of this submission will pave the way for a fundamental reform of healthcare that will flexibly address the issue of African American veterans with PTSD and increase the overall level of responsiveness of all actors involved in the circumstances. Using this extensive policy, the researcher is willing to increase the level of healthcare services and review the number of resources that are dedicated to helping African American veterans with PTSD. The prevalence of invalidism will not be nurtured, and the available resources will not be wasted. Despite quite a few changes that the author of the policy proposes to implement, the ultimate goal of this incentive is to integrate the existing principles into the proposed framework and adjust them so that they would be in line with the needs of African American veterans. Some of these crucial aspects include emphatic treatment and vocational rehabilitation. Using the proposed policy, we will be able to make sure that the interventions are recovery-focused and there are no principles that undermine or underestimate the value of the African American community and the minority veterans with PTSD.

This policy is expected to have a major impact on the development of rehabilitation strategies and facilitation of the treatment process. This will allow the current healthcare system to take care of the most relentlessly ill African American patients. The impact of this policy on healthcare can also be characterized by the fundamental changes that will occur in medicine and labor conditions. The existing technology allows us to conduct all-inclusive research projects and implement the most farfetched treatment practices. One of the most important concepts that will be addressed using this policy is the concern about symptom overstatement. All the defective check-up procedures will be replaced with culturally appropriate interventions that will be approved by African American veterans as well. The benefits of the proposed policy are also expected to include the reduction of impediments in terms of participation in different PTSD treatment practices. African American veterans deserve to come back from the battlefield and become productive members of society one more time. This is why the author of this proposal reconsidered the existing PTSD policy and realized that the implementation of certain practices would lead to improved patient outcomes.

The most important outcome of the implementation of this policy is the complete funding of the needs of African American veterans with PTSD. The researcher believes that this step will critically improve retention rates of healthcare personnel and improve the overall quality of services provided to the African American community. In perspective, the implementation of this policy will validate the existence of licensed mental health providers that practice PTSD specifically. The majority of faux disability claims will disappear due to an updated methodology of treating African American patients. Veterans will be treated appropriately, and the conditions of participating in a disability claim program will be revised. The author of this proposal expects that several programs that support African American veterans with PTSD will be deployed to provide the necessary assistance to this vulnerable population. The policy also suggests that the appointment scheduling procedures will also be impacted.

Additionally, the author of the proposal expects that the healthcare information system will also be revised and African American veterans with PTSD will receive continuous care. In terms of the military impact of the policy, it is expected to reduce mental health stigma and increase the involvement of military personnel in the process of elaborating veteran-related policies. Also, the policy presupposes that mental health awareness programs will become an essential part of military training and minimize the incidence of PTSD among African American soldiers in the future. The VA is expected to provide specific medications to its associates to ensure that more cognitive care practices are incorporated. Importantly, this policy is expected to trigger the advent of finance-based research on stigma and other types of military traumas. Therefore, the implementation of this policy will have an incredible impact on US healthcare and veteran policies in particular.

Conclusion

This policy proposal extensively dwelled on the existence of several issues that are commonly associated with African American veterans with PTSD. Taking into consideration numerous implications of this disorder and quite a few specific concepts that relate to the nature of African American soldiers and veterans, it is safe to say that any policy on PTSD has to be extensive enough to ensure that all the aspects of care are covered. The researcher accurately outlined the issue of racial disparities in PTSD treatment of veterans and then focused on the policy that would eliminate all those discrepancies. It was found out that the implementation of the policy will not be associated with major resource expenditures and the most important concept that has to be taken into account is the cultural exclusiveness of African American veterans.

In other words, this vulnerable population has to be treated differently, and the researcher conducted a serious literature review to identify the gaps and close them using the current proposal. It can be concluded that numerous issues have to be addressed. Nonetheless, the researcher believes that a decent relationship between the VA and policy-making institutions may ultimately lead to the creation of a practically flawless healthcare system where all veterans will be treated equally. The current state of affairs hints at the fact that a lot of hard work is necessary to revive the reimbursement system and get rid of unfairness inherent in the current treatment processes. While we cannot predict the future, we can make sure that the particular nature of the African American community is addressed properly. This will facilitate the process of providing care to any veteran, not only the minority representatives because practitioners will become way more knowledgeable and versatile.

PTSD is a serious disorder, and we cannot mitigate all of the discrepancies associated with African American veterans overnight. Nonetheless, the current policy proposal provides a rational framework for the upcoming incentives and makes the best effort to include all focal points into the healthcare equation. The impact of the proposed policy cannot be estimated yet, but it is going to affect the system of veteran care provision in the United States of America. Several essential resources have to be allocated properly and the author of this proposal critically addressed this issue. African American veterans with PTSD can be rightfully considered to be a vulnerable population that does not receive the recognition it deserves. This policy was elaborated to equalize the current state of affairs in healthcare and ensure that all the parties attain accurately calculated reimbursements that do not rely on veterans race and do not perceive the latter as one of the decisive factors when it comes to providing PTSD treatment. Most probably, even the attitude of African American veterans towards healthcare will be affected, and the researcher sees this as a positive outcome that cannot be replaced by any other benefits. A collaborative care environment will reduce the tension between veterans and care providers and the key idea behind the current policy proposal is that positive relationships between the parties may help them both. It may be concluded that this all-encompassing policy may be able to promote equality in healthcare and improve the majority of aspects that relate to the African American community and their veteran representatives who have PTSD.

Works Cited

Kaczkurkin, Antonia N., et al. Ethnic and Racial Differences in Clinically Relevant Symptoms in Active Duty Military Personnel with Posttraumatic Stress Disorder. Journal of Anxiety Disorders, vol. 43, 2016, pp. 9098., Web.

Koo, Kelly H., et al. PTSD Detection and Symptom Presentation: Racial/Ethnic Differences by Gender among Veterans with PTSD Returning from Iraq and Afghanistan. Journal of Affective Disorders, vol. 189, 2016, pp. 1016., Web.

Lee, Aaron A., and Jeanne M. Gabriele. Racial Differences in the Associations of Posttraumatic Stress and Insomnia with Body Mass Index among Trauma-Exposed Veterans. Behavioral Medicine, vol. 1, no. 1, 2017, pp. 18., Web.

Mustillo, Sarah A., and Ashleigh Kysar-Moon. Race, Gender, and Post-Traumatic Stress Disorder in the U.S. Military. Armed Forces & Society, vol. 43, no. 2, 2016, pp. 322345., Web.

Rosen, Marc I., et al. Racial Differences in Veterans Satisfaction with Examination of Disability from Posttraumatic Stress Disorder. Psychiatric Services, vol. 64, no. 4, 2013, pp. 354359., Web.

Spoont, Michele R., et al. Are There Racial/Ethnic Disparities in VA PTSD Treatment Retention? Depression and Anxiety, vol. 32, no. 6, 2014, pp. 415425., Web.

Tiet, Quyen, et al. Relationships between Racial/Ethnic Minority Status, Therapeutic Alliance, and Treatment Expectancies among Veterans with PTSD. Psychological Services, vol. 13, no. 3, 2016, pp. 317321., Web.

Minority Stress and Health: Societal Issues

Societal issues have been long known to influence the state of health of lesbian, gay, bisexual and transgender (LGBT) community. These people are affected by various negative attitudes which lead to complicated health issues. Discrimination and societal stigma cause problems with physical, as well as mental health in LGBT people. They often have psychiatric disorders, there is a high tendency towards suicides among them, and they suffer from substance abuse more frequently than people with traditional sexual orientation. Due to the peculiarities of the LGBT peoples personal life, they might experience limited support and restricted access to medical services. These factors negatively impact the LGBT communitys health.

Stigma is considered to have the most powerful effect on LGBT people. They are victimized at different levels of social life communication (school, workplace, or home), LGBT.1 Victimization causes significant adverse outcomes. LGBT people acquire high levels of psychological anxiety which negatively impacts their health. The research has shown that suicide attempts are much higher among gay, lesbian, and bisexual people than among heterosexual citizens.1 Stigma varies from minor forms like anti-gay humor to major forms like physical offense. Any of these forms may present harsh societal pressure.

Another societal factor which is close to stigma but still different from it is discrimination. Although these two factors have similar outcomes, the effects of discrimination may be more dangerous. LGBT people feel it when they are receiving medical treatment.1 They remark that if a medical worker is homophobic, it may influence the treatment methods and results. Such fear often is a reason why LGBT people are reluctant to apply to hospitals for care, which may lead to dramatic health damage.1

Apart from victimizing factors impacting the LGBT peoples health, there is also danger presented by the legislation system. The stress levels can be caused by the barriers to government recognition. Advocates of LGBT rights have difficulty framing their endeavors.2 The most common problems concerned with legislation are caused by the LGBT peoples inability to get married in most countries of the world. Additionally, they are often forbidden to adopt children. These restrictions negatively impact peoples lives, again causing constant stress risks.2 To prevent this societal issues damage presented to LGBT community, governments should implement changes which would allow these people to feel equal with the heterosexuals. This way, their life satisfaction will be higher, and health risks will be reduced.

Finally, there is a crucial factor of unequal access to health services for LGBT people. World Health Organization (WHO) fails to meet all the needs of these people regarding access to health facilities.3 While special normative acts have been created to improve the situation, WHO remains impartial in any cases. The need for LGBT peoples access to proper medical care is explained by the high disposition to some risks (psychological disorders, HIV/AIDS, suicides).3 Thus, equal access to medical care is another crucial factor in treating LGBT community.

While societal factors impacting the LGBT peoples health are various, they all have the similar outcome: the lives of these people are put under a lot of pressure. Physical and mental health disorders, tendency to suicides, constant depression, and high stress levels are caused by the societys reaction to LGBT community. The society should reduce the negative factors deteriorating the lives of LGBT people. Everyone deserves to be treated equally, and it is of particular importance to sustain the health of the community.

Reference List

Kelleher C. Minority stress and health: implications for lesbian, gay, bisexual, transgender, and questioning (LGBTQ) young people. Counselling Psychol Quart. 2009;22(4):373-379.

Mertus J. The rejection of human rights framings: the case of LGBT advocacy in the US. Human Research Quart. 2007;29(4):1036-1064.

Duvivier RJ, Wiley E. WHO and the health of LGBT individuals. The Lancet. 2009;385:1070-1071.

Post-Traumatic Stress Disorder Assets and Facilities

Introduction

This essay presents a list of sustenance amenities and researches for people with PTSD. Moreover, it will provide information towards how easy or difficult it was to detect PTSD assets and facilities in the area and categorize several breaches in the public in relations of assets and facilities for those individuals who have lived through shock and are in danger of emerging PTSD.

List of sustenance amenities and researches for people with PTSD

Beras, E. (2013). With community violence, post-traumatic stress can be a hidden wound. This article reveals the story of Rachel Zwipf, who is moving to another town due to the terrible events that happened to her family. Judith Cohen, who is a medical worker, provides her commentaries on the case. She has treated a lot of individuals of different age; still she claims that the academics are still acquiring knowledge about the way the brain and body retort to shock in infantile and mature age. One of the effects they are aware of is that when an individual is confronted with hazard, their brain appears to be redone to assume menace. It stops responding as if the domain around people is harmless (Beras, 2013).

Hudenko, W., Homaifar, B. & Wortzel, H. (2012). The relationship between PTSD and suicide. The given research investigates the connection among PTSD and suicide and delivers material that assists in comprehending suicide. A vast amount of study designates that there is an association between a lot of sorts of distress and suicidal actions (Hudenko, Homaifar & Wortzel, 2012). For instance, there is an indication that distressing proceedings such as infantile cruelty can upsurge an individuals suicide menace. A record of army sexual ordeal upsurges the hazard for suicide and deliberate self-damage as well, proposing a necessity to monitor for suicide hazard in this populace.

Jaffe, G. (2012). New name for PTSD could mean less stigma. The army field marshals and psychoanalysts are involved in a passionate discussion over whether to alter the definition of a disorder as longstanding as fighting.. The comparatively forthright application that instigated with the Army of the United States has elevated the new-fangled inquiries towards the reasons of PTSD, the best method to approach the disorder and the fences that stops people from receiving assistance and support. The alteration can have the foremost fiscal insinuations for health guarantors and national incapacity entitlements as well (Jaffe, 2012).

Tucker, D. (2009). Domestic violence, PTSD and brain injury: Military and civilian challenges  Part 1. The author investigates the soldierly and non-combatant challenges offered by home fierceness and performance, which is more frequently related to PTSD or TBI, in cases when they are attributable to involvements in a soldierly scenery or some other impact, for example, being a target for youngster cruelty or sexual attack or from brain damage influencing on the instinct mechanism of the victim. Moreover, the author will offer commendations for attorneys and adjudicators in addition to the assets for interference with the criminal and sustenance for the targets (Tucker, 2009).

Assessment of the gaps in the resources and services for people with PTSD

It was easy to detect PTSD assets and facilities in the area, as the society and the government are currently establishing a vast amount of amenities for this disorder. I would recommend the patient to review the sources provided to him and to seek assistance in the governmental facility. The people who are not engaged in this course and have no substantial acquaintance with PTSD be able to discover these assets.

A lot of gaps discourage people from looking for support for their mental health difficulties, counting their apprehensions towards undesirable occupation consequences, principles that treatment appears to be not operative, and the outlook of extensive interval periods and incomplete accessibility of sources. Women, even more so than male victims, express their apprehensions towards the probable side effects of the medicines, which are frequently applied to treat these complications. In my opinion, people should increase the awareness towards the support systems and their exceptional beneficial side that has no drawbacks to the mental health of the patient.

References

Beras, E. (2013). . Web.

Hudenko, W., Homaifar, B. & Wortzel, H. (2012). The relationship between PTSD and suicide. Web.

Jaffe, G. (2012). New name for PTSD could mean less stigma. Web.

Tucker, D. (2009). Domestic violence, PTSD and brain injury: Military and civilian challenges  Part 1. Web.

Stress and Strains in the Renaissance Society

Introduction

This paper considers the stresses and strains in the renaissance society after the plaque. In this essay, the stressors are outlined, a major stressor is identified from among the many and how the renaissance society responded to the stressor is discussed in detail.

Renaissance age refers to a period in history which was characterized by a movement towards intellectual reawakening among European scholars and academicians. It began in Italy and spread to the rest of Europe by the 16th century. Its spread affected many spheres of life because it highlighted or pointed to the misgivings in classical civilization.

The plague was an epidemic catastrophe that swept across Europe from 1347 to around 1351. The catastrophe affected and shaped all aspects of human life, i.e., socially, economically, and politically. Depopulation and decrease of labor was a characteristic which accelerated changes that had already started to take root in urban and rural economies across Europe. In general, the idea of exchange of wages for skilled labor became entrenched, services were hastened, and social balance became less rigorous.

The Renaissance, which had all marks of a psychological movement, affected the perception of the arts, religion, and education. The plaque menace had resulted in most elites and educated clergy dying thus denting church vibrancy and general social participation. In fewer than four years, the disease had caused a series of death spanning from Asia, Italy, France, and many other parts of the world.

Stresses and Strains

There are many challenges associated with the plague which influenced the renaissance civilization. Those challenges or effects touched every aspect of life in Europe spanning from church, trade, music, art, agriculture, and every other part of society. One of the strains as a result of the plaque ravage was food insecurity.

As a result of the plaque, many people had not been able to produce food. Lack of food or poor performance of the agricultural sector had adverse effects on the general economy of most European States. The poor performance of the agricultural sector could largely be attributed to many deaths and incapacitation effected by the plague. The few laborers that could be found charged high wages for their services, which further dampened productivity in the agricultural sector.

The labor resource was generally strained and was a big strain on the industrialists and other business people (the elites and aristocrats). Given the laborers charged highly or demanded high wages, the prices of goods and services generally became high. As the cost of living went up, the workers in industries, other trade professions; skilled workers demand even higher pay so that they can be in a position to cope up with the rising cost of living. Workers had huge bargaining power since there was no competition.

The church in a bid to survive also gave in to tricks and became a strain in itself on the society. In the hope of creating clean methods of getting the extra income, they began to levy by force fees on funeral services. They could afford to do this because funeral services and arrangements were on high demand. The elites, i.e., Lords and nobility, were not spared from the economic suffering because their farmlands were.

Another strain on the general society was a rebellion by some peasant and poor communities. The rebellion by peasants caused a lot of jitters and strain in Renaissance society. In response to the economic pressure caused by laborers rebellion, the nobility put the kings and rulers, especially in France and Italy, under immense pressure to forcefully control trade through price fixing with the aim of stabilizing the economy.

Stabilizing the economy was critical for the nobility as it would mean an end to abnormal and unprecedented social mobility. Yielding to pressure, the kings or leaders, in general, used their status and immense power to make this possible. The poor or peasants and those who did rebel this market control maneuvers by those in power were massacred or silenced or suppressed through imprisonment.

The Upper class approached rebel peasants in a cunning way; they artificially created new taxes so that they swindle from the poor and peasants their hard earned money (David 1954, 81).

By so doing, they continued suppressing the peasants and making them even poorer and with no support at all, until they were unwilling and unable to rebel anymore. Some places like Paris and Florence, people who started rebellion were able to amass wealth for the first time. However, their fortunes were short-lived as they were compelled to give these profits to the wealthy.

The post-plague society was put under further strain by the war between the French and English. The war only made the situation much worse as it was costly in terms of personnel, machinery used, finance, and administration. Both nations suffered from losing huge sums of money in war expenses; money which would have been used more profitably, e.g., in buying food for the population which was dying from severe starvation.

The war weakened the economy further making it hard for states or nation to come out of the economic depression. This scenario increasingly made it more difficult for the lower and middle classes to sustain themselves. Those who were privileged, for example, the ruling elite, just watched without doing anything to help with the situation.

Another stressor or strain that people had to deal with is the tremendous stress surfacing due to the barren emotional disquiet caused by years of watching helplessly as a ravaging plague takes away people especially friends and family members. Such an experience was traumatizing; it created to shock, depression, and panic that spread across many towns, cities, and rural areas. For instance, the Black Plague was estimated to have destroyed one-quarter of European Population.

The black plaque is widely believed to have been one of the most pronounced epidemics in history. It is estimated that in England alone, between 1348 and 1351, one million people died. This was approximately one-third of its population destroyed by the virus.

This kind of happenings traumatized the whole society. As a result, some people got lured into becoming religious fanatics, believing that God will show them grace and save them. In their religious stupor, the traumatized mass moved around lashing each other with canes or sticks trusting that their acts appeased God.

Resulting from the psychological trauma and deteriorating economies, there was also a blame game, i.e., different groups blamed each other for the cause of the plague. For instance, it is reported that the Hebrew were suspected and blamed for having poisoned the wells from which the rest of the community drew water. Such suspicion led to several Jews being massacred. Other groups shifted blame to the church for being materialistic, more interested in politics as opposed to spiritual matters.

Over the years, the church had accumulated immense wealth. Some people began to think differently that God was punishing them because of the sins being committed in the church. According to this group, the church was supposed to be a holy institution taking care of the needs of everyone regardless of his status in life, and what he/she offered to it.

Another trend that had developed and later plaque the post-plague renaissance society was dread for other people. Some people, out of imaginary fears, continued to distance and separate themselves from mainstream society as a measure of avoiding the possibility of catching the plague.

In Europe, most families that survived from plague suffered from shock, because the plague disease came without notice, and it swept many people at once. The resultant psychological stigma and trauma continued to stress relationships among members of society.

The major Stressor

The major stressor in the post plaque renaissance society was a lack of meaninglessness or mere despair. The economy was poor due to the effects of the plague and war but also due to the general class system that did not give the poor, peasants and women an opportunity to benefit meaningfully from their efforts. Before the plaque, family link and tradition was so intact that in many European countries such as Italy, a lot of efforts were put in place in organizing and arranging them.

Parents had the last say for their childrens future wives/husbands, and this was determined by the class and status of the family where the girl/boy came from. The reason for parent involvement was to influence the future economic condition of the family. God was central in all decisions which were made regarding the marriage of young men and women. Generally, women during this medieval time were viewed as inferior to men. In social interactions, they were regarded more or less as mens subjects.

The church, which was a poignant institution promulgated doctrines and teachings and enacted them as laws that gave men authority over women. With teachings that stressed respect for masters, the church in a way entrenched social inequality. With endorsement from the church, the elites, aristocrats, and men exploited the poor, peasants and women without remorse.

It was generally accepted as a natural law that women are born to serve men; thus, they should unquestioningly subserviently submit to their husbands. Women were not allowed to voice personal opinions or indicate that they could have personal judgment. Justification for such attitude was found in the book of Genesis where Adam beguiled Eve and not the other way round. Therefore, mans directives and commands were taken more or less like godly dictates to be followed to the letter.

The post-plague renaissance period was marked by a revolutionalized way of looking at everything. The way people spend their leisure moments changed; this was both the peasants and the wealthy. Death was no longer dreaded, and people became a little more daring. Those who had escaped the plague felt glad to have cheated death. Such realization in itself emboldened them, i.e., if they had managed to escape death, what else was there to fear. Solemnity associated with funeral processions waned, and people started to approach them as mere normal occurrences.

A look into post-renaissance art indicates the extent of post-plague renaissance despair. It is during this period that much artwork, sculptures, architecture, and paintings depict a charmed life. The kings and wealthy merchants commanded and commissioned cathedrals, monuments, and sculptures, designed in a way as to remind the people of how the disease had swept away many people. Others were built to give honor to God for standing by his people in given regions or areas.

Response to Major Stressor

The post plagues renaissance societys response to the challenge of or meaningfulness crisis was through rebellion. Signs of rebellion can be discerned in the abandonment and vandalism of churches. The rebellion in the art world best exemplifies the kind of rebellion that informed the response to the post plaque crisis. It is reported, for example, that church carvings was altered and made into coffins of totally different shapes that had pictures of copses on their lid.

This was to show a flattering image of the body inside the coffin wearing their best outfit. There were some paintings depicting people socializing with skeletons and were done under command of a powerful person called (danse macabre).

Many artists abandoned traditional ways of painting, which was characterized by Christian religious connotations or meanings. Artistic work from that period allude to the fact that the artists were depressed by death that engulfed them, this made them change the art world by painting pictures of sad and dead people.

Various art forms and styles were regenerated and old ones redone. This was a result of coming up with new painting and drawing to reflect modern civilization. Modern civilization was based on a rebellious attitude towards old structures, ways of thinking, and ways of organizing society.

Conclusion

The post-plague renaissance society was a strained and stressed society. Much stress and strain resulted from poor economic conditions but also the general desperation and hopelessness resulting from plague related trauma. As a result of the plague, the agricultural sector in most European countries was starting. Due to a reduced workforce, labor was expensive leading to many challenges for industrialists. The governments or leadership in the different states had a herculean task of managing society or maintaining law and order.

Governments were focused on how to jumpstart economies and bolster the morale of citizens. Incentives in the form of tax cuts for elites were adopted to encourage investment. However, nobility also pressured kings and rulers to increase taxes for common or peasants. Such like moves and the general experiences increased a general sense of despair among the majority citizens.

As a result of the general desperation among people, the basic response to the post-plague challenges was rebellion. Peasants rebelled against the elites and aristocrats. The decrease in population had led to increase in demand for laborers, thus affording peasant enormous bargaining power. Workers who had been working or elites at exploitative wages could now assuredly take off and travel around in search of better wages. They were sure of finding work opportunity that offered higher wages for their services.

It was not just the peasants and laborers who exhibited rebellious tendencies. As seen through art, even intellectual perceptions and interpretations changed dramatically in the post-plague renaissance age.

Old meanings ascribed to things like church artifacts no longer holds ground. An intellectual rebellion towards traditional tenets was the hallmark of that period. It is during those days that even conceptions about women began to be questioned. Women were now more involved in family affairs, taking on decision making roles, which was unheard off in the classical and medieval ages.

Bibliography

Alberti, L. Batista. The family in the Renaissance. South Carolina: University of South Carolina, 1969.

Borsi, Franco. Alberti Leon Battista: The Complete Works.

Translated by Carpanini Rudolf G. New York: Harper and Row, 1977.

Canning, Joseph, L. Hartmut, and J. M. Winter. Power, Violence and Mass Death in Pre-modern and Modern Times. Ashgate publishing, ltd, 2004.

Castiglione, Baldesar and B. Conte George, The book of the Courtier. Middlesex: Penguin Publishers, 1976.

David, Wallace. Giovanni Boccaccio, Decameron, Cambridge: Cambridge University Press, 1954

Hanning, Robert, W. Castiglione: the ideal and the real in Renaissance culture. Yale University Press, 1983.

Trevor, Dean and K. J. P. Lowe. Marriage in Italy, 1300-1650. 4th ed. Cambridge: Cambridge University Press, 2002

Posttraumatic Stress Disorder: Case Presentation Report

Assessment and Diagnosis

Identifying Data

  • Date of initial assessment: N/A
  • PSEUDO Name: Ana

Reason for Referral/Presenting Problem

Ana is a self-referred and re-occurring client who entered counseling after the case of domestic violence. Ana decided to seek mental health help for the first time after the assault case when an abusive partner broke into her home and threatened her with a knife. Recently, the Department of Corrections (DOC) informed Ana that her ex-partner would be released on probation. As a result, Ana expressed feelings of anxiety and fear for her and her daughters safety. During the counseling session, I assured Ana of confidentiality, and she allowed me to document her case for this presentation under a pseudo-name.

Source of Information. The information was obtained during the psychospiritual assessment of the client.

Summary

Ana is a 40-years old Spanish Speaking Latino female; the information on her previous education and profession was unavailable. She did not experience mental health problems until the domestic violence incident. Ana appeared very anxious due to the traumatizing effect of armed assault and worrying news about her ex-partners upcoming release. She has a daughter who recently arrived in the United States from Ecuador. Ana said concerns about her own and her daughters safety caused problems with sleeping and severe fatigue  sometimes, her mind went blank. From the spiritual perspective, Ana called herself a devout Christian believer and said that religion is one of the few things that offer her comfort in these difficult days full of fear and anxiety.

DSM-5 Diagnosis

  • F 41.1  Generalized Anxiety Disorder (provisional) (American Psychiatric Association [APA], 2013).
  • Differential diagnosis: Posttraumatic stress disorder.

Rationale

Judging from the initial assessment, Ana is experiencing the symptoms of generalized anxiety disorder. In particular, she complained about persistent anxiety, worries, and sleep disturbance. In addition, Ana talked about severe difficulties with concentrating and a constant feeling of fatigue. Lastly, Ana mentioned several episodes of her mind going blank. A differential diagnosis of posttraumatic stress disorder may also be applicable since Anas anxiety was primarily based on the DOCs letter containing information about the upcoming release of her abusive ex-partner.

Case Conceptualization

Step 1: Identify and List Client Concerns and Any Other Problem Areas

  • Anxiety: Worries about daughter
  • Fatigue: Worries about own safety
  • Mind going blank; Sleep disturbances

Step 2: Organize Concerns Into Logical Thematic Groupings Descriptive-Diagnostic

Generalized Anxiety Disorder (Descriptive-Diagnostic)

Step 3: Theoretical Inferences: Attach Thematic Groupings to Inferred Areas of Difficulty

  • Maladaptive thinking (CBT)
    • Ana experienced anxiety related to the following areas: her safety and her daughters safety.
  • Maladaptive behaviors (CBT)
    • Excessive worrying leading to sleep disturbances and subsequent symptoms, such

Step 4: Narrowed Inferences and Deeper Difficulties

Cognitive Distortions: Magnification and Helplessness

Cbt: I Fear for Myself and My Daughter; I Cannot Sleep, I Cannot Relax and Think About Anything Else.

Narrative of the Case Conceptualization

From the cognitive-behavioral therapy (CBT) perspective, Ana has expressed several maladaptive thoughts and behaviors. In particular, her anxiety stemming from excessive worries about the DOCs decision resulted in sleep disturbance. Ana has become fatigued and restless due to her constant maladaptive thinking. She also developed a cognitive distortion of magnification since she saw her ex-partners imminent release as an unavoidable, unmanageable threat. A magnified perception of threat and helplessness triggered crippling anxiety. In turn, anxiety resulted in Anas inability to shift focus and evaluate her situation without a lens of fear.

Treatment Planning/Integration/Counseling Theory

Treatment Plan
Treatment Plan

Integration of Faith

I apply the Christian faith to counseling via the Integration View, an approach proposed by Stanton Jones. According to Jones (2010), the integration of Christianity and psychology implies providing the notion of the lordship of Christ and Gods true Word with an appropriate place of authority in determining fundamental beliefs. In Anas case, I integrated Christianity into counseling in order to boost the clients confidence and her inner belief in her ability to overcome fear and anxiety. As Isaiah 41:10 says:

  • So do not fear, for I am with you;
  • do not be dismayed, for I am your God.
  • I will strengthen you and help you;
  • I will uphold you with my righteous right hand (Holy Bible, New International Version, 1973/2011);

The integration of faith had a positive impact on Ana. As a fellow Christian, she found my approach relatable and supported the idea of drawing mental strength and comfort in faith. In particular, she agreed that God would like to see her strong, not dismayed by the DOCs decision. Ana said that with Gods help, she would be able to proceed through the therapy and cooperate with the DOCs victim service unit. From the Christian perspective, Anas issues stemmed from desperation and fear. As such, we agreed that prayers and meditation would make a fine addition to the standard CBT interventions and cooperation with the DOC.

Personal Model of Counseling

I am convinced that effective counseling should be based on a scholarly foundation and include a spiritual element. My counseling model includes two elements  CBT as a theoretical basis and Christianity as a potent provider of moral strength for my clients and me. On the one hand, CBT-based interventions are well-suited for identifying and correcting harmful behaviors with a decent degree of effectiveness. On the other hand, Christianity grants me the inner power and wisdom to provide clients with spiritual guidance and moral support. Therefore, I intend to acquire a deeper knowledge of CBT and study the Christian texts to improve my mastery of the personal counseling model.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.

Holy Bible, New International Version. (2011). Biblica (Original version published 1973).

Jones, S. L. (2010). An integration view. In E. L. Johnson (Ed.), Psychology and Christianity: Five views (2nd ed., pp.101-142). IVP Academic.

Smoking and Stress Among Veterans

Abstract

For many people, smoking has been used as a method of self-medication for easing feelings of distress. However, research evidence has shown that continuous smoking and the failure to quit actually increases tension and anxiety. Nicotine is a substance that creates an instant sense of relaxation and relief, which enables people to smoke with the expectation that they can curb stress and anxiety. In the general population, the attempts to cut out smoking from daily life has shown to have a favorable impact on both physical and mental well-being, which suggests that in narrow population groups, such as veterans, similar results are expected to be revealed in the proposed qualitative study. In the target population of veterans, smoking has also been used as a form of stress relief, especially when it comes to PTSD.

This study proposal aims to explore the healthcare problem of smoking and stress among veterans. The challenge is extensive, and there is research evidence showing that smoking only exacerbates the symptoms of anxiety among people. The target population of veterans has been chosen for analysis because the individuals experience severe mental health symptoms and seek different methods to relieve them. The study will be of qualitative nature and look at a smaller sample size than in quantitative procedures. While there is bias from self-reported data, the qualitative study can help achieve more profound insight into the problem through the understanding of participants behaviors. The expectation of the study is that smoking does not help veterans deal with stress on a long-term basis, which is why behavioral interventions may be carried out to help them quit and achieve physical and mental well-being. The limitations of the proposed research include smaller sample size and the possibility of bias.

Statement of the Problem

Smoking and stress have come hand-in-hand as many people have engaged in smoking as a self-medication method to ease the feeling of pressure. However, research has found that smoking actually increases emotional tension and anxiety (Choi, Ota, & Watanuki, 2015). The effect of nicotine is such that it can provide a sense of relation, which makes people continue smoking in the belief that they can calm themselves down and ease the tension. However, such a feeling does not last a long time as the symptoms of withdrawal take place and increase the craving to continue smoking (Choi et al., 2015). Continuous smoking reduces the symptoms of withdrawal, but it does not alleviate anxiety on a long-term basis and cannot help people get rid of the stress that they experience. Therefore, smoking as a way of stress reduction creates a vicious circle  a person smokes to relieve stress but starts experiencing further strain from the withdrawal.

Significance of the Topic

The topic is significant to explore because of the misconception that smoking can alleviate the emotional burden of stress and anxiety when in reality, it has an exacerbating effect on emotional stress. It is essential to study the healthcare challenge because adults with stress and depression are twice as likely to engage in smoking as adults without depression (Kim et al., 2019). The majority of people begin smoking before experiencing the signs of stress or depression, and it is not clear whether smoking results in a reduced mental health state. It is also most likely that there is a much more complicated relationship between the two.

Because cigarette smoking is a significant health risk, researchers have explored the influence of cessation on stress levels and the changes in stress levels. For example, in the study by Kim et al. (2019), of the subject population that smokes, 78.3% felt stressed. Among research participants that successfully stopped smoking, 73% reported feeling stressed (Kim et al., 2019). In contrast, of those who failed to quit, 83% also reported high-stress levels (Kim et al., 2019). Besides, among people that made no attempts to stop smoking, 81% reported stress (Kim et al., 2019). Overall, individuals who were unsuccessful at stopping smoking experienced more stress compared to those who did not attempt to quit the habit (Kim et al., 2019). This shows that besides the adverse physical health consequences, smoking results in mental health complications that need further addressing.

Target Population

The target population of the proposed study includes veterans who are more likely to suffer from stress and even posttraumatic stress disorder (PTSD). Many people who experience emotional strain report engaging in smoking to manage their moods and deal with anxiety. Among veterans, the stress may be associated with their experiences during deployment or coping with life after the military. Even though smoking may feel like smoking helps relieve the symptoms of stress and alleviate the burden of mental strain, on a long-term basis, it can make stress and PTSD even worse. Therefore, it is essential to explore the issue of tobacco use among veterans who smoke in order to relieve stress. While quitting smoking can be challenging, veterans have experienced significant success in quitting smoking without making their stress and PTSD worse.

Literature Review

Relationship Between Stress and Smoking

The interplay between stress and smoking has been of interest among researchers, with scholarly studies available for review. The objective of the current literature review is to provide a comprehensive overview of the original scientific studies that are relevant to the topic. Considering the fact that the issue is extensive, the research literature ranges in dates of publication and scholarly journals in which it was published. A comprehensive study on perceived stress and smoking was carried out by Stubbs et al. (2017), who gathered data across forty-one countries from Europe, Africa, Asia, and the Americas. Evidence suggests that perceived stress can represent a limitation to smoking cessation even though that little is known about the link between perceived stress and smoking in countries that have different income levels (Stubbs et al., 2017). It was found that the prevalence of smoking was 27.3%, with the highest and lowest prevalence observed in Africa (13.4%) and Asia (32.1%), respectively (Stubbs et al., 2017). Importantly, older individuals were much more less likely to smoke in Europe than in order regions (Stubbs et al., 2017). In the overall sample, a one-unit increase in the perceived stress scale (in the range between 2 and 10) was associated with a 1.05 times higher likelihood of smoking (Stubbs et al., 2017). Overall, the perceived stress is significantly linked with the higher rates of smoking across countries with different levels of income.

A comprehensive study on the influence of smoking cessation attempts on the levels of stress was conducted by Kim et al. (2019), who suggested that even though smoking cessation can benefit both physical and mental health, the process of quitting is difficult and shows its relationship to stress levels. In the study, the researchers analyzed the connection between the attempts to stop smoking and stress levels. The scholars used data from Korean Community Health Survey that included 488,417 participants (Kim et al., 2019). Using the chi-square test and logistic regression, survey data was analyzed. It was found that the prevalence of stress among individuals who were unsuccessful at stopping smoking was 1.11-fold higher compared to those who made no attempts at quitting smoking (Kim et al., 2019).

The prevalence of stress levels in participants who were successful at stopping smoking was 0.87-fold lower compared to those who have not tried to quit smoking (Kim et al., 2019). Notably, the association was stronger in females than in males, which may explain why the two genders had variable success rates of smoking cessation. Such variables as income, the number of individuals in the family, and marital status were stratified to get analyzed (Kim et al., 2019). The results illustrate the trend that people who were unsuccessful at stopping smoking had a higher risk of stress in the majority of the strata, especially when it comes to men. Besides, it is shown that smoking cessation can reduce stress levels when the attempts have been successful (Twyman et al., 2019). However, quitting smoking can be harmful and result in increased stress if attempts fail.

In their study, Lawless et al. (2016) explored the perceived stress and smoking-associated levels and symptomology in both men and women. The research represented a retrospective analysis of 62 smokers who were screened, gave relevant sociodemographic information, and whose smoking behaviors and survey measures were carried completed (Lawless et al., 2016). It was found that males experienced a more significant negative association between the perceived levels of stress and the degree of smoking (measured in the number of cigarettes smoked each day). In females, the trend had the same direction, although the association between stress and smoking was not significant (Lawless et al., 2016). Such findings can be explained by the smoking behavior model that suggests that the acute deprivation of nicotine results in increased levels of stress. This means that those who smoke more cigarettes every day are subjected to fewer instances of nicotine deprivation and thus less stress. The study differs from the findings of Kim et al. (2019) because it does not show that heavy smokers have high rates of perceived stress. The discrepancy between the two articles may be linked to the fact that Lawless et al. (2016) used a smaller sample. Therefore, future research using a larger sample may be needed.

The behavioral and sociological perspectives have also been applied in order to study the connections between stress and smoking. In their study, Jahnel et al. (2019) explored everyday stress as a connective point between disadvantage and smoking. Through the social-ecological perspective, the sample of 194 daily smokers was examined. The participants were not attempting to quit smoking and recorded the information about smoking, including both situational and contextual factors, for three weeks. It was tested whether socioeconomic disadvantage, which was indicated by educational attainment, race, and income, exerts indirect effects on smoking, such as cigarettes smoked every day, via daily stress.

In their study, individuals with lower levels of education were much older compared to higher educated individuals, although no differences were found concerning gender and cigarettes smoked per day. Individuals who are disadvantaged socially in terms of their racial background and education are more likely to experience more daily stress. More everyday stress leads to more cigarettes smoked each day, which results in significant indirect effects of education and racial background of smoking as mediated by stress (Jahnel et al., 2019). While it can only be speculated, individuals with lower levels of educational attainment may be more vulnerable to daily stress because the stressors are much more severe and disruptive of their daily lives through the lack of material and psychological coping skills (Jahnel et al., 2019). For example, people of lower-income are more likely to experience long-term stress in the form of financial strain, which does not always have to result in the daily stress experiences but rather chronic stress. Therefore, the more socially disadvantaged a person is, the more likely are they to experience stress and engage in smoking behaviors.

Stress and Smoking in Veterans

While the studies discussed previously discussed the relationship between stress and smoking without a narrowed target population, it is essential to explore articles that focus on veterans as the target population. In their article, OToole et al. (2018) investigated the relationship between combat, posttraumatic stress disorder (PTSD), and smoking trajectory in a group of male Australian army veterans who served in Vietnam. A cohort of male Australian Vietnam veterans, which included 388 individuals, was interviewed using standardized psychiatric diagnostic and health interviews and the assessment of combat exposure. Over time, the smoking trajectory showed a spectrum of outcomes, which included veterans that never smoked, quit early, quit late, and continued smoking. Multivariate statistics were used for assessing the relative contributions of combat trauma exposure and PTSF while also controlling for potential confounders.

The analysis of the trajectory of smoking over time showed that 21.9% of veterans had never smoked, 45.1% had quit smoking by the time of the first wave, 16.2% were current smokers at first wave who had quit by the time of the second wave, 2.8% were late adopters and smoked currently while 13.9% were continuing smokers (OToole et al., 2018). Smoking was related to demographics in single-predictor models, as well as with intelligence, exposure to combat, PTSD symptoms, and alcohol disorders. The most significant finding related to the increased smoking levels due to the exposure to military combat and trauma. Smoking is used as a form of stress relief rather than post-stress disorder, which is more pertinent to smoking and the inability to quit.

In their study, Salas et al. (2022) explored increased smoking cessation among veterans with significant decreases in PTSD severity. The research was carried out because it was unknown whether the reduction of PTSD severity was linked to smoking cessation, an inadequate health behavior common in patients diagnosed with the disorder. To identify PTSD patients in need of specialty care, the Veterans Health Affairs medical record data was used (Salas et al., 2022). The scholars intended to find a relationship between clinically meaningful improvements in PTSD symptoms and the cessation of smoking within two years after baseline. On average, there was a clinically significant improvement of PTSD symptoms in 19.8% of participants who successfully quit smoking (Salas et al., 2022). It was found that patients with clinical diagnoses of PTSD had a meaningful improvement in their symptoms when they stopped smoking. Because patients with PTSD are likely to develop adverse physical and mental health conditions, it becomes of great importance to facilitate positive health behaviors.

The research by Peterson, Prochazka, and Battaglia (2015) explored smoking cessation and care management targeting veterans with posttraumatic stress disorder. The rationale for the research was that individuals with PTSD have higher rates of smoking and are less likely to quit because it relieves their symptoms (Pericot-Valverde et al., 2018). The study involved one hundred and twenty participants that were divided into control groups. The participants were engaged in an intervention that involved a telehealth PTSD program, a motivational interviewing-based smoking cessation program through a telehealth device, as well as weekly motivational interviewing counselling phone calls (Peterson et al., 2015). Motivational interviewing was shown to boost readiness for changing behaviors and smoking cessation care when it comes to the incorporation of in-person mental health care. Using the research, it is possible to combine a written smoking cessation curriculum and phone-based motivational interviewing counselling into a well-developed program that coordinates telehealth and self-care models.

Research Methods

The aim of the qualitative research is to gain an in-depth understanding of the real-world challenge that affects the target population of veterans. The significance of the study lies in need to address the health problem of smoking as a behavioral response to the increased stress levels among veterans. Veterans represent a vulnerable patient population that is at a higher risk of receiving medical care of lower quality, which results in worse medical outcomes compared to patients who have not experienced combat. Considering this healthcare limitation and the fact that smoking has an adverse effect on the physical health of individuals, it is essential to explore the relationship between smoking and stress in the veteran population. The purpose of the research is to evaluate the association between smoking and stress among veterans and determine whether such variables as gender and educational background have an influence on the relationship. The rationale for the research is connected to the issue that smoking is mistakenly used as a stress relief method while, in reality, it does not bring the desired results. From the socioeconomic perspective, it is essential to look at characteristic variables such as gender and educational background as possible predictors of increased smoking due to stress.

The study will involve veterans of different backgrounds, experiences, genders, and educational statuses. The research hypothesizes that the socioeconomic status of participants will have an influence on the relationship between stress and smoking, with veterans of lower educational levels and males being more likely to smoke due to stress. The research questions are the following:

  1. What is the connection between stress and smoking in the target population of veterans?
  2. Does the socioeconomic status (namely, gender and educational background) influence the likelihood of increased smoking due to stress?
  3. Does smoking alleviate the symptoms of stress on a long-term basis?
  4. What interventions can be put in place to improve the well-being of veterans who engage in smoking due to stress?

In contrast to the quantitative design, generalizability is not expected to be accomplished in the study. With the help of semi-structured interviews with focus groups, data will be gathered on participants perspectives on stress and smoking, with considerations of the socioeconomic status of respondents. The focus group design was selected because it can enable group discussions between study participants. This way, the veterans included in the study will be encouraged to share their views and experiences, thus facilitating a potential reflection in terms of hearing others. During the focus group interactions, veterans will be asked both open- and closed-ended questions to encourage discussions and interactions between the participants based on the researcher-supplied topic. The main goal of the focus group interviews is to evoke a certain degree of respondents feelings, attitudes, feelings, beliefs, reactions, and experiences that are otherwise not available using such methods as solely observations or one-on-one interviews.

The feelings, beliefs, and attitudes, which are expected to get revealed during focus group interactions may be somewhat independent of a group or its social setting. However, they are more likely to get revealed when participants, especially those with traumatic and stressful experiences of trauma, gather together and interact within a focus group that has common definitions. The focus group setting is especially useful in the current study because the experiences of veterans will range from one individual to another even though they share a similar language and culture. The degree of consensus on the given issue will be comprehensively explored during the focus groups. Due to this, it is essential that the interviewer ensures that the participants are open to sharing their specific experiences and opinions about the healthcare challenges of stress and smoking.

The qualitative study will be conducted in a community health center situated locally. Such organizations offer communities support through government-funded programs underpinned by integrated support and care models. The programs at community health centers can involve partnerships between non-governmental organizations specializing in veteran support as well as psychosocial support and other healthcare teams offering clinical care. The services aimed at helping veterans quit smoking varies within and across organizations, with most support provided with the help of outreach.

Because of the narrowly-defined target population of war veterans, the study will use purposive sampling to include as many participants as possible that fit the criteria of eligibility. Participants were eligible to participate in the focus groups if they had a former experience of combat and have engaged in smoking as a method of stress relief, being either ex-smokers or smoking currently. The initial surveys for participants assessed potential participants age, gender, socioeconomic status, educational background, and experiences associated with their time serving in the army and engaging in battles. The study subjects will not be reimbursed for participating in the research, with data being collected until the necessary level of information saturation is reached.

Discussions based on semi-structured interviews will be developed in such a way that is clear and understandable to the target population. They will be created by the research team based on the aims of the study. The guides for interview questions will cover such topics as stress developed as a result of trauma from battle (including PTSD), smoking history and current smoking behaviors, educational attainment experiences, as well as previous experiences with interventions aimed at smoking cessation and stress relief.

When it comes to the analysis of data, it will be collected, transcribed, and analyzed once the focus group discussions are fully complete. It is expected to carry out four focus group discussions over the course of two months, twice a month. Notably, the two week gaps between the focus groups are expected to give participants some time to think and reflect on what they and others have said. Besides, such gaps are necessary to ensure that the traumatic experiences of battle are not overwhelming and do not bring up the negative emotions and increase stress and smoking as a way of stress relief.

The transcripts of focus group discussions will be analyzed with the help of thematic analysis. The interviewer will develop summary notes of observations and talks after each focus group. The data will be continuously reviewed and compared for identifying patterns and themes in the data, participant groups and responses to specific questions asked by the interviewer. After all four focus groups are completed, each transcript will be reviewed for noting initial impressions and the understanding of the data. To develop a set of codes for thematic analysis, impressions and initial emerging themes will be discussed. The transcripts will have to be re-read and coded by the data analyst for relevant and meaningful sections and phases of the transcripts represented by themes and comments that several participants repeat in their discussions. Codes will be modified and revised as required in order to best represent the data to then arrange them based on emerging themes. Finally, solid themes will be reviewed and further discussed, with the study authors confirming the accuracy of data interpretation.

An important aspect of qualitative methodology is the reporting of strategies for ensuring the rigor of qualitative work. In the study, the researcher will consider how their experiences, professional background, and prior assumptions could influence data collection and the capacity to facilitate honest and open responses from the interviewed participants. It is important to be sensitive to the different priorities and values that researchers and study participants have. Bias is a common challenge of qualitative studies, but it is crucial to acknowledge the individual experiences and perspectives of participants.

Researchers will summarize, reflect, and give feedback on the information for confirming or clarifying data collected within focus groups. Data will be deliberately collected from sources that are quite different from one another, with varying demographic variables, geographic locations, and experiences, which can increase the transferability of study findings. Research findings dependability can be enhanced by involving another researcher in the processes of data collection and coding. The results will be presented in the form of tables summarizing relevant qualitative data for a better breakdown of information and illustration of findings.

In terms of research limitations, there are some challenges to be considered. The method of focus groups is limited by the dependency on the study design itself and can be addressed with the help of diligent planning. The limitations include less control over the produced data, limited leverage over the interactions within focus groups to keep participants focused on the topic, as well as difficulty assuring full anonymity and confidentiality as information is being shared within the veteran focus group. The relatively smaller number of study participants is another limitation in addition to bias stemming from self-reported data.

References

Choi, D., Ota, S., & Watanuki, S. (2015). Does cigarette smoking relieve stress? Evidence from the event-related potential (ERP). International Journal of Psychophysiology, 98(3), 470-476.

Jahnel, T., Ferguson, S. G., Shiffman, S., & Schuz, B. (2019). Daily stress as link between disadvantage and smoking: An ecological momentary assessment study. BMC Public Health, 19(1284).

Kim, S-J., Chae, W., Park, W-H., Park, M-H., Park, E-C., & Jang, S-I. (2019). The impact of smoking cessation attempts on stress levels. BMC Public Health, 19(267).

Lawless, M. H., Harrison, K. A., Grandits, G. A., Eberly, L. E., & Allen, S. S. (2015). Perceived stress and smoking-related behaviors and symptomatology in male and female smokers. Addictive Behaviors, 51, 8083.

OToole, B., Kirk, R., Bittoun, R., & Catts, S. (2018). Combat, posttraumatic stress disorder, and smoking trajectory in a cohort of male Australian army Vietnam veterans. Nicotine & Tobacco Research, 20(10), 1198-1205.

Pericot-Valverde, I., Elliott, R. J., Miller, M. E., Tidey, J. W., & Gaalema, D. E. (2018). Posttraumatic stress disorder and tobacco use: A systematic review and meta-analysis. Addictive Behaviors, 84, 238247.

Peterson, J., Prochazka, A., & Battaglia, C. (2015). Smoking cessation and care management for veterans with posttraumatic stress disorder: A study protocol for a randomized controlled trial. BMC Health Services Research, 15(46).

Salas, J., Gebauer, S., Gillis, A., van den Beck-Clark, C., Schneider, D., Schnurr, P., & Scherrer, J. (2022). Increased smoking cessation among veterans with large decreases in posttraumatic stress disorder severity. Nicotine & Tobacco Research, 24(2), 178-185.

Stubbs, B., Veronese, N., Vancampfort, D., Prina, M., Lin, P-Y., Tseng, P-T., & Koyanagi, A. (2017). Perceived stress and smoking across 41 countries: A global perspective across Europe, Africa, Asia and the Americas. Scientific Reports, 7(7597).

Twyman, L., Cowles, C., Walsberger, S., Baker, A., Bonevski, B., & Tackling Tobacco Mental Health Advisory Group. (2019). Theyre going to smoke anyway: A qualitative study of community mental health staff and consumer perspectives on the role of social and living environments in tobacco use and cessation. Frontiers in Psychiatry.

Post-Traumatic Stress Disorder and Parenting Style

Post-traumatic stress disorder (PTSD) is a severe mental condition that occurs due to single or repeated traumatic situations. Its cause can be any strong experience that causes an overstrain of the human nervous system: military conflicts, abduction, fire, and beating. Many parents are far from ideal because of a false idea about raising children. It is important to understand the reasons that led to such an opinion and summarize the solution to the problems that have arisen. This study analyzes the answers of ten parents to questions about their parenting style.

This quiz is designed to help parents better understand their parenting style. For each item, they indicate how much they agree or disagree with the statement. Ten parents of Americans took part in the interview, 3 of whom were men. The people selected for the interview were my acquaintances or passers-by who voluntarily agreed to participate. During the interview, several statements are voiced, with which parents must agree or disagree, and explain why. This paper analyzes several of the answers and reveals the theme of parenting style and post-traumatic diseases in children.

Some of the interview questions:

  1. On a scale of 1 to 10, with 1 being lowest and 10 being highest, how much do you believe that kids should make most of their own decisions without parental direction?
  2. On a scale of 1 to 10, with 1 being lowest and 10 being highest, how much do you believe that society would be better if parents were stricter with their kids?
  3. On a scale of 1 to 10, with 1 being lowest and 10 being highest, how much do you believe that kids need to learn early who the boss is in the family?
  4. On a scale of 1 to 10, with 1 being lowest and 10 being highest, how much do you believe that parents shouldnt restrict childrens activities or decisions?

One of the most common and severe traumatic events for children, in most cases, is episodes of domestic violence. Teenagers can openly declare panic attacks  transient, spontaneous states with sudden feelings of fear and anxiety (Cloitre et al., 2021). The trigger can be anything  a word, a sound, a smell, an image, being in a certain space, or a touch. Such manifestations can be incredibly stable and persist for a long time (Cross et al., 2018). Difficulties in diagnosing post-traumatic stress disorder are associated with the limited verbal capabilities of children and the tendency of parents to underestimate the symptoms of the child (Greene et al., 2020). The behavior of children suffering from post-traumatic syndrome is aimed at avoiding situations that actualize memories of trauma (De Young, Landolt, 2018). An example of a trigger is the creaking of brakes, the sound of a gunshot, and the smell of certain medications. Memories arise more often at night, rarely during the day; they are easier to bear.

During the interview, 6 out of 10 parents agreed with the first statement. On average, they answered the first question 4/10 because they believed that parents should be directly involved in the childs decisions. The parents found it difficult to answer the second question, but the average score for the answer was 4/10. Male parents were more likely to believe that discipline improves society. The parents answered the third question positively because they were sure that the child should perceive their parents as the authority and be afraid of them. Only 2 out of 10 people answered the last question positively. Therefore, it can be concluded that in most families, the authoritarian type of upbringing prevails.

By way of conclusion, it is important to note that it is necessary to ensure maximum child involvement in social relations: school attendance, social meetings, sports clubs, and active family recreation. Passion for the present is important  meetings, studies, creativity, and achievements. If a child wants to discuss a difficult event, you cannot refuse, but it is worth talking about it as a past experience. It is possible to reduce the likelihood of post-traumatic syndrome through the correct organization of life.

References

Cloitre, M., Brewin, C. R., Kazlauskas, E., LuegerSchuster, B., Karatzias, T., Hyland, P., & Shevlin, M. (2021). (2020). Journal of Child Psychology and Psychiatry, 62(3), 277-279.

Cross, D., Vance, L. A., Kim, Y. J., Ruchard, A. L., Fox, N., Jovanovic, T., & Bradley, B. (2018).. Psychological trauma: theory, research, practice, and policy, 10(3), 327.

De Young, A. C., & Landolt, M. A. (2018). . Current psychiatry reports, 20(11), 1-11.

Greene, C. A., McCarthy, K. J., Estabrook, R., Wakschlag, L. S., & Briggs-Gowan, M. J. (2020). Parenting, 20(2), 141-165.

Stress Reduction Among College Students

Elevated stress among college students is detrimental because it can negatively affect their physical and mental health. Undergraduate learners with distress are likely to experience such behaviors as increased alcohol consumption, unhealthy eating habits, less exercise, and poor sleep. Therefore, there is an increasing demand for appropriate distress management approaches to counter the aforementioned outcomes. Developing distress decreasing programs, such as mindfulness meditation intervention, on campuses might be an efficient methodology for minimizing stress among students in higher institutions (Huberty et al., 2019). This essay provides a summary of an article on mindfulness meditation, outlines key takeaways from the presentation, defines terms from the piece, and describes findings related to Calm, a mobile application that encourages mindfulness meditation.

Article Summary

Since it can impact learners mental and physical health, developing distress reduction strategies on campuses is of significant precedence. Mindfulness interventions are increasingly becoming popular in colleges because they might help lower stress levels among undergraduates. Huberty et al. (2019) conducted this research to examine mindfulness meditations efficacy delivered through Calm, a client-centered mobile application for eight weeks. The study also tested the programs feasibility through a mobile app and examined the possible implications it has on health behaviors. The methodology included a randomized wait-list control experiment with evaluations at baseline, eight weeks (post-intervention), and twelve weeks (follow-up) (Huberty et al., 2019). The findings revealed considerable modifications in all outcomes between the placebo and treatment grouping following covariate adjustments (post-intervention). Many learners in the group testified that Calm was instrumental in reducing stress since they were satisfied with the app and would recommend it to their schoolmates (Huberty et al., 2019). In conclusion, Calm is useful in mindfulness meditation to decrease stress and enhance self-compassion and mindfulness among students. As a health and physical educator, this research equips me with mindfulness knowledge to design future projects and help learners reduce stress levels.

Key Takeaways

There seems to be a similar degree of improvement in smartphone-based mindfulness applications compared to in-person attendance programs. However, Calm had a greater opportunity for continued use and convenient compliance. Another significant takeaway from the study is that mobile app mindfulness intervention is a promising approach to improving students quality of sleep by reducing disturbances. The finding is supported by Greeson and colleagues, who claim that there is a significant decrease in sleep problems after engaging in mindfulness meditation programs (Huberty et al., 2019). Thirdly, the change magnitude in perceived stress or mental health is greater after participating mindfulness meditation, especially at the follow-up stage. Finally, meditation has a sustained potential of improving mindfulness, even in the absence of a follow-up period. However, the mindfulness effect is more significant at the aforementioned assessment.

Definitions

Stress is defined as feelings of psychological, physical, or emotional tension that result from any challenge that makes one feel overwhelmed or frustrated. According to Huberty et al. (2019), college students have reported feeling overwhelmed due to the demands and stressors they encounter as they learn how to manage their finances, obtain autonomy from their families, make career choices, and balance extracurricular activities and an increased academic workload. Huberty et al. (2019) hold that anxiety, depression, and suicidal thoughts are the predictors of distress amid learners in college. Based on this survey, 60.8% of learners experienced overwhelming anxiety, and 38.2% reported being depressed, a condition that negatively impacted their functioning capability (Huberty et al., 2019). The research also claimed that 10.4% of undergraduates had suicidal ideation, which is among the leading causes of death among young adults and teenagers.

Mindfulness is described as a condition which involves paying attention to and being knowledgeable of the current occurrences with no judgments. There are two primary mindfulness-based interventions: mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) (Huberty et al., 2019). Mindfulness meditation, a constituent of MBCT and MBSR, effectively manages stress among college students (Huberty et al., 2019). However, the intervention is costly, rigorous, and time-consuming. In this study, the variables that were measured include the intervention and the control groups. In the intervention group, the efficacy of the mindfulness meditation intervention on college-going learners with high distress levels, the feasibility of delivering the program through the Calm mobile app, the sustained mindful meditation impacts on self-compassion, mindfulness, and distress, and the possible interventions effects on health deportments was evaluated. These variables were measured within twelve weeks of assessment. The effectiveness of the intervention was compared to a stress wait-list placebo category.

Findings

There were considerable variations in self-compassion, distress, and mindfulness between the intervention group and the control set; similar results were found for self-compassion and mindfulness. Across all outcomes, the effect sizes ranged from 0.50 (moderate) to 1.24 (large). There were substantial grouping and time interactions in sleep disturbance frameworks but no severe effects for other health behaviors (Huberty et al., 2019). Participants engaged in meditation for about thirty-eight minutes weekly during the treatments course and twenty minutes weekly during the scheduled follow-up sessions. Most learners in the intervention category reported the applications effectiveness in minimizing their distress levels. Moreover, most of them were gratified with the mobile app and promised to endorse it to their schoolmates.

Conclusion

In summation, this survey demonstrated the mobile applications effectiveness in minimizing distress and improving self-compassion and mindfulness in overwhelmed college students. Although there were no direct comparisons, it seems the efficacy degree of app-based mindfulness is congruent with that of in-person attendance; it can also be used continually by clients. However, there is constrained information regarding the palatability and effectiveness of delivering mindfulness meditation interventions through mobile applications. Therefore, more research should be conducted in the aforementioned area to establish the sustainability degree and efficacy in both long-term and short-term.

Reference

Huberty, J., Green, J., Glissman, C., Larkey, L., Puzia, M., & Lee, C. (2019). Efficacy of the mindfulness meditation mobile app calm to reduce stress among college students: Randomized controlled trial. JMIR MHealth UHealth, 7(6), 1-26. Web.

How Stress Affects Learning in Middle School

Introduction

Stress is one of the impeding factors in learning among middle school students. It comes at a time when this group of learners is experiencing a myriad of changes in their lives ranging from physical to psychological. In most cases, learners at this stage get stressed up from the immediate factors surrounding them like family members, peer groups, and dynamic lifestyles. It is therefore important to consider how these factors can affect learning and therefore devise ways and means of averting them.

How learning is affected by stress

Several changes are prevalent among students during their middle school age. This is at a time when they are approaching puberty and some of them are already adolescents. The social and physical factors can all contribute to stress at different levels (Gurian, p. 174). For instance, as they undergo the real physical changes, it actually interferes with their concentration in class because the developmental changes themselves slowly graduate into stress. This is inevitable owing to the fact they are not used to such changes.

Nevertheless, it should be noted that the main change is usually brought about by the graduating of these students to the middle school level whereby the amount of academic work to be done increases substantially. When the workload is overwhelming, students in middle school again find it challenging to merge the rapid change from piecemeal academic assignments they were used to while in the junior classes. Such rapid academic demands contribute to another level of stress. As a result, some students may withdraw from active class participation in the learning process due to academic difficulty (Gurian, p. 221).

It is also imperative to consider how familial factors can contribute to stress and therefore impede learning. In cases where the family unit is torn apart due to divorce or separation of parents, a vacuum is created in which some instrumental parental role will not be met due to the absence of one of the parents. Research studies have indicated that children who are brought up in single-parent families have a higher probability of encountering additional stress-related difficulties as they grow up. Family disintegrations account for a significant percentage of stress among middle school students today. Usually, when these learners can no longer cope due to the absence of parental support, they easily resort to drug and substance abuse. This is a critical part of stress development because once drug abuse sets in learning is adversely affected. In most cases, school dropouts and juvenile delinquency are directly attributed to drug and substance abuse.

Moreover, there is the case of students with natural learning difficulties. This may be as a result of mental retardation which makes them perform dismally throughout their academic life. Indeed, such students usually have a record of poor performance from previous grades and they are wholly presumed to be academically disabled (Kaye, p. 178). These learning problems are even aggravated when they graduate to middle school due to the complexity of the academic work to be done. The learning environment becomes even tighter as they have to absorb more details every day, learn better organisational skills like time management as well as integrate the new social environment into their daily programs. This rapid academic and social transition culminates into both physical and psychological stress which culminates into withdrawal effect and subsequent poor performance. Additionally, the fact that this category of learners know quite well that they have been labeled dismal academic performers may in itself be a source of secondary stress due to the preconceived pessimism and the thinking that they cannot do well like the rest (Brigman and Goodman, p. 59).

Nevertheless, although the learning difficulties experienced by these students at the middle school level are not a new phenomenon, it is worth noting the fact that the pessimistic attitude they develop eventually draws them to seek alternative sources of identity and a sense of belonging. This further pulls them away from academic matters which they feel are duly responsible for their predicament.

The concern here is not entirely on students with learning problems but also on the learners with normal learning abilities. It is however imperative to establish whether those with learning problems experience more stress levels than those without similar difficulties (Kaye, p. 122).

On a general platform, it has also been found that the social support derived from acquaintances outside family boundaries determines the ability of learners in middle school in dealing with stress. The worst part of this support is when it compounds the already existing learning intrigues. One such instance is when students at this level are wrongly influenced by their peers. It is in very rare cases when they will receive positive support from their peer groups (Brigman and Goodman, p. 132). Chances are that when they are overwhelmed by stress in the due process of learning, the influence of peer groups will definitely drive them away from concentrating on their academic work. In the end, stress will have contributed to poor academic performance, a scenario that would have been avoided through essential family and social support.

Conclusion

In summing up this paper, it is worth noting that stress among middle school students can adversely affect learning mainly due to withdrawal from the much demanding academic work coupled with the changing physical and environmental factors. Learners who no longer find meaning in pursuing academic work due to stress factors can seriously make reckless decisions which may culminate into school dropouts, drug, and substance abuse as well as juvenile delinquency. All the aforementioned factors are products of stress and contribute heavily to weak academic performance.

Works Cited

  1. Brigman Greg and Goodman Barbara Earley. Group counselling for school counsellors: a practical guide (2nd ed.). Maine: Walch Publishing, 2001.Print.
  2. Gurian Michael. Boys and Girls Learn Differently: a guide for teachers and parents. New York: Wiley & Sons, 2001. Print.
  3. Kaye Cathryn Berger. The complete guide to service learning. Minnesota: Free Spirit Publishing Inc, 2004.Print.

Teachers Wellbeing: Becoming Aware of Work-Relate Stress

Abstract

The impact of stresses in learning environments on students well-being is a subject of research that is being studied in more significant numbers. However, the effects of work-related pressure on educators well-being have received little attention from studies. Teacher self-efficacy pertains to an instructors belief in their ability to conduct occupation-related responsibilities satisfactorily and positively impact students educational performance (Poulou et al., 2019). This research will examine how teachers well-being and self-efficacy are affected by extreme stress conditions brought on by workplace stressors. It will also determine if instructors with high levels of self-efficacy are more productive and have a good outlook on their profession when they feel equipped to complete tasks. To further comprehend the connection between self-efficacy, burnout, well-being, and stress, this work will use a correlational research methodology to examine a few specific issues. To compensate for mistakes in data collection, the study will enroll 150 individuals. The Porterville Unified School District (PUSD), which has 10 elementary schools, will be used to find participants. The Ohio State Teachers Sense of Efficacy Scale will be used as an aspect of this research to gauge the challenges experienced by teachers in the classroom. The World Health Organization-Five Well-being Index, the Teacher Burnout Scale, and the Perceived Stress Scale will be applied to gauge the participants stress, well-being, and burnout levels. The importance of this study is that the information would support psychologists in creating efficient treatment programs for educators who seek mental health. For instance, offering instructors methods to cope effectively, practicing mindfulness, teaching them how to control their emotions when they are upset, helping them develop personal objectives, and leveraging their well-being to lessen mental health symptoms like anxiety and despair

Background

A growing amount of research has been conducted to examine the way stressors in educational environments impact the well-being of students (Houchens et al., 2017). However, limited research focuses on the way work-related stress can impact teachers well-being (Cheung et al., 2021). There are many factors that can negatively impact the health and well-being of a teacher within an educational setting. Ultimately, these factors could result in teachers leaving the profession early or developing health issues that could be detrimental to the individual. Overall, teachers have reported a higher level of job responsibilities than other professionals (Harmsen et al., 2018). These job responsibilities have been recognized by researchers as a significant problem in educational settings (Shen et al., 2015).

A teachers well-being can be characterized by a positive mindset toward teaching, achieving student outcomes, resilience, and flourishing (Hascher & Waber, 2021). This mindset is a result of constructive relationships with colleagues and students, confidence in ones own abilities, and a sense of being to meet ones professional and personal needs. It is crucial for teachers to take care of their physical, mental, and psychological health. This is especially true if they are going to contribute to students social, emotional, and psychological development. It is known that teachers who achieve success in their professional responsibilities have a higher level of occupational well-being than those who do not attain success (Kaynak, 2020).

The results of this study may provide educators and mental health professionals with information regarding work-related stressors. In addition, mental health professionals will be more prepared to provide support to educators, thus reducing burnout in the profession. The problem appears to be prevalent worldwide, as teachers report high levels of stress associated with their careers (Harmsen et al., 2018). In addition to bringing awareness to the issue of teacher burnout, it allows professionals to distinguish it from other mental health disorders, such as depression and anxiety (Cheung et al., 2021). Moreover, when teachers feel stressed and overwhelmed, students might sense their teachers level of emotional distress and begin to feel overwhelmed themselves. This could affect the teacher-student relationship, as well as student academic achievement outcomes. It is the primary purpose of teachers to establish positive relationships with their students. A failure to achieve this purpose relates to increased levels of stress and decreased well-being (Cui, 2022). Researchers have shown that beginning teachers are more likely to experience higher levels of stress than those who have been in the profession for some time (Farley & Chamberlain, 2021). Teachers who are aware of these stressors early in their careers may be able to minimize their risk of burnout and experience a sense of well-being.

The current study will examine whether teachers whose stress levels are high due to work-related stressors affect their well-being and self-efficacy. Additionally, it will explore whether teachers with a high level of self-efficacy perform better and have a positive perspective on their work when they feel competent to carry out work tasks effectively. Considering these points is essential as new teachers are known to quit their jobs within the first few years of joining this profession. In addition, it assists in creating some mental health programs for teachers to increase awareness of these issues. Moreover, this would help psychologists develop effective treatment plans for teachers who seek out mental health. For instance, providing teachers with effective coping strategies, mindfulness, learning how to regulate their emotions when in distress, setting personal goals, and using their well-being and reducing mental health symptoms that may include anxiety and depression (Seligman et al. 2005).

Literature Review

Well-being

According to Simons and Baldwin (2021), well-being is a state of positive feelings and meeting full potential in the world (p. 984). Well-being refers to good mental and physical health; the experience of positive emotional sensations such as satisfaction and happiness alongside the development of a persons potential, positive relationships, a sense of purpose, and some control over ones life (Cheung et al., 2021). Having a sense of well-being refers to a state of mind that allows individuals or a population to flourish and thrive in a sustainable way (Cheung et al., 2021). The foundation of prosperity must occur under sustainable conditions that enable individuals or populations to grow and prosper. Positive psychological health is often used to describe a state of subjective well-being (SWB), which is associated with a positive mental state (Ruggeri et al., 2020). Researchers have found that individuals who regularly experience happiness are more likely to succeed in their endeavors. For instance, happier individuals are likely to experience better interpersonal relationships, have better overall health, make more money, and have more creative ideas compared to those who experience less happiness (Lyubomirsky & Layous, 2013).

The positive activity model (Lyubomirsky & Layous, 2013) attempts to clarify why and how engaging in positive activities contributes to a happier, healthier, and a more satisfying life, all of which enhance peoples well-being. Dolan et al. (2008) conducted a study to explore factors that were associated with subjective well-being. These authors found that SWB plays a significant role in both physical and psychological health. According to the positive activity model, any activity feature (e.g., social support, culture, personality) can influence positive activity success. In general, individuals who are involved in positive activities tend to have higher levels of happiness. As a result, individuals are likely to experience positive emotions, thoughts, and actions. Therefore, an individual who is happy and has a positive attitude is likely developing an increased sense of well-being. Diener et al. (2003) state that a society that values not just the opinions of experts, but also the values of the entire community, must understand peoples feelings and thoughts about their own lives to effectively understand the concept of well-being.

A study by Danna and Griffin (1999) examined the effect an individuals workplace could have on their health and well-being. They found that excessive physical and mental demands, placed on the human body and mind by work-related stress, could result in detrimental physical and emotional outcomes. Furthermore, the authors examined whether an individuals health and well-being can affect the organization and the individuals performance. Individuals who experience poor health at work tend to be less productive, unable to make decisions, and are more likely to miss work because of illness (Danna & Griffin, 1999).

Teacher Well-being

Over the past few years, teachers well-being has gained a great amount of attention. Well-being usually comprises cognitive and effective components, which encompasses environmental and personal factors (Dordevic et al., 2021). Generally, teachers who are in good health and who are meeting their work-related demands on a day-to-day basis are known to be in a positive state of physical and mental health (Cheung et al., 2021). Moreover, teachers who balance the challenges they face at work with the resources they have access to can improve their overall health. In order to attain a sense of well-being, it is essential to understand that enjoyment of ones vocation is the primary contributor (Cheung et al., 2021).

Individuals who experience high levels of well-being means one has a good sense of self and a positive attitude toward others (Rogach et al., 2017). Teachers are expected to support students who exhibit negative behaviors, and this encompasses them to put their emotions aside and understand the function of the behaviors (Ross et al., 2012). Having to put their own feelings aside requires a great amount of effort and may take a toll on their emotional well-being (Morris & Feldman, 1996). Some teachers may not understand how to react to behaviors with the appropriate facial expressions and demeanor. If teachers do not see change in student behaviors after putting forth correct behavior interventions (e.g., demeanor and facial expressions), it could lead to feelings of incompetence as a teacher (Split et al., 2011).

Teachers who are aware of their emotions and effectively express themselves have a greater sense of well-being and are likely to seek out help to receive social support from their colleagues. Rodriguez et al. (2020) argued that preschool teachers are likely to be highly invested in their students social and emotional development, as well as physical care and nurturing, which often interferes with the teachers ability to focus on their own social and emotional development. The authors further explained that these types of impacts could negatively influence the teachers mental and physical well-being. As Braun et al. (2020) pointed out, expressive suppression is considered a response-focused strategy considering it takes place late in the regulatory process after the emotion has already been established. Braun et al. (2020) further explained that response-focused strategies are unhealthy and ineffective ways of regulating ones emotions because it requires an intense cognitive effort to utilize. A higher level of emotional reactivity and negative emotions are reported by individuals who tend to suppress their emotions as compared to those who are self-aware (Braun et al., 2020).

Teachers are often interrupted by unwanted behaviors from their students (Zhao & You, 2019), which forces them to attend to the behaviors, distracting them from their ability to teach other students (Bakar & Zainal, 2020). However, when teachers develop a positive relationship and rapport with their students, they begin to experience positive emotions (Hargreaves, 2000). In addition, it increases their future efforts in performing more effectively in student learning and behavioral outcomes, and it increases their confidence in their ability to perform work duties effectively, thus, resulting in an increased sense of well-being. Unfortunately, when teachers do not receive recognition for their efforts in performing their responsibilities, it leads them to question their abilities. Psychological and physical well-being can be adversely affected by teachers sense of self-efficacy, which is the belief that they can effectively handle the challenges, tasks, and obligations associated with their profession (Ross et al., 2012; Barni, et al. 2019).

Available Resources for Teachers

A study by Zhao and You (2019) investigated the factors and mechanisms that influence the vocational well-being of secondary school teachers in the multicultural context of western China, focusing primarily on the relationship between psychological capital (PsyCap), emotional labor, and vocational well-being among teachers. PsyCap refers to a set of resources one can use to be more successful and improve performance. In addition, it provides insight into oneself and promotes growth. To achieve the ultimate state of well-being for an individual, PsyCap is known to reduce stress levels and increase performance (e.g., self-efficacy) and resilience. According to Dicke et al. (2018) PsyCap is shown to reduce depressive symptoms and improves well-being by enhancing daily life as well as work performance. Based on these findings, PsyCap appears to enhance mood and energy levels, resulting in improved well-being.

It is essential that teachers maintain a good sense of well-being on a physical and psychological level so they can perform their duties effectively. Kaynak (2020) explored the way elementary school teachers perceive their sense of well-being and the extent to which negative factors impact their well-being. The study concluded that teachers feelings of well-being were primarily influenced by the growth of their students and the support of those with whom they worked. Further, the study found that assessment performance, incompetence, criticism, inappropriate student behavior, and excessive workload were factors that negatively affected the well-being of teachers. Tang et al. (2018) indicated that teachers with a positive sense of well-being are more likely to be motivated, self-effective, and committed to helping students learn.

Self-Efficacy

Self-efficacy can be described as a persons belief in their ability to accomplish specific tasks (Carey & Forsyth, 2009). It reflects an individuals capability of exerting control over their behavior, motivation, and social surroundings. This attribute is vital when addressing the professional realm as it enables individuals to make difficult decisions when called upon. This phenomenon affects ones ability to attain a particular goal and determines how much energy one will invest in achieving this specific objective (Carey & Forsyth, 2009).

Self-Efficacy Theory

The self-efficacy theory comprises therapeutic change, which is accomplished through mastery experiences stemming from successful performances. Self-efficacy is defined as peoples beliefs about their capabilities to produce designated levels of performance that exercise influence over events that affect their lives. Self-efficacy beliefs determine how people feel, think, motivate themselves and behave (Bandura, 1994, p. 71). Phobic behavior is more likely to result from self-efficacy deficiencies rather than outcome expectations. His argument is that an individuals self-efficacy can improve if they use psychological procedures that heighten the strength and level of self-efficacy. The theory further posits that self-efficacy achieved through the success of performances is based on several situational and personal factors, i.e., the pattern of their failures and success, the amount of effort people exert in their tasks, and the difficulty of the task. The self-efficacy theory is centered around information processing. The model suggests individuals process, weigh, and incorporate information regarding their abilities and use this information to regulate their effort and behavior appropriately (Bandura, 1994).

Teacher Self-efficacy

In order for teachers to reach high levels of self-efficacy, it requires a teacher to self-assess their ability to influence the outcomes of their students, particularly those students who seem unenthusiastic or challenging to educate (Ross et al., 2012). When teachers have a high sense of self-efficacy, they are known to perform more effectively in their job, have higher levels of job satisfaction, fewer difficulties dealing with student misconduct, and lower stress levels. In such instances, teachers are likely to take on more difficult goals to challenge their abilities. Additionally, they are likely to collaborate with others (e.g., staff members and parents), which leads to better student learning outcomes (Guskey & Passaro, 1994). When teachers have low levels of self-efficacy, they begin to believe they are not well-suited for their job and therefore start investing little effort in the classroom (Bandura, 1977). Self-efficacy among teachers is vital because it influences the academic achievement of students, effectiveness among teachers, and instructional practices. It also significantly impacts the well-being of teachers and overall school performance for students (Barni et al., 2019).

Stress Among Teachers

Choosing to pursue a teaching career offers a number of benefits, including having job security, having the opportunity to impact the life of a child, gaining leadership skills, and obtaining excellent benefit plans. A plethora of teachers have acknowledged teaching as a highly satisfying profession (Malla, 2020). Unfortunately, alongside these benefits are some disadvantages of pursuing this career. For instance, teachers may have to work long hours or under difficult conditions (i.e., disciplinary issues, extra-curricular activities, etc.) (Danna & Griffin, 1999; Ross et al., 2012). Further, teaching can be mentally challenging, resulting in fatigue, difficulty concentrating and changes in appetite, which can lead to great levels of stress and contribute to feelings of anxiety and depression (Tapp, 2021).

Unprecedented numbers of K-12 educators are leaving the classroom because of the stress they face. The teacher shortage had reached crisis proportions even before the COVID-19 pandemic. Since the COVID-19 pandemic, 80% of California districts have experienced shortages, and these shortages have only worsened (Lillis & Stanton, 2022). Over three out of four educators have filed a report claiming their job to be stressful (Heckman, 2019). Teachers have reported various stressors in their profession, including managing misbehaviors carried out by their students, not receiving the proper support from the administration, and a lack of autonomy. Moreover, teachers are subject to high-performance demands and role ambiguity (Ross et al., 2012). In the beginning stage of their teaching career, teachers are likely to experience high levels of pressure as they embark on this journey (Johnson et al., 2005). When a teacher is unfamiliar with a task or a particular program, it may cause them anxiety and bring forth negative emotions about themselves due to not meeting their job responsibilities effectively (Smetackova et al., 2019).

Teachers at the start of their careers experience higher levels of stress than teachers with decades of experience, who are likely to be more adept at managing stress. Being recognized for their work can relieve stress for teachers, which encourages them to perform their tasks more effectively (Sadeghi & Saadatpourvahid, 2016). Educators who experience long-term stress within their profession are likely to develop chronic exhaustion that results in teacher burnout syndrome (Smetackova et al., 2019).

The Effects of Teacher Burnout

A survey conducted in 2019, revealed 43% of respondents were experiencing burnout, showing an increase in the number of individuals exhibiting signs (American Medical Association, 2019). In January 2022, the American Teacher Panel (ATP) surveyed 2,360 teachers, finding that 59% of teachers experienced burnout, as opposed to 44% of working adults (Will, 2022). Burnout is a form of emotional or physical exhaustion that can result in a person feeling poorly accomplished or as if they are losing their identity (World Health Organization, 2019), and can be experienced due to incessant exposure to stress factors in certain professions. This is particularly a problem in the field of education. The term burnout has been described as repeated exposure to job-related stressors (Ross et al., 2012) and can be characterized using three principal dimensions: encountering dissociation with a job, constant feelings of exhaustion, and loss of confidence associated with professional abilities. These signs may include, but are not limited to, reduced output/performance, physical symptoms such as headaches, cynicism toward assigned tasks, and emotional fatigue (Scott, 2006). Burnout has also been associated with mental health issues such as depression and anxiety. An individual experiencing burnout likely has difficulty controlling their emotions, (i.e., sadness, guilt, or anger). As a result, they are susceptible to aggressive outbursts, panic attacks, and drug abuse (Fraga, 2019).

According to the American Medical Association (2019), burnout syndrome is included as a classified disease in the International Classification of Disease 11th revision (ICD-11). These individuals experience chronic stress in the workplace that they often have difficulty managing. Additionally, the ICD-11 requires an individual to meet three characteristics of the criteria to qualify for burnout syndrome: low levels of energy, negative outlook on all job responsibilities, and decreased efficacy. Researchers have found that teacher burnout has a significant effect on productivity (Kelly, 2021), mental health, learning outcomes, and school community (Inc, 2018). These factors will be discussed in the section below.

Productivity

According to Kelly (2021), burnout could result in poor productivity in service sector, which affects the well-being of the entire population. Unfortunately, teachers who experience burnout tend to have a negative perception of their job, experience negative emotions, and are not satisfied with their job. Additionally, they are forced to attend to other stressful tasks (e.g., staff meetings, extracurricular activities, etc.) preventing them from performing their job responsibilities (Chang, 2009). Teachers have been known to report negative experiences, including stress within the profession, which is known to have an impact on their work dedication and satisfaction (Sadeghi & Saadatpourvahid, 2016).

Mental Health

Teachers who experience burnout have a lower ability to manage teaching stressors, i.e., managing classrooms, dealing with student misbehavior, etc. In addition, burnout can also lead teachers to develop anxiety and depression, which lowers their quality of life. These individuals suffer from constant daytime fatigue due to job-related stress and emotional exhaustion, which in turn may result in adverse mood swings (Inc, 2018).

Learning Outcomes

Significant levels of burnout often result in teachers reducing their involvement in their students lives, which has a significant effect on the students learning outcomes. Low academic performance, lack of motivation, and continuous disciplinary issues among students are examples of some of the effects of teacher burnout (Inc, 2018). However, teachers who experienced positive student-teacher relationships reported pleasure and a decrease in stress or anger. Thus, showing improvement in student learning outcomes (Cui, 2022).

School Community

The school community is normally affected when a teacher begins to experience burnout. Some of the effects encountered by the school community due to teacher burnout include reduction of social engagement with their community, poor curriculum planning, lack of collaboration among school employees, lack of execution of new school programs, and poor school performance (Inc, 2018). Teachers experiencing burnout will suffer from an overwhelming feeling of powerlessness that will result in them practicing isolation.

Overall Support Available to Teachers

Teachers should be involved in ongoing, holistic programs that promote mental health (Sisask et al., 2013). Addressing mental health support in an educational setting is important for educators in order to thrive in their work environment (Will & Superville, 2022). Social Emotional Learning (SEL) is important to help educators build SEL competencies, because it helps in reducing emotional exhaustion, burnout, improves self-efficacy, and increases job satisfaction. Whalen (2021) discusses it is essential to take care of educators well-being because this would not only benefit teachers, but the whole school system. Professional development in SEL has shown in multiple research studies to improve the well-being of teachers and reducing stress (Whalen, 2021).

In these workshops, teachers can learn how to improve their personal well-being, engage in self-care, develop self-regulation skills, and learn coping strategies (Vesely et al., 2013). Gaining these effective skills and knowledge can further assist in educators developing a sense of satisfaction in the work they perform, which then leads to feelings of effectiveness and competence. Thus, resulting in educators becoming more resilient, which improves their well-being (Bobek, 2002).

Positive Behavior Intervention Support

In the late 1990s, Rob Horner and George Sugai developed the effective behavior support (EBS) program, later called Positive Behavior Intervention Supports (PBIS). By focusing on the use of data for informing decisions about the development, implementation, and evaluation of behaviors in evidence-based practices, PBIS aims to improve academic and social behavior outcomes for all students (Sugai & Simonsen, 2012).

PBIS has been implemented in schools in the United States for the past 30 years, and is a behavior support system plan intended to provide students and educators with a holistic behavior support plan (Grasley et al., 2021). Houchens et al. (2017) reported the implementation of PBIS was inspired by the application of behavioral analysis, a discipline that recognizes the value of teaching positive student behavior rather than punitive strategies. PBIS is a positive behavior management program that allows teachers to develop positive relationships with their students. Students are taught expected behaviors and are rewarded when these behaviors are exhibited. If teachers and staff implement PBIS effectively, it will decrease undesired behaviors in students, which in turn will decrease stressors for teachers in the classroom (Ross et al., 2012). Numerous studies have focused on the student benefits of PBIS; however, limited studies have focused on the effects of PBIS on teachers well-being.

Components of PBIS

This program has three tiers of support, including universal school-wide, targeted, and intensive individualized support. Tier 1 aims to prevent problematic behavior among all students within the school. Typically, approximately 80% of students will respond to Tier 1. Students who display desired behaviors are rewarded with an incentive. Tier 2 is provided to students who do not respond to Tier 1 interventions. Approximately 15-20% of students will benefit from Tier 2 interventions. The students in Tier 2 are provided with more individualized behavior and academic support (e.g., social skills group, after-school programs, school counseling, and a check-in check-out support system). Unfortunately, an average of 5% of students will not respond to Tier 1 or Tier 2 (Ross et., 2012). These students will move into Tier 3 because Tier 1 and Tier 2 supports have not been met, which means their needs are more individualized and intense. Furthermore, Tier 1 and Tier 2 supports will continue to be implemented in Tier 3. Tier 3 is a strategy that works best with students with developmental disabilities, emotional and behavioral problems, and students who are not responding to Tier 1 or Tier 2 systems of support. Tier 3 aims to determine the cause of the behavior and develops a behavior plan to support student behavior needs. The Functional Behavioral Assessment plan (FBA) utilized in Tier 3 is designed to target and manage extreme behaviors (Keller-Bell & Short, 2019).

School-Wide Positive Intervention Supports

According to Mcintosh et al. (2010), School-Wide Positive Intervention Supports (SW-PBIS) can be useful in strengthening or adding support in positive interactions between the students, teachers, and educational setting staff (e.g., administration, librarians, cafeteria staff, etc.). Additionally, it assists in reducing disruptive behaviors, and most importantly, it is known to decrease the stress that teachers may experience. When stress is reduced, it results in teachers having an increased sense of empowerment of how they perform their job. With SW-PBIS, teachers can learn how to teach appropriate behaviors and this, in turn, allows the teacher to gain a sense of control and empowerment over themselves and their students. As such, SW-PBIS is reinforcing not only for the students but for the teachers as well (Ross et al., 2012).

Among the many benefits of being a teacher is the opportunity to positively influence childrens lives. However, this is also accompanied by challenges which add to their stress levels. Experiencing high levels of stress, along with a decline in self-efficacy and well-being, can contribute to burnout, which can lead to depression or anxiety-based symptoms (Tapp, 2021). Having good mental and physical health is essential for a persons well-being, and experiencing positive emotions such as happiness, fulfillment, and a sense of purpose in life. The well-being of teachers is primarily determined by their physical health and their ability to meet their daily work requirements. Additionally, teachers who manage their work challenges and resources effectively can increase their productivity and well-being. Being able to maintain a sense of well-being is contingent upon the ability to enjoy ones career.

Furthermore, it is likely that teachers who have an increase in self efficacy will perform effectively in their job responsibilities and will likely be more satisfied in their work environment. Having access to effective resources such as PBIS can be beneficial in providing teachers with empowerment in the way they are performing in their job. PBIS enables teachers to experience less emotional exhaustion, feel more connected to their students, experience a greater sense of accomplishment in their work, and overall greater confidence in their abilities as educators (Ross et al. 2012). Additionally, teachers can use this program to gain more structure in their classrooms. Thus, teachers are likely to minimize depressive and anxiety-based symptoms with supports such as PBIS. Furthermore, teachers will likely experience higher levels of well-being and lower stress levels.

The Importance of the Current Study

Teachers have a significant impact on the overall societys future and progress. Therefore, addressing the issue of teachers well-being now is likely to have positive influence in teachers productivity and the quality of education in the future. Furthermore, the teaching profession requires substantial efforts to overcome the challenge of working with many students simultaneously while still being able to focus attention on individual students progress. Raising awareness on the topic of teachers well-being and informing workers in the education system on the issue can result in additional support for teachers, such as school administrators and clinical psychologists.

Next, the nature of the profession and occupational stressors such as the need to establish a connection with students with behavioral concerns makes teachers subjected to the risks of poorly managed life-work balance. Furthermore, according to Harmsen et al. (2018), teachers have more responsibilities than any other professional. Improving teachers knowledge about the importance of mental health for their productivity and students academic achievements can result in substantial changes in the education system. In particular, informing teachers about different coping strategies and the possibility of having meaningful collaborations with co-workers can improve the level of teachers job satisfaction and help them maintain a positive approach to fulfilling their duties.

Furthermore, work-related stress and burnout in teachers can potentially result in the development of depression and/or anxiety, which will significantly affect their personal life. Drawing attention to the importance of healthy well-being in the teachers profession can help prevent potential cases of burnout, depression, and/or anxiety among teachers in the future. Moreover, raising clinical psychologists awareness of the issue and improving the knowledge about possible treatment interventions and necessary coping skills will help address the existing cases of depression and/or anxiety among teachers. Thus, exploring the questions from the study is important for society, students, teachers and other education system workers, and clinical psychologists.

Research Questions and Hypotheses

This study will examine the following research questions:

  1. How does a teachers level of self-efficacy affect their level of well-being?
  2. Does the level of stress experienced by teachers increase or decrease because of their performance in their job responsibilities?

It is hypothesized that:

  1. teachers who report higher levels of stress experience higher levels of burnout,
  2. teachers who report high levels of burnout will report lower levels of well-being,
  3. teachers who report higher levels of well-being will report higher levels of productivity compared to those who report low levels of well-being,
  4. teachers who use PBIS are likely to experience an increased level of self-efficacy.

Methods

Procedure

Participants will be recruited from Porterville Unified School District (PUSD), which includes ten elementary schools. The elementary schools within PUSD include: Belleview Elementary School, John J. Doyle Elementary School, Los Robles Elementary, Monta Vista Elementary School, Olive Street Elementary School, Roche Avenue Elementary School, Santa Fe Elementary School, Vandalia Elementary School, West Putnam Elementary School, and Westfield Elementary School. The primary investigator will recruit participants by emailing the principals of the schools for permission to share an email that will contain a brief overview of the purpose of the current study and a direct link to Qualtrics Survey. Then the principle will be asked by the primary investigators via email to share this email and direct link with their teaching staff to gain potential participants. The direct link to Qualtrics Survey will be accessible to those teachers who choose to participate in the current study. The Qualtrics Survey will be completed online anonymously, and it will contain an informed consent, demographic questionnaire, and surveys. Once the participants have submitted their responses, the primary investigator will be notified via email by Qualtrics Survey. The assistant superintendent from PUSD has provided the primary investigator permission (e.g., signing a permission letter) to recruit elementary teachers who work in the schools in this district.

Participants

Inclusion criteria requires that participants be elementary school teachers, specifically, general education and special education elementary school teachers. Additionally, the participants will have had earned a clear credential, which means the participant has met all education and program requirements. Participants will be recruited from each of these elementary schools within PUSD.

Measures

As part of this study, the primary investigator will use The Ohio State Teachers Sense of Efficacy Scale to measure the difficulties faced by teachers in the classroom, the Perceived Stress Scale to measure the participants level of stress, the World Health Organization-Five Well-being Index to measure well-being, and the Teacher Burnout Scale to assess level of burnout.

The Ohio State Teachers Sense of Efficacy Scale

In order to assess problems teachers, face in the classroom, participants will be asked to complete The Ohio State Teachers Sense of Efficacy Scale, short form (OSTES; Tschannen-Moan & Hoy, 2001). This questionnaire consists of 12-items that uses a 9-point Likert rating scale (1 = Nothing to 9 = A Great Deal). OSTES scores are calculated by summing all unweighted responses, resulting in scores ranging from 1 to 9. Typically, three separate scores are calculated, each representing one of the scales three domains (e.g., engagement, instruction, and management). Instead of individual domain scores, a composite score is often generated. The OSTES was given to a sample of 410 participants which included 103 preservice teachers (84 female, 15 male), 255 in-service teachers (170 female, 84 male), and 38 participants who failed to indicate their teaching experience (Tschannen-Moan & Hoy, 2001). The reported alpha level of the original 24-item scale was.94, and the reliability of the 12-item scale was.90, suggesting excellent reliability. Accordingly, both the subscale scores and the total score for both forms can be utilized to assess efficacy. In comparison to other questionnaires that measure teacher efficacy, Tschannen-Moan and Hoy (2001) suggest that the OSTES  short form measures a broader range of teaching tasks.

Perceived Stress Scale

A psychological instrument commonly used for measuring stress perception is the Perceived Stress Scale (PSS; Cohen et al., 1983). PSS was designed to be used with community samples with a minimum level of education. Questions included in this scale are simple to understand and general in nature, thus avoiding content that was designed for a specific subpopulation (PSS; Cohen et al., 1983). The PSS consists of 10-items and measures the amount of stress one has experienced during the last month. Each of these ten items use a 5-point Likert rating scale (0 = Never to 4 = Very Often). PSS scores are obtained by reversing responses (e.g., 0=4, 1=3, 2=2, 3=1, & 4=0) to the four positively stated items (items 4, 5, 7, & 8) and then summing across all scale items. Participants will be asked to complete the PSS to determine how unexpected, difficult, and overwhelming situations affects their stress level. The scale includes a number of questions that directly address the level of stress currently experienced. The PSS specifically inquiries about ones emotions and thoughts during the past month. The sample of participants consisted of 476 college students, and the authors determined that a coefficient alpha level of 0.86 was determined for the PSS, indicating good reliability (Cohen et al., 1983).

The World Health Organization-Five Well-being Index

In order to assess general well-being, The World Health Organization-Five Well-being Index (WHO-5; Winther Topp et al., 2015) will be utilized. This is a short self-reported questionnaire based on a 5-point Likert scale (0 = At no time to 5 = all of the time). Raw scores of 0 to 25 are multiplied by 4 to give the final score, with 0 representing the worst possible well-being and 100 representing the best possible well-being. There are 30 different languages available for this questionnaire, which is intended for people who are at least 9 years of age (Winther Topp et al., 2015). There is sufficient evidence of validity in the WHO-5 in screening for depression and in assessing outcomes in clinical trials. In this questionnaire, working conditions of employed and self-employed individuals were assessed and analyzed. A good coefficient alpha reliability of 0.86 has been determined for the WHO-5.

The Teacher Burnout Scale

To assess for burnout among public school teachers, The Teacher Burnout Scale (The Teacher Burnout Scale; Seidman & Zager, 1987) will be utilized. This scale consists of a 21-item Likert scale (1 = Strongly disagree to 6 = Strongly Agree). The 21-item scale was administered to a sample of 490 full-time teachers in a public school to confirm and determine the reliability coefficients of the subscales. The alpha coefficients for the subscales were 0.89 for career satisfaction, 0.84 for perceived administrative support, 0.80 for coping with job related stress; and 0.72 for attitudes towards students. As a result of this coefficient alpha reliability the Teacher Burnout Scale has been determined to have a good internal consistency.

The measures being used to assess self-efficacy, stress, well-being, and burnout are considered adequate and reliable by the developers. The additional advantage is that these measures are not specific to any given population, making them easier to use in the context of the targeted population for this study. These measures are available to researchers at no cost, and do not require permission for their use, as long as they are appropriately referenced and cited.

Data Analysis

The aim of the current study is to determine how stress levels and self-efficacy are impacted by teachers whose stress levels are high due to work-related stressors (e.g., assessment periods, pressure of extracurricular activities, the unexpected, and utilizing PBIS). This study will examine the following questions by utilizing the correlational research design, thus seeking to understand the relationship between self-efficacy, burnout, well-being, and stress. An a priori analysis using a statistical program, G*power 3.1, was used to predict the sample size of this study. A medium effect size of.30, an alpha level of.05, and a power level of.95 estimates a sample of 138 participants. In addition, a sample of 84 participants is estimated to be needed to achieve a power level.80. A p-value of.05 will be used for this study to have significant findings. Researcher will recruit 150 participants to account for errors in data collection.

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