Theses/Dissertations - Social Work

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    Clinical practice with transgender and gender expansive clients at the intersection of religion and spirituality in Appalachia.
    (May 2023) Timbers, Veronica L., 1981-; Polson, Edward C.
    Research indicates that mental health clinicians lack competence and confidence in practice with TGE clients. Due to the limited number of clinicians who specialize in practice with TGE clients, access to quality mental health care is a concern. In rural areas, there is a national shortage of clinicians and higher rates of social isolation and stressors for TGE people. Based on these needs and gaps in services, this dissertation explores and describes mental health care practice with TGE clients in the region historically known as Appalachia. This region is highly rural and religious, leading to unique intersectional needs and strengths for TGE clients living there, but currently, there is no known peer-reviewed research on mental health care practice with TGE clients in this region. This dissertation includes two studies that explore current mental health practice with TGE clients in Appalachia and one study that considers the impact of Christian experiences on LGBTQIA+ people in this region. The findings indicate unique cultural factors related to rural location, the importance of family, and the impact of religion, which may be important for TGE clients to discuss in the therapeutic space. Findings confirm that like clinicians in other areas, Appalachian-based clinicians have limited graduate school training and perceived preparedness for practice with TGE clients. There are also statistically significant differences regarding perceived preparedness to practice with TGE clients among the counseling licensure types. Overall, Appalachian clinicians expressed a need for basic training related to diagnosis of gender dysphoria, differential diagnosis of gender dysphoria and other mental health symptoms, as well as in integrating the unique socio-cultural factors in Appalachia. This dissertation can be used to inform future research and to develop culturally responsive clinical trainings in this region.
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    Investigating organizational support for social workers during a global pandemic : an exploratory sequential mixed-methods study.
    (May 2023) Landers, Jillian C., 1994-; Madden, Elissa E.
    The coronavirus (COVID-19) pandemic was a novel global health disaster in which social workers experienced a rise in stress and needed support (Fish & Mittal, 2020; Holmes et al., 2021; Miller et al., 2020). According to Organizational Support Theory (OST), in exchange for tangible or socioemotional support from their employers, workers are more engaged (Eisenberger et al., 1986), and perceived organizational support can mediate the negative impacts caused by work strain (Baran et al., 2012). Thus, this dissertation investigated social workers’ experiences of support from their organizations during the COVID-19 pandemic to provide helpful information to social work leaders and researchers. Following the exploratory sequential mixed-methods approach, this dissertation employed a phenomenological qualitative study, a scoping literature review, and a quantitative survey study. The qualitative study and the scoping review found that social workers needed support from their workplace through multiple means, such as communication, co-worker connection and emotional support, tangible support, equity, and work flexibility. Work flexibility was an essential form of organizational support found in both studies. Also, according to OST, work flexibility is an element of support that can help employees engage in their work (Baran et al., 2012). Therefore, the third study analyzed social workers’ work flexibility relative to their work setting during COVID-19. Most of the social workers in the sample received more work flexibility from their employers during the pandemic across work settings. A cumulative odds ordinal logistic regression (OLR) with proportional odds showed that work settings were a significant factor in predicting more work flexibility during the pandemic. Social workers in school and healthcare settings were the least likely to report additional work flexibility compared to other settings within the sample. The findings from this dissertation present new insights into social workers’ experiences of organizational support during COVID-19 and provide recommendations for future similar disasters.
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    Explorations of pregnancy options counseling across varying settings.
    (May 2023) Hollenberger, Jennifer Trujillo, 1986-; Madden, Elissa E.
    Pregnancy options counseling is an intervention, often used across healthcare and social service settings, to assist ambivalent patients and clients in making decisions related to unintended pregnancy. While pregnancy options counseling seems to be a fairly common practice among social workers, health care providers, and other human service professionals, no evidence-based practice model currently exists. This work explores current practices and models of pregnancy options counseling, as well as the education, training, and preparation of providers across three different types of settings: adoption agencies, faith-based pregnancy resource centers, and healthcare organizations. The findings suggest that while there is a universal definition for the intervention there are differences in how it is being carried out among varying agency types. Additionally, the findings suggest education, training, and preparation of pregnancy options counselors could be strengthened. Social workers are embedded in agencies that provide pregnancy options counseling. This research informs social work practice as it relates to best practices in working with individuals facing an unintended pregnancy.
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    Actions speak louder than words : duality and professional boundaries in social work practice.
    (August 2022) Ishio, Melissa Hay, 1963-; Myers, Dennis Ray.
    Dual/multiple relationships may be impossible to avoid. Social workers are provided guidance by the NASW Code of Ethics concerning these types of relationships, but this guidance does not address practice settings in which duality is the norm rather than the exception. Research dedicated to exploring how social workers actually experience non-sexual dual/multiple relationships is lacking. This dissertation examines how ethical professional and personal relationships are negotiated in the helping relationship. Specifically, how do practice context and types of client encounters mediate the application of ethical guidelines intended to prescribe professional behavior in dual relationships with clients? The conceptual propositions of restrictive and universal definitions of professional boundaries and the task of balancing ethical decisions and practice judgements are employed in the formulation and implementation of this research. In particular, deontological and consequentialist/utilitarian ethical decision-making parameters frame the analysis of findings. Based on an electronic, cross-sectional survey, 165 social workers in the first article, “Social Workers’ Perceptions of Context in Navigating Duality,” reported on the likelihood of duality in three practice settings: rural, military, and congregational. Duality is perceived as most likely in congregational settings and least likely in military settings while duality patterns are perceived as more similar between rural and military settings. Based on findings from the same sample and data collection method, in the second article, “Social Workers’ Perceptions of Duality Domains,” the nature and types of inevitable duality encounters are examined. The findings support the salience of grouping encounters into four domains: financial encounters, faith encounters, dual professional encounters, and incidental/social encounters with each domain encompassing perceived intrinsic challenges to duality. The third article “Professional Boundary Settings and Duality: Civilian Social Workers in Military Settings,” provides 11 in-depth interviews with civilian social workers practicing in military settings overseas. These social workers describe their experiences of encountering duality on a daily basis, negotiating duality solutions that protect clients, and discovering situations in which duality is beneficial to the worker-client relationship. These three articles provide social work practitioners, researchers, and educators with new insights concerning how social workers perceive and navigate ethicality in situations wherein duality is unavoidable.
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    The impact of the COVID-19 pandemic on social work students.
    (2022-04-20) Scheffert, Aynsley Mihm, 1986-; Parrish, Danielle E.
    The onset of the COVID-19 pandemic was a time of abrupt and widespread change for social work students in the United States. This work seeks to illuminate the impacts of the COVID-19 pandemic on social work students’ experiences of stress, loss, and grief through quantitative, mixed methods, and qualitative methodological studies. The findings indicate students experienced elevated academic stress related to the onset of the COVID-19 pandemic and multiple and varied losses. Students identify a sense of continual adjustment due to ongoing changes throughout the pandemic alongside pervasive loss. Programmatic support through adaptation of coursework, community-building activities in the classroom and through academic resources were noted as helpful to students in reducing stress during this time as well as providing support. This work has offers recommendations for classroom management, programmatic responses, and policies in higher education to support students in times of educational disruption.
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    A study of faith community support and caregivers for persons living with dementia.
    (2021-04-01) Garrison, Brianna V., 1983-; Myers, Dennis Ray.
    Caregivers of persons living with dementia (PLWD) currently total more than 16 million (Alzheimer’s Association, 2020) and with the increasing prevalence of dementia this number will only continue to grow. Many caregivers express a desire for support from professionals and their community after the person they care for receives a diagnosis of dementia, yet many continue to experience difficulty navigating systems and their new role due to a lack of support (National Alliance for Caregiving & American Association of Retired Persons, 2020; Whitlach & Orsulic-Jeras, 2018). Faith communities are often a central source of social service support, guidance, and education (Pinson et al., 2010). Exploring caregivers’ experiences with faith communities is critical to understanding their role and impact on burden. Given the dire outcomes of high levels of burden without apt support, additional research is needed to continue to explore this phenomenon and identify ways to decrease burden for caregivers of persons living with dementia. This dissertation seeks to take steps toward these goals through the provision of a conceptual and prescriptive framework for the transforming faith communities into inclusive and supportive places of refuge for those impacted by dementia, exploration of current barriers and opportunities for social support in faith communities, and finally, by investigating caregivers’ perceptions of religious social support by faith communities and how this may influence burden. The theoretical frameworks of ecological system theory and person-centered care were utilized to guide the conceptualization and design of each of these studies. This dissertation is concluded by chapter five with a summary of each study and implications for social work practice and research.
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    The intersection of social work and Syrian women with refugee status : a transnational matricentric feminist perspective.
    (2021-04-12) Thomas, Kayte, 1982-; Yancey, Gaynor.
    Social workers have a history of engagement with refugees since the inception of the profession. However, many social workers engage with clients without knowing about their refugee status, and globalization and forced displacement is causing this to be a more frequent issue at this time. The Syrian war has created the largest refugee crisis the world has ever known, and yet the United States has had a lackluster response to welcoming Syrian refugees despite a strong record of previously welcoming refugees. With the recent change in presidential administration, it is expected that Syrian refugees will soon be welcomed in this nation. As such, social workers need to be prepared to support them effectively. Within the population of Syrians with refugee status, women (particularly mothers) are most at risk; therefore, this dissertation seeks to understand more about the relationship between Syrian mothers with refugee status and the social workers who support them. To accomplish this, a qualitative phenomenological study was conducted to gain insight into the dynamics between two resettled Syrian mothers, the refugee resettlement workers, and the state refugee office workers in Chapter Two. The following chapter, Chapter Three, looks at a quantitative survey of social workers in North Carolina to understand more about their perceptions towards Syrian women with refugee status in order to help the field become more prepared for future arrivals. From there, Chapter Four presents a conceptual article which creates a model for social workers who identify as Christian to welcome Syrian women with refugee status by creating a deeper and more empathetic understanding of each other through the use of crossover texts from the Holy Bible and Holy Qur’an. Altogether, this dissertation offers recommendations for social workers to improve their work with Syrian women with refugee status from a transnational feminist perspective which stands in solidarity with Syrian women on their journey and urges social workers to critically reflect upon their own perceptions in the process.
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    Iron sharpens iron : member experiences of collaboration in the Texas Hunger Initiative.
    (2021-04-13) Gatlin, Leah Helen, 1984-; Rogers, Robin K.
    Although the number of food planning councils (FPCs) has grown rapidly in the last twenty years, there is a paucity of research about these groups – especially about organizational theories relevant to their structures and elements that make them effective. Furthermore, the research that is available comes from few authors and even fewer FPCs. This dissertation explores the experiences of member organizations with collaboration within the Texas Hunger Initiative’s (THI’s) Hunger Free Community Coalitions (HFCCs). Chapter One provides an overview of the dissertation and grounds the work in Talcott Parsons’s theories. Chapter Two builds on Jones’s (2006) work exploring member characteristics in relationship to resource dependence and social network theories. Organizations reported a mean of 12 collaborative partners and being impacted by those collaborations from early in their relationship. Chapter Three utilizes Thomson, Perry, and Miller’s (2009) instrument to examine members’ experiences with collaboration. Respondents rated all five domains of collaboration favorably and asserted it was more worthwhile to stay in the collaboration than to leave. Chapter Four reports on a phenomenological study of member experiences of collaboration in THI’s HFCCs. Analysis of the interview data illuminated six major themes: collaboration is difficult, valuable, expands and improves services, requires intentionality, requires diversity united towards a common goal, and lessons learned from HFCC participants. Chapter Five contains a recap of the studies, provides important linkages between them, and includes implications and recommendations for social work research as well as social work practice and education.
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    A study of U.S. adoption breakdown : exploring current factors associated with breakdown and challenging times in adoption adjustment.
    (2020-10-28) Goodwin, Bonni G., 1981-; Madden, Elissa E.
    Adoption breakdown often results in devastating effects for the family and child. Children and parents who experience adoption breakdown suffer adverse residual effects of a traumatic experience. Given the dire outcomes following adoption breakdown, additional research is needed to continue to explore this phenomenon and identify ways to decrease the risk of breakdown for families and children. This study seeks to take steps towards these goals through a systematic review of current literature on adoption breakdown in the U.S., exploration of present factors associated with adoption breakdown, and finally, by investigating adoptive families’ adjustment process in adoption from the perspective of the adoption caseworker. The theoretical frameworks of attachment theory and ecological system theory were used to guide the conceptualization and design of each of these studies. Chapter Five provides a summary of each study with implications for social work practice and future research.
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    Public school response to the trauma of school shootings.
    (2020-03-31) Alexander, Bree Aryelle, 1990-; Harris, Helen E.
    Public school shootings in the United States have reached levels of epidemic concern. Current research related to U.S. school shootings addresses a variety of issues including historical analysis, political influences and policymaking, prevention efforts for school shootings, and risk factors for school shooters. However, research addressing individualized trauma in the aftermath of school shootings and how U.S. public schools are addressing this has been limited. The following research is intended to explore school leaders’ (i.e., administrators, teachers, and guidance counselors) experiences of school shootings and public school ability to address the trauma that may develop, identify strategies U.S. public schools are currently using or have access to for addressing trauma following school shootings, and offer alternative intervention methods for addressing school shooting related trauma.
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    Extensions of grace : an examination of clergy as gatekeepers in youth mental health.
    (2020-04-02) McClung, David Charles, 1988-; Pooler, David K.
    Approximately half of all mental health concerns will begin by 14 years of age and 75% will develop by 24 years of age. Congregations are often a primary point of contact for individuals seeking support related to a mental health concern. Current research indicates, however, that clergy may frequently lack the mental health education and relationships with mental health professionals to provide adequate support. Some of the factors that are thought to create these divisions in service delivery include historical tensions regarding differences in interpretation of mental health, lack of awareness of available community resources, ambivalence surrounding the perceived risks and benefits of collaboration, and mistrust of the values and practices of mental health professionals. Nevertheless, the opportunity to further integrate clergy and their congregations within systems of care remains evident. The present dissertation seeks to further explore the role of congregations as it relates as to youth mental health.
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    Justice, faith and politics : congregational engagement in social justice issues.
    (2020-04-17) Wilson Harper, Amanda, 1985-; Yancey, Gaynor.
    Social work and Christianity both have a longstanding history of social justice engagement. Congregations and the profession of social work are both navigating unique aspects of the United States’ current divided and partisan culture. In many congregations, social justice issues that are found in the Gospels are now interpreted as political rather than biblical. Congregational leaders are facing many challenges as they engage social justice issues from the pulpit and as a congregation. The perceptions and lived experiences of clergy and lay leaders that are discussed in the quantitative study and qualitative studies provide insight for congregations as they navigate social justice engagement since the 2016 U.S. presidential election. The quantitative secondary data analysis, Chapter Two, used data from the 2017 Preaching Controversial Justice Issues survey to explore the characteristics of clergy and congregations preaching about justice issues during the 2016 election year. The qualitative studies, Chapter Three and Chapter Four, used an interpretative phenomenological approach to explore the perceptions and lived experiences of clergy and lay leaders engaging social justice, their conceptualizations of social justice, and specifically, their engagement during the 2016 election year. The final chapter, Chapter Five, provides a summary and recommendations for social work practitioners as well as implications for future research.
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    Children with externalized behavior disorders : opportunities for the support systems of primary care and congregations.
    (2019-07-17) Scott, Rebecca Bell, 1974-; Myers, Dennis Ray.
    Children with externalized behaviors and their parents face significant challenges. Parents find themselves stressed and uncertain how to navigate the parenting demands of children with difficult behaviors. Two significant social support networks in the U.S. have the capacity to mollify the potential stress and negative outcomes that challenging childhood behaviors can have for the child, their family and their various social networks. These networks include the primary care medical system and congregations. Primary care clinics that have behaviorally integrated are poised to increase the access parents have to evidenced-based information and intervention for themselves and their children with disruptive behaviors and their families. Further, families with a child with difficult behaviors who are part of a congregation, they can also find significant support in this setting as well. The qualitative study, quantitative study and concept paper in this dissertation provide guidance for increasing access and effectiveness to treating and supporting children with challenging behaviors. An interpretative phenomenological approach was used to explore parents’ perceptions of their child’s disruptive behaviors and what they hope for from their primary care provider. The quantitative study focuses on exploring the outcomes of the primary care adaptation of an intervention model for children with difficult behaviors and their parents. The third article, chapter four, is a concept paper which focuses on congregations as an important system of care for children and their families while applying a liberation theology ethic. The chapter provides guidance for future research for a community-wide comprehensive approach to supporting families and children who have externalized behaviors. The final chapter provides a summary with implications for future research. This chapter includes recommendations for evaluation of practice and additional research.
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    Servants or saviors? Exploring the impact of international volunteerism on host communities and volunteers.
    (2018-10-26) Dickey, Jennifer Smyer, 1972-; Singletary, Jon.
    International volunteer service (IVS) has rapidly expanded in the last decade among its volunteer participants and sponsoring agencies. Scholars have diverse opinions on the efficacy and ethics of IVS. Proponents suggest that IVS brings a humanity to development that might otherwise be focused on merely economic growth. Critics, however, are concerned that IVS originating in the Global North and directed toward the Global South potentially reifies power differentials previously established through colonialism. Little research has explored the impact IVS is having on its stakeholders, namely, host communities who receive volunteers and international volunteers themselves. Distinct in focus, the qualitative and quantitative studies in this dissertation provide unique insight into the impact IVS has on its stakeholders and the intercultural relationship between volunteers and host community members. A phenomenological approach was used to explore Kenyans’ experiences of international volunteers’ behaviors and attitudes in their communities. While positive themes of skill transfer and honoring cultural practices emerged, so did negative themes that suggested international volunteers had demeaning perceptions of Kenyans, controlled collaborative projects, gave Kenyans cursory roles to play, and departed hastily without empowering Kenyans, which led to project failure. Recommendations for strengthening IVS practices were described. The quantitative study explored the impact IVS has on volunteers (n=490). In the context of a worldwide refugee crisis, IVS organizations responded by sending volunteers to serve the critical needs of refugees. This study explored the extent to which IVS changed volunteers’ perceptions of the refugees they served. Using paired samples t-tests, findings revealed a statistically significant mean difference in international volunteers’ perceptions of refugees before and after service. Applying Mezirow’s theory of transformative learning as a frame, the study sought to understand the change in perceptions that occurred in study participants. Finally, a qualitative study explored Kenyans’ understandings of humility and how the virtue relates to IVS practices. Findings suggested humility is an attitude of appreciation and equality in relation to others, while humility in practice is a posture of listening and learning from others and not having a “know it all” stance. Recommendations for future research were identified.
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    Faithful engagement : an examination of the nature and role of values in social policy practice.
    (2017-07-21) Sousa, Lori M., 1968-; Yancey, Gaynor.
    In social work, a commitment to individual and societal values is foundational, professionally-sanctioned and necessary for culturally sensitive, ethical practice. Values are instrumental in the formation of cultural norms, in the configuration of beliefs systems, and often, they serve as an impetus for policy practice (PP). It is, therefore, surprising that there is a lack of theoretical models that examine and assess the role of values in social PP. The aim of this dissertation is to gain greater insight into this arena. By understanding the nature of values and the role they play in all aspects of social policy, policy practitioners will be better equipped to engage in social PP in a manner that is consistent with ethical, social work practice. This dissertation includes three studies that provide substantial data to suggest that values are a critical, yet overlooked factor in social PP. Based on the findings of these studies, I, as the researcher, constructed the following models to aid policy practitioners in value-sensitive PP: 1) The Religion and Spirituality in Social Policy Practice model (RSSPP)--a framework for conceptualizing the process by which policy practitioners integrate RS in social PP; 2) The Client-Centered Value-Sensitive Social Policy Practice model (VSSPP)--a model used to assist policy practitioners in creating an environment where client values are identified, assessed and employed to guide social policy; and 3) The Individual Policy Frame--a diagram used illustrate significant factors that influence an individual’s values and impact that person’s social policy positions. This dissertation provides tools and suggestions that can be utilized by policy practitioners to engage in client-centered, social PP. Without adequate instruments, social workers often find themselves in an unfamiliar policy arena where their voices and the voices of those they advocate for are marginalized. This dissertation aims to create an empowering environment where social workers are equipped to engage in PP effectively, and where the values of clients and communities are esteemed.
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    Called to serve : empirical explorations and a review of calling and the social work profession.
    (2017-04-10) Olson, Erin Jane, 1979-; Singletary, Jon.
    The concept of calling as it relates to work was historically relegated to vocations and jobs within the church or ministry sector. More broadly, people have discussed being “called” to follow Christ or their specific religion, but only more recently have people’s jobs been described as a calling. The goal of the dissertation was to provide insights into the role and impact of a calling model on those pursuing and working in the social work profession. First, in a narrative review, the researcher looked at previous research on calling conducted in other professions and used those studies as a springboard for discussing the social work-specific research on calling. This review highlighted the need for important conversations and experiences around the concept of calling for students within social work. It also highlighted the value of utilizing a calling model with social work students. Second, in a qualitative study, the researcher conducted interviews with eight social workers who were at varying levels of their educational and professional journeys. The intent of this study was to determine the role of relationships in student decisions to pursue the social work degree. I identified four themes including the importance of relationships with family and friends, faculty and field supervisors, and also relationships and interactions with clients. Finally, the researcher conducted a quantitative study to understand how a sense of calling to social work might impact other areas of a student’s life. The researcher studied the relationship between calling, specifically the transcendent summons, and life satisfaction and then included potential moderating relationships with variables such living one’s calling, religiousness, and core self-evaluations. While the study provided valuable insights, some recommendations for future research include a broader and more diverse sample of participants, using a different measure for religiosity or spirituality, and a comparison of students from only non-religious institutions.
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    Christian-informed mindfulness : a theoretical and empirical exploration.
    (2016-07-05) Trammel, Regina C., 1976-; Harris, Helen E.
    Mindfulness is a theory and practice skill that originates from Buddhism. Most who study and use mindfulness do so by drawing from Buddhist precepts, values and practices. This dissertation explored and evaluated a Christian theory and practice framework that addresses a gap in the social work research and practice literature on mindfulness. The goal of the dissertation research was to provide theoretical and empirical support for those who seek a Christian alternative to existing mindfulness-based interventions. The researcher first identified Christian precepts, values and practices to help establish a Christian framework of mindfulness by comparing and contrasting Buddhist and Christian thought. This dissertation focused on Mahayana Buddhism and the mystical and contemplative branches of Christianity which were informative. Apophatic and kataphatic prayers in Christianity can assist those who desire a Christian-informed mindfulness practice because they induce an experience of transcendence and unity of the believer and the divine, leading to attainment of spiritual knowledge. Secondly, the researcher studied the effects of an MP3 Christian-informed mindfulness-based intervention innovation with social work and psychology students from two universities using a randomized controlled design. Results indicated that the intervention was effective in producing mindfulness states in the study sample but not in reducing their perceived stress. Recommendation by the researcher included expanding the study to a larger sample, replication of the study with a client population, and using a psychometric measure to observe changes in stress instead of a self-reported measure. Lastly, the researcher explored the experiences of nine Christian-identified practitioners who used mindfulness-based interventions with clients using a descriptive phenomenological design. The results of the study indicated that the practitioners, when using mindfulness-based interventions, sensed that God was present with them. The presence of God supported the therapeutic work by providing relevant insight for the practitioners and their clients. A need for formal training for practitioners in both third-wave behavioral therapies and a Christian-based mindfulness intervention was identified. Recommendations included future studies on clients’ perspectives and further training for practitioners to include mindfulness drawn from other religious frameworks.