Theses and Dissertations from UMD
Permanent URI for this communityhttp://hdl.handle.net/1903/2
New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM
More information is available at Theses and Dissertations at University of Maryland Libraries.
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Item Therapist Cultural Humility, Black LGB Identity Centrality, and Therapeutic Outcomes in Black LGB Adults.(2023) Teran Hernandez, Manuel; Shin, Richard Q.; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Black lesbian, gay, and bisexual (LGB) adults experience discrimination at individual and institutional levels (Page et al., 2020) in part due to simultaneous experiences of anti-Black racism and heterosexism. Despite this, Black LGB adults continue to underutilize therapeutic services and also report high rates of premature termination from therapy (Garrett-Walker & Longmire-Avital, 2018). The current study advances the literature by investigating the association between therapist cultural humility, Black LGB centrality, and therapeutic outcomes among Black LGB adults. A sample of Black LGB adults (N = 157) participated in an online survey to respond to measures on demographic information, therapist cultural humility, centrality with their race x sexual orientation (Black LGB centrality), and therapeutic outcomes. Results showed that therapist cultural humility was a significant predictor of therapist satisfaction but not future utilization of counseling services while controlling for age and socioeconomic status among Black LGB adults. The analyses found that Black LGB centrality was not a significant moderator in the association between therapist cultural humility and therapist satisfaction, and only significant in the relation between future utilization of counseling services for participants who reported high levels of Black LGB centrality. Recommendations for future clinical practice and research efforts are provided.Item Identity Conflict Among Religious Lesbian, Gay, and Bisexual Individuals: The Role of Coping Strategies on Psychological Distress(2021) Yeung, Jeffrey Garrick; Lent, Robert W; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Sexual minority people experience more negative physical and mental health compared to their heterosexual counterparts. Lesbian, gay, and bisexual (LGB) people who also identify as religious and spiritual may experience additional negative health outcomes especially in the case that their religious and spiritual values, beliefs, and practices come into conflict with their sexual minority identity. Applying minority stress theory (Meyer, 2003) and the integrative psychological mediation model (Hatzenbuehler, 2009), the present study takes an intersectionality approach (Crenshaw,1989) that examines the relationship between LGB and religious identity conflict and psychological distress and whether religious coping and discrimination-based (i.e., internalization and detachment) coping strategies meditate this link. Participants consisted of 469 religious LGB Christian adults in the United States who took an online survey. Results from a parallel multiple mediator analysis (Hayes, 2018) revealed that religious LGB identity conflict was indirectly related to more psychological distress via internalization coping, detachment coping, and negative religious coping. Unexpectedly, positive religious coping was not significantly related to the study variables, nor did it mediate the identity conflict and psychological distress link. Findings provide evidence for integration and application of intersectionality, minority stress, and psychological mediation theories to examine intersectional identity conflict between one’s LGB and religious identity, identity-specific coping meditators, and psychological distress. A discussion of the study results, limitations, and implications for future research and practice follows.Item SOCIAL AND ENVIRONMENTAL BARRIERS TO HEALTHCARE ACCESS AND UTILIZATION FOR LESBIAN, GAY, AND BISEXUAL PEOPLE IN CALIFORNIA.(2020) Akre, Ellesse-Roselee; Roby, Dylan H; Health Services Administration; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Sexual minorities, lesbian, gay and bisexual people, are exposed to chronic stigmatization and heteronormativity in their daily lives and when they access health care. There are no genetic differences between sexual minorities and their heterosexual counterparts; the literature demonstrates that chronic stress related to being a minority, experiences associated with accessing care in a system that assumes one is heterosexual, exposure to negative attitudes from others, and internalized negative attitudes regarding one’s sexuality impact health outcomes and healthcare access and utilization. While there are known barriers to healthcare access the literature does not examine how multiple social identities influence healthcare access in sexual minorities. Intersectionality posits that the interconnected nature of social identities creates an overlapping and interdependent system of disadvantage. This study had three aims: 1) To examine differences in healthcare access at the intersections of urbanicity, race/ethnicity, and sexual identity; 2) examine differences in healthcare access at the intersections of sexual identity, gender, and income; and 3) determine whether non-identifying sexual minorities have disparate access to healthcare compared to identifying sexual minorities. Using 2014-2017 California Health Interview Survey data combined with the supplemental sexual orientation special use research file, I examined the relationship between healthcare access and utilization outcomes and the intersections between sexual identity, urbanicity, gender, income, and sexual identity disclosures. Using known evidence of barriers to healthcare access as dependent variables I used predictive modeling to estimate odds ratios of experiencing barriers to healthcare access using adjusted logistic regressions. The results of my dissertation produced evidence that for sexual minorities in California, sexual identity is associated with varying levels of healthcare access when examined within the context of other social identities. That is, there are differences in access and utilization amongst sexual minorities based on income and gender, and within subgroups of sexual minorities, especially in female and bisexual subgroups. Urban and rural environment did not determine healthcare access in sexual minorities and there was not enough data to confidently estimate differences in access between urban and rural sexual minorities of color. Study findings demonstrate that the female gender has more disadvantages to healthcare access that advantages regardless of income and sexual identity. They also demonstrated that income does not fully mitigate access barriers in sexual minority women. Lastly, findings from the study demonstrate that the non-identifying sexual minority identity is associated with less access to healthcare, specifically in men. Findings from this dissertation contributes to the knowledge of how disparities in healthcare access and utilization continue to persist in the sexual minority population despite increased access to healthcare coverage. This dissertation suggests that other factors uniquely related to being female and bisexual are salient for accessing healthcare for sexual minorities. It is essential that researchers, policy makers, and healthcare providers and staff provide more data on sexual minorities, create curated policy to support the most vulnerable sexual minorities, and engage in culturally sensitive training to eliminate barriers to healthcare access for sexual minorities to eliminate healthcare access disparities.Item ONLINE AND REAL LIFE COMMUNITIES OF LESBIAN, GAY, AND BISEXUAL PEOPLE: INTERNALIZED HOMONEGATIVITY, LIFE SATISFACTION, AND SEXUAL RISK TAKING(2019) Welch, James Christopher; Shin, Richard Q; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Previous research has demonstrated potential benefits provided to LGB people through affiliation with a larger LGB community (Sheets & Mohr, 2009; Halpin & Allen, 2004; Davidson et al., 2017). However, LGB people living in rural areas or who otherwise lack access to LGB communities may have difficulty accessing these benefits (De La Cruz, 2018; Oswald & Culton, 2003; Bachmann & Simon, 2014). With the advent of the digital age, humans are able to interact in new, virtual spaces that circumvent many of the difficulties associated with gathering in real-world spaces (boyd & Ellison, 2008). However, the ways humans are able to interact in virtual, online spaces remains relatively understudied. This study sought to explore potential similarities of benefits provided by real life and online communities as they relate to internalized homonegativity and life satisfaction, and to explore how sexual risk taking may be associated with affiliation with online communities in an internet recruited sample of LGB people. LGB persons’ affiliations with online communities of LGB people were not significantly related to sexual risk taking, life satisfaction, or internalized homonegativity. Affiliation with real life LGB community was significantly related to only life satisfaction. Life satisfaction was significantly related to sexual risk taking. Online and real life LGB community affiliation were significantly correlated. Limitations, implications, and future directions are discussed.