Defense Date

2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Social Work

First Advisor

Kia J. Bentley, Ph.D

Second Advisor

Patrick V. Dattalo, Ph.D

Third Advisor

Sarah Kye Price, Ph.D.

Fourth Advisor

Jennifer Manuel, Ph.D. Graduate Affiliate

Fifth Advisor

Christopher P. Kogut, M.D.

Abstract

Provider-based stigma is defined as the negative attitudes, beliefs, and behaviors of mental health providers toward clients they serve. Often unintentional and unknowingly conveyed, this phenomenon has been indicated in previous research (e.g. Lauber, Nordt, Braunschweig, & Rössler, 2006; Nordt, Rössler, & Lauber, 2006; Hugo, 2001; Schulze, 2007). Other instruments crafted to measure provider stigma have utilized theory in their development, without incorporating the voice of the client (e.g. Wilkins & Abell, 2010; Kennedy, Abell, & Mennicke 2014). To better address the social injustice posed by provider stigma, the profession requires a valid and reliable measure, guided by theory, which also reflects the client and family experience. This study attempts to do so, referencing the five themes of the experience-based model (Charles, 2013) to guide item development. These themes include: blame & shame; disinterest, annoyance, and/or irritation; degradation & dehumanization; poor prognosis/fostering dependence; coercion/lack of ‘real’ choice.

The measure’s item pool was generated following Nunnally and Bernstein’s (1994) domain sampling method, in reflection of the experience-based model, and reviewed by a series of focus groups. The electronically hosted survey was distributed to a purposive sample of mental health service providers employed at Virginia’s public mental health agencies. Using a final sample of N = 220, factor analysis indicated a four factor solution, accounting for 32.454% of the items’ variance. Refinement resulted in a scale of 20-items demonstrating adequate internal consistency, measured by Cronbach’s alpha = 0.817. The four factors of the Mental Health Provider Self-Assessment of Stigma Scale (MHPSASS) were labeled: Irritation & Impatience (eight items); Choice & Capacity (five items); Adherence & Dependence (four items); Devalue & Depersonalize (three items). Hypothesized relationships were found between provider self-rating of burnout and MHPSASS score (Pearson’s r = 0.235, p = 0.001) as well as social desirability level and MHPSASS score (r = -0.169, p = 0.015), supporting the MHPSASS’ construct validity.

As a measure of provider-based stigma, the MHPSASS displays adequate reliability and validity. Future studies are indicated, including replication. Limitations include agency response rate, unknowable individual level-response rate, social desirability, and the potentially burdensome length of the survey package.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

4-24-2015

Included in

Social Work Commons

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