Defense Date


Document Type


Degree Name

Doctor of Philosophy


Social Work

First Advisor

Kia J. Bentley


The purpose of this study is to understand and describe the experiences of parents of, and clinicians who provide services to, adolescents with co-occurring mental health and substance use challenges, particularly as they relate to issues of guilt, blame, and responsibility. The study is based in a theoretical framework derived from Symbolic Interactionism (Blumer, 1969), Attribution Theory (Heider, 1958), and Barrett`s (1995) Theory of Guilt and Shame. The guiding question the study is: What are the experiences of parents of adolescents with co-occurring mental health and substance abuse challenges and clinicians who provide treatment services around issues of blame, guilt, and responsibility, and how do those experiences shape their collaboration? Twenty three participants engaged in in-depth interviews. The results have been analyzed using a phenomenological approach to qualitative research. The results of the study have been organized within four domains. The first domain, Sources of and Impact of Guilt and Shame was comprised of three themes: (a) Parents experience of guilt related to their behaviors, (b) Parents` experiences of guilt has a serious impact on families, and (c) Guilt and shame felt by parents shaped the therapeutic process. The second domain, Being Blamed and Blaming Others, was comprised of two themes: (a) Feeling blame from every direction and (b) Parents blaming others. The third domain, Potential Pitfalls and Strategies for Success included three themes: (a) Anticipate issues of blame and guilt, (b) Inclusion and exclusion of parents in the therapeutic process, and (c) Clarify the process. The fourth domain is Training and Theoretical Orientation Issues, consisting of two key themes: (a) Theoretical orientation shapes practice with parents and (b) Importance of training specifically focused on working with families. Strengths and limitations of the study, along with implications for clinical practice, social work education, and future research, are discussed.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

May 2013

Included in

Social Work Commons