Jaime E. Blackmon, MS, University of Connecticut; Robert Henning, PhD, University of Connecticut
This case study reports on the strengths and challenges of integrating a clinical perspective in Participatory Action Research (PAR) to address mental health issues in corrections as part of a Total Worker Health initiative. Researchers in the Health Improvement Through Employee Control (HITEC) program in the Center for the Promotion of Health in the New England Workplace (Cherniack et al., 2016; Cherniack et al., 2019; Dugan et al., 2016) recruited an experienced graduate student in clinical psychology to directly support employees in intervention planning efforts. Psychoeducation occurred across several modalities and included novel approaches to address mental health, and the clinical roles of introduction, integration, implementation, and interpretation are described.
Corrections is a unique employment setting with numerous under-researched sources of stress (Buden et al., 2016; Dignam et al., 1986). Due to the demands of the job, employees are at high risk for physical harm, familial tensions, psychological stress, and occupational burnout (Dowden & Rellier, 2004; Schaufeli & Peeters, 2000). Correctional research has recommended various methods for control of identified stressors, including improving the work environment to reduce stress, and identifying risk factors of burnout (Vickovic & Morrow, 2020). However, correctional settings remain stress-inducing. In March 2020, many occupational systems and structures were upended by changes in regulations due to COVID-19, and correctional facilities were not exempt from these effects (CDC, 2021; Montoya-Barthelemy, 2020; Okano & Blower, 2020; Rubin, 2020). To increase effectiveness of intervention planning efforts, HITEC researchers recruited an experienced graduate student in clinical psychology to share her clinical expertise directly with employees during their intervention planning efforts.
The multifaceted 4I-Approach can be used to describe the clinical graduate student’s involvement in PAR efforts. The first component was Introduction to the Role, where the student was offered the position by the clinical supervisor and then received guidance from a HITEC researcher in the industrial/organizational (I/O) psychology division as well as the clinical supervisor. The second component was Integration into the Role, where the student reviewed HITEC publications and the use of the IDEAS Tool (a structured approach that employees use during intervention planning). Additionally, the student attended regular meetings with HITEC researchers and with employee design teams (DTs) made up of 5-7 correctional officers. The third component involved Implementation of Clinical Skills, where the student developed training materials and provided psychoeducation to DT members on demand during intervention planning efforts. The fourth and final component is ongoing, and involves Interpretation of Experience, where the clinical student collaborates with HITEC researchers, including graduate students in I/O psychology, on various research studies, and engages in writing projects to summarize results of shared professional experiences with PAR.
Members of the union-led employee design teams engaged in intervention planning efforts benefited from receiving expert support from the clinical student as needed in six key areas: 1) Validation of employee’s mental health concerns; for example, stress-related concerns that impact family and off-the-job daily routines and substance abuse concerns, 2) Nonjudgmental professional listening; for example, regarding frustration with co-workers and employers and uncertainty and confusion about how to implement HITEC recommendations, 3) Translating concerns about mental health into identifiable issues that can be addressed through intervention design efforts, 4) Learning about various options for interventions, including proven forms of training that are available, 5) Receiving advice on how to disseminate information to peers in non-threatening ways; for example, using relevant examples, using a Cognitive Behavioral Therapy orientation in which DT members can become their own trainers, and 6) Helping DT members develop survey items for pre-and-post intervention evaluations, an activity that occurred in conjunction with I/O researchers that involved further development and review of survey items.
The 4I-Approach was used successfully to orient and train a graduate student in clinical psychology to share her expertise to support employee participatory design of Total Worker Health interventions to benefit the mental health of corrections workers. This approach also revealed six key ways that employees most needed expert support (mentioned above). HITEC researchers believe involving a clinical graduate student in interventions planning efforts resulted in high-quality and non-threatening psychoeducation trainings that significantly advanced these participatory intervention planning efforts. An added benefit was the clinical student’s enhanced exposure to the field of occupational health science and the value of involving employees in group efforts to address their own mental health issues through application of Total Worker Health principles.
Integrating clinical expertise in DT efforts is feasible and advantageous for developing interventions to improve the quality of corrections employees’ mental health. Future participatory action research may benefit from including the 4I-Approach when involving outside clinical expertise to ensure effective introduction, integration, implementation, and interpretation of clinical psychology expertise in participatory intervention planning efforts. The 4I-Approach could also be further refined and streamlined to involve other interdisciplinary perspectives.