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Date of Award


Degree Type

Dissertation (On-Campus Access Only)

Degree Name

Doctor of Psychology (PsyD)

Committee Chair

Ruth Zuniga, PhD


High prevalence rates of comorbid metabolic disorders among individuals with severe mental illnesses (SMI) frequently lead to significant medical complications. Due to this, lifestyle changes are needed to reduce the progression of metabolic disorders, such as type 2 diabetes (T2D and cardiovascular disease (CVD); however, several factors may impact their ability to attend to lifestyle changes. Yet residential staff frequently receive little to no training regarding behavioral activation skills and metabolic disorders. This pilot study was aimed at identifying the effects of a medically holistic training for residential staff. For the purposes of this study, a 2-day training incorporating health education, motivational interviewing, and mindful eating within the context of SMI was developed and implemented at a local behavioral healthcare agency. A repeated measures design was conducted with a total of 19 participants (76.5% female). The paired samples t-test demonstrated significant statistical improvements across several variables. Specifically, knowledge regarding T2D, t(18) = -2.60, p = .02, and CVD, t(18) = -2.24, p = .04 improved significantly. Participants’ perceived importance of self-management behaviors did not change; however, participants’ perceived self-confidence in helping their residents improve self-management behaviors regarding T2D, t(18) = -4.95, p < .001, and CVD, t(18) = -4.01, p = .001, demonstrated significant improvement. Their perceived ability to generalize these skills was also increased, t(18) = -7.76, p < .001. For observation purposes a within-factors ANOVA was calculated for the 8 participants who completed the 6-month follow-up, with no significant improvements found at the final point in time. The results of this pilot study indicate that a medically holistic training is a promising module which may help build residential staff knowledge and skills, thus potentially leading to increased engagement with residents. Future research with larger sample sizes to better assess the sustained effects of the training and potential mediating relationships is recommended.

Available for download on Friday, May 29, 2020