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Ukamaka Oruche
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Dr. Ukamaka Oruche’s interdisciplinary intervention program supports parents and caregivers of adolescents with disruptive behavior disorders (DBD). Adolescents with DBD, characterized by ongoing patterns of antisocial and defiant behaviors, have lower educational achievement, greater involvement with the criminal justice system, and lower rates of stable, long-term placement in the child welfare system than adolescents without DBD.
These adolescents have complex treatment regimens that require active parent involvement with child service and mental health systems. Parents describe feeling stressed, disrespected, and blamed for their adolescents’ behavior problems. These negative experiences leave parents feeling disengaged from care and less likely to follow recommended treatment, which can contribute to poor adolescent outcomes.
Low-income urban parents, particularly African Americans, are at greater risk for aversive interactions with professionals because of socio-economic disadvantage. Dr. Oruche developed the theoretical-based Family Management Efficacy intervention to address the stress parents and caregivers experience in caring for their adolescents with DBD.
Her intervention research is designed to strengthen family member’s perceived self-efficacy to manage interactions both within the family and with child service system professionals. Research products include a standardized treatment manual, a facilitator guide, parent workbooks, and fidelity checklists.
Dr. Oruche’s work to support parents and caregivers of adolescents with DBD is another example of how IUPUI faculty are TRANSLATING RESEARCH INTO PRACTICE.
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Item 4. Getting A Grip On My Depression: A Grounded Theory Explaining How Latina Adolescents Experience, Self-Manage, And Seek Treatment For Depressive Symptoms(Journal of Adolescent Health, 2019) McCord Stafford, Allison; Aalsma, Matthew C.; Bigatti, Silvia M.; Oruche, Ukamaka M.; Burke Draucker, ClaireLatina adolescents are more likely to experience depressive symptoms and less likely to receive mental health services than White peers. Although evidence-based treatments exist to treat adolescent depression, few treatments have been modified to meet the cultural needs of this population. In order to develop culturally sensitive strategies for preventing, identifying, and treating depressive symptoms in Latina adolescents, it is necessary to understand how they experience, self-manage, and seek treatment for their depressive symptoms over time from their own perspective. The purpose of this study was to develop a theoretical framework that explains how Latina adolescents experience, self-manage, and seek treatment for their depressive symptoms.Item Activation in persons with mental health disorders: An integrative review(Wiley, 2021-07-26) Keen, Alyson; Lu, Yvonne; Oruche, Ukamaka M.; Mazurenko, Olena; Burke Draucker, Claire; School of NursingWHAT IS KNOWN ON THE SUBJECT?: Evidence indicates a strong relationship between patient activation (i.e. confidence, knowledge and skills to self-manage health) and positive health behaviours and outcomes in a variety of clinical populations. Because persons with mental health disorders experience significant disease burden but often underutilize mental health treatment or experience poor treatment outcomes, they would likely benefit from increases in activation. No systematic reviews have been conducted to summarize and synthesize research on patient activation in persons with mental health disorders. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: To our knowledge, this is the first comprehensive review to identify factors associated with activation and interventions that have shown to be effective in persons with mental health disorders. This integrative review indicates that better health status, less depression, positive health attitudes and behaviours, and higher quality therapeutic relationships may be associated with higher levels of activation in persons with mental health disorders. This review also indicates that a variety of interventions, most notably educational programs, are effective in increasing levels of patient activation in persons with mental health disorders. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Psychiatric mental health nurses and other clinicians should consider routine assessment of patient activation to inform individualized treatment plans for their clients. Clinicians should aim to form high-quality therapeutic relationships with clients as a way to promote higher levels of activation. Interventions that have been found to be effective in improving activation could be offered in a variety of mental health settings. ABSTRACT: Introduction Patient activation is understanding one's role in the healthcare process and having confidence, knowledge, and skills to self-manage one's health and health care. Researchers have begun to investigate patient activation in persons with mental health disorders, but no systematic reviews have been conducted to summarize and synthesize this research. For psychiatric mental health nurses and other clinicians to develop strategies to increase patient activation in this population, more information is needed about factors associated with activation and interventions that increase activation. Review Questions (1) What factors are associated with levels of activation in persons diagnosed with mental health disorders? (2) What interventions have shown to be effective at increasing levels of activation in persons diagnosed with mental health disorders? Method A 5-stage integrative review as described by Whittemore & Knafl. Results Twenty-nine articles were included in the review. Ten provided correlations between activation and other factors, and 20 examined the effects of interventions on activation. Some studies revealed significant correlations between a variety of health and treatment-related factors, and others revealed that some interventions, most notably educational programs, were shown to increase activation. Discussion The findings of this comprehensive review can inform psychiatric mental health nurses and other clinicians in developing strategies to increase activation in the patients with whom they work. More research is needed to provide a deeper understanding of the role of activation in the recovery and treatment of persons with mental health disorders. Implications for Practice Psychiatric nurses and other clinicians should assess for patient activation and incorporate strategies to increase levels of activation in patients in their practice. Positive therapeutic relationships likely enhance activation in persons with mental health disorders.Item At Risk Children: Collaborating With Families and Communities to Promote Equitable Mental Health Care(2015) Oruche, Ukamaka M.Item Attacking the Drug Epidemic: Healthcare Delivery Perspective(2017) Oruche, Ukamaka M.Addiction is a chronic and recurring brain disease. Despite the associated symptoms and behaviors, prevention works, treatment is effective, and recovery is possible for everyone. Together we can attack current drug epidemic using a public health framework of integrated, comprehensive and multipronged approach appropriate to each person’s need.Item Barriers and facilitators to treatment participation by adolescents in a community mental health clinic(2013-05-17) Oruche, Ukamaka M.; Downs, Sarah M.; Holloway, Evan D.; Burke Draucker, Claire; Aalsma, Matthew C.An estimated 40–60% of children in mental health treatment drop out before completing their treatment plans, resulting in increased risk for ongoing clinical symptoms and functional impairment, lower satisfaction with treatment, and other poor outcomes. Research has focused predominately on child, caregiver, and family factors that affect treatment participation in this population and relatively less on organizational factors. Findings are limited by focus on children between 3 and 14 years of age and included only caregivers’ and/or therapists’ perspectives. The purpose of this descriptive qualitative study was to identify organizational factors that influenced participation in treatment, with special attention to factors that contributed to dropout in adolescents. The sample included 12 adolescent–caregiver dyads drawn from two groups in a large public mental health provider database. Analysis of focus group interview data revealed several perceived facilitators and barriers to adolescent participation in treatment and provided several practical suggestions for improving treatment participation. Implications of the findings for psychiatric mental health nurses and other clinicians who provide services to families of adolescents with mental health concerns are discussed.Item Breakout Session: Attacking the Drug Epidemic(Bowen Center for Health Workforce Research & Policy, 2017-06-20) Duwve, Joan; Herrmann, Debbie; McClelland, Jim; Oruche, Ukamaka M.This panel presented on Governor Eric Holcomb’s fourth pillar, “Addressing the Drug Epidemic” and explored the implications of this pillar for the health workforce. Panelists described various initiatives taken within the State to attack the epidemic, including: public health workforce strategies, behavioral health and primary care integration, and the formation of the Commission to Combat Drug Abuse.Item Burdens Experienced by Siblings of Adolescents with Disruptive Behavior Disorders(2015) Oruche, Ukamaka M.Item The Challenges for Primary Caregivers of Adolescents With Disruptive Behavior Disorders(SAGE, 2014-12-10) Oruche, Ukamaka M.; Burke Draucker, Claire; Al-Khattab, Halima; Cravens, Hillary A.; Lowry, Brittany; Lindsey, Laura M.Adolescents with disruptive behavior disorders (DBD), including oppositional defiant disorder and conduct disorder, present unique challenges for their families. Although, most empirically supported treatments for DBD are family-based, the emphasis is typically on the behavior of the child rather than on the life challenges and resultant distress experienced by the family members. Fifteen families of adolescents with DBD were recruited from a large publicly funded Community Mental Health Center. For this report, data from in-depth interviews with the adolescents’ primary caregivers were analyzed by standard content analytic procedures to describe the challenges they experienced living with and caring for the adolescents. The primary caregivers reported that the challenges were overwhelming, demanding, and unrelenting. The two most salient challenges were (a) managing the adolescents’ aggressive, defiant, and deceitful behaviors, and (b) interacting frequently with a number of child-serving agencies. A number of clinical implications are drawn from these findings.Item The Described Experience of Primary Caregivers of Children with Mental Health Needs(2012-10) Oruche, Ukamaka M.; Gerkensmeyer, Janis; Stephen, Linda; Wheeler, Corrine A; Hanna, Kathleen M.About 10% of our nation's children have serious mental health needs that result in significant functional impairments. Although research has found that primary caregivers of children with mental health needs have high levels of depressive symptoms and distress, little is known about the challenges these caregivers face. Focus groups with 20 caregivers of children with mental health needs between 2 and 17 years of age revealed these themes: struggling with care systems, living in fear, being burdened and exhausted, worrying about the rest of the family, and having good things happen. Caregivers described extreme challenges and many unmet needs that are important to consider in efforts to improve both children's and caregivers' well-being.Item Developing a Multiple Caregiver Group for Caregivers of Adolescents With Disruptive Behaviors(Elsevier, 2017) Oruche, Ukamaka M.; Robb, Sheri L.; Aalsma, Matthew; Pescosolido, Bernice; Brown-Podgorski, Brittany; Burke Draucker, Claire; School of NursingThis article describes the development of a 6-week multiple caregiver group intervention for primary caregivers of adolescents diagnosed with Oppositional Defiant Disorder or Conduct Disorder in low-income African American families. The intervention is aimed at increasing the primary caregivers' self-efficacy in managing interactions within the family and especially with child serving educational, mental health, juvenile justice, and child welfare systems. Development of the intervention involved seven iterative activities performed in a collaborative effort between an interdisciplinary academic team, community engagement specialists, members of the targeted population, and clinical partners from a large public mental health system. The intervention development process described in this article can provide guidance for teams that aim to develop new mental health interventions that target specific outcomes in populations with unique needs.