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N e u m a nn U n i v e r s i t y

Volume 3, Spring 2018

Journal of Student Research and Academic Scholarship

Editorial Statement Catalyst: The Neumann Journal of Student Research and Academic Scholarship is an interdisciplinary peer-reviewed student journal. The journal articles consist of academic research manuscripts authored by Neumann University undergraduate and graduate students with the endorsement of faculty members. The mission of Catalyst is to provide a vehicle to showcase the excellent academic research projects and scholarship of Neumann University students. Catalyst is published biennially in April and is available in an electronic format.

Co-Editors Stephanie Smith Budhai, PhD Associate Professor and Director of Graduate Education Division of Education and Human Services

Maureen Williams, MLIS Information Literacy Coordinator and Reference Librarian Library Services

Editorial Review Board Barbara Hanes, EdD Samuel Lemon, EdD Jackie Martin, M.S. Colleen McDonough, PhD Sophia Park, ThD

Megan Scranton, EdD Robert Till, PhD Beth Toler, ThD Maria Traub, PhD Patricia Welsh, EdD, RN

For more information about submitting or reviewing articles for Catalyst, please visit us at or email us at

Special Acknowledgements Special Acknowledgements Creating and publishing this issue of Catalyst was a collaborative undertaking and could not have been accomplished without help from the following people: Lawrence DiPaolo, PhD Tiffany McGregor, MLIS Carol DiAntonio

Table of Contents Arts and Sciences

Education and Human Services


103 “The Impact of Parental Involvement on

15 31

“Art Impacts Young People’s Lives” Samantha Locklear, student author John Mizzoni, PhD, faculty advisor “The Gem That is Jem: Understanding Harper Lee’s To Kill a Mockingbird Through the Tears of an Adolescent” Megan McDermott, student author Anne Ramirez, PhD, faculty advisor “Iago’s Motive or Lack of Motive in Othello: Comparison of Two Scholars’ Interpretation” Kelly Perdue, student author Gail Corso, PhD, faculty advisor

Student Achievement” Brianna Troyer, student author Kenneth D. Waters, EdD, faculty sponsor

119 “The Effects of Learning Chess in a Low

Socio-Economic School” Bridget McDermott, student author Patarick Boyle, EdD, faculty advisor

134 “Autism: A Different Way of Being Human” Nicole Fantom, Jacqueline Paxson, Kiera Scarbrough, student authors Daniel McKee, EdD, faculty advisor

Business and Information Management

146 “Journey Out of Darkness”


162 “Integrating Spirituality and Psychotherapy:

“The Current Need for National Paid Parental Leave” Casey Jeronimo, student author Robert Till, PhD, faculty advisor

Continuing Adult and Professional Studies

56 71

“More Than Man’s Best Friend: Exploring the Use of Animal-Assisted Interventions” Christine Gibble, student author Jackie Martin, MS, faculty advisor “More Than Just Performance: Using Multiple Accountability Systems to Build Better Relationships in a Franchise System” Jonathan Steward, student author Susan Dixon, JD , faculty advisor

Karen Rodgers, student author Sophia S. Park ThD, faculty advisor

A Jungian Perspective” Lynn B. Strange, student author Sr. Suzanne Mayer, ihm, PhD, faculty advisor

Nursing and Health Sciences

182 “Effectiveness of Mindfulness-Based Programs

for Veterans with PTSD: Integrative Research Review to Support Improved Patient Outcomes” Denee Gable, student author Theresa Pietsch, PhD, faculty advisor

196 “Mandating Cardiac Pre-Participation

Screenings in Adolescent Athletes” Taylor Krupiak, student author Kathleen Neal, PhD, faculty advisor

Arts and Sciences

Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

Art Impacts Young People's Lives Student Author: Samantha Locklear Academic Program: Arts & Sciences Faculty Advisor: John Mizzoni, Ph.D. Abstract: Times of economic struggle may affect multiple aspects of society. In this paper, the impact of financial setbacks to educational programs in the arts are explored. The idea that art can have major positive influences on today’s youth may seem doubtful to some, and that is what this paper strives to address. First, readers will learn that art instills confidence in children and young adults, even if they are facing difficult times. Furthermore, scientific studies show how the arts, especially music, can benefit cognitive thinking. Lastly, the social benefits of creative freedom are mentioned, and applied to people of different backgrounds. School administrators who are dealing with financial instability ought to consider the benefits that art has on the lives of young people before eliminating such programs from academic curriculums. If the general public were better informed of the benefits of artistic activities they might be taken more seriously.

It may be difficult for adults to realize what young people go through in their school environments these days. Peer pressure and academic status only make up part of the stress that students face on a day to day basis. Students need stress-free time in their schedules, too. Typically, ‘stress-free’ moments are those in which someone feels a sense of calmness. Such periods of relaxation are often found in fine arts classes, with good reason. When creating art, it can be easy to concentrate on the task at hand which prevents the mind from becoming preoccupied with thoughts that may cause stress. Arts courses are still considered academic disciplines because, like other classes, they require learning and active engagement. However, art related courses are often undermined and face budget cuts due to struggling economies. In 2013, 50 public schools in Chicago were forced to close their doors permanently, causing over 160 art and music teachers to lose their jobs (Fang, 2013). Likewise, while facing a 304 million dollar


setback, the city of Philadelphia eliminated art programs altogether in the majority of its schools (Fang, 2013). Limiting funds for art programs has become a national problem, according to Linda Emma, a writer for Demand Media. She claims that monetary distribution towards art programs provided by the National Endowment to the Arts decreased by at least six percent in 2012 (Emma, 2016). This information makes one wonder about the significance of art in the lives of students. When deciding to limit funds on art classes, administrators should consider this question: “Does art positively stimulate learning and social capabilities in young people?” Research suggests that art does enhance learning and social capabilities for people both in and outside of the classroom. It does so by building confidence, stimulating brain cognition and making people feel engaged in society. Art affects people in a positive way by giving them a sense of confidence. Freedom of thought and expression that art programs offer is crucial, especially during adolescence. Carolyn Cannuscio’s (2012) article “Using Art to Amplify Youth Voices on Housing Insecurity” supports this idea by means of an observational study. Her work focuses on a group of young people and their efforts to raise awareness about the issue of homelessness in Philadelphia by painting murals on abandoned row homes. Through these acts of service, participants gained more confidence to express their views on important issues, such as homelessness. The participants were not the only ones who became more optimistic because of the program, however. Cannuscio observed changes in the entire community. Residents of several neighborhoods in Philadelphia came together to support the cause (Cannuscio, 2012). Other studies suggest that confidence in the classroom is just as important. For example, the “Evolution” program, discussed in “Re- Engaging At-Risk Youth through Art – The Evolution Program”, helped encourage young adults to make further strides towards future education. Over 80% of


participants went on to higher education after completing the program (Brown & Jeanneret, 2015). Clearly, most people involved with this art program felt encouraged to engage themselves in other academic areas. Along with statistics, interviews were included, showing that participants were reported to have noticed “confidence boosts” in themselves. One person explained, “After ‘Evolution’, I want to continue my art and develop new skills,” (Brown & Jeanneret, 2015, p.11). This insight belonged to just one of many participants who was impacted enough to become more confident in making important life decisions. Similarly, Andrea Cooper writes about an after-school program called “Turnaround Arts” which allows children in underprivileged schools to get involved with the arts. Cooper observes a school in Roxbury, Massachusetts, that adopted “Turnaround Arts” after facing severe disciplinary problems. Circumstances changed for the better, because in 2013, the school ranked in the top two percent of schools in Boston (Cooper, 2015). In fact, this program was so successful that other schools benefited from it as well. Children who were involved in “Turnaround Arts” became more confident in their academic successes and felt safer in their school environment, which allowed attendance records to increase in more than 50% of the piloted schools (The Art of Success, 2015). The claim that art classes are the only ones that may build confidence in students is often debated. This makes sense, for confidence can be enhanced by any school subject. For instance, if students struggle in math, they can still get a good grade on a test, and that may boost their self-esteem when handling the course. Understanding the confidence that art provides is different. Unlike math equations, which require very specific and calculated approaches, artful influences, both visual and musical, derive from the creator’s own feelings. One key to building confidence involves a strong sense of self-awareness (Coholic & Eys, 2016). Diana Coholic’s


and Mark Eys’ research on mindfulness-based interventions for young children is centered around creative activities. Their Holistic Arts-Based Program focuses more on a connection with one’s emotional self rather than an analytical self that may be expected from math or sciencebased programs. In one activity, children are expected to mold clay while listening to a descriptive audio clip. This exercise is meant to allow the participants to feel strengthened by their imaginations and to be aware of their feelings and actions while they listen (Coholic & Eys, 2016). From this, it is easy to grasp why belittling the fine arts abilities to improve a student’s self-reflective skills is erroneous. Yes, other school subjects do the same. Visual arts such as sculpting, painting, drawing, dancing, or even writing allow emotional influences to be prominent throughout the entire creative process, not just in the end result. Musical arts work in the same way because musical composition and performance Young people gain confidence with self-awareness which leads to a sense of self-worth. Inner compassion that children in the Holistic Arts-Based Program develop allows them to view the world with open-minded optimism (2016). Another way that art impacts young people is by enhancing brain cognition. Many forms of art, especially music, help stimulate productivity in certain neural areas of the brain. According to David Sousa, a neuroscientist, listening to composers such as Mozart enhances the temporal lobe. Doing so enriches the brain’s capability to rationalize and make better decisions (How the Arts Develop the Young Brain, 2016). Sousa references scientific studies in which children were involved in creative activities. The participants—who were separated into four groups—partook in different lessons, including singing, piano playing and computer training. Results show that the children who had received the piano lessons increased scores on tests of


spatial-temporal reasoning by 34% (Sousa, 2016). Children who experienced the other forms of training were not impacted as significantly. Posner and Patoine bring up similar studies in their article, “How Arts Training Improves Attention and Cognition”. The authors reference a study conducted by E. Glenn Schellenberg which he titled “Music Lessons Enhance IQ”. Schellenberg’s research examined 72 children who were musically trained and 36 kids who were not (Posner & Patoine, 2009). Posner and Patoine state that the children who were involved with music had significantly higher IQs than those who were not. A study conducted by Ellen Winner is also important to consider. Like Schellenberg, Winner examined brain development of children who had musical training for several years. Just in the first 15 months of testing, there were intensive changes in certain neural circuits in the brain, caused by processing music for long periods of time (Posner and Patoine, 2009). Michael Wachter and Heather Kirkwood-Mazik (2015) take a different approach when describing art’s influence on the brain’s neural processes by alluding to associations that young adults make between photographic art and popular marketing concepts. The authors claim that partaking in this activity would “activate high-involvement learning, creative elaboration, and analytical reasoning,” (pg. 1). Many young people who were involved in this activity felt impacted by other creative points of view. For instance, according to the authors, 27% of people involved who were surveyed believed that synthesizing art with marketing theory stimulated learning and critical thinking skills (Wachter & Kirkwood- Mazik, 2015). Using studies such as these suggests that artistic involvement makes it easier for the brain to process information and apply it to studies. Clearly, there is an abundance of scientific research which promotes the positive impacts that art has on the brain. Though such evidence may be difficult to argue against, there can still


be speculation. Some critics may claim that all people have unique interests and different ways of thinking, thus suggesting that art cannot be pursued by all people. While this may be true, it is important to consider which form of art is being discussed. The arts cover a wide range of subjects, from paintings or sculpture that categorize traditional visual arts, to literary studies, or even musical practices. Assuming that someone must appreciate all art forms in order to benefit from them seems far-fetched. After all, a student that gets no satisfaction from a standard studio art class can still appreciate the music that he or she hears on the radio. As Sousa (2016) found through his research, music stimulates the brain in a positive way by helping enhance cognitive thought and reasoning. Because of this, music helps students in other academic areas as well, especially those that involve math and reading. Not everyone enjoys being in a creative environment, but there are some who do reap the benefits. Posner and Patoine (2009) found that young people who involve themselves in artistic activities have higher IQ’s than those who do not. And, in cases of young people with special needs, critics ought to reconsider their doubts. In some instances, creating art allows young people with special needs to be more focused. Patti Drapeau, an educational consultant, says that it is easier for people to remember things when thinking creatively about the subject, which could explain the benefits of concentration (Cooper, 2015, p. 22). Art is also significant in the social aspects of young people’s lives, for it creates a connection between people and allows individuals to become engaged in society. Liana Heitin, author of “Arts Program Shows Promise in Special Ed. Classes”, briefly discusses an educational program called Everyday Arts for Special Education (E.A.S.E). Though Heitin claims that detailed information about the artistic involvement of children with special needs is scarce, her observations show that such children feel more engaged in creative environments (Heitin, 2014).


She mentions Ms. Rosenberry, a special education teacher for second graders who sought training in the E.A.S.E program. Rosenberry would help her students by involving them with art and by encouraging them to make eye contact to allow them to make strong connections with teachers and other students (Heitin, 2014). Listening to music proved to be helpful as well, for it allowed the young children to be more focused in their classroom environment. Likewise, Brown and Jeanneret express how troubled members of society were impacted in a social way because of art. One member of the “Evolution� program had complex mental disabilities and needed special attention. Though he was initially verbally abusive, by the time the program ended, he was much calmer and more focused (Re- Engaging At-Risk Youth through Art – The Evolution Program, 2015). This is a significant social breakthrough, since the young man learned how to control his outbursts and become more sociable with other members in the group. It is evident that when people think and work in a creative way, they not only become more focused on their creations, but become more engaged with their peers as well. The public often views art as a mere hobby and because of this, some people may question how a hobby could have such a large impact on the social life of an individual. It is true, that art is a hobby for some, but for others, it is a passion. All types of hobbies can allow people to connect socially. Two people who have similar interests in the things they enjoy or what they like to do, often become good friends once they get to know one another. The arts are appreciated worldwide, so it is likely that people can connect socially through creative involvement. This is a huge step for people who struggle with social anxiety, for it allows them to take small steps in expressing themselves in other ways. Some people have trouble with expressing themselves verbally, and through creating art, they learn to show their feelings through the creations that they make.


By enhancing learning and social capabilities, and instilling a sense of confidence or selfacceptance, art plays significant roles in the lives of young people. Knowing this, it is difficult to understand why art programs continue to be cut from educational curriculums so that funding may be provided elsewhere. One may only wonder how many school administrators truly understand the influential power that art has on students. A child’s creative tendencies should not be overlooked, but encouraged. Even adolescents and young adults deserve to express themselves freely, for it is their God given right to do so. Art also has brought young people together in acts of service. Such volunteer opportunities have given participants the confidence to be successful leaders as they move on through different stages of their lives. Working together as members of a group also makes young people feel more engaged in social settings. Even if administrators are still not convinced by such findings, it is important for them to know that art’s role in the classroom is just as significant. Students who are involved in the arts tend to have higher average test grades than those who are not, because critical thinking skills that they develop help with math and reading. Increased brain cognition may occur both from visual and musical arts and therefore, music as an art form as extremely impactful. The purpose of this paper is not to diminish the significance that sports or academics have on the lives school-aged people; rather, it is to highlight the benefits that come from the arts. Moving forward, it is essential that more positive information about art is shared with school-board members. More art programs will be excised from schools, so long as people remain oblivious to how important these classes are and losing them would be detrimental for today’s youth.


Works Cited Brown, R., Jeanneret, N. (2015). Re- Engaging At-Risk Youth through Art The Evolution Program. International Journal of Education & the Arts, 16(14). Retrieved from Cannuscio, C., Et al. (2012) Using Art to Amplify Youth Voices on Housing Insecurity. American Journal of Public Health, 102(1), 10-12. doi:10.2105/AJPH.2011.300494. Retrieved from Coholic, D., & Eys, M. (2016). Benefits of an Arts-Based Mindfulness Group Intervention for Vulnerable Children. Child & Adolescent Social Work Journal, 33(1), 1-13. doi:10.1007/s10560-015-0431-3 Cooper, A. (2015). The Art of Success. Instructor, 124(4), 21-25. Retrieved from http: // Emma, L. (2016). Budget Cuts to Art Programs in Schools. Retrieved from Fang, M. (2013). Public Schools Slash Arts Education And Turn To Private Funding. Retrieved from education-relying-more-on-private-arts-funding/ Heitin, L. (2014). Arts Program Shows Promise in Special Ed. Classes. (Cover story). Education Week, 33(32), 1-13. Retrieved from


Posner, M. I., & Patoine, B. (2009). How Arts Training Improves Attention and Cognition.Retrieved February 05, 2016, from nition/ Schellenberg, E. G. (2002). Music Lessons Enhance IQ. Psychology Science. Retrieved from Sousa, D. A. (2016). How the Arts Develop the Young Brain. Retrieved from Wachter, M., & Kirkwood-Mazik, H. (2015). Art Isn’t Easy. . . But it Makes Learning Easier: Using Art to Improve Brain Cognition. Marketing Education Review, 25(1), 39-45. doi:10.1080/10528008.2015.999602


Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

The Gem That is Jem: Understanding Harper Lee’s To Kill a Mockingbird Through the Tears of an Adolescent Student Author: Megan McDermott Academic Program: Arts & Sciences Faculty Advisor: Anne Ramirez, Ph. D. Abstract: Harper Lee’s novel To Kill a Mockingbird continues to inspire with its universal lessons of human dignity. Although Jem Finch is a name that anyone familiar with Mockingbird will immediately recognize, he has all too often been overlooked, whereas Atticus and Scout tend to steal the spotlight. Scout’s childhood perspective has been repeatedly examined, yet she does not undergo such a radical transformation as her older brother Jem does during the pivotal years of his adolescence. Moreover, the ideals Lee attributed to Atticus’ character greatly impacted Americans from all walks of life. No other fictional character has inspired generations of lawyers to pursue justice than Atticus Finch. His son Jem is similarly inspired as he fully comprehends his father’s integrity and service to the truth. This paper analyzes how Jem’s “inbetween,” coming-of-age stage of adolescence allows one to comprehend the events of the novel through a unique perspective, and explores how that perspective can drive young adult readers to engage with complicated yet important issues. Jem’s growth in consciousness displays the direction Lee wished her readers would follow. Just as Atticus strived to convince people in 1930s Alabama “to weep” in the face of evil like Jem, Lee also wished her world of 1960 America would shed tears when confronted with injustices. The need for such conviction and awareness is still needed today. As Jem transitions from childhood to adolescence, and from ignorance to awareness, readers experience a similar journey. Through Jem, Lee demonstrates the process of how a young person inspired by the integrity of a role model, develops traits of empathy and compassion. Finally, this paper considers various attitudes towards race and class in the South of the 1930s in a light that is seldom focused on in response to Mockingbird: through the eyes of an adolescent.

" seems that only children weep." ~ Atticus Finch Although Jem Finch is a name that anyone familiar with Harper Lee’s To Kill a Mockingbird will immediately recognize, young Jem has all too often been overlooked, whereas Atticus and Scout tend to steal the spotlight in the reception of Harper Lee’s classic American


novel. Readers and critics widely perceive Mockingbird to be a coming-of-age story which focuses on Scout’s development and life experience. But Scout, who progresses from six to nine years of age throughout the novel, does not undergo such a radical transformation as her older brother Jem does during the critical years of his adolescence. Because Jem is more mature than Scout, the reader witnesses his transformative journey of moral consciousness as he becomes increasingly aware of the injustice, prejudice, violence, and hypocrisy in his community. Standing on the threshold between childhood and adulthood, Jem’s character development is notably more dynamic than either Atticus or Scout. Furthermore, Jem’s character may reveal the perspective that Lee hopes her readers will attain on the ethical issues arising in the novel. The very first lines of To Kill a Mockingbird begin: “When he was nearly thirteen, my brother Jem got his arm badly broken at the elbow.” Scout as narrator continues to focus on her brother for the entire first paragraph, emphasizing the permanent though not disabling impact of his injury: “When it healed, and Jem’s fears of never being able to play football were assuaged, he was seldom self-conscious about his injury.” (Lee 3). There Jem is in the opening lines, a teenage boy simply concerned about playing football – and the possibility of losing that activity. And then— relief. His arm eventually heals. What a trivial thing in a novel that is anything but trivial. Initially, those opening lines feel insignificant, but beauty and depth are found in their obscurity. Lee masterfully places them here in order to foreshadow the crux of the story’s most critical metaphors. “I maintain that the Ewells started it all,” says Scout in the second paragraph. But then, 16

she proclaims: “Jem...said it started long before that. He said it began the summer Dill came to us, when Dill first gave us the idea of making Boo Radley come out.” (Lee 3). Jem continues to significantly influence the structure of the story. As the novel progresses, and as it is widely perceived, Lee constructed the character of Boo Radley [the infamous recluse of Maycomb] to serve as the famous mockingbird metaphor of innocence in relation to the Tom Robinson case. However, Lee also weaves in this metaphor throughout the story in another way. As we recall the opening lines, we find that it is with Jem, and his growth as an adolescent, that readers encounter another important layer of the mockingbird. Lee describes Jem’s growth with more complexity whereas Scout seems to be more of an observer as events unfold in Maycomb. Though Scout does indeed witness and learn about the injustices taking place in her society, we do not experience the same depth of emotion in her reactions as we do with Jem. The clearest example of this takes place after Tom Robinson’s trial. The guilty verdict which follows is incomprehensible to Jem. Chapter 22 opens with the words “It was Jem’s turn to cry” (Lee 234). He looks to his father for some explanation of the jury’s guilty verdict, asking, “How could they do it, how could they?” Atticus answers, “I don’t know, but they did it. They’ve done it before and they did it tonight and they’ll do it again and when they do it seems that only children weep” (Lee 234). Although Jem is still an innocent child in many ways at this point in the novel, he is just old enough to recognize and deeply comprehend a situation of true injustice. He is truly heartbroken; for his reaction is not one of anger or rage but of deep empathy. His tears indicate how clearly he has understood and internalized the situation. 17

Jem is quite unique here; he is the only one in the novel who undergoes the experience through both a child’s and adult’s eyes. Jem’s “in-between” stage of adolescence allows us to to see the events of the novel through this unique perspective. Many young adult and adolescent readers can engage with the complicated issues of Lee’s narrative through this lens. In light of this, can we conclude that perhaps Jem’s growth in character and awareness represents the direction that Lee wished her readers and audiences would follow? Just as Atticus strived to convince people in 1930s Alabama “to weep” in the face of evil, Lee also wished her world of 1960 America would shed similar tears when confronted with such injustices. As Jem transitions from childhood to adolescence, and from ignorance to awareness, we as readers experience a similar journey. Through Jem, Lee manages to reverently demonstrate the process of how a young person inspired by the integrity of his father develops traits of empathy and compassion. Simultaneously, Lee explored varying attitudes towards race and class in the Deep South of the 1930s in a light that is seldom focused on in research and criticism of To Kill a Mockingbird: through the eyes of an adolescent. Atticus Finch has been revered as a global hero ever since Lee introduced him to the world through Mockingbird. Atticus has become a cultural icon that many people—especially young people— deeply admire. His wisdom is most associated with that perennial life lesson: if justice is to have any hope, it must find its basis in empathy and he is the legend to whom many


now practicing lawyers have attributed their decision to pursue justice as a career. However, in wake of Harper Lee’s recently published novel, Go Set a Watchman, the heroic perception of Atticus Finch has been skewed and challenged. Many of us now know that the 72 year old Atticus of Watchman is a very different character than originally perceived in Mockingbird. Yet just a few years prior to the 2015 release of Lee’s Go Set a Watchman, biographer Charles J. Shields emphasized an important point about the author’s real-life father, A.C. Lee :

“Mr. Lee himself only gradually rose to the moral standards of Atticus. Though more enlightened than most, A.C. was no saint, no prophet in the wilderness crying out in regards to racial matters. In many ways, he was typical of his generation, he believed that the current social order, segregation, was natural and created harmony between the races.” (Shields 121)

This description of Atticus resembles the earlier portrayal of Atticus in Go Set a Watchman rather than the Atticus of Mockingbird. However, Shields then delves into a fascinating find: that A.C. changed his views about race relations during the remainder of the 1950s: “Formerly a conservative on the matters of race and social progress, he became an advocate for the rights of Negroes. Part of the reason for his change of mind was the influence of events that no thoughtful American in the 1950s could ignore. In 1954, two white men murdered Emmett Till, a 14-year old Negro visiting Mississippi for whistling at a white woman” (Shields 125). By the time Mockingbird was published, A.C. counted himself as an activist defending the civil rights of Negroes. Though Atticus is portrayed negatively in Watchman with regard to race issues, this


earlier culture may reflect the real A.C. Lee’s outlook at that time period, yet the latter’s vision apparently progressed before his death in 1962, after Mockingbird was published, but before the completion of the famous film starring Gregory Peck. Occasional critics - most notably Malcolm Gladwell - have complained about the perspective of Atticus in Mockingbird before Go Set a Watchman ever appeared. And indeed, its publication made Atticus’ character much more controversial. Although the perception of Atticus Finch has unfairly changed in the wake of Lee’s Go Set a Watchman, it is vitally important to note that this novel is not a sequel but a preMockingbird draft that was slowly edited and morphed into our now beloved American classic. The Atticus of Mockingbird was the Atticus which Lee desired the world to know; he is nonetheless heroic even if neither the real A.C. Lee nor the Atticus of Watchman were of the same stature. After years of deep thought, reflection, and editing, Lee realized the power a figure such as the Atticus of Mockingbird could have on the world. The Atticus of Watchman, she realized, could never affect the hearts and minds of a society steeped in prejudice or racism. Lee brilliantly used the childhood perspective of Scout and (even more so) Jem’s adolescent vantagepoint in Mockingbird to serve as catalysts of empathy, understanding, and relatability. The didactic tone of Watchman, she and her editors both knew, did not have this potential. Through Jem’s character, through his empathy, and his coming-of-age transformation toward awareness, one can see how Atticus’ integrity in Mockingbird is a positive, constructive, and meaningful catalyst for change. Jem’s growth is a metaphor for our growth as readers and the 20

growth which Lee wished to awaken within her prevailing society’s consciousness. Jonathan Rapping comments on the present Atticus controversy: “One can certainly look beyond the story of Mockingbird to paint a less flattering picture of Atticus—whether by arguing that he did not do enough to promote the cause of justice, or by claiming that the Atticus of Watchman is the same as the Atticus of Mockingbird.” (Rapping 846) It is important to remember that Atticus is a fictional character. Readers and critics can certainly wonder about who Atticus is beyond his representation of Tom Robinson. However, we can also choose to look to Lee’s Mockingbird as one that stands alone— “a story about one lawyer in one case doing what is righteous and noble.” This perspective allows us to keep “an important symbol in the American quest for justice.” (Rapping 846) An interesting point to note about Rapping’s article is that he writes from a lawyer’s perspective:

‘As a law professor and the president of a non-profit organization that trains and supports public defenders in some of our nation’s most broken criminal justice systems, I regularly work with current and future lawyers. Many of these lawyers struggle to maintain their idealism in arenas—both academic and professional—that frequently promote values inconsistent with the principles they strive to embrace. From this perspective, I appreciate having a popular culture symbol, like Atticus, that both reminds us of the noble role a lawyer can play in addressing injustice and inspires our profession to be better.’ (Rapping 846)

Most insight we glean about Mockingbird, Harper Lee, and Maycomb mainly comes 21

from the viewpoints of literary theorists, journalists, and writers within academia. Yet here we have a perspective of an individual who was motivated to dedicate his entire life in following the footsteps of a heroic figure such as Atticus. Like Jem, who comes-of-age and begins to emulate his father’s attributes as he grows in awareness, many young lawyers, as well as people from all walks of life, were deeply moved by the portrayal of Atticus.

Teresa Phelps asks “What is it then that we carry away from To Kill a Mockingbird? Or, for those of who teach the book year after year, what is it that we are hoping that our students will take away?” She concludes: “We thus read (and teach) To Kill a Mockingbird to learn about character. A generation of young lawyers and law students has identified with Atticus and emulated his values… He manages at once to be of and not of Maycomb; he has defined and individual self not in opposition to others, as have so many heroes of twentieth century fiction, but as part of a community - a self in relation to others.” (Phelps 166)

Atticus’ integrity and sense of justice has a chain reaction. Jem often emulates Atticus while Scout observes; she then seems to emulate Jem on many occasions throughout the book. Jennifer Murray, in More Than One Way to (Mis) Read a Mockingbird, emphasizes this: “Scout is essentially an observer, registering the events around her more than she is transformed by them.” (Murray 80) She asserts that it is Scout’s older brother who goes through the most progressive stages of moral transformation in the story. Murray further observes that “Jem is becoming a man, but the novel keeps open the dialectic between childhood and adulthood,


between innocence and experience. Indeed, we see Jem struggling to reconcile his childhood belief that justice given in the courtroom will always favor the truth with his experience of events which has shown him that this is not always true.” (Murray 81) Jem’s tears during and after Tom’s trial highlight this dialectic.

Moreover, the heroic ideals Harper Lee attributed to Atticus’ character greatly impacted the consciousness of American readers. Jem can be seen to similarly awaken as he begins to fully comprehend his father’s integrity and willingness to serve the truth. The effect that Atticus had and still has on the moral development of young readers is quite profound. In our reading of the novel, we witness the same striking effect on his children as they navigate their way through the injustices of their “tired old town.” (Lee 5). He becomes a character with whom many young people can easily identify with as they reminisce their own teenage years and as he comes-of-age throughout the three years of the story, readers experience how his brilliant imagination, his empathy, and formation of character, are in part byproducts of his admiration of Atticus; who is both his father and role model. In one of the novel’s most memorable scenes, Jem discovers that Atticus is much more of a hero than he initially perceived him to be. In the scene where the rabid dog Tim Johnson is roving the street by the Finch’s home, the children watch as Atticus and Mr. Tate, the town sheriff, try to stop the dog from wandering around and endangering the town. To Scout and Jem’s astonishment, Atticus kills the dog in a swift, single shot. Jem has always respected


Atticus in his intelligence and wisdom. But here in the mad dog scene, Jem learns that his older father of 50, whom he thought to be less-athletically inclined than other dads and mostly studious, is not weak or incapable, but merely humble. Scout thinks that Atticus had never told them about being “the deadest shot in Maycomb county” (Lee 98) simply because “it just slipped his mind.” (Lee 99) Yet it is Jem who realizes that it’s more complicated than that, “something you wouldn’t understand,” he says to Scout (Lee 98). Atticus’s integrity, and quiet dignity, is further manifested in his authentic humility:

“Atticus is real old, but I wouldn’t care if he couldn’t do anything-I wouldn’t care if he couldn’t do a blessed thing.” Jem picked up a rock and threw it jubilantly at the carhouse. Running after it, he called back: “Atticus is a gentleman, just like me!” (Lee 109). Jem becomes utterly impressed with his father for this display of skill, but all the more so because Atticus had never felt the need to mention it nor boast of it. Jem not only learns the importance of humility, but he also sees how one must be able to face something frightening, such as a rabid dog, and at least attempt to shoot it in order to stop others from catching the disease. The entire scene becomes a metaphor for Atticus’ courage and humility when he defends Tom Robinson: he would have to defend the innocent Tom from the “usual disease,” the racism and prejudice of Maycomb, and from the “mad rage” of Bob Ewell. The young boy is in complete awe of his father’s courage, and, in reaction, associates his father’s qualities as ideals to emulate. Similarly, Lee’s intention is to bring readers to the same resolution.


Generally speaking, there are different types of courage one can exhibit: physical, intellectual, and moral courage. Most heroes tend to exhibit physical courage. Yet it can be argued that moral courage may be even more important, and it was this type that Atticus embodied. Moral courage involves having the strength to stick with our convictions, to do the right thing, even when the whole world questions and criticizes us for it. Atticus’s choice to represent Tom brings hardships to him and his family. But he was willing to bear them with a head held high. Atticus does not have to take Tom’s case seriously and he knows that he will lose his defense - yet he does it anyway and strives his very best.

Though not depicted in the film version of Mockingbird, Atticus uses Jem’s interactions with Mrs. Dubose to teach his son about the power of this kind of moral courage and these scenes are some of the most significant examples of Atticus’s influence on Jem’s development in the novel. Mrs. Dubose was a sick and bitter old woman who would shout out insults to Jem and Scout whenever they passed by her home. Jem tried to listen his father’s advice to remain a gentleman in such situations, but he eventually snapped one day and destroyed her flowers. As punishment, Atticus makes Jem read to her everyday after school. When Mrs. Dubose died soon afterwards, Atticus revealed the true nature of Jem’s punishment. She had been a morphine addict for many years, but wanted to overcome that addiction before she left this life. Atticus tells Jem that even if he had not destroyed Mrs. Dubose's flowers, he would "have made you go read to her anyway," not only because he wanted to distract her from the suffering of withdrawal


from morphine but because:

“I wanted you to see what real courage is, instead of getting the idea that courage is a man with a gun in his hand. It's when you're licked before you begin but you begin anyway and see it through no matter what. You rarely win, but sometimes you do.” (Lee 123)

Atticus is challenging a typical “strong-man ethos of courage.” He learns to “return good for evil, to feel no animosity for one who uses him badly, to see the soul beneath the slime.” (Heims 60) But there is something more than this lesson for Jem in his encounter with Mrs. Dubose. One also senses that Atticus is prepping Jem for what is to come in the trial. Atticus is “licked before he begins” defending Tom yet he’s going to see it through no matter what. In perhaps the most famous of all lines from To Kill a Mockingbird, Atticus declares: “Shoot all the bluejays you want...but remember it’s a sin to kill a mockingbird.” (Lee 99) The children have just been given air rifles for Christmas but Atticus refuses to teach them how to shoot: “Atticus wasn’t interested in guns.” (Lee 99) Uncle Jack does the honors. Most people tend to assume Atticus’ famous words of advice are spoken to both Scout and Jem. But, we learn that this is not the case. An examination of the scene reveals it is Jem whom Atticus’ words are specifically directed towards: “Atticus said to Jem one day, ‘I’d rather you shot at tin cans in the backyard, but I know you’ll go after birds. Shoot all the bluejays you want, if you can hit ‘em, but remember it’s a sin to kill a mockingbird.” (Lee 99) Jem was explicitly instructed by Atticus


the core lesson of empathy from the book. Scout indeeds learns the lesson as well through her observation but it is Jem who is directly guided by Atticus in this matter. As readers, we feel as if we are in Jem’s shoes more so than Scout’s when we hear: “Mockingbirds don’t do one thing but make music for us to enjoy... They don’t do one thing but sing their hearts out for us.” (Lee 100) Jem’s critical age of adolescence, Atticus knows, is an important time for individuals to form morals and develop understanding about the world around them. Jem weeps over the inhumanity of human beings, and by the end, we can sense that Atticus himself feels the same sense of inhumanity more deeply because Mr. Ewell attempted to kill his own children. He laments: “I cannot conceive of a man who’d do such a thing.” (Lee 308) Atticus was able to kill the mad dog with rabies but he was not as successful in his attempt to tackle the mad disease of racism and prejudice in Maycomb. Although he tried his best, he failed in winning the trial, and his efforts ignited the mad rage of Bob Ewell. Thus, Atticus’ own son symbolically becomes another mockingbird, a near-victim of this contagious and cyclical disease. We are poignantly reminded of those haunting first opening lines of Mockingbird: “When he was nearly thirteen, my brother Jem got his arm badly broken at the elbow.” (Lee 3) Indeed, those words foreshadow the significant metaphor Jem’s character embodies. He is strongly connected to Boo; they both capture the innocence of the mockingbird symbol. Again we recall Scout’s opening narration: “I maintain that the Ewells started it all… But Jem...said it started long before that. He said it began the summer Dill came to us, when Dill first gave us the idea of making Boo Radley come out.” (Lee 3). Furthermore, Boo’s reputation in Maycomb also 27

serves as a metaphor for the Tom Robinson case. And it is Jem’s transformation that can be seen to underscore both of these core metaphors.. Harper Lee brilliantly and humbly chose to pen the character of Jem to highlight his growth in moral consciousness through the lessons he learned from Atticus in To Kill a Mockingbird instead of continuing to be her father’s critic as she had done in Go Set a Watchman. From this standpoint, can we view Lee herself as the true hero? She learned to be who she was from her real-life father, and, as a result, she created the character of Atticus Finch, whom her father increasingly resembled at the end of his life. Lee not only understood the necessity of heroes to create hope and change in society but she became a hero herself in creating one of the most admired heroes of our time: a character of integrity to inspire and encourage lawyers, teachers, her readers, and especially the young people, of her generation and future generations to come. Atticus Finch, along with his son Jem, are poignant sources of motivation for everyday individuals striving to the best of their abilities to make some sort of difference in this world. “Lawyers were, I suppose, children once too.” ~ Charles Lamb Lee intuitively chose this line attributed to Victorian writer Charles Lamb as her novel’s epigraph. It may be because of Harper Lee that we now have lawyers such as Jonathan Rapping whose lives were inspired and changed by such a character. In the forward to LIFE magazine’s special edition of The Enduring Legacy of Harper Lee


and To Kill A Mockingbird, Melissa Fay Greene gives a beautiful insight behind one of the lures of the novel: “Harper Lee gets childhood. She remembers the hot, buggy, still, boring, endless, precious hours between breakfast and supper all summer long...when all there is to do is to poke around the dirt, examine mosquito bites, improve your treehouse, act out stories and hope to goodness that something will happen somewhere.” To remember childhood in such vivid and honest detail— Greene states that “you have to have been paying attention your whole life… you have to have hoarded away everything you saw, smelled, tasted, heard, touched, and thought.” Lee was a person on “whom nothing was lost.” Her sharp perception and ability to articulate the nuances of childhood are among Lee’s own heroic super powers. Lee herself was a writer of true integrity and Mockingbird’s legacy remains; resonating the world over with its universal and fundamental lesson of human dignity. Works Cited Greene, Melissa Faye. LIFE Magazine: The Enduring Legacy of Harper Lee and To Kill a

Mockingbird. “Foreword: The Story Behind the Story.” Time Inc. Books. New York. 2016. Print.

Heims, Neil. “"Were You Ever a Turtle?": To Kill a Mockingbird - Casting the Self as the

Other.” Critical Insights: To Kill a Mockingbird. Salem Press, 2010, pp. 50-65.

Lee, Harper. To Kill a Mockingbird. New York: Harper Perennial Modern Classics, 2006. Print. 29

Murray, Jennifer. “More Than One Way to (Mis) Read a Mockingbird.” Southern Literary

Journal 43. 2010. Pp. 75-91.

Phelps, Teresa Goodwin. ‘The Margins of Maycomb: A Rereading of To Kill a Mockingbird.’

Alabama Law Review 45. 1994. Pp. 511-530.

Rapping, Jonathan A. "It's A Sin To Kill A Mockingbird: The Need For Idealism In The Legal Profession." Michigan Law Review 114.6 (2016): 847-865. Academic Search Complete. Shields, Charles J. Mockingbird: A Portrait of Harper Lee. New York: Henry Holt, 2006. Print. Shields, Charles J. I Am Scout: The Biography of Harper Lee. New York: Henry Holt, 2008. Print.


Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

Iago’s Motive or Lack of Motive in Othello: Comparison of Two Scholars’ Interpretation Student Author: Kelly Perdue Academic Program: Arts & Sciences Faculty Advisor: Gail Corso, Ph.D. Abstract: Two articles analyze the character of Iago in Shakespeare's play "Othello" and are compared to each other. "Shakespeare's Iago", written by George L. Geckle describes Iago's motives and references his portrayal in adaptations of the play to be the embodiment of sin or vices, putting him in an antagonistic role to be likened to the Devil. He believes that Iago acts out of contempt and jealousy, and how Iago seems to have multiple motives for the horrendous actions he took. The other article, "Iago the Psychopath", by Fred West, analyzes Iago's character in the manner with which a psychopath has come to be defined by doctors. Nearly motiveless, lacking remorse for his actions, and doing reprehensible deeds simply for his own satisfaction; West explains how Iago's behaviors and actions suit this interpretation, one which I find very convincing. In my paper I go over each article's main points and why I agree with one over the other, providing an in depth look into one of the most depraved and villainous characters in literature.

When it comes to a famous work of literature, readers, even scholars, differ in their interpretations or conclusions about said work. Opinions differ about plots, themes, characters, or even just one character in particular. In Shakespeare's Othello Iago stands as one of the most despicable characters in literature. Iago uses deceit and cunning to trick Othello into believing that his newlywed wife committed adultery against him to drive him into a literal madness. So consumed with rage at this perceived adultery, Othello kills his wife Desdemona and attempts to have Cassio – the other suspected infidel – killed when he feels he has gained significant proof and warning from his supposed friend, "honest Iago." Scholars, including George L. Geckle, in


his article "Shakespeare's Iago," written in 2010, and Fred West's “Iago the Psychopath,” written in 1978, analyze Iago's desire to commit such villainous acts. Geckle believes that Iago acts out of contempt and jealousy, and argues that behind his actions the character has multiple motives: Othello had promoted Cassio to a higher rank than he, unfounded suspicions that Othello possibly slept with Iago’s own wife, Emilia, and even that Iago enviously wants the type of love the Moor and Desdemona have, if not Desdemona herself. However, West's views of Iago go in a different direction. To West, Iago exemplifies a realistic portrayal of the definition of a psychopath, nearly motiveless in his operations against Othello. A psychopath lacks the capacity to feel remorse for their actions, and seeks to attend to their own satisfaction. The idea of a psychopathic Iago is more compelling than one who acts out of anger and jealousy because the reasons Geckle lists for Iago’s behavior do not quite add up to each other, and instead are rather disconnected and haphazard from one another. When compared to West’s point of view of Iago taking on the characteristics of a psychopath, Iago’s strange line of thinking becomes understandable. Instead of acting out of anger or jealousy, Iago gives excuses to explain away his actions, and does what he desires for his own satisfaction. While Geckle offers interesting ideas to understand the character throughout the play, West’s view better explains all of Iago’s actions and behaviors through the atypical mindset of a psychopath. In “Shakespeare’s Iago,” Geckle contemplates the motives of the character from Othello. Geckle – although preferring Hamlet as the greater Shakespearean tragedy – still recognizes the worth of Othello. It can excite, and Iago, himself, brings the main source of excitement. It is an 32

accurate statement, whether or not Geckle concludes that sexual jealousy or mistrust and suspicion drive the main conflict (Geckle 65). Regarding Iago’s motives, Geckle compares them to those of the devil and the Seven Deadly Sins. He explains how Othello and Desdemona’s love for each other is expressed and displayed clearly. However in Act 3 scene 3, Iago begins to convince Othello of Desdemona’s infidelity, in what Geckle calls one of the “temptation scenes” (66). He mentions this after he gives a quote by Samuel Taylor Coleridge, possibly in reference to the idea of temptation, how in two instances, Othello describes Iago with words that liken him to a devil. Geckle examines the possible motives of Iago to commit such an act of deceit and betrayal, and quotes the most blatant and obvious reason. First, in Act 1 Scene 3 line 387, of how Iago “hates the Moor,” Iago’s cited lines suggest the particular reasons why he hates Othello because Cassio, Othello’s Lieutenant, had been promoted to the position he desires. Iago claims that Cassio possibly possessed little military experience, and points out that he comes from Florence rather than from Venice like Iago and Roderigo, as if to demean him. In short, “Iago is angry that his ambition, which derives from pride, has been frustrated: again, Cassio got the job that the proud Iago wanted, and Iago is envious and angry” (Geckle 67). Geckle recounts this back to the devil concept stated by character Othello and reviewer Coleridge, who notes that traits of Pride, Envy, and Jealousy were at that era, traits associated typically with the Devil. Geckle explains how, at the time, Shakespeare could have seen many plays with villainous characters who displayed those types of traits. Having learned from these plays, he incorporated such traits into the 33

character of Iago (Geckle 68). Geckle mentions that Iago might have suspected that Othello slept with his own wife, Emilia, which suggests that his motivations could be due to “revenge” and “jealousy.” The ideas are later reaffirmed by Emilia when she talks to Desdemona and mentions that he’s at least suspicious of an affair:

...It is brought up by Emilia in Act 4, Scene 2, the 'brothel' scene, when she asserts...that

Othello’s been ‘abused by some most villainous knave, / Some base

notorious knave,

some scurvy fellow’ (146-47) and adds, much to Iago’s nervous

dismay: ‘Some such squire he was / That turned your wit the seamy side without / And made you to suspect me with the Moor.’ (Othello qtd. in Geckle 69)

Aside from Geckle analyzing Iago’s interactions in the play itself, he also examines different plays and films of how Iago has been portrayed. Through analysis Geckle shows how Iago enviously desires the type of love Othello and Desdemona have. From his research about these productions, he includes much of theater critic Benedict Nightingale's views on the treacherous character. In Nightingale's review of the 1990 Royal Shakespeare Company production, he interprets the actor's portrayal of Iago as desirous for affection from his wife, Emilia, though unable to feel passion or love for her. In turn, Geckle reveals Iago’s contempt, even jealousy, of Othello’s relationship with Desdemona, which culminates into an unhealthy


and intentionally destructive obsession (Geckle 69). While this interpretation reveals where Iago's feelings might come from, the truth of the portrayal needs to be questioned, however an understandable explanation. Geckle disregards the potential significance of Iago’s military life, however. Though Iago could have very well been born with that unhealthy, destructive disposition, or perhaps even gained it in life, the fact remains that Iago, like Cassio and Othello, is a man of war, a soldier. He probably spent much of his life training for the military, and then became a part of it - which might also contribute to why he feels better suited for the position of lieutenant than Cassio. Possibly, because of a marital life, Iago tended to military tasks, rather than focusing on promotions and romance. When he observes the happily married Othello and Desdemona, he sees plainly their love for one another. It contrasts with his relationship with his own wife, Emilia, causing Iago to become upset that he is indifferent toward his spouse. Although that could further explain the idea of jealousy, Iago disregards concern towards others, even his wife. Iago acts apathetic often enough that feeling something which “gnaw[ed] [his] in[n]ards” is elusive to him (Othello 2.1.223). Geckle adds to his thoughts on the play by considering Othello's own actions and the consequences of them. He begins referencing another production, one made in 1981 as a television series, that displayed Iago as “a joker—the morality-play Vice figure, if you will—and a violent racist,” (Geckle 70). The main idea of such an iteration, that of a vicious Iago as a violent racist, came from F. R. Leavis, in his own essay titled, “Diabolic Intellect and the Noble Hero: or The Sentimentalist’s Othello.” Leavis finds that Othello got what he deserved - his love 35

for Desdemona borne of his ignorant view of himself and of her as a Venetian woman; almost a concept that he misunderstands, a type that he finds more fascination with, rather than the person whom he loves directly. Plenty of other interpretations along with Geckle agree that Othello has a bit of sexual anxiety in regards to his wife (Geckle 71). However, Geckle disbelieves that Othello gets what he deserves, and compares the story to its source:

Giraldi Cinthio’s novella...[Where] Cinthio’s Moorish Captain is much less noble in character than Shakespeare’s Othello the General, and Cinthio’s Ensign, himself in love with but ignored by Disdemona [sic], as she is called, is described as ‘scoundrelly’ and ‘wicked.’ He accuses Disdemona of adultery with a Corporal, the Cassio figure. The

Ensign himself steals

Disdemona’s handkerchief and also actually kills Disdemona himself by battering her to death with a sand-filled stocking. He later goes with the Corporal to the Signoria, and they accuse the Moor, who has turned on the Ensign and stripped him of his rank, of Disdemona’s murder. The Moor, who had agreed to and had participated in the murder, is captured and tortured, but he endures and denies everything, and is later killed by Disdemona’s kinsmen. The Ensign is later arrested on a charge of bearing false witness, is tortured, and subsequently dies from his injuries.

(Geckle 72)

In comparison to the original plot, Shakespeare changes the characterization and actions of both the Moor and the Ensign, modifying their behavior to appear more sympathetic or more


vile to the audience, and adds the character of Iago entirely. As a result, Geckle believes that Othello was spared punishment at the end of Shakespeare’s play because the only punishment – albeit a self-inflicted one - that he received was his own death. But Iago was injured towards the end of the play, was discovered for his deceit and treachery, had also murdered his wife like Othello did, and was sentenced to torture and execution. Compared to Othello, Iago’s actions and resulting punishment were more egregious. By contrast, Othello would have been stripped of his power and taken to trial, but instead he succumbs to his grief-stricken desire, and killed himself. To some people death is one of the worst things imaginable, but compared to Iago’s future treatment, Geckle's frustrations with Othello are understandable. The general, in the original story, also commits wrong deeds like Iago; he conspired to murder Cassio and actually murders his wife Desdemona. Although, in Shakespeare’s version, Othello feels remorse for his actions, as everything Iago told him was a lie or orchestrated in favor of his lies, and Othello gets the “quick” or “easy” way out through committing suicide. However, Shakespeare’s version of the play is clearly meant to be a tragedy. Othello, a tragic character – realized his mistakes – which evokes pity from the audience. Iago, on the other hand, who is characterized as the villain – cunning, deceitful, and lacking any kind of remorse – allows the audience to feel satisfied when they learn of his fate, and he gets his retribution. Fred West, in “Iago the Psychopath,” considers the character's lack of remorse, discussing how Iago displays attributes of a “psychopath.” In particular West references A. C. Bradley, who analyzed the character of Iago to the same extent, only, at the time, the science of 37

psychology was obscure, and the neurological disorder of psychopathy had yet to gain a definition nor a name. To supplement this, the author also calls upon Hervey Cleckley, a psychiatrist who studied the behaviors of real people alive at the time. Some of those people he studied helped to define the meaning of the term, as he identified and classified the specific characteristics of psychopaths. Cleckley, himself, even mentioned how the character of Iago carries out his deceitful and treacherous acts without any clear or understandable motive to which a regular person might attribute (as qtd. West 29). The gist of West’s article involves how he cites and uses those two main sources, Bradley and Cleckley, alongside his own explanations and quotations from the text, to support his thesis that within Iago lies further psychological depth. West mentions the accuracy of Shakespeare’s works that display the psychological effects and mindsets of characters, and liability likewise falls upon Iago. He states that assigning Iago the role of a Devil or a villainous character is far too simple given Iago’s true nature, compared to a similar character in Titus Andronicus (West 27). West notes the comparisons to the character of Aaron in Titus Andronicus, the likely springboard from which Iago arose. Aaron committed clearly wretched acts, but also possessed “very human motives that urge him on to evil deeds: the illicit love of the queen with its concomitant chance of power, and the threat to the life of his baby son” (West 28). Iago was changed into something different, a character who commits horrible deeds, yet even to himself, neglects to state them or recognize them outwardly as morally bad, “But whereas Aaron makes his final exit lusting to do more evil, and calling evil 38

by its name, Iago is a more complex psychopath . . . [who] does not regard his own actions as horrendously evil” (West 28). One of West’s main points that explains how Iago demonstrates the characteristics of a psychopath involves his motives, or lack thereof. West mentions Iago's position in rank, as Cassio is assigned as Othello’s lieutenant, and how Iago seems jealous of the fact. But then Iago mentions his wife, and how he harbors suspicions that Othello has slept with her before, though he lacks any evidence. As West says, his reasons seem to come almost as “afterthoughts,” just an excuse to do what he wants: As Coleridge said, Iago is motiveless. His motives-or excuses- come more as afterthoughts, not as stimuli toward the heinous actions he perpetrates. Like the psychopath described by Cleckley, Iago is impulsive, but he sees nothing basically wrong with his own behavior, no matter how erratic or antisocial; therefore, he doesn’t bother to find or invent excuses unless prodded. (West 29-30) Iago does not regard or acknowledge his behavior as antisocial, villainous, or even strange in regards to his interactions with others. He gives excuses for his actions without there being any understandable correlation between them. Also, in regards to Iago's jealousy or frustration at Cassio’s promotion, he argues, “What he [Iago] says in reference to the causes of his frustrations and hatred is not borne out by any evidence in the play” (West 32). On pages 30 and 31, West quotes both Bradley and Cleckley for his next point, that even though a facade, Iago, or a psychopath, will appear friendly, good-natured, and easy to get along with to those 39

around him, seeming like an all-around interesting or great guy to those who meet him initially: True enough, Iago seems always to support his general. He moves jovially and at ease among the gentlemen of Cyprus, even as he sets up Cassio for a drunken fall (II.iii). He is more convincing yet in his ribald but humorous description of women to Desdemona, who is far more amused than offended. (II.i as qtd. in West 30) People can more easily believe this facade because Iago had been guiltless of doing any horrible act prior to the start of Othello because he was a soldier, one who, in that occupation, certain exceptions are made for doing deeds that are considered acceptable, compared to those of a regular citizen. There, in war, he would have been able to do what he wanted, and as a soldier, have the ability to kill and even be praised and hailed a hero because of it, because he fought for his homeland: [H]is more excessive asocial whims had been pretty well channeled off in the violence of war where even killing was not only accepted but honored. The psychopath is asocial; war is asocial; Iago was in his element, and praised for his actions, not condemned. He did what heroic Othello did, the difference being that Othello was supremely motivated and master of himself, while Iago was satisfying his quest for instant pleasure in excitement. (West 31) Although merely hypothetical, Iago’s backstory appears quite plausible. The audience knows that Iago, a soldier, fought in wars, and people could have explained away Iago’s asocial behavior – should he let his “mask,” or outward likable appearances, slip – either due to the effects of war, or simply the military training he would have gone through beforehand. 40

Leading West into his next reference, he quotes Cleckley who explains that a psychopath’s main motive remains simple yet impulsive: a desire for excitement because a psychopath has an inability to form true connections that last with the people that surround them and avoid many serious values or goals. As a result, they act on an impulsive desire, on a whim, in order to achieve a sense of excitement or pleasure. This could perhaps be shown in the very first scene, where Iago, bored with the current state of affairs without any wars to fight in, decides to play a “prank” on Brabantio, and, by acting on a whim, suddenly tells Roderigo to wake him by spreading rumors to spoil Brabantio’s happiness (West 31). After having looked over the scene, however, I noticed it would only be a little while before Iago mentions how Desdemona has run off with Othello. A specific detail that relates to his agenda against Othello, it seems to discredit West’s idea that Iago acted on impulse, as a psychopath would have. Other characteristics refer to,Iago’s complete lack of remorse for lying constantly, and doing so without fail or hesitation. Another characteristic, based on Cleckley’s studies, indicates that generally, psychopaths individually have higher intelligence than average (as qtd. West 33). One of the most obvious examples found in the play of this intelligence, is how Iago explicitly and expertly manipulates almost everyone involved, where he convinces Roderigo to pay for their trip, instigates Cassio’s drunkenness and initiates a fight, deceives Othello, and incorporates deftly the handkerchief into the mix even though not previously planned by him: Not only does he prove his exceptional skill at planning events, but when he finds himself in an exceedingly dangerous situation, not once does he falter or display uncertainty, but 41

adroitly shifts the circumstances to his own favor. (West 33) Iago proves himself adept in planning, in manipulation, and in flexibility when it comes to changing circumstances, displaying his higher intelligence. In conclusion, both articles have interesting interpretations to offer on the character, but West’s thesis that Iago exhibits the traits of a psychopath are compelling. The article compels, in part, because the research cited by Ceckley still holds up to today’s definition of a psychopath, but also because Shakespeare’s take – written in the 17th century – realistically and understandably shows the mannerisms of one. Compared to today’s colloquial usage of the word, the term “psychopath” has been incorrectly used to describe many characters shown in recent or modern media. Refreshingly, someone explains the disorder and identifies how Iago exemplifies its traits perfectly – lack of remorse, apparent inability to perceive one's own actions as bad or wrong, lack of motives, false amiability, impulsion towards excitement. A psychopath's traits, unknown to many due to their mysterious and disturbing nature, have been shown. This includes Iago’s violent turn at the end of the play, as acting with physical violence had never been his initial intention. While Geckle did have good points, and interesting interpretations demonstrated by the play’s various performances and ideas, in the end, as West mentioned, it all seemed like a bit too much. However true that a person could have multiple reasons to want to revenge against another or harm them, any of the proposed reasons seemed disconnected entirely from each other. Iago’s being jealous of Desdemona’s and Othello’s love for each other makes little sense in the context of his despising Othello for having supposedly slept with his wife. This is a 42

suspicion even Iago recognizes as unproven and unfounded, yet he says he will act against Othello even as if true, “He’s done my office. I know not if ‘t be true, / But I, for mere suspicion in that kind, Will do as if for surety” (Othello 1.3.325). It is a rather calm and controlled statement, in comparison to Othello’s outrage he displays at both his wife and towards Iago, himself. This includes when Iago and Emilia are alone together in Act III, scene 3. She wants to spend some time with him, and he rebuffs and ignores her - until she happens to present him with something that furthers his deception - the handkerchief, something she has heard him say he wanted many times over, “My wayward husband hath a hundred times Wooed me to steal it, but she so loves the token” (Othello 3.3301-302). All this in mind, Fred West’s article provided the better argument, convincing me completely and assuring my notions of what the type of person Iago characterizes, that of a psychopath out for his own impulsive pleasures and success. Works Cited Geckle, George L. “Shakespeare’s Iago.” Renaissance Papers 2010): 65-76. Humanities International Complete. Web. 21 Apr. 2016. Shakespeare, William, Barbara A. Mowat, and Paul Werstine. Othello. New York: Washington Square Press, 2004. Print. West, Fred. “Iago the Psychopath.” South Atlantic Bulletin 43.2 (1978): 27-35. May 1978. JSTOR. Web. 21 Apr. 2016.


Business & Information Management

Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

The Current Need for National Paid Parental Leave Student Author: Casey Jeronimo Academic Program: Business & Information Management Faculty Advisor: Robert Till, Ph.D. Abstract: A woman’s role in the workforce has changed dramatically in the last few decades. It was once commonly accepted for a wife to stay at home with her family, and for the husband to work and support them. A shift in this societal norm has created a demand for change to meet the needs of today’s diverse workforce. In other words, times have changed and so have the roles of mothers and fathers. Now it is more common than not for both parents to work, creating a need for support from employers or the government. Despite more parents working, the only leave policy currently offered to aid working families in the United States is the federal Family and Medical Leave Act. In this paper, the current state of U.S national policies on parental leave will be discussed, along with the pros and cons of Paid Parental Leave, what companies are currently doing in terms of paid leave, and whether or not leave should be mandatory or simply encouraged. A woman’s role in the workforce has changed dramatically in the last few decades. It was once commonly accepted for a wife to stay at home with her family, and for the husband to work and support them. A shift in this societal norm has created a demand for change to meet the needs of today’s diverse workforce. In other words, times have changed and so have the roles of mother and father. Now it is more common than not for both parents to work, creating a need for support from employers. Despite more parents working, the only leave policy currently offered to aid working families in the United States is the federal Family and Medical Leave Act. In this paper, the current state of U.S national policies on parental leave will be discussed, along with the pros and cons on companies and society, what companies are currently doing in terms of paid


leave, and whether or not leave should be mandatory or simply encouraged. The U.S. has fallen behind in paid and employment protected leave for parents with a new child compared to many other countries. The United States is one of the only industrialized countries with no national paid leave policy for mothers and fathers (Dudek, 2017). Most private employers in the U.S. do not provide paid leave to employees (Adema, 30). In the United States, the federal Family and Medical Leave Act allows up to 12 weeks unpaid leave during any 12 month period. This leave can be taken during a birth, adoption, or to take care of a sick child, spouse, or parent with a serious health condition. This act guarantees job security, the employee is entitled to return to the same or comparable job as they had before taking time off for leave. It also requires employers to maintain healthcare benefits as if the employee never took leave. The FMLA prohibits employees from collecting unemployment or government compensation while using this leave. Among some of the guidelines, the FMLA only applies to companies with 50 or more workers, and is only for employees that have been employed for at least a year, or 1,250 hours. It requires employees to notify their employer prior to requesting leave and permits the employee to request medical opinions to justify an employee’s absence. Under the FMLA, if an employee does not return to their job after taking leave, the employer may request the employee repay all health care premiums that were distributed during the absence. The FMLA does not apply to all family types or non-traditional families that may have a need for it. Shockingly, this act only applies to about 6% of the nation’s corporations, and 60% of its workforce (Wisensale,


6). Family leave policies have gained importance and acknowledgment due to the rising number of dual-career parents and single working parents. Still, a 2007 analysis found that 4 out of 127 countries had no national paid leave policy for parents, including the United States. Other countries included in this analysis that also had no paid leave policy were Liberia, Papua New Guinea, and Swaziland. The same study also provided information that concluded 98 countries require women to have access to at least 14 weeks of paid leave after the birth of a child. This is a far cry from the United States, where the Department of Labor gathered that only 12% of private sector employees were able to take paid family leave through their employer. In spite of this, the National Bureau of Economic Research is showing an improvement among fathers. In 2015, the number of men taking time off after becoming a parent was up to 10% of employed fathers. That means that the number of men taking paternity leave grew to 21,700 (Zagorsky, 2015). Although the United States provides no legal right to flexible hours, a common strategy for governments and employers to help parents balance work and family life is to give them the ability to create flexible work hours. The U.S. has no obligation to provide flexible hours for employees, but doing so has proven to be effective in organizations. Data collected from the American Time Use Survey taken in 2011 states that 53% of employees report having some flexibility in arranging work hours. Another 40% states that they have some control over the


days they work (Adema, 42). The United States offers a substantially lower amount of support to its employees when it comes to paid family leave. More than 100 countries, including Australia, Canada, and the United Kingdom offer up to 14 or more weeks of paid leave, and more than 50 countries offer paid leave for fathers as well (Dudek, 2017). As of right now, the only parent leave policy accepted nationwide in the United States is the FMLA. A report from Glassdoor and Llewellyn consulting concluded that Employers in the European Union offer a minimum of 14 weeks paid leave for parents. Most countries are considerably more generous and do more for their employees, though. The United Kingdom offers up to 52 weeks, 39 of which are partially paid. Neither the United States nor the European Union mandate paternity leave, but many E.U. countries still offer it to employees. Among some of the countries, Finland offers fathers 45 days off, pay being dependent on the father’s salary and varies over time. Also, Sweden pays up to 80% of earnings during leave for fathers taking off. Another benefit by the European Union is that most countries also offer leave after parents take off for a birth. It is required that employers must offer at least four months of parental leave in the first 8 years of a child’s life. This leave after the intentional birth does not have to be paid, but normally it is to some extent. These countries produce access to this leave to support the quality of life and for parents to spend more time with children, look for schools for them, and to make childcare arrangements in preparation for the transition back into the workforce. As for the United States, some big companies and the


U.S. Military have made new or expanded policies for various forms of parental leave. But, nationwide, most employers still do not offer any real paid leave for parents. The Human Rights Watch concluded that United States employers lose productivity gains and turnover savings that policies for leave create in other countries. California, New Jersey, and Rhode Island are among the states that do offer a form of paid family leave. Their leave programs provide income support while children are very young, or while caring for a sick adult dependent. Each of these states has run a short term or temporary disability insurance program for over 50 years. Maternity leave is included in these programs, in addition income support is available to mothers before childbirth as well. California and New Jersey run paid leave programs through public state disability insurance/temporary disability insurance (SDI/TDI) frameworks. These frameworks hold necessary information about workers and employers, collect contributions from employees, and pay benefits (Adema, 48). California offers up to 6 weeks paid leave to employees, during this period they only receive about 55% of their normal pay. There has been considerable research evaluating the effects of paid leave on economic, social, and health outcomes (Adema, 38). The advantages attributed to paid leave are creating incentives for mothers to find employment. This incentive could be created by establishing entitlement to paid maternity leave after they have given birth, which could possibly be a driving force for mothers to work. This could, in turn, increase the number of mothers working. The


expectation of post-natal security or maternity leave could also be an advantage because woman will be less likely to quit. By not offering paid leave to their employees, organizations could be negatively affected. The cost would be a loss in productivity while searching for a replacement, recruiting, hiring, and training someone new for a position. Paid leave would also decrease the extent of work interruptions by letting mothers take the leave they need and to take the time to find childcare before returning to work. Economic and health benefits of paid leave around childbirth can have significant effects. Some of the Economic Benefits brought on by paid parental leave are improved employee morale, retention, and family incomes. These benefits reduce cost for employers by keeping employees satisfied and on the job. Paid parental leave also can have economy wide benefits such as reduced government spending on public assistance and increased labor force participation. In favor of the government, paid leave could have an adverse effect on generating a larger tax base and increase consumer spending. The social payoffs for paid parental leave can be positive. Both mothers and fathers can benefit when parents can take leave. Mothers, especially, can greatly benefit when the father is able to take time off from work to stay home with a new child. Some of the benefits that can be reaped by a father staying home include higher female employment, less gender stereotyping at home, less gender stereotyping at work, and better life satisfaction for fathers. Also, the social normalization of father’s taking leave helps to reduce negative effects taking leave may have on


the earnings and career profiles of females in the workforce (Adema, 40). Paid parental leave for both parents helps women to return to work and ensures income security for both parents. A study by the U.S. Government Accountability Office found that paid leave for fathers does create gender equality in the workplace and at home, and that it may increase women’s job tenure and their wage growth. For either a man or a woman, paid parental leave can provide numerous positive effects. It can have positive or neutral effects on things like productivity, profitability, turnover, and employee morale, which was concluded in a study by the Center for Economic Policy. The CEO of the Center for Parental Leave Leadership offers companies consulting, coaching, training, and research of parental leave to help businesses. Beacon said, “Without a work culture that supports new parents, a paid-leave policy is simply words on paper.” One way to enhance support for parents with young children is through offering paid maternity and parental leave to a greater number of workers that are eligible. Paid leave increases the likelihood that women work, both by offering them employment protection to facilitate their return to work and by giving them an incentive to work prior to childbirth. This can be good for women and men, families and businesses. Paid leave allows new mothers to recover from pregnancy and childbirth. It allows both parents to care for and bond with their new child, and can reduce maternal stress and improve the mother’s life satisfaction during early infancy. Another positive affect is associated with higher female employment. Families benefit when


fathers are able to spend more time at home during early infancy. This will in turn reduce gender stereotyping at home and in society, it will provide higher life satisfaction for family members, and have a positive effect on the child’s development. Cons surrounding paid parental leave include the possibility of increasing the time women spend outside of the workforce, which in term would interrupt careers and possibly eliminate the ability to advance in an organization. Also, if women are spending time outside of work, it could widen the gender wage gap further and have an opposite effect of what is intended. Employees taking an extensive leave could have a negative effect on the organization. This is because employers could face hiring cost, employers may have to hire replacement workers, or retain existing workers to cover work missed by employees on leave. Also, depending on the skill level of a position, hiring/replacement costs could greatly increase for an employer. Most U.S. programs paid leave programs are financed entirely by employee contributions, such as payroll taxes. But, even when employers are not paying, they could face cost connected to severance pay and exit interviews, and reduced productivity until a new employee is completely trained. Because of the risk mothers may introduce, employers could become discriminatory towards childbearing aged women during hiring or promoting processes. Employers might be more inclined to invest less in the training and development of women in this age group because they are likely to take time off, or live the job permanently after starting a family.


Large inequalities emerge when a woman becomes a mother and men become fathers. Where women are less likely to be employed once they have a child, the same cannot be said for a man. In 2014, the employment rate for mothers with children under the age of 18 was about 23.5% lower than father’s employment rates. In 2015, only 52.6% of mothers with children under one year were working. Oppositely, men with young children suffered no effect on employment. Women are also affected by the “motherhood policy” which incurs that mothers receive lower wages than childless women. Fathers do not suffer such penalties in their careers. Although American women are successful in moving into managerial positions, they are less likely to move up the corporate ladder than men in an organization (Adema, 31). When big firms are trying to recruit and keep valuable employees at their companies, they will offer them benefits to retain them. So, typically only top employees with skills that largely benefit the company will get the opportunity to take parental leave. Many elite employers fight to attract new talent with benefits that are highly sought after. Tech companies have not only revised policies on leave, but have gender-neutralized them to gain a competitive advantage over other companies. Among some of the companies providing access to both men and women when it comes to parental leave are Facebook, Etsy, Spotify, and Netflix. They have concluded that it is unlawful for women to reap the primary benefit of parental leave because they are considered a “primary caregiver” as the social norm. But, only about 10-15% of employers offer paid paternity leave, and it is almost only offered to employers working white collar jobs.


Normal employees in a company may have the opportunity to take unpaid leave in some cases, but most cannot afford to take the time off. Other times, men that work have no right to parental leave and are not covered under any laws. According to the National Partnership for Women and Families, 22% of employees that are eligible for the leave will actually take it because they cannot afford to lose income. In some cases, men with normal jobs may not even be able to use sick leave or vacation time. Normally, this is determined by the terms and conditions of an employer’s leave. The benefits involved in paid family leave programs to individuals, to businesses, and to society are substantial. American business report few negative effects from existing family leave laws. Public parental leave laws can be a win-win for businesses; they would not have to spend money on additional benefits being provided by the company, and would also be offering employees more support and reasons to remain loyal to that organization. The United States could create a national paid leave policy by creating federally funded programs. Like in the case of California and New Jersey, the programs can be employee-funded, reducing any opposition by employers. The programs would need to be publicly available and include introductions of paid leave incremental in ensuring the use of the benefits that workers are contributing to. A survey by Applebaum and Milkman evaluated the effect of the first state-administered paid family leave program in the country instituted by California. It evaluated the way the program was working and how it affected firms and people. In their research, they concluded that 89% of employers


reported positive or no effect on productivity, 99% of employers reported an increase in morale, 87% of respondents said that the paid family leave had produced no increase in cost, and 8% of firms reported that it resulted in cost savings because employees were able to use the paid leave instead of using paid sick leave or vacation days. The majority of the firms coordinated their own benefits with the program as well. Also, to create a culture in which men and women can share leave and equality, employers have to encourage and support employees. If paid leave was provided nationally for both men and women, women would have more time to advance in their careers, earn more income, and be more ambitious. Providing paid parental leave would create more options and support for working parents. It would be made possible for men to spend more time at home, and create a healthy work-life balance. The effects of a nationally accepted paid family leave program in the United States would positively benefit business, society, and the economy. Works Cited Adema, Willem, et al. "Paid Parental Leave and Other Supports for Parents with Young Children: The United States in International Comparison." International Social Security Review, vol. 69, no. 2, Apr-Jun2016, pp. 29-51. EBSCOhost, doi:10.1111/issr.12100. Lewis, Jeremy and Lewis, Suzan. The Work-Family Challenge: Rethinking Employment. Thousand Oaks, London: SAGE Publications. 1996. Print. Dudek, Alev. “The Only Industrial Nation Without Parental Leave -- Worst Yet To Come?� 54

Huffington Post, Accessed March 2017. Peck, Emily. “The End Of Maternity Leave As We Know It?” Huffington Post, Accessed March 2017. Wisensale, Steven K. Family Leave Policy: The Political Economy of Work and Family in America. Armonk, NY: M.E. Sharpe, 2001. Print Zargosky, Jay L. “Divergent Trends in US Maternity and Paternity Leave, 1994-2015.” American Journal of Public Health, vol. 107, no. 3, Mar, 2017, pp. 460-465. EBSCOhost, doi: 10.2105/AJPH.2016.303607.


Continuing Adult & Professional Studies

Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

More Than Man’s Best Friend: Exploring the Use of Animal – Assisted Interventions Student Author: Christine Gibble. Academic Program: Continuing Adult and Professional Studies Faculty Advisor: Jackie Martin, M.S. Abstract: In this paper the relationship between a patient and a therapy animal are explored, as well as the animal - human bond as it relates to the Franciscan Tradition. Literature reviews and case studies of animal - assisted interventions indicate animals have become more than just companions and this kind of complementary therapy, combined with traditional medicine, has physical, mental and emotional benefits. Conclusions can be made that the utilization of animalassisted interventions meet a variety of human needs beneficial to the healing process.

Introduction: Animals have been an aspect of non-human support throughout history, whether it be the use of a horse to plow a field, a pigeon to carry a note, or a dog to herd sheep. Archeological evidence demonstrates a change in human attitudes towards animals 40,000 years ago when some animals, namely the wolf and the African wildcat, found their way into human social settings as domestic dependents (Serpell 86). Today these animals, known as modern dog and cat, are found in two-thirds of U.S. households (Cherniak and Cherniak 1). In addition to the home, animal companions, specifically dogs, find themselves in human social settings for the purpose of therapeutic support through an approach called Animal – Assisted Therapy (AAT). The purpose of this paper is to define the use of service dogs, explore the physical, mental and


emotional benefits of the use of Animal – Assisted Therapy (AAT) and Animal – Assisted Activities (AAA), and highlight how such interventions meet a variety of human needs beneficial to the healing process. Literature Review: The use of service and therapy dogs as a therapeutic intervention is a relatively new treatment approach instituted by Dr. Boris Levinson, an American child psychiatrist, in the early 1960s. Dr. Levinson is considered the pioneer of the use of AAT (Rossetti and King 45). Levinson's theory observed that patients were less anxious and resistant to therapy when his dog was involved in sessions. Tielsch and Gilmer (65) note Levinson’s case of a child patient who refused to speak during sessions, but would interact and speak to Jingles, Levinson's dog, prior to his therapy sessions. The beforehand presence of Jingles helped to build a rapport between Levinson and the child patient, and furthermore resulted in the incorporation of Jingles presence in sessions with other patients. Levinson’s research has been credited as the catalyst for interest into the use of dogs in therapy and stated that dogs possess a "social lubricant" effect with patients (Tielsch and Gilmer 65). In the 1970's Dr. Samuel Corson, a professor of psychiatry and biophysics, researched the effects of dogs in psychotherapy with patients. Corson also found that humans with animals, in a therapeutic setting, were sometimes seen as more accessible and open to conversation. Furthermore, Corson substantiated with research that withdrawn patients were more likely to interact with new acquaintances in the presence of a dog (Tielsch and Gilmer 66). Interestingly, Sigmund Freud also recognized the role of animals in therapy and stated that his 57

dog had a "special sense". Freud believed that his Chow Chow brought a calming presence to therapy sessions (Tielsch and Gilmer 66). Only recently, in the last fifty years, have the merits and benefits of a service and therapy dog been recognized and integrated into therapeutic intervention plans. Today it seems ordinary to open a newsfeed and see an article noting the benefits of pets in the workplace, or how dogs help veterans cope with Post Traumatic Stress Disorder (PTSD), however these benefits do not occur by simply placing a dog in the room. There are clear distinctions between a family pet to those of service and therapy dog. Notably, there are two categories of dogs that provide assistance to those with disabilities: service dogs and therapy dogs. The Americans with Disabilities Act (ADA) defines a service animal as "any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability. The work or tasks performed by a service animal must be directly related to the handler's disability" (Mills and Yeager 12). With these specifics in mind, service dogs are trained to aide with disabilities such as visual impairment, or mobility problems, and are owned by the individual for whom the dog provides service (Shubert 21). Service animals are subjected to a rigorous training period of 1 to 2 years to prepare the animal for the tasks and commands that they will be expected to complete when assisting a person with a disability (Tielsch and Gilmer 65).


As previously mentioned, service dogs can be trained to perform a myriad of tasks and are expected to work alongside a handler. Service dogs trained to assist the visually impaired are referred to as guide dogs (Mills and Yeager 13). Guide dogs are trained to assist with navigation, such as negotiating sidewalks and steps, and stopping for traffic (Mills and Yeager 13). According to the American Humane Society, approximately 1,600 guide dogs are trained annually (Ensminger 47). Hearing dogs are trained to assist those who have a hearing impairment, whether it be deaf or hard of hearing (Mills and Yeager 13). The dogs are trained to alert handlers to a variety of sounds such as alarm clocks, doorbells, sirens, and smoke alarms. The hearing dog can also be trained to lead handlers to the source of the sound (Mills and Yeager 13). Service dogs also serve as the arms and legs of those with mobility impairments. The service dog can be taught to retrieve items, open doors, turn on and off lights, and carry bags (Shubert 22). Larger service dogs can support a handler getting in and out of a chair and also pull wheelchairs (Shubert 22). Individuals with disabilities need help completing the tasks that ablebodied persons do without hesitating. With the assistance of a service dog, these tasks are accomplished with minimal effort and the life of the disabled person is often greatly enhanced. Doctors, nurses, and mental health professionals are constantly looking for new approaches to aid healing and increase feelings of wellness with complementary therapies. Complementary, or supplemental therapies, enhance and support conventional treatment protocols. (Marcus 45). Animal – Assisted Therapy and Animal – Assisted Activities fall into the category of supplemental therapy, as it aims to optimize healing environments and has been 59

shown to aide in a broad range of physical and mental conditions (Marcus 45.) Animal- Assisted Therapy (AAT) is defined as a general approach or intervention within a therapeutic setting in which the animal serves as a source of sensory stimulation with the expectation to reduce stress, improve mental and physical health, as well as increasing social interaction (Friedmann and Tsai 96; Carminati, 452). AAT has been reported in literature to aid patients in therapeutic settings with benefits such as improvement in mood and extended life expectancy (Tielsch and Gilmer 65). Animal – Assisted Activities (AAA) signifies activities that involve a pet visiting a patient or client, usually spontaneously, in a group or individual setting (Mills 15). Because of the spontaneous nature of AAA, it is often left out of individualized treatment plans, whereas AAT can be a significant part of treatment for people with physical, emotional, or cognitive diagnoses (Rossetti and King 47). For many, a dog's all- accepting disposition decreases pain, anxiety, and depression (Winkle, Crowe and Hendrix 57). There are a number of benefits to AAT and AAA including increased feelings of self-efficacy and a sense of accomplishment, which leads to a more positive self-regard. AAT and AAA can be integrated into treatment plans for many medical diagnoses to aide healing and wellness beyond traditional treatment strategies. Patients diagnosed with cancer, coping with stress, and even those suffering from chronic pain can benefit from the supplemental use of AAT and AAA. The American Cancer Society estimates that cancer is the cause of one in four deaths in the United States and the second leading cause of death overall (Johnson et al.


225). In spite of those statistics, patients diagnosed with cancer are living longer and undergo multiple rounds of medical treatment including the supplemental use of treatments like AAT and AAA. Johnson et al. (225) reported a sample of 453 doctors treating cancer, of which 83 percent had used a complementary therapy during treatment. Tielsch and Gilmer (68) report on a study of adults receiving chemotherapy in which 86 percent opted to have the treatment administered in a room with a therapy dog present. The National Institute of Health concluded complementary therapies, such as AAT, were found to support the mind’s capacity to improve mood and selfperceived health (Johnson et al. 226). The evidence- based research of Johnson, et al. (230) revealed that cancer patients experienced, overall, less anxiety and depression when AAT was incorporated as a complementary treatment as opposed to those who were simply treated for cancer. There are also benefits to using a therapy dog as a complementary therapy to treat chronic pain. About 100 million Americans are dealing with chronic pain (Relieving Pain in America 397). Marcus et al. (47) evaluated the impact of a therapy dog on the potential for reducing pain through a sampling of patients in a pain clinic waiting room. Participants were given the choice of waiting in a room with a therapy dog or in a room with reading material. The time the participants were left in the waiting room averaged fifteen minutes. After completing their time in the waiting room the participants completed a post - intervention survey which included demographic information, a pain scale, and standard mood screening questions. It was also documented whether subjects returned to the therapy dog room after the clinical 61

appointment had ended to spend additional time with the dog, which many did. Overall, participant’s calmness, cheerfulness, and pleasantness increased after meeting with the therapy dog. In this evidence - based clinical trial, 62 percent of the participants who visited the therapy dog had clinically meaningful pain relief. Improvements in mood and stress were also significant (Marcus et al. 53). This data supports that complementary treatment, such as AAT, might reduce the symptoms of pain in those who suffer from chronic pain. AAT and AAA, as complementary therapies, not only promotes healing and wellness, but its use can also be helpful in alleviating the stress of daily life. A study by Barker et al. published in 2010 sought to understand the presence of a therapy dog and its effect on stress. The study reports that, on average, Americans rate their stress level as 4.9 on a 10-point scale. The most commonly reported stress management techniques include listening to music, exercising/walking, watching television, and surfing the Internet/going online; however, pet ownership and AAT are also reported to reduce stress (Barker et al. 80). Touching, or simply being accompanied by an animal, can increase levels of the stress-reducing hormone oxytocin and decrease production of the stress hormone cortisol (Barker et al. 89). Playing with a dog or cat can elevate levels of serotonin and dopamine, which calm and relax. (Barker et al. 87). Even individuals with borderline hypertension who adopted dogs from a shelter experienced a significant decrease in blood pressure within five months (Barker et al. 88). Researchers also noted lower blood pressure, heart rate, and the fastest recovery following stressors in an AAT environment (Barker et al. 80). The American population is dealing with a large amount of stress 62

on a daily basis. One simple way to cope with stress is through pet ownership or interaction with a therapy dog. Another vulnerable population that can benefit from the presence of a therapy dog, or pet in general, would be the elderly. Cherniack and Cherniack published a review of literature titled "The Benefit of Pets and Animal - Assisted Therapy to the Health of Older Individuals" in 2014. Their publication draws attention to the ways in which pets and therapy animals contribute to the psychological and physical well-being of the elderly population. The psychological benefits of their literature review include evidence provided by a documented clinical trial citing how animals relieve boredom, loneliness, and foster social interaction (3), as well as a study polling over one thousand people over the age of 65 and finding that two-thirds consider their dog to be their “best friend” and “reason for getting up in the morning” (6). Additionally, they report numerous health and physical advantages that exist as a result from the presence of a pet or therapy animal among the elderly. A survey study of 1179 elderly persons concluded that those who owned a pet had significantly lower pulse pressure and were at a lesser risk of hypertension (4). Cherniack and Cherniack cite multiple studies demonstrating the ways in which walking a dog promotes physical activity for older individuals (5). Ultimately, the companionship of a pet can ease loneliness and is a great stimulus for healthy exercise, which can substantially boost mood, lessen depression, and help elderly individuals remain healthy. Medical benefits of AAT and AAA, as complementary interventions, are quite apparent, as are the psychological effects of a service or therapy dog. An interaction with a therapy dog 63

during a session of AAT or AAA can assist persons with psychiatric disabilities by preventing or interrupting impulsive or destructive behaviors (Mills and Yeager 13). Therapy dogs can be used in a variety of settings that aide in therapeutic treatment, such as physical contact to help ground patients, or to help someone dealing with PTSD to feel safe by turning on a light (Shubert 23). Service and therapy dogs can also empower individuals with panic disorder or agoraphobia to venture out into the world by creating a safe atmosphere (Shubert 23). Studies also show that AAT reduced apprehension in a therapy setting, and the presence of a therapy dog decreased depressive indications, feelings of distress, and reduced anxiety (Rossetti and King 47). One study, conducted in a psychiatric facility, found that patients who participated in AAA sessions showed improvements in self-esteem, positive psychiatric characteristics, and advancing emotional symptoms after eight weeks (Tielsch and Gilmer 69). For many with mental illness, a dog’s all – accepting disposition promotes a safe and more therapeutic environment. Experiential Learning To complete the Experiential Learning portion of this project, the student researcher attended a seminar entitled Animal – Assisted Interventions. The information presented covered a range of therapeutic benefits that animals possess. This six hour continuing education presentation was open to those in the helping profession. In attendance were nurses, psychologists, counselors, occupational and physical therapists, social workers and a university student. The speaker, Jonathan Jordan, MSW, LCSW, not only integrates dogs into his own


practice but, perhaps more importantly, feels passionately about motivating and educating others about the human- animal bond to improve therapeutic outcomes (Jordan). The seminar covered a vast amount of material including the history of animals in service, the different categories of support animals, laws that cover the animals and handlers, as well as protocol to integrate an animal into a facility or therapy setting. Mr. Jordan outlined the different subcategories of animals involved in the therapeutic process and how each is utilized. He also explained how certain diagnoses can be treated by incorporating and partnering with an animal. According to Jordan, any diagnosis can benefit from AAT or AAA; however, it is up to the treating therapist to decide, on an individual basis, whether or not the use of Animal – Assisted intervention, complementary to traditional treatment methods, would be appropriate. Jordan also mentioned that one should never assume that clients want to integrate animals into therapy, and that clients should always be consulted beforehand. Perhaps the most interesting element of the seminar was the diverse span of the occupations in attendance. All occupations that were represented at the seminar were that of the helping profession; but there was no single occupation that was more heavily represented. The fact that interest in AAT and AAA is so widespread among the helping profession indicates the clear merit of its use. Ultimately, this seminar was illuminating in showing just how AAT and AAA can be utilized in the therapeutic process.


Franciscan Tradition “Until one has loved an animal, a part of one's soul remains unawakened.” ~ attributed to St. Francis of Assisi The concept of the human – animal relationship goes in tandem with the teachings of St. Francis and the Franciscan Tradition. One of the pillars of the Franciscan Tradition emphasizes the dignity of the human person, the goodness of all creation, the responsibility to care for all creatures as sisters and brothers, and the importance of gratitude for all creation (Chinnici 13). St. Francis was inspired by all creation. In his Canticle of Creatures, St. Francis thanks God for the experience of Nature, each moment of relationship with any living being, be it animal, plant or human, and the possibility of a religious experience with each (Fox 14). A clear and consistent theme that was present throughout this research was the animal – human bond that existed between multiple populations; whether it be someone ill, disabled, or those struggling with emotional difficulties, and the service/ therapy dog. Dogs can provide a more intimate and effective human – animal bond and experience (Mills and Yeager 13). St. Francis referred to animals as “brother” and “sister” and treated all of God’s creation with deep respect and love. St. Francis taught that having a relationship with animals is a spiritual experience; however, the animal – human bond is more than what is seen on the surface. The relationship between owner and dog is arguably a manifestation of the teachings of St. Francis. This union opens a huge realm of spirituality which ultimately improves our relationship with others and through that a deeper connection with God. 66

Conclusion It is only within the last fifty years that tangible evidence has shown real benefits pertaining to the human-animal relationship, specifically relating to dogs. It is unmistakable that the utilization of a therapy dog has clear benefits and meets a variety of human needs; physically, psychologically, emotionally, and spiritually. Service dogs assist individuals with a range of physical disabilities including vision impairments, hearing deficits, and mobility challenges. Evidence -based studies show that the complementary use of AAT and AAA, when combined with conventional treatment protocols, can improve, and enhance the lives of individuals dealing with chronic illness or pain, stress of daily life, anxiety and depression, and numerous other mental health diagnoses. Perhaps the most profound concept that has come from this research is that whether an individual is ill, disabled, or working through emotional issues, the simple presence of an animal provides support; a path to becoming more sound and whole, illustrating healing at its core. In loving memory of Louise Gibble (1926 – 2017)

Works Cited Barker, Sandra, Janet Knisely, Nancy McCain, Christine Schubert, and Anand Pandurangi. "Exploratory Study of Stress-Buffering Response Patterns from Interaction with a Therapy Dog." Anthrozoos 23.1 (2011): 79-91. Academic Search Complete Web. 2 Feb. 2016. 67

Benda, William. "The Therapeutic Nature of the Human-animal Bond." International Journal of Therapy and Rehabilitation 12 (2005): 284. CINAHL Complete. Web. 27 Oct. 2016. Carminati, Giuliana Galli, et al. "A Hypothesis about Jung's Collective Unconscious and Animal – Assisted Therapy." Neuroquantology, vol. 11, no. 3, Sept. 2013, pp. 451-465. Academic Search Complete. Web. 9 Mar. 2017. Cherniack, Paul, and Ariella R. Cherniack. "The Benefit of Pets and Animal - Assisted Therapy to the Health of Older Individuals." Current Gerontology & Geriatrics Research (2014): 19. Academic Search Complete. Web. 2 Feb. 2016. Chinnici, Joseph P. The Franciscan Intellectual Tradition: Tracing Its Origins and Identifying Its Central Components. Vol. 1. NY: Franciscan Institute, 2003. Print. Ensminger, John J. Service and Therapy Dogs in American Society: Science, Law and the Evolution of Canine Caregivers. Charles C Thomas, 2010. Academic Search Complete. Web. 1 Apr. 2017. Fox, Michael W. St. Francis of Assisi, Animals, and Nature. Washington: Humane Society of the United States, 1989. Print. Friedmann, Erika and Chia – Chun Tsai. “The Animal – Human Bond: Health and Wellness.” Handbook on Animal – Assisted Therapy: Theoretical Foundations and Guidelines for Practice, edited by Aubrey H. Fine, Academic Press, 2006, pp. 95-117. Web. 9 Mar. 2017.


Johnson, Rebecca A., Richard L. Meadows, Jennifer S. Haubner, and Kathleen Sevedge. "Animal - Assisted Activity among Patients with Cancer: Effects on Mood, Fatigue, SelfPerceived Health, and Sense of Coherence." Oncology Nursing Forum 35.2 (2008): 22532. CINAHL Complete. Web. 3 Feb. 2016. Jordan, Jonathan. “Animal – Assisted Interventions.” PESI, Inc., Delaware. 16 Nov. 2016. Lecture: Continuing Education. Kwong, Marilyn J., and Kim Bartholomew. ""Not Just a Dog”: An Attachment Perspective on Relationships with Assistance Dogs." Attachment and Human Development 13.5 (2011): 421-36. Academic Search Complete. Web. 3 Feb. 2016. Marcus, Dawn A., Cheryl D. Bernstein, Janet M. Constantin, Frank A. Kunkel, Paula Breuer, and Raymond B. Hanlon. "Animal - Assisted Therapy at an Outpatient Pain Management Clinic." Pain Medicine 13.1 (2012): 45-57. PsycINFO. Web. 3 Feb. 2016. Mills, James T., and Arthur F. Yeager. "Definitions of Animals Used in Healthcare Settings." U.S. Army Medical Department Journal (Apr-Jun 2012): 12-17. Academic Search Complete. Web. 26 January 2016. O'Conner-Von, Susan. "Animal - Assisted Therapy." Complementary & Alternative Therapies in Nursing. 6th Ed. New York: Springer, LLC, 2010. 207-23. Print.


"Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research." Military Medicine, vol. 181, no. 5, May 2016, pp. 397-399. Medline. Web. 31 May 2017.

Rossetti, J., and C. King. "Use of Animal - Assisted Therapy with Psychiatric Patients." Journal of Psychosocial Nursing and Mental Health Services 48.11 (2010): 44-48. CINAHL Complete. Web. 26 January 2016. Serpell, James A. "Anthropomorphism and Anthropomorphic Selection—Beyond the "Cute Response." Society & Animals, vol. 11, no. 1, Mar. 2003, pp. 83-100. Academic Search Complete. Web. 9 Mar. 2017. Shubert, Jan. "Dogs and Human Health/Mental: From the Pleasure of Their Company to the Benefits of Their Assistance." U.S. Army Medical Department Journal (Apr-Jun2012): 21-29. Academic Search Complete. Web. 26 January 2016.

Tielsch Goddard, Anna, and Mary Jo Gilmer. "The Role and Impact of Animals with Pediatric Patients." Pediatric Nursing 41.2 (March-April 2015): 65-71. Academic Search Complete. Web. 29 January 2016. Winkle, Melissa, Terry K. Crowe, and Ingrid Hendrix. "Service Dogs and People with Physical Disabilities Partnerships: A Systematic Review." Occupational Therapy International 19.1 (2012): 54-66. Academic Search Complete. Web. 26 January 2016.


Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

More than Just Performance: Using Multiple Accountability Systems to Build Better Relationships in a Franchise System Student Author: Jonathan Steward Academic Program: Continuing Adult and Professional Studies Faculty Advisor: Susan Dixon, J.D. Abstract: In business format franchising, a franchisor provides a license to a franchisee to receive support, use trademarks, and follow systems in return for a fee. Business owners franchise their brands for one or more of three reasons – agency theory, resource scarcity, or dual symbiosis. The relationship between franchisor and franchisee is inherently a legal one and has historically been viewed as an economic exchange (EE) between two parties. In recent years, the relationship between franchisee and franchisor has come to be viewed through a social exchange lens rather than strictly an EE. The success or failure of a franchise system and its franchisees has become more about the relationship between the two parties than it is about the legal agreement. Research into the effectiveness of the relationship between franchisor and franchisee has primarily focused on four areas – affective commitment, intent to expand, opportunism, and intent to leave. Franchisors that have been able to manage these four areas historically are more successful than those who do not. This researcher believes that one of the ways that franchisors can improve performance of franchisees is through the use of accountability systems. There are three types of accountability systems - hierarchical, personal, and cultural. The research set out to prove that using multiple accountability systems would lead to better relationships between franchisor and franchisee as measured by those four areas. Franchisees in a franchise system within the personal care industry were offered multiple accountability systems. Those franchisees were surveyed to determine their opinions in the four areas of affective commitment, intent to expand, opportunism, and intent to leave. The research contributes to the growing movement toward social exchange theory (SET) and the importance of building relationships within franchise systems. Franchisees who were offered a variety of accountability systems, and encouraged to build relationships between franchisees and franchisor, had the highest performance in all four areas. Franchisees who were offered fewer accountability systems had similar performance to each other in all four areas, which was lower than the group offered a variety of accountability systems. Based on this research, franchisors are encouraged to offer multiple accountability systems to franchisees in their systems. Franchisors are also encouraged to facilitate both operational and social interaction among franchisees in their system. Future research could focus on conducting similar studies in the restaurant segment – by far the largest segment in the franchise industry. Additionally, future research could focus on tying operational performance to the qualitative observations of the franchisees noted in this research.


Section I – Introduction Background The earliest concept of franchising existed in the Middle Ages when landowners would provide rights to serfs to use their land and property in return for a fee later called a royalty (Libava, 2011). Isaac Singer made the concept more widely known in the United States in the 1800s when he provided an exclusive license to businessmen to sell his revolutionary sewing machines in certain geographic areas (Libava, 2011). According to the International Franchise Association (IFA), the franchise industry in the United States is comprised of over 770,000 businesses that account for over 8.5 million jobs and $840 billion of direct economic output (2014). The IFA is the world’s oldest and largest organization representing franchising worldwide and focuses on education and advocacy for franchisees, franchisors, and suppliers (2015). The most prevalent form of modern franchising – commonly called business format franchising – became popular in the United States in the 1960’s after the opening of the Interstate highway system (Libava, 2011). The increased mobility the roads provided created a need for more consistency and Ray Kroc – who made McDonald's famous – used franchising to create uniformity across the McDonald's’ brand (Libava, 2011). Business Format Franchising is a business model whereby one party – the franchisor – provides a license to another party – the franchisee – in return for a fee (Grunhagen & Dorsch, 2003). Since most of those fees are percentage based, a franchisor can increase its revenue by helping the franchisee increase its sales (Shane, 2010). In business format franchising, franchisees receive the resources they need to run a business – a proven business system,


trademarks, and support in areas such as operations, marketing and real estate (Grunhagen & Dorsch, 2003). At its basis, the connection between a franchisee and franchisor is a legal one (Lusthaus, 2015). However, according to the IFA, the success or failure of a franchise system and its franchisees is more about the relationship between the two parties than it is about the legal agreement (2015). A franchise system’s strength comes from having individual franchisees execute a proven system repeatedly (Shane, 2010). A system can become worthless without that consistency (Hawthorne, 2010). Achieving that uniformity can be difficult for franchisors since franchisees are considered independent businesses (Shane, 2010). Using influence is the most effective way for franchisors to achieve their goals (Shane, 2010). Franchisors must be able to interact and provide support to franchisees at all levels of business experience and savvy. Most franchisees are first-time business owners and inexperienced in the intricacies of leading an organization (Curin & Kraetsch, 2012). In order for a franchise system to thrive, knowledge must reach all levels of franchisee groups (Hawthorne, 2010). It can be challenging to get franchisees in a franchise system to cooperate with one another and be accountable to following the system (Shane, 2010). There are many ways that a franchisor can build a strong relationship – accountability, communication, listening, mentoring, conflict resolution, et cetera. (Schumacher & Crosby, 2004). There are three different types of accountability – hierarchical, personal, and cultural (Tye, 2014). Hierarchical accountability can sometimes be referred to as positional power. Traditionally, it was assumed that franchisors exhibited hierarchical accountability to their


franchisees (Spinelli & Birley, 1998). Although hierarchical accountability is effective at getting tasks completed, it can be demotivating (Tye, 2014). In recent years, the development of larger and more savvy franchisees and the legal difficulties in terminating franchise agreements have limited the success of pure hierarchical accountability (Spinelli & Birley, 1998). Also, since franchisors make more money by increasing sales – rather than profits – some franchisees may questions the motives of franchisor suggestions (Shane, 2010). Some forms of hierarchical accountability are necessary in franchising. All franchise systems are required to conduct some form of brand standards review (O’Connell, 2014). This brand standards review is designed to ensure that the franchisee is adhering to the minimum requirements of the brand (O’Connell, 2014). Another common type of hierarchical accountability is a business review. There are many different types of business reviews, but the term is commonly accepted in franchising to denote a comprehensive review of a franchisee’s business by a franchisor representative. This review often includes discussions of structure, operations, incremental and national marketing, personnel management, financial management, et cetera (Stites, 2011). Personal accountability means that a franchisee does not need any pressure, but does something as a reflection of his/her own personal values (Tye, 2014). When a franchisee believes in a practice and has seen it successfully used in other franchisee organizations, then they do not need a group to encourage them to do it (Hawthorne, 2010). Being able to use personal accountability in a franchise system can require a level of experience and business savvy that many franchisees do not possess (Curin & Kraetsch, 2012). Cultural Accountability – or peer pressure – is a particularly powerful force in franchising (Tye, 2014). The decision to join a franchise system is not merely an investor


business decision, but has a social component – a sense of belonging – that engenders a commitment to a system and the system’s goals and values (Mignonac, Vandenberghe, Perrigot, El Akremi, & Herrbach, 2015). One way to develop this sense of belonging is to create opportunities for interaction among franchisees rather than strictly between franchiseefranchisor. The franchisee-franchisor relationship assumes that a profit will be generated by both parties, but the easiest way to generate higher profits is often to instill a sense of competition between franchisees (Hawthorne, 2010). Peer performance groups are one way to create this competition, although the majority of franchisors do not facilitate them in their systems (Stites, 2014). Classic franchise theory holds that franchisors franchise for one of three reasons – resource scarcity, agency theory, or plural form symbiosis (Combs, Ketchen, & Short, 2011). Resource scarcity is the concept by which a company does not have the resources to expand through corporately owned units and, consequently, expands through franchising instead (Combs, Ketchen, & Short, 2011). Agency theory is the concept by which a company chooses to franchise rather than to build oversight infrastructure at a distance from its home base of operations because of the cost and complexity of doing so (Combs, Ketchen, & Short, 2011). Plural form symbiosis explains why some companies choose to have both franchised and corporate units in the same geographic area – defining it as advantageous to the brand to the have the natural competition that would occur between the two formats (Combs, Ketchen, & Short, 2011). Franchisors have not traditionally provided peer performance groups due to the prevalence of agency theory in structuring franchisor oversight (Penard, Raynaud, & Saussier,


2011). The reliance on agency theory has evolved in recent years as the value of socialexchange theory (SET) has become more prevalent in franchising (Meek, Davis, Baucus, & Germain, 2011). Some franchisors have now begun to recognize the value of providing additional support – particularly in the area of relationship commitment (Meek, et al., 2011). Existing research on the quantitative value of this relationship commitment has been mixed (Nijmeijer, Fabbricotti, & Huijsman, 2014). However, relationship commitment does have value to the franchisor because relationship commitment does influence whether a franchisee leaves the system and limits the investment franchisors must make to find and train new franchisees (Meek, et al., 2011). It is much cheaper for a franchisor to keep existing franchisees than it is to attract new ones (Hayes, 2009). Providing performance groups does not mean that a franchisee will definitely participate in a group, although making them formal and keeping them small can limit this problem (Stites, 2014). Franchisees can be hesitant to participate because choosing the wrong performance group can be worse than not being in a performance group at all (Fenn, 1998). Another barrier to franchisee participation is the difficulty in getting franchisees with different cultural backgrounds and language barriers to interact with each other (Lord, 2015). According to a 2009 study conducted in New Zealand, franchisees for whom English was a second language were less likely to establish relationships outside of their cultural group (Lord, 2015). Also, a 2012 New Zealand study found that franchisees for whom English was a second language performed significantly lower in both unit economics and brand standards (Lord, 2015). The most effective performance groups are small in size, composed of similar franchisees, endorsed by Franchisee Advisory Councils (FACs), and led by franchisees (Stites,


2014). FACs are groups of franchisees that are either elected or nominated to consult with the franchisor and represent the interests of all franchisees in a franchise system. A franchisorfacilitated peer group can be an effective tool for trading ideas between franchisee and franchisor (Scott, n.d.). A hierarchical business review can be used to ensure that practices and procedures that are being used by franchisees and shared in a peer group are approved (Hawthorne, 2014). This researcher attended a roundtable meeting titled “Creating Franchisee High Performance Groups” at the 2016 IFA Convention. The session was facilitated by Jim Canfield of Renaissance Executive Forums. Mr. Canfield explained that peer performance groups often evolve through four stages (J. Canfield, personal communication, February 22, 2016). These stages include 1) idea exchange, 2) best practice exchange, 3) accountability group, and 4) high performance group (J. Canfield, personal communication, February 22, 2016). Because Stage 3 is where the greatest increase in performance occurs, franchisors are best served by keeping performance groups at Stage 3 for as long as possible (J. Canfield, personal communication, February 22, 2016). Purpose of the Research This research is designed to add to the growing body of work on the benefits of approaching franchisor-franchisee relationships from a SET standpoint rather than an EE perspective. This research hopes to break new ground in quantifying the value of multiple accountability systems and, in particular, how peer performance groups can increase affective commitment among experienced franchisees. Affective commitment can be defined as one’s emotional attachment to an organization (Smikle, 2014). Grunhagen and Dorsch conducted a study that found that affective commitment declined as franchisees become more experienced in a system (2003). While the study that Steward undertook focused on one franchise system, the


work is designed to be applicable to any franchisor considering how to increase the affective commitment of their franchisees. Problem Statement The problem is that most franchisors do not use multiple accountability systems (Stites, 2014). The author believes that by offering multiple accountability systems, a franchisor can improve franchisee engagement in four different areas – affective commitment, intent to expand, opportunism, and intent to stay. Opportunism is when a franchisee acts to benefit his own interests at the expense of the franchisor’s interests (Mignonac et al., 2015). Research Questions In order to address this problem, the researcher plans to explore several questions: 1.

What impact do accountability groups have on affective commitment?


What impact do accountability groups have on intent to acquire

additional units? 3.

What impact do accountability groups have on opportunism?


How do peer accountability groups impact franchisees’ tendency to

leave a franchise system? Research Methodology Different groups of franchisees in a franchise system in the personal care industry were offered different types of accountability systems at the franchisor’s discretion. At the conclusion of the study period, these different cohorts of franchisees were provided an anonymous survey based on which accountability systems were used. The survey was designed to measure four types of franchisee engagement – affective commitment, intent to expand, opportunism, and


intent to leave. The results of the surveys from each cohort were compared to determine learnings about the relative franchisee engagement between cohorts. Importance of Research This research is important to franchisors on a financial level. By increasing engagement, a franchisee is more likely to expand and remain a positive and productive part of the system than it otherwise would. In so doing, it reduces the increased costs that franchisors face in recruiting and training new franchisees in the system compared to retaining existing franchisees. Experienced franchisees also need less support, which reduces the monitoring costs that the franchisor incurs. When considering the growing importance of SET, improving franchisee engagement is also consistent with the future of franchising. By adding multiple accountability systems to all the other methods that franchisors use to improve their relationship with their franchisees, the franchise system and individual franchisees can be more successful in many ways. Lastly, a franchise system that has good relationships between franchisees creates a more positive environment for everyone involved. From a human interaction standpoint, this research helps to provide a blueprint on how to create this positive environment. Section II: Literature Review A review of the literature shows that there has been an evolution in franchise research regarding the importance of SET in franchisee-franchisor relations. Furthermore, there are four key measures of the health of the relationship between franchisees and franchisors – affective commitment, intent to expand, opportunism, and intent to remain. Lastly, research shows that strong performance in these four areas leads to better performance of both franchisees and franchisors.


Most traditional research in the franchising space has focused on the economic advantages that franchising provides when compared to traditional corporate ownership of outlets (Combs, Ketchen, & Short, 2011). More specifically, the research has assumed that franchisors franchise their concepts for one of three reasons – resource scarcity, agency theory, or plural form symbiosis (Combs, Ketchen, & Short, 2011). Resource scarcity is the concept by which a company does not have the resources to expand through corporately owned units and, consequently, expands through franchising instead (Combs, Ketchen, & Short, 2011). Agency theory is the concept by which a company chooses to franchise rather than build oversight infrastructure at a distance from its home base of operations because of the cost and complexity of doing so (Combs, Ketchen, & Short, 2011). Plural form symbiosis explains why some companies choose to have both franchised and corporate units in the same geographic area – defining it as advantageous to the brand to the have the natural competition that would occur between the two formats (Combs, Ketchen, & Short, 2011). Researchers explored the relationship between franchisees and franchisors from an EE theory perspective (Mignonac et al., 2015). EE theory holds franchisees are “single economic actors simply reacting to economic incentive mechanisms” (Mignonac et al., 2015). There has recently been more research that has been focused on SET and the impact that SET has on franchise relations (Mignonac et al., 2015). SET holds that there are “both economic and social outcomes that engender obligations between the parties, expectations of future rewards, and a willingness to invest time and effort in the relationship” (Mignonac et al., 2015). Mignonac et al. posited that the relationships that franchisors build with their franchisees is what causes a franchisee to act in the best interest of the system even when the action may not be to the benefit of his own business (2015). The researchers discovered this by measuring


franchisee affective commitment to the system (Mignonac et al., 2015). Affective commitment can be defined as one’s emotional attachment to an organization (Smikle, 2014). The researchers then compared this commitment with franchisee tendencies in relation to performance, intent to acquire additional units, opportunism (opportunism is when a franchisee acts to benefit his own interests at the expense of the franchisor’s interests), and intent to leave the system (Mignonac et al., 2015). Their research depended on surveys to measure franchisee tendencies and found that affective commitment does have an influence on various franchisee tendencies and that SET could be an important component of understanding how to influence franchisee performance (Mignonac et al., 2015). This researcher believes that the study published by Mignonac, et al. in 2015 showed that creating strong relationships between franchisee and franchisor can be considered important to strengthening a franchise system. Although this work was completed in France and involved French franchisees and French franchisors, the principles of affective commitment, intent to expand, opportunism, and intent to leave are similar to the issues facing franchisees and franchisors based in the United States. According to the IFA, France has a mature franchising industry with 1,234 franchisors and almost 50,000 franchisees operating in the country (McGarry, 2010). Meek, et al. expanded on the importance of SET in the dynamics of the franchisorfranchisee relationship and why franchisees choose to exit a system (2011). The researchers posited that increased collaboration – a form of peer accountability – could reduce the incidence of franchisees choosing to leave a franchise system (Meek et al., 2011). A study of franchisees in multiple franchise systems primarily in the Midwestern United States was used to measure level of communication, commitment, and propensity to leave and found that collaborative


communication can increase franchisee’s affective commitment (Meek et al., 2011). Importantly, the study also found that continuance commitment (continuance commitment is the idea that alternatives are unattractive due to cost or unattractiveness) is very affected by collaborative communication (Meek et al., 2011). This researcher believes that the work published by Meek, et al. in 2011 shows that multiple accountability models could result in greater collaborative communication which can increase a franchisee’s commitment and tendency to stay within the system. This study was particularly valuable due to the fact that multiple franchise systems were studied. Although continuance commitment was not measured in the study that Steward undertook, it is important to note that continuance commitment is one portion of the intent to leave metric. Grunhagen and Dorsch approached a similar question from the perspective of whether the franchisor provided value to the franchisee (2003). The researchers assumed a relational exchange, but recognized that the benefits to the franchisee and franchisor may not be limited to economic (Grunhagen and Dorsch, 2003). Relational exchanges are defined as relationships in which benefits and burdens are shared by both parties (Grunhagen and Dorsch, 2003). The study of franchisees in the fast food industry in Illinois was divided into single unit and multi-unit franchisees (Grunhagen and Dorsch, 2003). This study used a survey of franchisees to measure the past, current, and future value that franchisees received from being part of a franchise system (Grunhagen and Dorsch, 2003). The research found that franchisees generally found that past value was greater than current or perceived future value (Grunhagen and Dorsch, 2003). This researcher believes that Grunhagen and Dorsch showed in their 2003 published research that building strong relationships from a SET perspective could help overcome the decline of relational exchange value that franchisees believe occurs as their tenure increases in


the system. That decline of relational exchange value over the length of the franchiseefranchisor relationship is a key finding of this study as franchise systems in the United States mature. Spinelli and Birley broke new ground by taking the position that franchise systems were inter-organizational (where franchisees and franchisors have more equal footing within the organization) in practice rather than taking the traditional position that franchisors were channel leaders in an intra-channel system due to the contractual agreements in place (1998). The researchers hypothesized that this was possible with the “development of large franchisee territories, the growing power of franchisee organizations, and the legal difficulties which franchisors face in terminating contracts” (Spinelli & Birley, 1998). The growth of larger franchisee organizations – both multi-unit and multi-concept – has been one of the biggest trends in franchising in the recent past (Daley, 2015). By using a survey across multiple franchise systems, the researchers were able to show that franchisee satisfaction can be increased when the franchisor provides better services and increased cooperation among franchisees and with the franchisor (Spinelli & Birley, 1998). This researcher believes that Spinelli and Birley showed in their 1998 work that multiple accountability models can allow a franchisor to increase cooperation. This research was completed in the United Kingdom. According to the IFA, the United Kingdom is one of the most attractive markets for U.S. franchisors due to common language and a less complex legal landscape that does not include many of the registrations, notification periods, and documents that are required by the Federal Trade Commission (FTC) in the United States (McGarry, 2010). Spinelli and Birley also enlisted U.S. franchisors as they were developing their questions to ensure that there was applicability to the U.S. market (Spinelli & Birley, 1998).


Initiating change, such as implementing multiple accountability systems into a franchise system, is not without potential peril. In 2013, Evelien Croonen – an Assistant Professor of Economics and Business who specializes in franchise research – and Maryse Brand – an Associate Professor of Entrepreneurship – conducted a study into franchisee responses to franchisor-initiated strategic change. Both researchers are professors at the University of Groningen in the Netherlands. While it is estimated that only 1/3 of change initiatives are successful, that number is often lower in franchise organizations due to the need to influence franchisees rather than direct them (Croonen & Brand, 2015). Franchisees react in either constructive or destructive ways that can also impact the way that franchisor employees view the change (Croonen & Brand, 2015). Change interferes with franchisee’s desires for optimal profit and operational independence (Croonen & Brand, 2015). Therefore, this research downplays SET and uses classic franchise agency theory in association with the organizational behavior concept known as EVLN (exit, voice, loyalty, neglect) to explain franchisee reaction to most franchisor initiated change (Croonen & Brand, 2015). Croonen & Brand’s research focused on a couple of case studies of franchisor initiated change within the same franchise system and measured the franchisee response (2015). The antecedents of the response were found to be based on the trust and satisfaction the franchisee had prior to the change (Croonen & Brand, 2015). Surprisingly, the effect of opportunism was lower than expected (Croonen & Brand, 2015). The literature review reveals there is ample groundwork for the importance of not only EE between franchisee and franchisor, but also the importance of SET. The relationships that franchisors build and the services that they provide have been shown to increase the affective


commitment of franchisees, the performance of franchisees, and to lessen the likelihood of opportunism and tendency to leave the system. Multiple accountability systems may be one way to leverage SET in a franchise system. Although change presents some risk to a franchise system, implementing an initiative in a system with strong franchisee-franchisor relationships lessens this risk. By expanding upon this work, this researcher hopes to show that providing multiple accountability systems can improve franchisee engagement in a franchise system and contribute to the growing research that emphasizes the importance of SET in franchiseefranchisor relationships. Section III – Research Methodology Introduction Consistent with much of the research that was reviewed in Section II, a survey was used to measure franchisee engagement in four different areas – affective commitment, intent to expand, opportunism, and intent to leave. This survey was conducted anonymously because this researcher works with the franchisees, who were selected to be studied. This anonymity was designed to reduce response bias that may result from the researcher’s hierarchical role. Although the use of a survey is quantitative research and the findings are presented in a quantitative manner, this research is actually mixed method. In his role with the franchisor, this researcher is responsible for interacting with the franchisees to be studied and facilitating the ways in which different accountability groups were provided to the franchisees. This approach is consistent with the constructivist grounded theory that has become more prevalent in recent years.


Research Questions Affective commitment is one of the three elements in Meyer and Allen’s organizational commitment model – with continuance and normative commitment being the other two (Merritt, 2011). Organizational commitment can be defined as the “psychological link between the employee and his or her organization that makes it less likely that the employee will voluntarily leave the organization” (Allen & Meyer, 1996). The model is a widely used tool to measure a relationship to organizational turnover. (Culpepper, 2000). A modification and shortening of the affective commitment questions were used in the survey to accommodate the difference in an employee-employer and franchisee-franchisor relationship. Similar to the method used in Mignonac, et al, the word “organization” was replaced with “franchise organization” and items were worded positively (2015). In order to avoid fatigue, the research included only four questions, although the questions were split equally between the joy and love factors (Merritt, 2011). The affective commitment questions were – ·

I feel a strong sense of belonging to my franchise organization


I feel like “part of the family” at the franchise organization


I feel emotionally attached to this franchise organization


I enjoy discussing my franchise organization with people outside of it

The intent to acquire additional units was measured through the use of one question – ·

I intend to own one or several additional units of this franchise

organizations in the next two years Opportunism is one of the biggest challenges that can be faced in franchising (Gassenheimer, et al, 1996). Opportunism is less likely in hierarchical organizations, but more likely in


organizations where separate structures exist (Provan & Skinner, 1989). The relationship that exists between franchisees and franchisors determines the level of opportunism that exists (Dev, et al, 2016). Jambulingam and Nevin developed a seven-item scale to measure opportunism in a franchise system (Mignonac, et al, 2011). Provan and Skinner developed a six-item scale to measure opportunism (Gassenheimer, et al, 1996). A combination of these models was used for this survey. In order to reduce fatigue, the number of questions was reduced to four. The questions regarding opportunism included – ·

My franchisor is always truthful with me


I always share information in a timely manner with my franchisor


I sometimes make vague promises to my franchisor that I later ignore


On occasion, I put the interests of my organization above the system

The intent to leave was measured through the use of one question – ·

I plan to voluntarily leave the franchise organization within the next two years

Methodological Approach Research is used in many different ways to help organize the theories that an inquirer may pursue. In quantitative research, theories are tested for veracity or application. (Creswell, 2014, p. 51). In qualitative research, theories are created as a result of the research that is being done (Creswell, 2014, p. 51). In mixed-method research, quantitative and qualitative research methods are used in a variety of ways (Creswell, 2014 p. 51). Classically, research design often called for the researcher to remain an objective observer (Higginbottom & Lauridsen, 2014). A Constructivist worldview focuses on the interaction among people and how individuals create meaning from their world experiences


(Creswell, 2014, p. 8). This researcher’s goal is to interpret the thoughts others have of the world rather than starting with an assumption (Creswell, p. 8). This researcher has been intimately involved in the franchising industry for over 17 years and worked with many of the subjects at the same time that the research was conducted. Constructivist Grounded Theory allows for personal experience to become integrated into the research process (Brooks, 2012). Constructivist Grounded Theory was an evolution of classical Grounded Theory – which used a positivist worldview – that was pioneered by Kathy Charmaz in the mid 1990’s (Higginbottom & Lauridsen, 2014). This method does not result in one answer, but results in multiple realities that may apply in different ways to different participants based on their interactions and experiences (Higginbottom & Lauridsen, 2014). Constructivist Grounded Theory is a qualitative form of research (Higginbottom & Lauridsen, 2014). This researcher explored using different sets of accountability systems within one franchise system to determine whether multiple accountability systems can affect franchisee engagement. This researcher facilitated hierarchical business reviews and peer performance groups within the franchise system. Background of franchise system to be studied The franchise system studied is the largest brand in the hair care industry and is the 86th largest franchisor in the world (Halter, 2015). The system is 100 percent franchised and consists of over 4,000 locations and had one billion dollars in sales in the 2014. (Halter, 2015). The brand was founded in 1982 when the two partners saw a change in the traditional hair care industry towards a no appointment, low-cost model (Yastrow & LeBeau, 2013). In 1983, a third partner was brought in to help franchise the concept (Yastrow & LeBeau, 2013). Although they were not the first to pioneer this model, they have grown to be the largest (Yastrow & LeBeau,


2013). In 1997, that third partner bought out the others and assumed control of the company (Yastrow & LeBeau, 2013). The company has grown quickly over the past 20 years – growing from 250 franchisees who owned 500 units and were supported by 45 corporate employees to 1,200 franchisees who owned 3,800 units and were supported by 225 corporate employees in that timeframe (Overholser, S. personal communication. September 28, 2015). The organization has had 44 straight quarters of same-to-same unit sales ($) growth and 39 straight quarters of same-to-same unit customer count growth (Overholser, S. personal communication. September 28, 2015). Approximately 40 percent of the franchisees in the system currently receive a hierarchical business review each year from their Business Services Manager or Director. One hundred percent of units receive a brand standards inspection every six months that includes direction for four walls management of the salon. Framework for quantitative research The framework for the quantitative research offered different types of accountability systems to different groups of franchisees within the same franchise system. These franchisees were assigned to one of three subsets to analyze their experience. The subsets were based on what types of accountability systems they participated in. These accountability systems, which were discussed in more detail earlier in this research include – ·

Peer Performance Groups – a type of peer accountability system where franchisees

meet together to help improve each other’s performance. ·

Hierarchical Business Review – a type of hierarchical accountability system where

a franchisor representative sits down one-on-one with a franchisee to discuss the franchisee’s performance and develop an action plan to improve it.



Brand Standards Review – a type of hierarchical accountability system where a

franchisor representative inspects the franchisee’s business for the purpose of determining whether the franchisee is adhering to the requirements that the franchisor has put in place to comply with the brand. All franchisees in all franchise systems receive some type of brand standards review. The following chart shows which types of accountability systems each subset participated in – Types of Accountability Peer

Group A Group B











Group C


Members of each subset were provided a survey. The survey was built using a five-point Likert scale (Croasmun and Ostrum, 2011). Building on the research of Mignonac, et al, the researcher focused on four specific areas of the franchisee’s relationship to the franchisor – affective commitment, opportunism, and intent to leave the system. The subsets were then compared against one another to determine whether accountability systems had any impact.


Section IV – Data Analysis and Results Response The results of the research are presented below. The data was collected over a seven day period in November 2016 after franchisees had participated in different accountability groups over a one year period. The link to an anonymous online survey was sent to 224 designated operator franchisees that own approximately 1,000 units within the researcher’s geographic region of responsibility. This region represents roughly one quarter of the total franchise system. This researcher’s region of responsibility is concentrated in the Northeastern, MidAtlantic, and Great Lakes areas of the United States. The survey link was disseminated through the franchisor’s e-mail system. The franchisees belong to one of three groups that were previously identified – Types of Accountability Peer

Group A Group B











Group C


32 in Group A, 74 in Group B, and 118 in Group C. Surveys were received from 24 respondents in Group A (75 percent), 24 respondents in Group B (32 percent), and 35 respondents in Group C (30 percent). Overall participation in the survey was 37 percent. Findings


Results for the survey within each group were consistent among all four measures – affective commitment, intent to expand, opportunism, and intent to exit. The respondents in Group A – the group that participates in peer groups – had higher affective commitment, higher intent to expand, lower opportunism, and lower intent to exit. Although not an original metric, it is consistent with those findings to note that Group A also had a higher participation level in the survey. The respondents in Group B – the group that received hierarchical business reviews – and the respondents in Group C – the group that neither participated in hierarchical business reviews nor participate in peer groups – were close in their response levels in three of the four areas – affective commitment, higher intent to expand, and lower intent to exit. Both Group B and C had lower affective commitment, lower intent to expand, and higher intent to exit than Group A. Group C and Group A had significantly lower levels of opportunism than Group B. In most areas, Group C was almost as high as Group A in this area. Results While this survey had a limited sample size and only followed one franchise system, the findings of the research supported the literature review in the Group A results. It was expected that the group that participated in peer groups would have the highest affective commitment, intent to expand, lowest levels of opportunism, and intent to stay. The research bore out that assumption. However, the findings of the research differed from the literature review within Group B. It was expected that Group A, B, and C would be staggered in their response levels since Group B received more support from the franchisor than Group C did. The results showed that Group B had similar results to Group C and, in fact, in some cases Group C exhibited higher affective


commitment, intent to expand, lower levels of opportunism, and intent to stay. This result shows that hierarchical business reviews in and of themselves did not drive the social exchange component of the franchisee-franchisor relationship. One of the key elements of opportunism is the idea of putting the interests of the system above the interests of the individual organization. Lowering opportunism is critical in the migration from pure EE to SET. However, it was on this question that the three groups were closest together and – although statistically insignificant – Group C exhibited a lower level of opportunistic tendency than Group A. While Group A was overall more engaged, the opportunism measure was the closest of the four measures. Intent to expand exhibited the highest level of Bottom 2 box responses among Groups B and C. This indicates a greater division of opinion in this area than in the other areas of engagement. The full results of the survey – in addition to the comments (with identifying characteristics removed) – are included in Appendix A. Limitations The primary limitation of this research is the fact that only one franchise system in a limited geographic area of the country was researched. This franchise system is focused on a smaller segment of the franchising industry. In addition, the researcher was involved with the franchise system and his previous relationships may contribute to the findings. Many franchise systems would have leaders with similar skills that would be involved in deploying multiple accountability systems. The portion of the franchise system that was utilizing peer performance groups consisted of franchisees that own eight or more units. By definition, this group would likely consist of


more experienced franchisees. The size of these organizations could have influenced the responses to the survey. Similar to the research published by Grunhagen and Dorsch in 2003 about the decline in relational exchange value over time, this experience could have affected the results specifically of the opportunism area of franchisee engagement. Lastly, due to the relationships that the researcher had with the franchisees, he believed that it was important to maintain anonymity within the survey and to limit the identifying characteristics that were defined. Therefore, key indicators like organization size, tenure, and organizational performance were purposely not included in the research. These tags could influence the results significantly. For example, a franchisee who is not financially successful may have a greater tendency to see themselves out of the system in five years than one who is financially stable. Additionally, hierarchical business reviews may very well have improved franchisee performance and may have value in that area even if they did not necessarily improve the social engagement of franchisees. Section V – Conclusions It is possible to deploy multiple accountability systems in a franchise system. These systems would include personal, peer, and hierarchical accountability. The literature review showed that franchising research has evolved from a model where the relationship between a franchisee and franchisor is a legal one that is based on an economic exchange to a relational model that is based on social exchange. More and more, franchisees are searching for the opportunity to belong to something as much as they are looking for a system that offers strong financial results. In multiple research studies in different types of systems around the world, tactics such as increased communication, collaboration, and value provided by the franchisor was shown to


improve franchisee engagement. Multiple studies confirmed that four key elements of franchisee engagement include affective commitment, intent to expand, opportunism, and intent to leave. This research departed from other research in determining whether offering multiple accountability systems within a franchise system could improve the four key elements of franchisee engagement. The findings confirm the previous research about the effective use of SET within the context of franchisee-franchisor relationships. The members of Group A have the opportunity to interact with their fellow franchisees more often and belong to a group that further strengthens the ties to the franchisor system. This group clearly had higher affective commitment, higher intent to expand, and higher intent to stay. All of these measurements are advantageous not only to the franchisee, but also to the franchisor. Any costs the franchisor may incur to promote peer accountability and additional engagement by the franchisee are shown – by this research – to likely be a good investment. The addition of extra hierarchical accountability to the franchisee-franchisor relationship through the use of business reviews was not shown by the research to result in a significant change in affective commitment, intent to expand, opportunism, or intent to stay. While business reviews may have value in increasing performance or brand equity, franchisors should not pursue them as a strategy solely due to the possible SET implications. Interestingly, the research seems to indicate that hierarchical business reviews may actually increase the levels of opportunism within a franchise system. Section VI – Organizational Recommendations The research contributes to the growing body of work that shows that SET has value within the franchise-franchisor relationship and can lead to higher levels of affective commitment, an intent to expand, lower levels of opportunism, and an intent to stay. It is


worthwhile to an organization to take steps to increase the level of social exchange and to increase the level of peer accountability in an organization. At the yearly IFA Convention in February, trends in franchising are presented and discussed. Peer performance groups and accountability systems have been topics of discussion at previous conventions. It would be worthwhile to share the results of the research in that forum through a roundtable discussion or breakout session to benefit all franchisors and franchisees. There are also smaller regional franchising conferences where the research could be shared in breakout sessions. Future researchers could focus on multiple franchise systems in a larger geographic area than the area that was used in this study. In addition, future researchers may want to focus on the applicability of the research findings within the foodservice portion of the franchising industry, which is by far the largest segment of franchising. Future researchers may want to focus on organizations that use peer performance groups across a larger cross-section of their systems. Future researchers may want to include performance related tags to further segment research results. Lastly, future researchers may want to focus on systems that are experiencing negative or flat sales and profitability growth to determine the level of participation in those conditions. Section VII – Reflections on Leadership Practice The researcher is a student at Neumann University in Aston, PA. Neumann University provides a Catholic education in the Franciscan tradition. The author is not Catholic, but he can embrace the core values of the University and has sought to exemplify them throughout his experience in the Organizational and Strategic Leadership (OSL) program. Although Franciscan values exist throughout Biblical teachings, Neumann University has chosen to emphasize service in five areas – reverence, integrity, service, excellence, and stewardship.


All five Franciscan values relate well to franchising. Franchising exists to allow people to better themselves in ways that might not otherwise have been possible. The relationship between franchisee and franchisor is a symbiotic one in which each party needs to do his/her part for the other to reach each person’s potential. This author believes that two of the values apply more specifically to the franchise relationship than the others; they are reverence and excellence. Reverence relates to the worth and dignity of each person. We do this by encouraging meaningful conversation and embracing varying points of view. In an economic exchange model, the driving motivation is money rather than relationship or communication. This can allow differing points of view to be stifled if they do not result in an increase in sales or profits. A social exchange approach encourages the building of relationships with one another as the primary goal and assumes that economic benefits will follow. Building even further on that, peer performance groups begin by building personal relationships and eventually grow to the point where performance is focused upon. By placing franchisee and franchisor on an equal footing, social exchange encourages the building of a community of like minded people within the franchise system. Excellence relates to performing to the best of our abilities. Franciscan values teach us that cooperating, rather than competing, will aid us in our quest for excellence. Part of this cooperation is sharing with one another and recognizing that everyone has the ability to be a teacher. Franchising allows people to achieve their dreams and perform to the best of their abilities by providing a proven system for business owners to follow. Peer performance groups advance this concept by helping franchisees to realize that cooperating with one another will help the whole be greater than the sum of its parts. In a peer performance group, every member can be a teacher on any given subject. This research adds to the existing research that helps


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Education & Human Services

Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

The Impact of Parental Involvement on Student Achievement Student Author: Brianna Troyer Academic Program: Education & Human Services Faculty Advisor: Kenneth D. Waters, Ed.D. Abstract Parental involvement within school systems has been a highly researched topic over the past 20 years. The purpose of this paper is to highlight relevant research focused on how parental involvement can impact student achievement, as well as provide strategies that educators can use to increase parents’ involvement at school. Overall, research has revealed positive outcomes in a student’s ability to succeed academically and socially when parents are engaged within academia. The findings concluded that the impact of parental involvement on a student’s ability to achieve is dependent on ongoing communication between the home and school.

Introduction A considerable amount of research exists in relation to the impact of parental involvement on student achievement. You and Nguyen (2011) assert that a student’s selfconcept and locus of control are enhanced when parents participate in their student’s learning process. Larocque, Kleiman, and Darling (2011) supports You and Nguyen’s (2011) findings by stating, “Working with the school, parents and caregivers can help create collaborative partnerships that support all aspects of a child’s achievement at school” (p. 115).


After an examination of the literature, the purpose of this paper is to highlight relevant research on how parental involvement can impact student achievement. This review will also provide strategies that educators can employ to increase parents’ willingness to become a prominent factor in their child’s school environment. By presenting this literature, one will be able to gain knowledge on how parental involvement can influence a child’s ability to succeed academically. Evidenced-based strategies that can be instituted to advance student learning through parent-teacher collaboration will also be presented. The literature as it pertains to the impact of parental involvement on student achievement is extensive. Therefore, seminal and current research on this subject will be presented. Strategies that have been identified as being prominent in an attempt to increase parental involvement at their child’s school will also be included in this paper. Beginning the review of literature with an historical breakdown of the impact of parental involvement on student achievement and then transitioning to strategies that can be utilized to augment the number of parents involved in school settings will illustrate how these practices play a key role in a child’s ability to thrive academically. For the past 25 years, examining the impact of parental involvement on students’ academic outcomes has been of considerable interest among scholars (Jinnah & Walters, 2008; Epstein, Sanders, Simon, Salinas, Jansorn, & Van Voorhis, 2002; Nokali, Bachman and VotrubaDrzal, 2010). Examining this phenomenon has been done to identify appropriate strategies that can be employed to strengthen the relationship between parents and the schools their children 104

attend. Epstein (2002), who is considered one of the nation’s leading experts on explaining how parental involvement can impact a student’s achievement levels, designed a framework that highlights the number of ways parents can play a role in their child’s academic development and advancement (Dervarics & O’Brien, 2011; Epstein, et al., 2002). There are six levels to the framework established by Epstein et al. (2002). These levels include: ● Parenting ● Communicating ● Volunteering ● Learning at home ● Decision making ● Collaborating with community It should be noted that only three of the six levels of the Epstein et al. (2002) framework will be discussed throughout this review of the literature. Parenting, communicating, and decision making are the levels that will be explained based on the premise that parenting, communicating, and decision making are in line with the overarching purpose of this paper.

History of Parental Involvement Throughout America’s history, “parent[al] involvement had moved from education being the primary responsibility of the family to an almost hands-off approach from the family and back again” (Watson et al., 2012, p. 43). Historically, parents had primary responsibility over 105

their children’s education (Watson, Sanders-Lawson, & McNeal, 2012). Dating as far back to the 17th century, parents’ perspectives in relation to school governance, curriculum support, teacher choice, and religious teachings were heavily considered (Hiatt-Michael, 1994). However, in the 18th century, American leaders attempted to transition the education system from the parent’s responsibility to the governments’ (Hiatt-Michael, 1994). Hiatt-Michael (1994) specifically highlighted George Washington, who was advocating for a national education system that would be supported by federal or state taxes. However, state legislators did not support this notion and decided to leave education in the parents’ hands (Hiatt-Michael, 1994). Hiatt-Michael (1994) noted that as a result of parents making decisions for their child’s education, attending school became less of a priority. For instance, Watson et al. (2012) explained that children were encouraged to enter the workforce, specifically laboring careers. This shift in priorities can be attributed to the growing population within cities that were emerging in the country (Watson et al., 2012). Concerned educators and parent activists eventually joined forces to organize protests that argued to institute a more formalized system of education (Hiatt-Michael, 1994). Throughout the early part of the 19th century, a shift occurred where parents’ voices and power over what their children experienced in school began to diminish. This transition can be attributed to the growing demands of America’s industrial workforce. Depending on one’s disposition towards education, teaching children became less of a priority, and integrating young people into the workplace took precedence. Subsequently, as the ongoing formalization and 106

standardization of education started to become commonplace, parents became considerably more disconnected from their child’s learning (Hiatt, 1994). To address the divide between parents and their children’s schools, the National Congress of Mothers (NCM) was formed (Hiatt, 1994). Established in 1897, NCM grew dramatically in membership and eventually led to the foundation of the Parent Teacher Association (PTA). Consisting of over 4 million members, the PTA is recognized as a renowned non-profit organization dedicated to the educational success of children (Parent Teacher Association, n.d.). This national organization also encourages parents to participate in school-related events and to become more involved in their child’s education. Hiatt (1994) stated “[that] by the 1940s, parents of all social classes considered the monthly PTA meeting a mandatory community event” (p. 8). Defining Parental Involvement Studies examining the impact of parental involvement on student achievement failed to define parental involvement as a multifaceted objective. In their meta-analysis study, Fan and Chen (2001) found that researchers focused exclusively on singular components of parental involvement. Some investigations emphasized parent-child communication or home supervision, whereas other studies focused on parents’ aspirations for their children or the level of contact and participation parents had with their student’s school. Consequently, inconsistent results dominate this body of literature, largely because researchers have continually utilized different variables to operationalize the term parental involvement among studies. 107

In addition to researchers being unable to agree on an operational definition for parental involvement in relation to its impact on students’ academic outcomes, myriad studies also exist where pupils’ academic achievement levels are inconsistently measured as well. There are studies that focus on examining students’ achievement levels through standardized tests scores and GPAs, while other investigations examine only learners’ grade promotion and retention rates (Fan & Chen, 2001). According to Fan and Chen (2001), these inconsistencies are problematic. To address these findings, Fan and Chen (2001) posited that future studies should acknowledge the complexities associated with defining parental involvement and measuring its impact on students’ academic achievement levels.

Types of Parental Involvement Fisher (2016) supported Fan and Chen’s (2001) assertion about what future studies around this phenomenon should resemble. In fact, Fisher (2016) described parental involvement as a broad spectrum of parental actions and activities that can occur either in or outside the school building. Fisher (2016) explained that there are 44 different ways a parent can integrate themselves into a school environment. These activities include, but are not limited to: (a) fundraising for the school; (b) reviewing exams with their child after receiving a grade; (c) attending parent-teacher meetings; and (d) facilitating classroom events. Home-based and school-based participation are recognized as the two different types of parental involvement (Hayes, 2011). For example, home-based participation is when a parent


takes their child to the library, while school-based involvement might focus on parents attending parent-teacher conferences, or spending time volunteering in their child’s school (Epstein et al., 2002; Pomerantz, Moorman, & Litwack, 2007). Further, home-based participation revolves around parents communicating with their children about school assignments and issues (Hayes, 2011). Parental Involvement on Student Achievement Literature suggests that when there is effective communication between the school and family, a child’s learning process is enriched (Cordry & Wilson, 2004). Cordry and Wilson (2004) explained that when schools and families work in unison, there is a better chance of a student’s character and academic achievement being developed at a greater rate than those individuals who parents are not as involved. Research also highlights the notion that when parents and schools are in congruence with one another, students exhibit greater academic and nonacademic success (Larocque, et al. 2011). According to the Department of Education (ED) (n.d.), when families, schools, and communities collaborate with one another, students are more successful. The ED (n.d.) also noted several community benefits from families and schools working together. Moreover, Nokali et al. (2010) suggested that when parents are actively involved in their child’s education, schools are better positioned to improve its students’ ability to achieve. High parental involvement resulted in students displaying more positive behaviors, as well as an increase in the quality of work children produced (Gonzales-DeHass, Holbein & Quilter, 2005). 109

Gonzales-DeHass et al. (2005) also mentioned that high parental involvement impacts a learner’s ability to: (a) focus; (b) stay clear of distractions; (c) experience lower frustration levels; and (d) cope with failure better than their contemporaries. In conjunction with Gonzales-DeHass et al. (2005) findings, the National Education Association (NEA) asserted that parental involvement has an overall positive impact on student learning. As cited by the NEA, the Southwest Educational Development Laboratory (2002) published a report explaining that when parents are more involved in their child’s learning process, the student is more likely to show positive school outcomes, such as: (a) higher grades; (b) lower school absences; (c) demonstration of enhanced social skills; and (d) continuing onto higher education. Research has also compared different types of parental involvement and the results of varying types of involvement between countries. In a two-year longitudinal study, conducted in the United States and China, the principal investigators revealed that American parents exhibited autonomy support and focused on developing each one of their child’s abilities (Cheung & Pomerantz, 2011). Autonomy support is described as the interpersonal behavior teachers provide during instruction to identify, nurture, and build students’ inner motivational resources (Deci & Ryan, 1985; Reeve, Deci, & Ryan, 2004). Chinese parents displayed a controlled involvement in which their children were required to think or feel a certain way (Cheung & Pomerantz, 2011). Nonetheless, results from both countries showed that parental involvement increased students’ academic engagement and achievement levels. When parents were consistently active in school 110

activities, students: (a) were more invested in their academics; (b) spent additional time on class assignments when away from the school’s campus; (c) used self-regulated learning strategies; and (d) earned higher grades (Cheung & Pomerantz, 2011). Research has also noted that parental involvement impacts more than a student’s ability to academically achieve. Pomerantz et. al (2007) learned that parental involvement can also strengthen a child’s behavior and relationships with peers. These changes in students’ actions revolved around following school rules more frequently, while also refraining from displaying aggressive behavior towards classmates. Gonzales-DeHass et al. (2005) suggest that students developed a strong work ethic when their school work was reinforced by their parents at home. Parental Involvement Strategies Findings show that parental involvement can impact different aspects of a student’s life. The results in Okeke’s (2014) study concluded that parents are concerned about and eager to be involved in their child’s education. One issue that arises is that parents are not always sure how to involve themselves in an appropriate manner (Okeke, 2014). The need for an open line of communication between parents and teachers is considered paramount, primarily because of its correlation to a student’s ability to succeed (Sheldon & Epstein, 2005). Epstein et al.’s (2002) framework supports Sheldon and Epstein’s (2005) findings by indicating that communication serves as a crucial component in whether or not parents play an active role in their child’s school activities. Epstein et al. (2002) stated:


Two-way communications by teachers and families increase understanding and cooperation between school and home. Thoughtful two-way communications also show students that their teachers and parents are working together to help students succeed in school. (p.59) Unfortunately, DePlanty, Coulter-Kern and Duchane (2007) noted that there is not always an open line of communication between parents and teachers. For example, mending this barrier can be achieved if schools utilize workshops, brochures, and parent-teacher conferences to educate its parents on the importance of communicating with one another (DePlanty et al. 2007). The Epstein et al. (2002) framework supported this idea and explained that when parents collaborate with schools, their children develop further developed and experience exponential growth as well. Parent-teacher focus groups are considered another meaningful way to enhance communication between parents and schools. Duckworth and Kostel (1999) defined focus groups as “an approach to building appropriate communication, resolving conflicts, and creating mutual respect between teachers and parents� (pp.199 - 200). Focus groups essentially provide parents with a sense of comfort in knowing that their issues are being heard and valued (Knopf & Swick, 2008): This strategy (focus groups) is advantageous as it contributes to a broader cultural perspective of the families represented, provides increased open-mindedness through


participation and active listening to parent perspectives, and helps with conflict resolution as one-on-one conflicts are reduced in the group setting.” (p.424) Home visits and maintaining a family communication journal are additional strategies that have been documented as being beneficial when educators wish to learn more about a child's home environment. Knopf and Swick (2008) also investigated the advantages and disadvantages associated with home visits and family communication journals. Home visits were reported to be reliant on the nature of implementation, thus resulting in inconsistencies across studies. However, Knopf and Swick (2008) documented success when parents had an established rapport with their child’s teacher. During home-visits, because teachers are exposed to a student’s physical and emotional home environments, and then they are capable of transferring this insight back into the classroom to accommodate that child’s needs (Knopf & Swick, 2008). Similarly, family communication journals were found to increase the amount of information between the school and home. A journal is specifically used by parents and educators to create continuous dialogue among one another. Knopf and Swick (2008) proposed this as a way to emotionally support families, while concurrently learning more about the student. Technology is considered another efficient way to allow parents and teachers to collaborate with each other on a consistent basis. According to Olmstead (2003), “both parents and teacher placed high value on keeping parents updated with student progress and saw the importance in using technology for communication” (p. 36). Although emailing was cited as the 113

most convenient and efficient method to communicate, parents and teachers should not solely depend on this mode of communicating (Knopf & Swick, 2008). Utilizing the school’s website was favored among parents, but disliked by teachers, because they found updating the school’s website too cumbersome (Olmstead, 2003). Epstein et al. (2002) explained the need for schools to incorporate parents’ perspectives into decisions that impact student learning. In fact, decision-making is the fifth level of Epstein’s (2002) framework. Okeke (2014) supported this concept and suggested that parents should be involved in helping a school develop its curriculum. Including parents in the curriculum process will allow parents to feel that they are equal partners with the school (Okeke, 2014). Further, Henderson and Mapp (2002) suggest that for optimal involvement in decisionmaking, parents should become knowledgeable about the school’s operations of laws that govern these processes. It is also recommended that parents join their school’s PTA to remain informed and supportive of their child’s progress (Henderson & Mapp, 2002). Summary This review of the literature presents research that has been conducted around the impact of parental involvement on student achievement. Substantial investigations revealed positive outcomes in a student’s ability to succeed academically and socially when their parents actively participate in school-sponsored events and approaches. In particular, students’ academics, social interactions, and displayed behavior improved. Despite the aforementioned findings, research


continues to ascertain that parents remain uninformed about how to adequately be a part of their students’ school environments. Research-based strategies that can be employed in relation to helping parents become more aware of participating in school-related activities were presented in this review of the literature. Engaging in school-or home-based activities are examples of strategies parents can partake in when looking to become a part of their student’s learning experience. Parents can also join the school’s Parent Teacher Association (PTA), if one is available, and/or attend scheduled parent-teacher conferences. Home-based activities include, but are not limited to parents reading with their children or exposing students to activities that develop and advance a child’s academic and civic capacities, such as trips to the library and museum. Overall, the literature presented on the impact of parental involvement on a student’s ability to achieve is dependent on ongoing communication between the home and school. Therefore, if students’ achievement levels are expected to increase, teachers, parents, and communities must find a way to educate parents on the impact of their presence at their child’s school.

References Cheung, C.S., & Pomerantz, E.M. (2011). Parents’ involvement in children’s learning in the United States and China: Implications for children’s academic and emotional adjustment. Child Development, 82(3) 932-950. Cordry, S., & Wilson, J. (2004). Parents as first teacher. Education, 125(1), 56. 115

Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York, NY: Plenum Publishing Co. Department of Education. (n.d.) Family and community engagement. Retrieved from DePlanty, J., Coulter-Kern, R., & Duchane, K.A. (2007). Perceptions of parent involvement in academic achievement. The Journal of Educational Research, 100(6) 361-368. Duckworth, S. V., & Kostell, P. H. (1999). The parent panel: Supporting children with special needs. Childhood Education, 75(4),199–203. Epstein, J. L., Sanders, M.G., Simon, B.S., Salinas, K.C., Jansorn, N.R., Van Voorhis, F.L. (2002). School, family, and community partnerships: Your handbook for action, (2nd ed.). Thousand Oaks, CA: Corwin Press. Fan, X. & Chen, M. (2001). Parental involvement and students’ academic achievement : A metaanalysis. Educational Psychology Review, 13(1), 1-22. Fisher, Y. (2016). Multi-dimensional perception of parental involvement. Universal Journal of Educational Research, 4(2), 457-463. Gonzales-DeHass, A., Holbein, M., & Quilter, S. (2005). Examining the relationships between parental involvement and student motivation. Educational Psychology, 17(2), 99-124. Hayes, D. (2011). Predicting parental home and school involvement in high school African American adolescents. High School Journal, 94(4), 154–166.


Henderson, A.T. & Mapp, K.L., (2002) A new wave of evidence: The impact of school, family, and community connections on student achievement. Southwest Educational Development Laboratory. Hiatt, D. B. (1994). Parent involvement in American public schools: A historical perspective 16421994. The School Community Journal, 4(2), 27-38. Jinnah, H.A. & Walters, L.H., (2008). Including parents in evaluation of a child development program: Relevance of parent involvement. Early Childhood Research & Practice, 10(1) Knopf, H.T., & Swick, K.J. (2008). Using our understanding of families to strengthen family involvement. Early Childhood Education Journal, 35, 419-427. Larocque, M., Kleiman, I., & Darling, S. M. (2011). Parental involvement: The missing link in school achievement. Preventing School Failure, 55(3), 115-122. National Education Association (NEA) (n.d.). Research spotlight on parental involvement in education. NEA reviews of the research on the best practices in education. Retrieved May 30, 2017, from Nokali, N.E., Bachman, H.J., & Votruba-Drzal, E. (2010). Parent involvement and children’s academic and social development in elementary school. Child Development, 81(3), 9881005. Okeke, C.I. (2014). Effective home-school partnership: Some strategies to help strengthen parental involvement. South African Journal of Education, 34(3) 1-9.


Olmstead, C. (2003). Using technology to increase parent involvement in schools. TechTrends, 57(6) 28. Parent Teacher Association. (n.d.). Why join the PTA. Retrived from Pomerantz, E. M., Moorman, E.A., & Litwack, S.D. (2007). The how, whom, and why of parents’ involvement in children’s academic lives: more is not always better. Academic Educational Research Association, 77(3) 373-410. Reeve, J., Deci, E. L., & Ryan, R. M. (2004). Self-determination theory: A dialectical framework for understanding the sociocultural influences on student motivation. In D. McInerney & S. Van Etten (Eds.), Research on sociocultural influences on motivation and learning: Big theories revisited (pp. 31–59). Greenwich, CT: Information Age Press. Sheldon, S. B. & Epstein, J. L. (2005). Involvement counts: Family and community partnerships and math achievement. The Journal of Educational Research, 98, 196-206. Watson, G.L., Sanders-Lawson, E.R., & McNeal, L., (2012). Understanding parental involvement in American public education. International Journal of Humanities and Social Science, 2(19). You, S. & Nguyen, J.T. (2011). Parents’ involvement in adolescents’ schooling: A multidimensional conceptualization and mediational model. Educational Psychology, 31(5), 547-558.


Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

The Effects of Learning Chess in a Low Socio-Economic School Student Author: Bridget McDermott Academic Program: Education & Human Services Faculty Advisor: Patrick Boyle, Ed.D. Abstract: This paper explores the effects of learning chess for low-income students in Pennsylvania through before and after school activities, focusing on students in third through fifth grade, using their math assessment scores as measurable data for the research. It discusses the impact chess has on gifted learners, students in special education, and how critical thinking and problem-solving skills are significantly improved. The paper compared math test scores of students who learned chess compared to those who learned through typical methods. Interviews were conducted with the students’ teachers to see if learning the game of chess impacted the students’ behaviors in the classroom as well. Introduction Chess is a complex intellectual game. Chess requires strategy, reasoning, problem solving, and leadership skills. When taught to children, the game of chess may also have several positive effects, including an impact on math and behavioral skills. The purpose of this action research study was to explore the possible effects of learning chess on students’ math skills and their behavior. The study was conducted in a low socio-economic school district in Pennsylvania. Participants included third through fifth graders who attended a before school extracurricular program. The students were taught the game of chess every school day for a period of four


months. The students’ math scores from the beginning of the school year were compared to their scores from the middle of the year. Interviews were conducted with the students’ teachers about any changes in behaviors that were noticed after the game of chess was taught to the students. This paper is guided by the following research question: What effect, if any, does offering a before-school program that teaches the game of chess to third through fifth graders at a low socio-economic school have on these students’ math skills and behaviors? Literature Review Leadership Skills Learning the game of chess encourages leadership skills in students as well as helps students overcome any self-conscious feelings they may have towards being a leader. Being a leader, you need to plan for what may come rather than just wait for an event to happen (Oshri, 2015). This can relate to playing chess. In fact,“capturing pieces and making moves demonstrates an ability to control, plan, and execute. Learning how to manipulate the pieces on the board fosters one’s ability to both lead and sacrifice: to lose builds a capacity for humility; to win builds confidence” (Hunt, 2014, p. 360). In order to be a leader, a person must be calm, patient, a strategic thinker, and show sportsmanship. Staying calm while playing chess allows a person to make better decisions and not act out of fear. Playing chess requires patience since most players need to think about their next move and what move their opponent may make. An average chess game takes about forty moves before the game is completed. This can take anywhere from a few minutes to a few 120

hours. Being a leader, a person needs patience when developing a plan and figuring out possible outcomes of that plan. Finally, showing sportsmanship is learned through chess. In chess there are two opponents, one will win and one will lose. There are not participation trophies. Chess teaches students early on how to cope with losing and how to act in certain situations, just like a leader needs to be able to do. Someone cannot be born a leader; a leader must be made. Chess helps make a leader by teaching a person to focus, pay attention, and strategize. Also, in chess, piece values are varied. While playing chess, deciding when to play certain pieces greatly affects how the game is played. This correlates to real life because every person has different values. It is the leader’s decision to choose how to use the resources available to complete a task. Making decisions like this require critical and quick thinking. Critical Thinking Chess requires higher-order thinking while playing the game. When playing, students must think critically to plan their next move. Not only do different pieces move in different directions, it also requires much thought to predict the move an opponent will do next (Oshri, 2015). There is no one single way to win the game of chess. The odds of an opponent making the same moves game after game are extremely low. When it comes to thinking in life, there is not one specific way to think. A person learns new ways to think in situations as they get older. When a person learns new skills in a game, the skills can then transfer to other areas in life (Adams, 2012). A study by Sigirtmac (2016) found the greatest increase in students’ fluency and 121

elaboration skills after learning the game of chess compared to students who received no chess instruction; a slight increase in abstract scores was also found. Chess also teaches students to think abstractly. It helps a student think about if/then statements in a hands-on learning approach. Students also learn to recognize patterns through the movement of pieces. When students begin to see patterns in the game, it helps them predict what problems will arise. This can correlate to behaviors. If students understand the pattern of punishment for an act they have committed, it may prevent or delay the act from occurring. Problem Solving Since chess is a game of intelligence, and it helps develop strategic thinking and problem-solving skills of children, it may also be effective in improving children’s cognitive skills (Sigirtmac, 2016). Barrett (2011) noted that “chess transfers to learning through a far approach, it is difficult to fully use the skills learned through playing chess in other areas of life. Although, chess instruction can provide a means of teaching students to focus on what is important in a given situation”( p. 182). Learning chess in heuristic strategies is more likely to result in a transfer of skills. This is because heuristic strategies, such as simple problem-solving strategies, are best used when given math problem-solving situations (Trinchero, 2015). A study was done in Iran relating problem solving skills to mathematics in the classroom. This study stated that an educational system can not target specific problem-solving skills in students. This skill is something that is inherited. They emphasize incorporating any activity into the school setting that can improve a students’ problem-solving skills; an example of this activity 122

is chess (Rezvani & Fadaee, 2014). Their study showed that math scores did not improve due to chess instruction, however, skills learned in chess generalized into other areas of learning, such as problem-solving and other mathematical domains. In School When children are younger, it is the best time to teach them a new skill. Their minds are still developing, and they are able to learn things more quickly. They want to learn and ask questions as they go. Chess is considered the perfect teaching tool since it encompasses different ways of thinking which then can be transferred into the math curriculum. It is a fair game to play since language is not a factor for English Language Learners, race and religion are not addressed, and educational backgrounds do not affect a person when learning the game. Most students are new to the game, but if a student already knows how to play, it will give that student a leadership role to assist other students in learning how to play. It is a universal game, so wherever the students go in life the rules of chess will remain the same. Although chess relates most directly to skills needed in a math curriculum, it can also be integrated into other subjects. A teacher can incorporate the history of chess and discuss how each piece received its name (king, queen, rook, knights, etc.). Within science, it teaches students about trial and error (moving a piece a certain way then learning that another move would have been better). Chess helps students think critically during reading discussions. After learning chess, students are more aware of predictions, cause and effect situations, and problem and solutions. 123

Math Scores According to Aydin (2015), “Chess is considered as a model for cognitive processes and abilities such as perception, information management, attention, memory, logical thinking and problem solving” (p. 908). Chess involves focused attention and problem-solving. Thus, playing chess should strengthen these cognitive abilities and therefore benefits students’ school performance. It improves children's mathematical skills because it has a similar thought process as mathematics does as well as promotes suitable habits of mind (Salas, 2016). This is possible because mathematics and chess share some common features such as: numerical and spatial relationships as well as quantity-based problems; strategies to solve problems; cognitive skills; and meta-cognitive skills (Sala, 2016). In mathematics, there are multi-step questions that require children to analyze the problem and take the necessary steps to understand the concept before coming up with a solution (Barrett, 2011). This correlates to chess since a player needs to analyze what piece to move as well as prevent other pieces from being taken or opening up a better move for the opponent. Chess also helps people see alternative methods to a problem, which can be used in math when there are multiple ways to solve a problem. Salas (2016) stated he saw a positive upward trend in students’ cognitive and academic abilities after the game of chess was introduced in the classroom.


Gifted Students A student who is gifted typically has great memorization skills, the ability to focus for a long period of time, and ability to think outside the box. Gifted students typically need to be challenged and stimulated within the classroom. Learning the game of chess can be done at the student’s pace. It reinforces concentration, problem solving, and planning; all of which a student who is gifted relies on to learn. Thomasina Adams, who is a fifth grade gifted teacher, saw much success using chess in her gifted classroom (Adams, 2012). She stated that “shy and quiet students learned to take risks, which transferred over to other areas of academics” (Adams, 2012, p. 250). Chess made the students question themselves as they began to play a move. In chess, a person has to think many steps ahead; plan a move, but also avoid any mistakes, think of the opponent’s possible attack, and plan for if or when the opponent does attack. Special Education More recently, math has evolved from the memorization of facts and how to solve problems into understanding why problems are solved certain ways. Since a student with a learning disability may lack the ability to think or visualize in certain way, chess is a perfect example to aid in the different thinking strategies. Chess is “a model for cognitive processes and abilities, such as perception, information management, attention, memory, logical thinking and problem solving” (Aydin, 2015, p. 907). Storey (2000) strongly advocated that educators consider utilizing the game of chess as an instructional strategy for students receiving special education services to reinforce such skills 125

as concentration, problem identification, problem-solving, planning strategies, creativity, and lucid thinking. Research has shown that students have excelled in the areas of counting and calculating on tests after replacing one day of math instruction per week with a chess lesson. It also encourages self-directed learning, which is useful for students with a learning disability because they can learn the game at their own pace. Barrett (2011) conducted a study on special education students who received daily chess instruction and compared the results to students who did not receive daily chess instruction. The data showed that although the students who participated in daily chess instruction received a half hour less of math instruction per day, their scores on their end of the year math assessment were still higher than their peers who did not receive the chess instruction and spent more time doing math each day. Low Socioeconomic Schools Most students in low socio-economic settings need structure, positive reinforcement, and quality extracurricular activities while at school as well as at home. Attending an after-school chess program fosters academic achievement and social development. It shows students how they can succeed outside of the classroom and how to think and act in the real world. It teaches students not just how to help themselves, but also how to help their community. Through learning leadership, critical thinking, and problem-solving skills in chess, the students can take charge of their future, despite their low socio-economic status.


Method Research Approach When conducting this study, both quantitative and qualitative research approaches were used. Students’ beginning of the year math benchmark assessments to the middle of the year math benchmark assessments were compared. The students’ teachers were interviewed to see if there was an impact in the students’ behaviors during the school day after the students’ were taught how to play chess. Setting The study consisted of twenty-five male and female students from third through fifth grade all in the same low socio-economic school in the Upper Darby School District receiving the Go Math! Curriculum. Data was collected and gathered from the test results given by the students’ teachers. The beginning of the year math benchmark assessments were given in September 2016, the middle of the year math benchmark assessments will be given in January 2017. The teachers were interviewed to see if learning the game of chess had a positive or negative impact in the classroom. Interviews were conducted during grade level meetings, which were held on a bi-weekly basis. These interviews were analyzed and thoroughly discussed in the findings section of the research paper. Findings In September of the 2016-2017 school year, students took a beginning of the year math benchmark assessment, 95% of students scored below basic and 5% of students scored basic. 127

None of the students used in this research scored proficient or advanced on the assessment. In January of the 2016-2017 school year, students took the middle of the year benchmark assessment, 58% of the students scored below basic, 32% of the students scored basic, 11% scored proficient, and 0% scored advanced. 43% of the students moved up a proficiency level or higher. The greatest increase were seen in students who went from below basic to basic. Although it is still below grade level, they are moving closer to becoming proficient at their grade level. 2% of the students jumped two proficiency levels (from below basic to proficient). One student decreased their score from basic to below basic. Compared to all students in third through fifth grade that took this assessment, the average increase was 14%, which is equivalent to half a proficiency grade. Almost half of the students in the study doubled the expected score increase that was set by the district.


Prior to the beginning of chess club, about half of the students involved in the club had behavioral issues. Issues included lack of participation, lying, focusing issues, and lack of leadership skills. While interviewing teachers throughout the research process, teachers saw slow, but progressive changes in student behaviors. The behaviors teachers first began to notice were positive changes in the students’ focus. The students were more alert in class and showed enthusiasm when participating. They would think through problems and questions rather than just say the first answer that came to their mind. When explaining an answer, they were able to include more details than they previously were able to. They were also able to explain how they solved the problem in detail rather than just simply giving an answer. Towards the end of the data collection, the teachers were writing less office referrals than the beginning of the school year. They said this was due to students getting into fewer confrontations because they were able to work through problems instead of reacting right away. The game of chess allowed students to visualize that with every action there is a reaction. If the students participated in an action (fighting, name calling), they became more aware that there would be a consequence to that action (office referral, loss of recess, principal time-out), and therefore, began to peacefully solve their problems. It is important to note a few limitations of this study. This study did not take into account students who were had learning disabilities or had an IEP that identifies they already have difficulty with learning and are performing significantly below grade level. This assessment was


also multiple choice so the students had a 25% chance of choosing the correct answer on each testing item. Implications and Recommendations

From this study I have concluded that learning the game of chess during a before school activity did increase students’ test scores in math. Almost half of the students increased a proficiency level from the beginning of the year to the middle of the year in math. If I did this action research project again, I would be curious to see if the game of chess had an effect on students’ comprehension skills, mainly on open-ended questions where they would have to explain their reasoning behind their thinking. After interviewing teachers, they said most of their students participated more in class after learning the game of chess. I feel this would relate to open-ended questions since typically when a student participates, a teacher asks the student to explain how they came across an answer. I would like to know if the student can transfer this skill onto a test where they have to read an open-ended question and then respond. Does the answer contain as much detail as they did when the student was explaining it in class, since the teacher noted the student is able to explain more when they participate? Another recommendation I would make is to target more specific behaviors. The teachers I worked with, along with myself, generally looked at behaviors as a whole. If I were to continue this action research, I would focus on how chess could prevent fighting within the school setting. I would choose fighting specifically since it is a big problem in the school I am currently


working at. I would research different chess tactics/skills that can be taught to have students prevent physical/verbal aggression towards one another. A final recommendation I would make is to do this research in a variety of schools. My action research study took place in a low socio-economic setting. These students have many factors going on in their home life so that school is not always a top priority. That being said, a big issue was attendance throughout this research period. There were many students that were either did not attend chess club multiple times or had many absences from school. I feel more accurate results of the benefits of learning chess would have been shown if I did this action research in multiple schools throughout the county, not just the school I currently work in. A change I would have made to this research is to focus on a particular grade and align the game of chess to the students’ curriculum. For example, in chess the queen can move horizontal, vertical, and diagonal. In third grade, the students learn these terms. In fourth grade, the students turn these terms into angles and triangles. Chess also relates to area and perimeter which is an end of third grade/beginning of fourth grade skill. As a teacher, to get the students engaged in the lesson, I would first have the students play the game of chess and introduce these terms, then I would teach the students the lesson. If a teacher took the time and aligned chess to the state standards and the district’s curriculum, then other teachers would be able to incorporate the game of chess into their classroom. From the research I have conducted it shows learning and playing the game of chess has a positive effect on both students’ math skills and their behavior. I truly believe all students could benefit from learning chess. 131

References Adams, T. P. (2012). Chess from square 1: Incorporating chess into the gifted class. Gifted Child Today, 35(4), 243-251. Aydin, M. (2015). Examining the impact of chess for the visual impairment on mathematics. Academic Journals 10 (7), 907-911. Barrett, D. C., & Fish, W. W. (2011). Our move: using chess to improve math achievement for students who receive special education services. International Journal of Special Education,26(3), 181-193. Hunt, S. J., & Cangemi, J. (2014). Want to improve your leadership skills? Play chess! Education, 134(3), 359-368. Oshri, B. (2015). Predicting Moves in Chess using Convolutional Neural Networks. Semantic Scholar, 1-8. Rezvani, M., & Fadaee, M. (2014). Effect of chess training on math problem-solving ability of Elementary School Students . Journal of Applied Environmental and Biological Studies , 4(5), 249-245. Sala, G., & Gobet, F. (2016.). Do the benefits of chess instruction transfer to academic and cognitive skills? Educational Research Review (18). 46-57 Sigirtmac, A. (2016). An investigation on the effectiveness of chess training on creativity and theory of mind development at early childhood. Academic Journals 11(11) 1056-1063 Smith, J. P. and Cage, B. N. (2000). The effects of chess instruction on the mathematics 132

achievements of southern, rural, black secondary students. Research in the Schools, 7, 19-26. Trinchero, R. (2016). Chess training and mathematical problem solving: the role of teaching heuristics in transfer of learning. Eurasia Journal of Mathematics, Science & Technology Education,,12(3), 655-668


Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

Autism: A Different Way of Being Human Student Authors: Nicole Fantom, Jacqueline Paxson, Kiera Scarbrough Academic Program: Education & Human Services Faculty Advisor: Daniel McKee, Ed.D Abstract: Children with Autism Spectrum Disorders (ASD) display an array of abilities and encounter unique challenges within the school environment. For teachers, understanding the needs of students with ASD is essential in order to deliver appropriate and well-designed instructional services. This paper will describe qualitative research, conducted by three preservice teachers, focused on enhancing their knowledge of ASD and applying these insights in support of three individual children. By focusing on the “why” of student behavior, these future teachers developed important dispositions and competencies that will support their efforts as general education or special education teachers. This paper describes what they have learned through their research and how it can be of benefit, particularly to those with ASD. All three children discussed in this paper are male. This is a common characteristic associated with Autism. However, no two people manifest Autism in the same way. Many characteristics are common in all individuals with ASD, but those with Autism may be different in many ways. It is essential that these differences are recognized and are responded to in a caring, compassionate, and appropriate manner.

Introduction According to the Center for Disease Control (CDC), “about 1 in 68 children has been identified with autism spectrum disorder” (CDC, 2017). Autism is the four-year-old boy who is non-verbal, so he screams and flaps his arms instead. Autism is the classmate who becomes fixated on lining up all of her pencils in a row and is isolated often because she struggles with the social aspect of communication. Autism is the world-renowned author and college professor who 134

brings international attention to the challenges of autism. Autism is “different, but not less” Temple Grandin would say. It is one of the more common disabilities in which students are educated alongside their typically developing peers in a general education classroom. No two individuals with Autism have the same exact behaviors, so it is important to focus on the person rather than the disability label. Often, teachers become so preoccupied with the label autism, they forget they are working with a person—someone’s brother, sister, daughter, son. In doing so, one fails to assume competence. We may associate those with Autism only with the negative and stereotypical behaviors of the disorder. It is important to see beyond this label and to allow the individual to prevail. According to the Centers for Disease Control, “autism spectrum disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges” (CDC, 2017). Individuals with ASD often have problems making friends; interpreting and utilizing both verbal and nonverbal communication; and demonstrating certain behaviors such as making eye contact and adapting to changes in routine. They may also struggle with being touched and may repeat actions, words, and phrases over and over. This paper will share insights gathered regarding pre-service teachers’ development of a deeper understanding of students on the Autism spectrum and will specifically apply the findings to three children who have been identified with this condition.


Child One Being Uniquely Human Autism is not an illness. It is, rather, a unique way of being human. It is important to ask ourselves: how can we support and help a child with Autism? First, one must examine their beliefs and misconceptions about children with Autism. While some may look to changing the child and their behavior, we need to consider how can we change or fix our beliefs and misconceptions about the disorder. Second, we have to listen to our children. We can learn many things from books, articles, and conferences, but the most valuable way to learn about Autism is through the children, their parents, and adults with Autism (Prizant, 2015). Finally, we have to ask why. Why does someone exhibit autistic behaviors? Why does she rock back and forth? Why does he flap his hands? Why does she repeat random facts over and over? Dr. Barry M. Prizant, author of Uniquely Human, states that these autistic behaviors are “nonexistent,” meaning that the behaviors are “human responses based on a person’s experience” (2015, p. 5) that allow those children and adults to bring regulation or some form of control back into their lives. Although these behaviors are categorized as dismissive or “noncompliant” (Prizant, 2015, p. 6), we need to start asking, “What purpose does it serve [for the person with ASD]? Does this behavior help the person, even though it looks different?” (Prizant, 2015, p. 6). Child One is a third-grade student currently being taught at a Catholic school in West Philadelphia. Child One exhibits many of the autistic behaviors that would have been considered


typical indicators of Asperger’s Syndrome (AS) prior to the 2013 DSM-V update, which separated Asperger’s Syndrome, Autism, and Pervasive Developmental Disorder Not Otherwise Specified into three separate categories rather than combine them into one under the umbrella of autism. Asperger’s Syndrome “is one of the several subtypes of autism folded under the single diagnosis of autism spectrum disorder (ASD)” (AutismSpeaks, 2017) and it was commonly associated with those on the high functioning end of the spectrum. The most common developmental issue children with Asperger’s Syndrome exhibit is difficulty with social interactions with their peers. When interacting, Child One will look in the general area of the person speaking, but will never make eye contact. Child One’s speech is characterized by a monotone quality, a formal voice. Child One is also slightly above average in terms of academic achievement, but may stare blankly into space and have difficulty accepting responsibility or admitting fault. For example, if Child One were caught talking, he might point out that a peer was also talking, even though that behavior had occurred a few hours earlier. All of these behaviors have been observed by Child One’s teacher and his peers. However, one must ask why does Child One exhibit these behaviors? Prizant hypothesizes that Child One’s behavior is the result of being dysregulated or having a lack of control. Child One may feel overstimulated and anxious if encountering something beyond his comfort zone. For example, when Child One is called on without warning, his eyes may become wide and begin to move from side to side, as if looking for an escape from


the unwanted attention. This is Child One’s way of coping with the lack of control in that situation. Teachers and others who work with Child One can provide Child One with a warning to provide him with a sense of security and preparedness. This warning may involve tapping Child One’s desk to prepare him for participation in the classroom discussion or talking with Child One and explaining when he will be called on during the lesson. Prizant identifies “enthusiasms” as those topics about which children on the Autism know an extensive amount of information. Prizant states that children “use the enthusiasm as a way to expand [their] outlook and [can] improve their life” (2017, p. 55). Child One loves video games and enthuses about them constantly. This helps to promote Child One’s social interactions because the majority of his peers love video games as well. However, if Child One’s teacher unknowingly mentions a feature of a video game, Child One may speak incessantly about that feature, sometimes without a clear connection to the lesson being taught. For example, during a science lesson about the Solar System, Child One’s teacher mentions meteorites and Child One raises his hand and talks about what he does with the meteorites in video games. His interest in video games can be built upon and incorporated into lessons to facilitate Child One’s participation and engagement. Prizant (2015) also focuses on the concept of social understanding. Prizant states that the social world for a person with Autism can feel like “an unfamiliar cafeteria, with rules that all other diners apparently already know but seem nearly impossible to learn” (p. 111). In other


words, there are unspoken rules that society follows and understands, but a person with Autism may have difficulty following and understanding. An example of an unspoken rule that is hard for Child One to follow is knowing when to be honest and how to be sensitive. Child One does not lie. When Child One interacts with his peers, he tells the truth in a brutally honest way, but he does not know how to present that truth in a compassionate manner. A good way to help Child One with his honesty is through the use of social stories that involve Child One and his peers acting out situations and practicing how to act properly. Child One’s behaviors are the result of being dysregulated. Child One uses these behaviors as way to regulate himself and become balanced again. He feels safe and secure within his body once the regulation occurs. Although Child One’s behaviors may be considered “weird” by others, it is important to understand that these regulating behaviors help him relax, cope and become safe again. Autism is not an illness; it is Child One’s unique way of being human. Child Two Asking “Why,” Instead of “What Now?” The term Autism can prompt many reactions. We may hear, “Stop flapping your hands,” “He pulls you around like a doll,” or “What is he doing now?” Many may view the autistic behaviors as self-stimulatory or obsessions. As educators, we must dig deeper because there is a purpose behind each individual’s behaviors. One question educators should always ask is “Why?” Asking that question is the best way to understand a student with Autism. There are 139

many characteristics that can be perceived as nuisances or annoyances, but in reality, they serve a purpose for the individual. After observing and experiencing an individual with autism during their daily life, it is apparent that their behavior provides a sense of security and predictability. Child Two is a 15-year-old boy whose autistic regulators include enthusiasms, routines, and communication. These actions provide a sense of calmness and joyfulness in situations that can be unpredictable for Child Two. Child Two is enthusiastic about DVDs. He has an entire collection of DVDs that he has received as presents for birthdays and holidays. They are the only items on his gift wish list. Child Two does not watch the movies, however; he likes to open the cases, look at the front cover of the DVDs, and say the release date or any other numbers on the case. He finds joy in looking at his DVDs and walking around with them. Having a DVD with him makes Child Two feel secure. It is a comfort and an interest for him. These interests and strengths can be used in a math or reading lesson in which the specific numbers or words from the DVDs are used so the child is more engaged and interested in the lessons taught. Routines can also provide a sense of calmness and joy by developing a sense of predictability, control, and trust. Students with Autism need to know what is coming next. They cannot focus without a routine, can become very upset with sudden changes, and cannot understand why the routine is not being followed. For Child Two, routine has always been very important. He keeps a close eye on the calendar to know when DVDs are getting released or


which holidays are coming. He also trusts that every Sunday he has dinner with his family. When he was young, a break in this routine or schedule was very upsetting to him. While Child Two handles changes to his routine much better now, he still relies on a consistent schedule. Child Two’s routines, like his enthusiasms, provide a sense of security and safety. In the classroom, it would be extremely important to create a personal schedule for this child to keep on his desk so he can have a constant reminder of the events that will be occurring on a given day. Another primary characteristic of Autism spectrum disorders is difficulty with traditional communication. Many students with Autism are nonverbal, a particularly challenging trait for parents, families, and educators. Children on the Autism spectrum need to develop other ways to express and communicate their desires and needs with families and educators. Child Two went from being completely nonverbal as a young child to speaking short phrases as he grew older, which marked major progress and gave hope to his family. He is often prompted by family members or those around him to communicate verbally. For instance, his mother may give him two choices of food at the dinner table and he is asked to verbally answer which he would like to eat. He responds verbally to questions when he is prompted to do so. Oftentimes, Child Two would take adults by the hand and bring them to whatever he wanted. This is called intentional communication. Prizant (2015) writes, “When a child takes his mother by the hand, she is not using her as a tool; it is intentional communication, a starting point on which to build� (p. 214). Child Two initially engaged in this alternate form of communicating. He would take someone to


the closet to get his jacket to go home or to the refrigerator for a drink. Child Two still does this at times, but much less so than when he was a child. Now, Child Two points to things that he would like. For example, at dinner time, he will point to the foods he would like for someone to put on his plate. Communication can be very difficult, but it is up to the families and educators to develop alternative forms of communication that can be used in the classroom and at home for the individual to express his wants and needs. It is important that these forms of communication are generalized to both the home and school. The underlying cause of the behaviors exhibited when enthusiasms are missing, routine is broken, and communication is lacking, is emotional dysregulation. Family members and teachers need to consider how the child self-regulates. For example, when giving a speech, many people often pace to keep themselves relaxed. However, many students with Autism are ill-equipped to deal with these challenges in this more typical way because of their neurology (Prizant, 2015, p.19). Their enthusiasms, routines, and communication alternatives help regulate their emotions in a similar way to others’ pacing when they are experiencing emotional dysregulation. Asking “why� will help figure out what the underlying cause of the behaviors is and make it easier for one to help a child with autism in a more positive way. Child Three Exploring the Sensory Component of Autism Spectrum Disorders


Child Three is an energetic and bright eight-year-old, who happens to have significant sensory issues. He is verbal and often repeats lines verbatim that he has seen on his favorite television show, SpongeBob Squarepants. Child Three is fully included in a second grade classroom with his peers. Child Three has overstimulated sensory issues related to sight and hearing and understimulated sensory issues with touch. For example, Child Three becomes overwhelmed with lights that are too bright or any visual that contains too many colors or patterns. When he hears a loud or unexpected noise, Child Three becomes frightened at first and then fixated on finding the source of the noise. However, Child Three is under-stimulated in the area of touch. This makes it difficult for him to understand what pain is and why he has to be careful when touching certain things. These sensory issues prove to be a problem for Child Three in school. On the first day of school, Child Three had a severely negative reaction after walking into his outer space-themed classroom. The teacher had decorated the classroom with many different images and illustrations about space; however, the colorful classroom was very visually overwhelming to Child Three. Furthermore, Child Three’s teacher explained that he becomes very distracted and fixated on noises outside of the classroom and school, oftentimes completely withdrawing from classroom activities to focus on such sounds. Finally, as a result of Child Three’s understimulated sense of touch, he has had multiple injuries on the school playground, but he did not know he had hurt himself. 143

Addressing Child Three’s sensory needs is important so that he can focus less on the sensory stimuli and more on his education. In terms of visual stimuli, keeping decorations to a minimum may be hard for elementary school teachers, but it is imperative if they have a student like Child Three who cannot focus otherwise. We must make our classrooms safe and inviting for all students, not just those who are typically developing. When looking at these behaviors, teachers should not dismiss them as autistic behaviors, but rather, “[a]sk what is motivating it? What purpose does it serve?” (Prizant, 2015, p. 6). Is Child Three’s screaming helping him cope with bright lights and elaborate bulletin boards? Is his arm flapping a way of trying to avoid focusing on the trash truck outside so that he can pay attention to the lesson? A good way to help students with this overstimulation is to incorporate colors and patterns in small increments so that he may get comfortable with them. Additionally, lighting can have a negative impact on students with ASD. Although we cannot control whether our classrooms have bright fluorescent lighting, we can try to incorporate lamps and natural lighting as much as possible. Furthermore, auditory stimuli can be hard to control, but keeping the classroom doors and windows closed when possible will help keep unexpected loud noises somewhat controlled. Additionally, changing a child’s seat to a place with fewer auditory distractions can prove to be meaningful for all students affected, not just those with ASD, because it alleviates any possible interruptions to maintain the attention of every student. Finally, it is important to teach children about safety—at home, in the community,


in the school, and on the playground. While Child Three may not always feel pain, he will know how to prevent and identify injury and know to go to a teacher when something unsafe happens. When thinking about Autism, it is important to remember that “we’re all human, and these are human behaviors” (Prizan, 2015, p. 6). Autism is a challenge and it is important for teachers to “get it,” as Prizant says. In order to “get it,” we must be empathetic; we must recognize that these individuals with ASD are behaving as humans; we must be sensitive; we must access support from other knowledgeable professionals; we must build trust with our students; and finally, we must be flexible. After all, Autism is not a disability, it is a different ability.

References Asperger's syndrome. (n.d). Retrieved April 18, 2017 from

Centers for Disease Control and Prevention. (n.d). Retrieved March 30, 2017 from

Centers for Disease Control and Prevention. (n.d). Retrieved March 30, 2017 from

Prizant, B. (2015). Uniquely Human. New York, NY: Simon & Schuster. What is Asperger’s syndrome. (n.d). Retrieved April 18, 2017 from


Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

Journey Out of Darkness Student Author: Karen Rodgers Academic Program: Pastoral Clinical Mental Health Counseling Faculty Advisor: Dr. Sophia S. Park Th.D., LMFT Abstract: At some point in life, everyone will experience darkness and feel a sense of despair. This paper acknowledges this fact and encourages the reader to look for God’s presence during our time of darkness. Recognizing God’s presence can help guide us out of the darkness. The everyday hustle and bustle of our daily lives combined with a sense of despair, however, can make it difficult to feel God’s presence. Time spent in solitude and contemplation helps to reconnect us to our inner self as well as to God. This reconnection allows us to feel God’s presence. In this paper I utilize my own journey through a time of darkness that blanketed my life. I mention how I intermittently felt God’s presence in the beginning of my journey and how the use of sacred spaces helped to strengthen and steady my feeling of God’s presence, leading me to a new and different happy and contented life. This new life now includes work as a Pastoral Counselor with clients who have experienced the loss of a loved one. Lastly, in this paper I reflect on work that I now do with clients in an effort to help shed light on my clients in their time of darkness. Introduction Ten years ago my young, vibrant, extremely handsome, priceless father of our three beautiful daughters was killed in an accident at work. My happy and contented life exploded in an instant, leaving behind debris laden with a sense of darkness and heavy grief. There were many people who graciously helped to rescue me and my daughters from the debris; helping to shed some light on us in our time of darkness. I am and will forever be grateful for their love and 146

support in our darkest hour. These people were also instrumental in guiding me into another profession, Pastoral Counseling. In this paper, I touch on my journey after the explosion and how my faith and sense of God’s presence served as a magnetic force leading me to a new and different happy and contented life. I also reflect about my current clinical work in an effort to help shed light on my clients in their time of darkness. Now what “Karen, your life before January 19 is over. Now what do you want to do?” The counselor kept talking but that was all I heard. “Now what do you want to do?” echoed in my mind. Honestly, I wanted to turn back the clock to January 18, so that I could make my husband stay home from work on the nineteenth; that is what I wanted to do. I knew that was not an option. I somehow got off the phone with the counselor and I went into my bathroom and just threw up. I called that counselor in desperation to talk with someone, anyone, in hopes of relieving the gut-wrenching, nauseating heaviness I was lugging around with me. I had never felt this way before. I felt as if I was carrying the weight of the world on my shoulders and I just could not move or breathe. I just wanted my old life back. “Now what do you want to do?” kept playing over and over again in my mind. As time passed, it became very clear to me that what the counselor said was true; my life before January 19 was over. My quest to answer this haunting


question guided me out of the darkness, allowing me to focus on the well-being of my children and move in the direction of pastoral counseling. As a pastoral counselor I recognize everybody at some point in his/her life will experience darkness and feel a sense of despair. Glimpses of light can appear if we are open to recognize the light; this light can serve to guide us through our darkness. Solitude and space allow us to connect to our inner self and to God. Over the course of time, we can emerge from darkness into a new normal. Darkness and glimpses of light Darkness can be caused by trials and tribulations experienced in life which can generate feelings of pain and suffering and can create a sense of darkness and despair. St. Ignatius Loyola used the term desolation to refer to a kind of darkness. He defined desolation as: Desolation, at its root, is a feeling of being separated from God, which manifests itself in general feelings of loneliness, anxiety and despair . . . a darkness of soul, disturbance in it, movement to things low and earthly, the unquiet of different agitations and temptations, moving to want of confidence, without hope, without love, when one finds oneself lazy, tepid and as if separated from His Creator and Lord (Mossa, 2012, p. 132133).


In times of darkness, it can be difficult to pray and feel a sense of connectedness to God. The sense of being alone and perhaps even abandoned flows through our conscious creating a heavy feeling hard to carry. No one is exempt from experiencing darkness and desolation, not even God’s only Son, Jesus Christ. Kushner (2004) observes that “Pain is the price we pay for being alive” ( p. 72). When Jesus was condemned and crucified, a sense of darkness moved into His life. Jesus went from being a celebrated and welcomed individual lauded in a Palm Sunday procession to being mocked, beaten and sentenced to be crucified. We hear Jesus’ despair in the Gospel of Mark: “And at the ninth hour, Jesus cried out with a loud voice, saying, ‘Eloi, Eloi, lama sabachthani’ which is translated, ‘My God, My God, why have you forsaken Me?’” (vss. 15:33-34 NKJV) The words that Jesus chose when He cried out for Eloi portray a sense of rawness, pain and suffering. Jesus suffered. Human beings suffer. While darkness enters into everyone’s life at some point, glimpses of light are present and are indicative of God’s presence. Such glimpses have guided me out of dark times I have experienced. When Jesus was on the cross and cried out to Eloi, the mere act of His calling out infers that Jesus was acknowledging His Father’s presence. “Even on the cross He did not hide Himself from sight; rather, He made all creation witness to the presence of its Maker” (Saint Athanasius, 1993, p. 56); this offers a sense of hope; Jesus’ revealing that God is present during the darkest times.


Darkness has visited with me many times. The longest and most impressionable visit happened after the death of my husband. For about two years, I can honestly say that a sense of darkness blanketed my life. For the first four or five months I experienced immense sadness, difficulty sleeping, eating and I developed anxiety. I had a hard time concentrating on things. The everyday hum and laughter that once surrounded me was now eerily silent. I felt as if a door had slammed shut; the music was silenced and the lights were turned off. All I was aware of now were my own scattered thoughts. I found myself calling out to God just as Jesus did; somehow I too felt His presence. God revealed His presence to me in the very beginning of my journey through grief. The first night I spent without my husband was extremely long. I tried to go to bed, but I could not bring myself to lie down. I spent the night on my couch in the fetal position looking out my front bay window at my neighborhood. I do not remember what thoughts ran through my head that night. I think I was just in so much shock; I felt numb. I do, however, remember watching the sun rise and thinking, “The sun is still rising today.” It was God’s gentle but powerful way of letting me know that He was with me and that my life would continue. God continued to let me know that He was with me by working through other people. My husband’s family, our friends and our community just swooped me and my three girls up and provided us with love and support by dropping off meals and notes of encouragement. I sensed God’s presence at Paul’s funeral Mass when my three-year-old nestled on my lap and fell asleep.


This allowed me to listen to Father’s sermon which was about a little boy who had gone swimming in a lake and began to struggle. The boy’s father noticed his son struggling, grabbed a piece of rope, ran out into the lake and threw the rope to the boy. The current was moving and as the boy grabbed the rope, it broke. His father panicked and yelled to his son, “Reach beyond the break!” The image that the homilist portrayed in his sermon and the actual words of the panicking dad to “reach beyond the break” served as a light to me in my time of darkness. I felt as if God Himself was encouraging me to “reach beyond the break!” I utilize my own experience of being in darkness when I talk with my clients. I listen to them talk about their thoughts and feelings that are associated with the death of their loved one. Nouwen (1975) shares that “as healers we have to receive the story of our fellow human beings with a compassionate heart, a heart that does not judge or condemn but recognizes how the stranger’s story connects with our own” (p. 96). I allow myself to go back into darkness with my clients and try to companion them in their grief.

I visited with one client at her house a couple of months after her husband died in hospice. She had that same lost stare that masked my face after my husband died. I sat next to her on her living room couch and listened to her tell me that she was having a hard time sleeping, eating and concentrating. She talked about her husband, his illness and about how he died. She shared about how much she missed him and how much she loved him. I asked very few questions; I just listened. I understood how unsettled she felt and acknowledged and mirrored


her feelings back to her. After about an hour into my visit, I met her in her grief by letting her know that I too had experienced the loss of my husband. After I told her that, I will never forget the look in her eyes as if to say to me, “You do see me.” I then felt guided to tell my client, “Your sadness and sorrow will not always feel as heavy as they do now. I can’t tell you when they will feel lighter, but someday they will.” I was drawn to offering a sense of hope or light to her in her darkness.

Solitude and Space connect to Self and God In my day to day world full of noise and chaos, I recognize that time spent in solitude can bring silence and calm into my hectic life. Time spent in solitude serves as a conduit to self knowledge and self awareness. The co-authors Au and Cannon (1995) note that “Solitude is a time of intimacy with one’s self” (p. 52). It is a time when I can really reflect on my life and examine my innermost thoughts and feelings. During this time, I also find myself connecting to God. Joann Wolski Conn (1989) points out that “The intuition of our ‘real self’ brings this awareness of our profound union with God and with all persons and things” (p. 33). I am able to listen to God and am able to feel His presence. Henri Nouwen (2013) describes this encounter when he writes, “We slowly learn to see, within our very own hearts, the reflection of the one who breathed life into us” (p. 138).


Time spent in solitude is not always easy to attend. The hustle and bustle of everyday activities like work, taking care of children and managing a house creates distractions for me. As Nouwen (1975) asserts: Being busy, active and on the move has nearly become part of our constitution. When we are asked to sit in a chair, without a paper to read, a radio to listen to, a television to watch, without a visitor or phone, we are inclined to become so restless and tense that we welcome anything that will distract us (p. 73). I have learned to seek out places where I can process my thoughts and feelings and feel God’s presence. I refer to these types of places as my sacred spaces. I have found sacred space in my house, in my church, in nature, in my pastoral counseling coursework and in talking with certain people. It is a space where I can sort out my feelings, adjust or develop a new vision of what my life should look like or just be with God and feel his Presence. My world was turned upside down the day my husband died and I found myself searching for calmness and peace. By connecting to my inner self, I was able to dig deeply within my inner self and think about my life and what was really happening within me. I was immensely sad for myself and my girls. I felt such a sense of loss, despair, confusion and anger. I thought about each one of my beautiful daughters and ran through my mind how Paul’s death would affect them. I thought about myself and wondered how my own future would look. I


considered all these thoughts and feelings in mind until I could not contemplate them anymore. I figured out where I wanted to place these thoughts and feelings.

As I utilized my sacred spaces to connect to my inner self; I felt God’s presence in each one of these spaces. In the quiet of my bedroom at night after my kids went to sleep, I wrote in my journal, read books on spirituality and grief, and prayed. At the end of some extremely long days, this sacred time connected me to both God and Paul, providing a sense of comfort. In my sacred space in Ridley Creek Park, I walked the four and a half mile path. I listened to the birds and the flow of the creek, soothing music to my ears. I watched the park change from brown to green during the spring months, reminding me of the continuation of life and giving me hope. I felt as though God and Paul were walking with me, allowing me to see, hear and witness life all around me. I found sacred space with some of my friends and my grief group members with whom I felt free and safe to express my feelings. In this space I heard myself talking and felt God working through all of my friends and my grief group members by their hospitality and through their support.

When I first meet with clients, I recognize that they are wounded warriors in great need of rest and gentle care. I am mindful of their restlessness and offer sacred space by just listening to them; Once again Nouwen (1975) offers me the challenge:


Healing is the humble but also very demanding task of creating and offering a friendly empty space where strangers can reflect on their pain and suffering without fear, and find the confidence that makes them look for new ways right in the center of their confusion (p. 97).

In so doing, I emulate the gift my friends and my grief group members gave to me; allowing my clients to release their thoughts and emotions; I say very little. I recognize from my own grieving process, and how healing it is just to be able to talk about your loved one who has died. I tell my clients that they need to try to be kind and gentle to themselves during this fragile time; grief work is hard work that drains your energy. I offer suggestions like walking, journaling, taking naps, drinking a nice warm cup of tea; I encourage them to try to do a little something for themselves each day. I talk with my clients about grief support groups and give them a little education on the benefits of attending these. I provide my clients with information about grief to educate them on common feelings that they may experience in the grieving process and encourage them to spend time in solitude, reading this information and thinking about how they want to process their feelings. My hope is that my suggestions encourage them to find their own sacred space where they can discern how to work through their feelings of grief and feel God’s love and support as they work through all of this.


New Normal “I left the woods for as good a reason as I went there. Perhaps it seemed to me I had several more lives to live, and could not spare any more time for that one” (Thoreau, 1995, p. 209). One day, almost two years after Paul died, I was driving my kids to one of their activities and I turned on the radio. I had not listened to pop music since Paul died. My kids said, “Hey mom, you have the radio on!” Just like that, I realized that the storm had calmed. Just as darkness has entered my life many times, it has left my life many times. I am drawn to a story in the New Testament describing how Jesus and His disciples experienced a storm. These verses affirm my belief that God is present with us during the storms in our life and that the storm will subside and peace will follow. And a great windstorm arose, and the waves beat into the boat so that it was already filling. But He was in the stern, asleep on a pillow. And they awoke Him and said to Him, ‘Teacher do you not care that we are perishing?’ “Then he arose and rebuked the wind and said to the sea, ‘Peace, be still!’ And the wind ceased and there was a great calm (Mark 4:37-39) It took time, contemplation and a strong sense of faith for me to adjust to my husband’s death. I also came to realize that in the midst of my storms, Jesus was present in my small craft.


Focusing on, “Now what do you want to do?” helped me to turn my attention on moving forward. This focus helped me to emerge into a new normal. Joann Conn (1996) in her collection of essays on spirituality comments on the paradoxes seen within what John of the Cross named the “dark night.” She suggests: Since we are not educated for darkness, however, we see this experience, because of the shape it takes, as a sign of death. Dark night is instead a sign of life, of growth, of development in our relationship with God, in our best human relationships, and in our societal life. It is a sign to move on in hope to a new vision, a new experience.” (p. 414) Spending time in my sacred spaces, processing my thoughts and feeling God’s presence enabled me to redefine my life and develop a vision of how I wanted my life to look. I refer to this redefinition and vision using a term that comes in the aftermath of a crisis; it is my “new normal.” What I imagined was a vision of a bridge. I was on one side with my girls and my husband, on the other side. I just wanted to get to a place where I knew with certainty that he was on that other side so I could accept this painful reality and have a sense of peace. The bridge represented eternal connection and the two sides, physical location. I even designed our tombstone to reflect this image so that when I go to the cemetery, I would repeatedly be reminded of the meaning of my vision. In my new normal, I accepted that Paul’s physical death could not be changed; he was not coming back to life. I realized that my life before January 19 was over, that the thoughts and dreams I once had, needed to be changed. Finally, I was okay


with that; I felt comfortable saying that I did not like it, but there was nothing I could do to change it. In my new normal, the anxiety that I felt after Paul died about having to raise three girls by myself dissipated and gave birth to feelings of gratitude. I found myself being more thankful that God gave me three girls to continue my journey through life. In the beginning, my threeyear-old who loves hugs, was such a source of warmth. My thirteen- and eleven-year olds were very active and kept me busy driving them to and from their events; they also kept me on my toes with all the drama associated with teens and preteens. They were instrumental in helping me see that life does go on. In my new normal, I recognized that although Paul is not physically with us, he is spiritually with us. I feel his presence when I am having a tough day. Somehow when I am at my breaking point, I hear his happy voice saying, “Ahh, Love‌â€?. When I am in joyful times, I visualize his smiling at us. I have developed a different relationship with him, but his love is still with me. My kids have also developed a different relationship with him. They have adjusted to the fact that although the loss of his physical presence has created a void in their lives, his love remains with them serving a gentle reminder that there is more to this world than what is seen. Their relationship now with him includes little signs which they feel connect them to him. The number seven was significant to Paul. When one of my daughters was traveling in Europe and checked into a hostel, she said that she was nervous staying in a big room with many people she


did not know. When they gave her bed number seven, she said she knew she would be fine because her Dad was with her. I work with clients to help them accept that their life has changed; the life they had with their loved one can no longer be the one that supports them. I companion my clients and offer support to them as they adjust to life without their loved one. For example, I worked with one client for almost six months. Over that course of time, I witnessed her transformation from despair to acceptance and hope. When I first met with her, she was very distraught and anxious about having to live without her husband; it was difficult for her to even talk. Through our sessions, I witnessed her build her strength in managing her household responsibilities, health issues and relationship challenges with her daughter. When she talked of these accomplishments, I would ask her how she felt and the word she would use was empowered. I felt honored when she would share her stories of how she felt her husband’s presence during this time as it gave witness to her developing a different relationship with her husband, while adjusting to her new life. The last day I visited with her, as I stood at the door waiting for her to open it, a blue butterfly flew around me. When she opened the door, I pointed out the butterfly to her. She smiled and nodded and said that her husband’s favorite color was blue. I smiled and nodded too. Feeling a warm connection with my client at this point, I asked her what she thought about the butterfly. My client responded by saying that she felt the butterfly was a sign from her husband that she was ready to fly and that she was going to be alright.


Conclusion Things happen in life that can cause our lives to change dramatically. I draw on Kushner’s (2004) wisdom in saying: “We may not ever understand why we suffer or be able to control the forces that cause our suffering, but we can have a lot to say about what suffering does to us, and what sort of people we become because of it (p. 73). God is present with me during my time of darkness even if I may sometimes feel as though He is not and feel disconnected from God’s presence. It is then the time spent in solitude that helps to reconnect me to my inner self as well as to God. Sometimes God’s presence comes in the form of people, nature, Scripture and other things like books and music. This reconnection guides me to move through my darkness and see the vision of God’s calling in my life. Bibliography Au, W., Cannon, N. (1995). Urgings of the Heart. Mahwah, New Jersey: Paulist Press. Conn, J.W. (1989). Spirituality and Personal Maturity. Lanham, Maryland: University Press of America, Inc. Conn, J.W. (1996). Woman’s Spirituality. Eugene, OR: Wipf and Stock Publishers. Kushner, H.S.(2004). When Bad Things Happen to Good People. New York: First Anchor Books. Mossa, M. SJ (2012) Saint Ignatius Loyola: The Spiritual Writings, Woodstock, Vermont:


SkyLight Paths Publishing. Nouwen, H. (2013). Discernment: Reading the Signs of daily Life. New York: HarperCollins Publishers. Nouwen, H. (1975). Reaching Out: The Three Movements of the Spiritual Life. New York: Doubleday. Saint Athanasius (Patriarch of Alexandria)(1998). On the Incarnation: The Treatise De Incarnatione Verbi Dei. Crestwood, New York: St Vladimir's Seminary Press Thoreau,H. D. (1995). Walden; Or, Life in the Wood. New York: Dover Publications, Inc.


Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

Integrating Spirituality and Psychotherapy: A Jungian Perspective Student Author: Lynn B. Strange Academic Program: Pastoral Clinical Mental Health Counseling Faculty Advisor: Sr. Suzanne Mayer, IHM, Ph.D. Abstract: This paper explores the theory and practice of integrating spirituality and psychotherapy using the lens of Jungian Analytic Psychology. The theory, a derivative of radical analysis, enriches my understanding of the relationship between the psychological and spiritual dimensions of human existence, especially the importance of spirituality as the response to our most basic longing to be whole. Rather than simply fixing the client’s problem by removing or reducing symptoms, the Jungian perspective views the symptoms as a calling from within to expand consciousness. This paper examines the dynamics of personal transformation and growth through the three core tenets of complexes, reconciling opposites and transcendence. I include examples of my therapeutic work with individuals with whom I worked during my clinical internships. As each client told me the story of their painful experiences, I listened for their unconscious psychological complexes which blocked their access to the spiritual meaning beneath their woundedness. In addition, I listened for guidance and inspiration from my own unconscious, expecting that working through their complexes would lead to their fuller individuation. "Trust that which gives you meaning and accept it as your guide" (Jung, as cited in Stangor, 2010)


Introduction When asked if he had changed after the death of his 25-year-old son, Nicholas Wolterstorff, the Noah Porter Professor Emeritus of Philosophical Theology at Yale University, reflected in his book Lament for a Son (1987): "Have I changed? The suffering of the world has worked its way deeper inside me. I never knew that sorrow could be like this” (p. 72). As I read this passage shortly after the death of my 24-year-old son Bradley, immense gratitude flooded through me. Wolterstorff had given words to an experience for which I previously had no language. In the aftermath of Bradley’s death, for the first time I had a palpable sense of suffering in the world. With this heightened awareness, I heard an inner calling to find deeper meaning in my life. As meaning revealed itself, I trusted this new wisdom to guide me in my grief. The intensity of my motivation to find meaning grew beyond the impact of Bradley’s death itself. I was propelled on a spiritual journey driven by a profound hunger to find my authentic self. While living through my grief, I repeatedly hit roadblocks that intensified over time and sucked my energy, preventing forward movement. Led through coincidence or, as Jung calls it, synchronicity, I found a therapist who practiced Jungian psychotherapy and immediately felt her capacity to touch something essential that needed to be healed. That essential something was my soul being re-traumatized by what Jung calls a complex. Through my therapist’s guidance, I sought to understand this menacing complex


and began the inner work toward a greater sense of wholeness. It was my own personal experience with this therapy that convinced me of the power of Jungian Analytic Psychology and, I discovered, as many others have expressed, a person cannot truly understand Jung by reading his extensive publications. Rather, each individual must, as explained by respected Jungian analyst June Singer (1994), “assimilate his concepts into yourself and live them actively” (p. xiv). Overview of Analytic Psychology Similar to Maslow’s belief in the developmental potential of human beings, as illustrated in his hierarchy of needs and self-actualization, Carl G. Jung, who somewhat preceded Maslow and other Humanists, believed in every person’s potential for positive development by discovering his or her own unique and personal meaning in life. Jung’s ideas and understanding of the human condition developed out of his own experiences and self-knowledge, to which Jung (1989) attests: “My own understanding is the sole treasure I possess, and the greatest” (p. 88). After receiving a medical degree, Jung (1989) chose to pursue psychiatry, as the “two currents of my interest could flow together and in a united stream dig their own bed… the place where the collision of nature and spirit became reality” (p. 109). Unwilling to accept an entirely rational approach to psychology, Jung conceived a theory that was at odds with the conventional wisdom of his time. His resulting theory contained the discipline of


science, but was not tied strictly to a methodology. Jung incorporated religious insights, but was not bound to formal religious traditions; he valued creative energies, but was not limited by specific arts (Singer, 1994, p. 5). During an extensive period of self-analysis that Jung (1989) called a "confrontation with the unconscious" (pp. 170-99), he developed his theories of archetypes, complexes, the collective unconscious and the individuation process. He also fostered a deeper understanding of the symbolism found in dreams and other creative processes which became foundational in his clinical approach which he called Analytic Psychology. Through the years, Jung continued to develop and expand his theory by drawing on his clinical practice and his study of wide-ranging fields, such as alchemy, astrology, mythology, fairy tales and Eastern wisdom traditions. Jung viewed human development as a fluid and dynamic process that reflects the ongoing emotional, psychological, cognitive, physical and spiritual changes in life, much like Buddhist and Hindu beliefs of the ever-changing nature of people’s thoughts, feelings, and behaviors. Believing that human beings are inwardly whole, Jung thought that most of us have lost conscious contact with parts of ourselves. By accessing the unconscious through a process, he terms individuation, the ego begins to develop an appropriate relationship with what Jung calls the Self, or wholeness. Jung (1968) defines Self as “not only the centre but also the whole circumference which embraces both conscious and


unconscious” (para. 443). As an inner guide, the Self urges increasing consciousness which gives cohesion, meaning, direction, and purpose. Individuation is a process “by which every living thing becomes what it was destined to become from the beginning” (Jung, 1969b, para. 144). This innate drive towards balance and wholeness is contained in a function of the human psyche. Returning to wholeness through the process of individuation is like coming home to one’s origin, one’s Self. Although a close colleague of Sigmund Freud, Jung expanded the psychoanalytic “father’s construct,” when he conceived both a personal unconscious and a collective unconscious. The personal unconscious contains memories repressed from our own lives that reveals itself in behavior, imagination and dreams. The collective unconscious contains inherited, universal images and themes Jung termed archetypes that are present in the psyche of all people and can be traced through all of humanity (Jung, 1969c, para. 135-136). Archetypes form the core of our complexes, emotionally charged content which impact our personality and functioning in daily life. Self-awareness of unconscious dynamics allows us to recognize and defuse the power of complexes. Whereas Freud reduced psychic processes of complexes to rational explanations, Jung freely speculated on the realms of the ineffable mystery without concrete explanations. This significant difference between the two onceclose friends led to disagreements and eventually disrupted their relationship.


Jungian analysis is considered a dialectical process, a polemic within the Self to reach an awareness and understanding of unconscious material. The primary aim is to create an ongoing relationship between the client’s conscious and unconscious to promote the movement toward psychological wholeness. Singer (1994) notes a distinguishing feature of the analytical approach is that therapists are “not merely observers … but active partners in a mutual endeavor” (p. 25). Both therapist and client influence each other to bring about transformation and personal growth. With receptivity, the counselor listens to “hear the feeling behind the words,” continually clarifying “to make sure the intended message is getting across,” and assessing “the patient’s motivations and capacity for carrying on therapy” (p. 25). Beyond spoken words, the therapist listens to the tone of voice and observes the degree of sincerity revealed through facial and body language. Tuning into the overall expression of the client forms an essential part of the therapeutic process. Jung (1969a) wrote, “If a doctor wants to guide another, or even accompany him a step of the way, he must feel with that person’s psyche” (para. 519). This will not happen if the therapist is judgmental. Unless the most difficult aspects of a client are accepted by the therapist, the client will not feel understood nor inclined to share his/her inner experience. Respecting that each person has a unique and compelling story, Jung believed that psychological instability and crisis arises when one’s story has been rejected or denied. Jing


(1976) writes, “Most people need someone to confess to, otherwise the basis of experience is not sufficiently real” (para. 1811). When individuals can hear their own words and “confess to” another, they see their story with new eyes and deepen self-understanding. Jungian psychotherapy aims to harmonize inner conflict through three core tenets: identifying complexes, reconciling of opposites and transcendence. The process of individuation makes possible the metamorphosis from caterpillar to butterfly, a transformation that awakens authenticity, wonder, and a reverence for life. Complexes Early family life contains expectations and messages, spoken and unspoken by caregivers and siblings, which impact children’s values and beliefs. Each affect how, as children grow, they perceive and process their lives. Over time, thoughts, feelings and experiences are forgotten or repressed and reside in the personal unconscious. A central aspect of Jungian theory is the significant influence that the personal unconscious exerts on present thoughts, emotions and behaviors. Singer (1994) makes the point that the forces include both negative unacceptable images and positive rich sources of creativity and direction (p. 88-89). A withdrawal from consciousness that occurs in each person from time to time was recognized by Jung (1960) to arise from the presence of clusters of ideas, thoughts, memories, and perceptions he referred to as "feeling-toned complexes" (para. 74). These


clusters of emotionally-charged content suspend the person’s attention and redirect his or her thinking and behavior. Jungian analyst Susan Schwartz explains: “Complexes either repress or promote consciousness, inhibit or inspire, hinder development or provide the seeds for new life” (as cited in D’Andrea, Ivey & Ivey, 2012, p. 237). The relevant insight does not involve which part of polar opposites the complex falls, but instead whether or not the complexes control the person. When the complex controls the individual, an imbalance between consciousness and the unconscious negatively impacts his/her mental health. Negative complexes indicate unresolved problems that grow from emotional wounding and are often the root of despair. Whenever a stimulus word or experience touches the hidden complex, the individual feels an exaggerated emotional reaction, as was the case with my roadblock in the grief process. Negative complexes repress consciousness, hinder development and split off the feeling of pain from awareness, “as if the complex were an autonomous being” (Jung, 1969b, para. 21). As Jungian analysts Sandner and Beebe (1984) explain, “splitting is normal … [but] … becomes pathological or diagnosable as illness, only when the splitting off of complexes becomes too wide and deep and the conflict too intense” (p. 296). Counseling aims to guide clients to identify negative complexes by bringing them into conscious awareness. The objective is to recognize the strong feeling tone and create strategies for managing this split-off personality, not get rid of


the complex. As the complex slowly becomes conscious, it is possible to reduce or even disengage the complex’s volatile, negative force on the client’s energy. When the negative complex is strongly charged and overpowering, the wounding often stems from a caregiver relationship. As described by Jung’s long-time associate Jolande Jacobi (1959), “Unbeknownst to them, the words, opinions, desires, and strivings of the mother or father have taken possession of their ego,” causing “difficulties of adaptation” and a “relative loss of reality” (p. 15-16). At the core of a complex is an archetypal symbol. The Great Mother, an expression of the feminine, correlates with mother nature. As explained by Jungian analyst Edward Edinger (1968), the positive aspect of “the great mother corresponds to the unconscious which can nourish and support the ego or [the negative aspect] can swallow it up in psychosis or suicide” (p. 13). The archetype of the Spiritual Father is an expression of the masculine as relating to spirit, light and the heavens. Edinger (1968) clarifies that “the positive aspect of the spiritual father principle conveys law, order, discipline, rationality and inspiration. Its negative aspect is that it may lead to alienation from concrete reality causing inflation … or presumption that generates grandiose thoughts” (p. 13-14). Many of my clients from my internship site experienced extremely difficult parental relationships which manifested in negative complexes. If the client’s mother complex is negative, Jung suggests that he/she may assign positive qualities to the therapist that were


unavailable in his/her mother, commenting, “Nothing in the world embraces us so completely as the mother.” Jung (1956) continues, “When the neurotic complains that the world does not understand him, he is telling us … that he wants his mother” (para. 682). When contact with the positive complex becomes active in the treatment, the client reexperiences his/her intense inner need to be recognized by another person. One of my clients, Ann (pseudonym), was a 40-year-old woman who endured a chaotic upbringing as she was subjected to the pervasive verbal abuse and drug addiction of her family. “Ann’s” maternal relationship was tumultuous, creating within her feelings of being unlovable and unacceptable. Caught very young in the negative mother complex, Ann sought the safety and found the positive mother in a kind, understanding neighborhood woman. Even as a child, something called out to her to stay alive, an impulse to individuate. The relationship gave her the inner strength and insight to seek the opposite of her maternal experience. As an adult, Ann turned to the masculine world of the military for protection and stability. Already vulnerable, she was targeted and overpowered by sexual abuse. When the masculine betrayed her, Ann felt annihilated by the force of a negative father complex and became terrified of men. The powerless, worthless and fearful emotions evoked by Ann’s mother and her military experience manifested in chronic depression, military sexual trauma (MST), substance abuse and an inability to adapt in life. Desperately needing someone with whom she could feel safe, Ann asked to meet with me and I embraced her therapeutically with acceptance and understanding. Employing courage and 171

intelligence, Ann gradually distanced the negative complexes and found the opposite in me, the positive mother, somehow knowing it was the only way. Reconciling of Opposites Central to his theory of Analytic Psychology is Jung’s (1966) view of the psyche as “a self-regulating system that maintains its equilibrium just as the body does” (para.330). When the system goes too far in one direction, the healthy psyche calls forth compensation and adapts through its content of opposites: conscious and unconscious, masculine and feminine, eternal and temporal. The two components are always postured against each other and thought of as dualities that are mutually exclusive. However, “For Jung, whatever is true in our conscious attitude, an attitude representing the opposite view resides in the unconscious” (Singer, 1994, p. 179) and each gives its opposite meaning. At the moment of separation in birth, we are flung into the realm of opposites and experience the tension of polarity. Jung (1956) explains: “Yearning begins at birth when we are violently thrust from our original state of mindless unity…the oneness of indifference” (para. 500). Yearning is fundamental to the human condition and the hunger to belong lies at the heart of human nature. Throughout life we experience the psychic instinct to resolve the tension of separation through the process of individuation. The Self urges increasing consciousness, unfolding of opposites and reuniting to our original state of wholeness. The Jungian perspective is to “respect the … guidance of one’s center, the source of one’s


deepest intuitions, feelings, and values” (Signell, 1990, p. 22). To reconcile the forces of opposites, Jung respected the patient’s psyche as an essential guide. With the appropriate therapeutic alliance, a client’s psyche moves toward healing itself and, as Jungian psychoanalyst Edward Whitmont (1969) describes, “Eventually the unconscious will begin to provide … positive suggestions for possibilities of development which could reconcile the opposing positions, showing … what paths are required of us or closed to us, according to the inherent plan of the Self” (p. 294). Steered by instinctual forces, imagination awakens us to the Self, inspires the unconscious to connect with the ego and uncovers positive forces which weaken the influence of the dominating unconscious. Jung (1971) cautioned, “Passive fantasy … is always in need of conscious criticism … whereas active fantasy … does not require criticism so much as understanding” (para.714). Active fantasy or imagination is the outcome of a conscious attitude that is open to objective unreality beyond rational interpretation. Reconciling opposites is a gradual process of untangling oneself from the forces of negative energy that have become conditioned in our bodies and minds. Only confrontation with the negative complex allows the client to contend with its overpowering force to reconcile with the positive. Holding and reconciling opposites involves being true to ourselves and owning what is distasteful about ourselves. As Jacobi (1959) explains, “Something in [us] knows full well that no complex can be resolved unless [we face] the


conflict that causes it, and this requires courage, strength and an ego that is capable of suffering” (p. 18). When an individual avoids facing the real conflict, he/she displaces it with a pseudo problem and often suffers with a psychological disorder. Another client “John” was raised in a strict, patriarchal Catholic environment and endured years of his father’s disparaging verbal abuse with messages intended to shame the growing boy. Harboring deeply embedded anger, John struggled with depression, substance abuse and a negative father complex that caused intolerable pain whenever he spoke of any figure he considered masculine, including God. “Anything potent, any content highly charged with energy…has a wide range of symbolic meanings” (Jung, 1956, para. 238). The word “God” was symbolic of the punishing, overpowering masculine experience of John’s childhood. By asking to meet with me to make sense of it, he marshalled the courage to challenge the punitive, judgmental God of his childhood. John questioned “the opulence of the Church” in the face of the world’s vast homelessness. I asked him if ornate structures and clothing resembled the lifestyle of Jesus. Reflecting on Jesus, he identified with a positive image of the human son from scripture, opposite to the destructive image of the Old Testament God reinforced by his father. Reaching within, John discovered authentic truths in the deeper Self. In that moment, I felt the presence of something greater that gave him the energy to search for a different way of seeing. As John stood in the Great Mystery, he brought forth qualities of courage, resilience and hope.


Transcendence Jung refers to the transcendent function as “the mediating force between opposites within the psyche, a function that arises out of intense and concentrated conflicts within the individual” (Perluss, 2008, para. 1). In counseling, the function guides clients to become conscious of psychic tensions embedded in unconscious material of psychological opposites. The function creates a transition from one attitude to another. Jung (1984) wrote, “When there are two things that are opposites, they must be united by a third thing, that is, a new unity, not just by a compromise between the two … Unless something new comes into the relationship, it cannot work” (p. 186). The parts of a distressed or disharmonious relationship between the ego and the unconscious are united through the transcendent function, the third thing, which manifests itself in the symbolism of dreams, fantasies, visions, myths and art (Jacobi, 1959). Giving vital importance to the transcendent power of symbols, Jung (1971) explains, “With birth of the symbol, the regression … changes into progression, blockage gives way to flowing, and the pull of the primordial abyss is broken” (para. 445). Symbols serve as guides “for something divined but not yet known to the observer. Under these circumstances … it has a life-giving and stimulating effect” (Jung, as cited by Jacobi, 1959, p.97). As the transcendent function, a symbol arises from the unconscious and its life-giving effect forces the energy of opposites into a common flow towards new meaning. To illustrate, Jung


(1956) refers to: “Jesus’ challenge to Nicodemus: Do not think carnally, or you will be flesh, but think symbolically, and then you will be spirit” (para. 335). By use of example, Jung demonstrates how symbolic truths do not rely on rational or intellectual thinking, but are rooted in the structure of the psyche. Synthesizing pairs of opposites through symbolism has a unique healing characteristic to reestablish health and wholeness. As clarified by Hall and Nordby (1973), “A symbol is a disguised representation of a repressed wish … attempts to individuate … into a harmonious balanced whole” (p.119). When one connects with the unconscious, "it is as if a new instinct were aroused, and the soul were seized by a hitherto unknown longing; the image of earthly love pales before that of the heavenly" (Jung, 1956, para. 615). Transcendence is a way of stepping out of ourselves and into the unknown and beyond our powers of comprehension. Duality exists in the practical world of matter while transcendence moves beyond thought into unity. The transcendent function reveals the capability of uniting these opposing forces in personality and working toward wholeness as a function that is inherent in humans. Jung (1960) stressed the importance for therapists to grasp the subjective meaning of their client’s ideas and symbols to discern a sense of meaning. To understand how clients are trying to express themselves, he stressed therapists need to comprehend it "in and through ourselves” (p. 186). This "constructive understanding … analzyses, but it does not


reduce� (p. 187). Until the client is able to evoke the transcendent function independently, the therapist must hold this capacity for him/her. During my sessions with Ann, I held both the negative forces of oppression and the positive forces of nourishment to cultivate a balance of her psyche. In our fifth of six sessions, she brought her drawing of a butterfly as a parting gift to me (Figure 1). Art is an organizing principle and her drawing reflects the luminosity of the butterfly symbol. Despite all of the negative chaos and trauma in her life, she still showed the capacity for individuation through the creative imagination of this stunning gift. She drew a symbol of resurrection: the shape of a butterfly, the possibility of transcendence.


Figure 1 The drawing reflected so many dimensions of her inner life, the sharp edges of rage, the bridges of possibility and new life with a sense of reverence in feminine genitalia, not degradation. From the unconscious, Ann drew the butterfly as a symbol of the conscious ordering of the opposites revealing the transcendent aspect that touches our ability of restoring wholeness. Viewing the butterfly together, we joined in wonder and raised the transcendent moment in both of us, the Great Mystery, for her to carry forward. To deal with the punishing God, John had to make a choice: continue to numb himself with alcohol or engage in the challenging process of individuation. In choosing the latter, he came to understand that therapy held up for him the possibility of something different in Jesus, a positive image from somewhere in his past that could be integrated in the present to create a moment of transcendence. Active imagination brought the positive into consciousness and transcendence broke through to provide balance between the negative and positive. In our sessions, I held for John the numinous experience of something greater, the Great Mystery. In future therapy with John, holding the tension would not require dwelling on the past, but past experiences would need to be explored further to understand the present. Holding the tension of the past and hope for the future in the present moment is the life-giving Way of transcendence to carry him forward.


Conclusion As the various tenets reveal, Jungian Analytic Psychology “above all, is optimistic. It is not so much oriented backward toward the cause of dysfunction as it is oriented forward, toward what the psyche can be when it is fully developed” (Singer, 1994, p. 368). Oriented forward, Jungian counseling acknowledges the totality of each person and guides him/her to discover what has not been recognized or lived out in one’s life. Jungian therapy has the potential to empower individuals to live in a different way than they had previously. With heightened insight and understanding, clients often expand their lens of seeing existence beyond the gratification of their own personal needs and desires. Letting go of immature fixations and making adjustments to become a mature adult is not what most people anticipate of therapy. But as Jacobi (1959) writes, “No one who … flees the task implicit in all suffering, can ‘go through’ and receive this wisdom” (p. 138). Transformation of personality requires learning to understand a greater sense of self beyond the wounded child, which begins with discovering and claiming one’s own inner voice. The healthy ego cultivates a dialectical relationship with one’s true essence, the Self, in an effort to realize a deeper source of meaning in life. With the utmost respect for human beings and our cosmic connection, Carl Jung had a reverence for the unknown. In one of his most renowned pieces published, Jung (1989) wrote, “A person must sense that he lives in a world which in some respects is mysterious; that things happen and can be experienced which remain inexplicable; that not everything


which happens can be anticipated� (p. 356). While human beings lean towards rational thinking, Jungian Analytic Psychology provides an approach to capture the irrational, the healing power of the numinous and mysterious with a faith in that which gives us meaning. References D’Andrea, M. J., Ivey, M. B. & Ivey A. E. (2012). Theories of Counseling and Psychotherapy: A Multicultural Perspective. Thousand Oaks, CA: SAGE Publications, Inc. Edinger, E.D. (1968). Outline of analytical psychology. Quadrant: The journal of the C.G. Jung Foundation, 1, 13-14. Retrieved from Hall, C. S. & Nordby, V. J. (1973). A Primer of Jungian Psychology. New York, NY: Penguin Group Inc. Jacobi, J. (1959). Complex/archetype/symbol: In the psychology of C.G. Jung. (R. Manheim, Trans.). Princeton, NJ: Princeton University Press. Jung, C.G. (1956). Symbols of transformation: An analysis of the prelude to a case of schizophrenia. In H. Read, M. Fordham, G. Adler & W. McGuire (Eds.) The collected works of C.G. Jung (Vol. 5, rev. 2nd ed.). (R.F.C. Hull, Trans). Princeton, NJ: Princeton University Press. Jung, C.G. (1960). The Psychogenesis of mental disease. In H. Read, M. Fordham, G. Adler


& W. McGuire (Eds.) The collected works of C.G. Jung (Vol. 3, 2nd ed.). (R.F.C. Hull, Trans). Princeton, NJ: Princeton University Press. Jung, C.G. (1964). Man and his symbols. Garden City, New York, NY: Doubleday. Jung, C.G. (1966). The practice of psychotherapy. G. Adler (Ed.). Princeton, NJ; Princeton University Press. Jung, C.G. (1968). Psychology and alchemy. In G. Adler & R.F.C. (Eds.), The collected works of C. G. Jung (Vol. 12). (G. Adler & R.F.C. Hull, Trans.). Princeton, NJ; Princeton University Press. Jung, C.G. (1969a), Psychology and religion: West and east. In G. Adler & R.F.C. Hull (Eds.) The collected works of C. G Jung (Vol. 11). (G. Adler & R.F.C. Hull, Trans). Princeton, NJ: Princeton University Press. Jung, C.G. (1969b). Structure & dynamics of the psyche. In G. Adler & R.F.C. Hull (Eds.), The collected works of C. G. Jung (Vol. 8). (G. Adler & R.F.C. Hull, Trans.). Princeton, NJ: Princeton University Press. Jung, C.G. (1969c). Part 1: The Archetypes and the collective unconscious. In R.F.C. Hull (Ed.), The collected works of C. G. Jung (Vol. 9, 2nd ed.). (R.F.C. Hull, Trans.). Princeton, NJ: Princeton University Press. Jung, C.G. (1971). Psychological types. G. Adler & R.F.C. Hull (Eds.), The collected works of C. G. Jung (Vol. 6). (G. Adler & R.F.C. Hull, Trans.). Princeton, NJ: Princeton University Press. 181

Jung, C.G. (1976). The symbolic life: Miscellaneous writings. In H. Read, M. Fordham, G. Adler, & W. McGuire (Eds.), The collected works of C. G Jung (Vol. 18). (R.F.C. Hull, Trans.). Princeton, NJ: Princeton University Press. Jung, C. G. (1984). Seminar on dream analysis (W. McGuire, Ed.). Princeton, NJ: Princeton University Press. Jung, C. G. (1989). Memories, dreams, reflections. A. JaffĂŠ (Ed.). (C. Winston & R. Winston, Trans.). New York, NY: Vintage Books. Perluss, B. (2008). The transcendent function. Psyche and nature. Retrieved from Sandner, D.R. and Beebe, J. (1984). Psychopathology and analysis. In M. Stein (ed.) Jungian Analysis. Boulder, CO & London, UK: Shambhala. Signell, K. A. (1990). Wisdom of the heart: Working with women's dreams. New York, NY: Bantam. Singer, J. (1994). Boundaries of the soul. New York, NY: Anchor Books. Stangor, C. (2010). Introduction to psychology. Retrieved from Whitmont, E. (1969). The symbolic quest. New York, NY: Putnam. Wolterstorff, N. (1987). Lament for a son. Grand Rapids, MI: William B. Eerdmans Publishing Company.


Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

Effectiveness of Mindfulness-Based Programs for Veterans with PTSD: Integrative Research Review to Support Improved Patient Outcomes Student Author: Denee Gable Academic Program: Nursing Faculty Advisor: Theresa Pietsch, Ph.D. Abstract: To help treat the clinical issue of PTSD, mindfulness-based therapy has been added as an adjunct to the standard of care in order to try and address the deep psychological issues that the disorder causes. The review of the current literature on the subject examines six research studies which compared the effects of mindfulness-based therapy on the severity of PTSD symptoms against those provided with only the standard treatment. Through Neumann University’s databases and journals tab, specifically EBSCO Host CINAHL Complete, relevant research studies were found to answer the clinical question. The keywords used in the database were: veterans, PTSD, and mindfulness. The search was completed with all databases activated along with the following filters: Published within the last five years (2011-2016), full text articles, and peer-reviewed. Relevant research articles were chosen through rapid critical appraisal, with only six of the studies meeting the inclusion criteria included in the integrative research review. The findings of all the studies were consistent—all six studies showed that the severity of PTSD symptoms lessened when the patient completed mindfulness-based therapy as opposed to receiving just the standard treatment for PTSD. Introduction Just like veterans had the duty to protect our country, practitioners have the duty to protect our veterans. We must honor our veterans who made the greatest sacrifice of all—to uphold the safety of our country. As practitioners, we can honor our veterans by providing them with the most current, evidence-based treatment. This treatment extends far beyond just their physiological well-being and enters into the more complex area of their psychological health.


One psychological ailment that unfortunately many of our country’s veterans suffer from is posttraumatic stress disorder (PTSD). This debilitating disorder destroys their quality of life. Although PTSD symptoms vary from patient to patient, the clinical definition is as follows: Clinically, there are four symptom clusters that characterize and diagnose PTSD: Intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. The symptom cluster, negative alterations in cognitions and mood, is broken down further into two symptoms: persistent and distorted blame of self or others, and persistent negative emotional state. The symptom cluster, alterations in arousal and reactivity, is defined as reckless or destructive behavior (Diagnostic and Statistical Manual, Fifth Edition, Text Revision [DSM-V-TR]; American Psychiatric Association, 2013). The Veterans Administration practice guidelines recommend the standard of care for the treatment of PTSD to be pharmacologic and psychotherapeutic interventions (U.S. Department of Veterans Affairs/Department of Defense, 2010). We must ask ourselves, are prescribing pills and writing referrals to psychologists all that can be done to ease their suffering? PTSD devastates the lives of those suffering from it. The symptoms target the relationships of the veterans, leaving them feeling isolated and alone. Those suffering often turn to substance abuse to help mask these unbearable symptoms. Naturally, suicide rates are high in these veterans that are forced to battle this awful and unique disorder. A veteran’s war does not end just because they have returned home. They may live the rest of their lives haunted by moments in time that so stressed the human condition that they relive them over and over again. 184

Tragically, for many, their only escape is to take their own life. According to the U.S. Department of Veteran Affairs, based on the most recent data available, in fiscal year 2009, the suicide rate among male Veteran VA users was 38.3 per 100,000, compared to 12.8 per 100,000 in females (Hudenko, Homaifar, & Wortzel, 2016). Based upon these saddening statistics for our country’s veterans, the burning clinical question this integrative review seeks to answer using the format of PICOT (Population, Intervention, Comparison of Intervention, Outcome, Time) is this: In veterans with PTSD, how does the standard of care or treatment as usual of pharmacological intervention with cognitive behavioral therapy compare to using mindfulness-based therapy as an adjunct to the standard treatment, affect the severity of PTSD symptoms and quality of life after eight weeks? Many behavioral interventions exist to address the overwhelming symptoms, but most recently it is recognized that these interventions do little to address the larger holistic issues affecting the PTSD sufferers. Addressing this concern is where the concept of “mindfulness” was born. Kabat-Zinn defines mindfulness as paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally (Kearney et al., 2012). Research is recently showing that mindfulness allows sufferers of PTSD to better manage the symptoms of the disorder. A common method of teaching mindfulness is a series of classes called mindfulnessbased stress reduction (MBSR) founded by Jon Kabat-Zinn in 1979. This specific method progresses toward the goal of these studies. Prior research supports the findings that mindfulness-based treatments are an up-and-coming intervention for 185

management of not only PTSD but for many other ailments such as chronic pain and depression (Kearney et al., 2012). All of this is evident through many current and credible research studies. Methods Through Neumann University’s databases and journals tab, specifically EBSCO Host CINAHL Complete, relevant research studies were found to answer the clinical question. The keywords used in the database were: Veterans, PTSD, and mindfulness. The search was completed with all databases activated along with the following filters: Published within the last five years (2011-2016), full text articles, and peer-reviewed. Relevant research articles were chosen through rapid critical appraisal, with only six of the studies meeting the inclusion criteria included in the integrative research review. The Melnyk Pyramid was used to evaluate the quality of evidence for all six research studies. The Melnyk Pyramid is a reliable resource and provides strategies and information on conducting research in nursing (Melnyk & Fineout-Overholt, 2011). The Melnyk Pyramid provides the appraiser with levels of evidence ranging from level I to level VII. Level I is the highest quality of evidence consisting of systematic reviews and meta-analysis of randomized controlled trials. Level VII is the lowest quality of evidence consisting only of expert opinion. All of the studies were analyzed and appraised individually for their quality and strength of evidence.


Findings Mindfulness-based therapy is effective for helping veterans suffering from PTSD. All six studies, namely studies by Kearney, McDermott, Malte, Martinez, & Simpson., (2012), Kearney et al. (2013), King et al. (2013), Marzabadi and Hashemi Zadeh, (2014), Polusny et al. (2015), and Possemato et al. (2016), support the effectiveness of mindfulness-based treatment as an adjunct to the standard of care for veterans with PTSD. All studies report that the veteran participants showed improved outcomes. Findings from Marzabadi and Hashemi Zadeh’s (2014) study show that mindfulness techniques have a significant positive effect on mental health. Similarly, the Kearney et al. (2012) study found that veterans participating in the MBSR program experienced significant improvements in measures of mental health. Specifically, depression and PTSD symptoms including experiential avoidance and behavioral activation, along with mental and physical health-related quality of life were improved. Likewise, according to the Kearney et al. (2013) study, after undergoing mindfulness-based therapy, veterans experienced clinically meaningful changes in both PTSD symptoms and health-related quality of life. Consistently, findings from the King et al. (2013) study, show that the number of treatment completers with “clinically meaningful” improvements in PTSD symptoms was significantly greater in those completing mindfulness-based cognitive therapy (MBCT) compared to those only completing the usual treatment. The Polusny et al. (2015) study also found that the participants receiving MBSR therapy showed significant improvement in PTSD symptoms. Finally, the Possemato et al. 187

(2016) study found that veterans who completed mindfulness-based therapy reported a decrease in the severity of their PTSD symptoms and depression symptoms as opposed to those undergoing traditional treatment. Similarities and Differences in Methods of Studies Five out of the six studies were conducted in the United States in a VA setting while one study was conducted in Iran. Four out of the six research studies used a randomized controlled trial design when assigning veteran participants to groups, namely studies by Kearney et al. (2013), Marzabadi and Hashemi Zadeh, (2014), Polusny et al. (2015), and Possemato et al. (2016). There are common sample characteristics that are consistent among all six research studies. The common characteristics are veterans with combat PTSD and adults—predominantly males. Five of the research studies used questionnaire-type tools for measurement of PTSD symptoms. The study by Marzabadi and Hashemi Zadeh, (2014), also used questionnaire-type tools, but measured quality of life as opposed to PTSD symptoms. Three out of the six articles, namely those by Kearney et al. (2012), Kearney et al. (2013), and Polusny et al. (2015) used the PTSD Checklist Civilian version (PCL-C) to assess PTSD symptoms. Two out of the six studies, namely those by King et al. (2013) and Possemato et al. (2016) used clinician administered interview (CAPS) and a self-report checklist. Also, one out of the six studies namely Marzabadi and Hashemi Zadeh’s (2014) study used the World Health Organization (WHO) Quality of Life Questionnaire-26 (WHOQOL-26). All six research studies provided 188

information on the validity and reliability of the measurement tools used in their studies to allow the reader to appraise the tools’ credibility. All six research studies used high quality data analyses. Researchers Marzabadi and Hashemi Zadeh (2014), and Possemato et al. (2016), used Repeated Measure ANOVA function of SPSS version 17 to analyze their research data. Furthermore, Possemato et al. (2016) also utilized the intention-to-treat analyses as did three other studies, namely Kearney et al. (2013), King et al. (2013), and Polusny et al. (2015). In addition to the intention-to-treat analyses, these three studies also utilized “completer” analyses. One article used descriptive statistics, mediation analyses, and linear mixed model, namely by Kearney et al. (2012). Discussion The integrative review seeks to critically appraise and evaluate the six research studies selected. The six selected studies address the psychological problem of PTSD. As innovations transpire and new techniques are developed, addressing PTSD effectively and holistically becomes possible. Mindfulness-based programs have the potential of becoming an effective, holistic approach to reduce the severity of the unbearable symptoms associated with PTSD for our country’s veterans, in turn improving their quality of life. However, any new innovational intervention requires practitioners to call upon research and evidence to support its usefulness. The integrative review supports the usefulness of mindfulness-based programs. Although each article used and analyzed a slightly different mindfulness program, the outcomes were synonymous. Two out of the six studies, namely those by Kearney et al. (2012) 189

and Kearney et al. (2013) utilized an eight-week MBSR program based off of Kabat-Zinn’s MBSR program. Both studies compared the control group which received treatment as usual (TAU) and the experimental group that received MBSR training. Researchers King et al. (2013) also utilized an eight-week program that they termed MBCT. However, similarly to the Kearney et al. (2012) and Kearney et al. (2013) studies, the control group received TAU and the experimental group received mindfulness training. Furthermore, two other studies, namely those by Marzabadi and Hashemi Zadeh, (2014) and Possemato et al. (2016) utilized a brief four-week mindfulness program, also based off of Kabat-Zinn’s MBSR program. Similarly to Kearney et al. (2012), Kearney et al. (2013), and King et al. (2013), the control group received TAU and the experimental group received mindfulness training. Researchers Polusny et al. (2015) utilized a nine-week MBSR program. However, unlike the five other studies, these researchers compared the control group that received present-centered group therapy to the experimental group that received MBSR training. Present-centered group therapy controls for nonspecific therapeutic factors by providing professional contact, a credible therapeutic rationale, and corresponding specific ingredients (e.g. problem solving) for reducing distress (Polusny et al., 2015). Despite the slight differences in mindfulness training and comparison groups, all studies showed improved outcomes. All six studies present substantial statistical evidence that providing mindfulness training to veterans with PTSD decreases the severity of symptoms thus leading to an improvement in their quality of life.


Why do mindfulness-based techniques support improved patient outcomes? The answer is hidden within PTSD itself. According to Marzabadi and Hashemi Zadeh’s (2014) study, PTSD causes the sufferer an increase in negative thoughts that weave together to create an unchangeable reality. They lose control of their own mental landscape. Mindfulness-based therapy helps those suffering to regain some control over their mind. The negative thoughts still occur, but now the patient has the ability to ignore them. Just being able to ignore the thoughts and mental phenomena associated with PTSD breaks the curse of seeing it as an unchangeable reality. According to Marzabadi and Hashemi Zadeh (2014), mindfulness training also helps to modify judgeless feelings. PTSD can cause the patient to feel guilt-ridden; therefore the patients judge themselves. Mindfulness-based therapy helps the patients to stop judging themselves for feeling the way they do. It helps them better understand their feelings and aids them in creating judgeless thoughts. Naturally, this leads to reduced stress overall. As a whole, mindfulness techniques were found to aid those suffering from PTSD by making them more cognizant of what they are feeling and of not passing blame on those feelings. Quality and Strength of Evidence Four out of the six research studies chosen for this integrative review are a Level II on the Melnyk Pyramid. Level II is characterized as a randomized controlled trial (Melnyk & FineoutOverholt, 2011). According to the Melnyk Pyramid, these four articles are considered to be a strong level of evidence leading to their credibility. The four research studies that utilized a randomized clinical controlled trial are, namely by Kearney et al. (2013), Marzabadi & Hashemi 191

Zadeh, (2014), Polusny et al. (2015), and Possemato et al. (2016). Two out of the six research studies are a level III on the Melnyk Pyramid slightly decreasing the strength of evidence however albeit minor. According to the Melnyk Pyramid, Level III is considered a qausiexperimental controlled trial without randomization (Melnyk & Fineout-Overholt, 2011). The research studies that utilized this particular strength of evidence are namely by King et al. (2013) and Kearney et al. (2012). Despite the six research studies being appraised at such high level of evidence, there are limitations to be noted. In regards to generalizability of the studies, almost all reported sample participants are veteran males; moreover three out of the six studies reported using mostly Caucasian veteran males. Furthermore, one research study was conducted outside of the United States in Iran, which may cause generalizable issues. Also, to be noted, all six studies used the DSM-IV-TR for diagnostic criteria for PTSD. This is not the most updated version; the most updated version, DSM-V-TR, was published in 2013. Moreover, three out of the six studies were published in either the year of 2012 or 2013, which more than likely interfered with the researchers using the most current diagnostic criteria for PTSD. Implication to Practice Based on the evidence provided by these six research studies, mindfulness-based interventions can serve as an adjunct to the standard of care or TAU for veterans with PTSD. Practitioners must practice to their full ability and treat patients with the most current and effective interventions. Mindfulness-based interventions serve as a holistic approach for additional treatment to this debilitating psychological disorder. Particularly for clinicians 192

practicing in a primary care setting, mindfulness training allow for health promotion and prevention as opposed to our veterans needing an acute inpatient intervention. When an acute intervention is necessary, treatment has already failed. Not only is this significantly negative for the patient’s health, but it is a costly financial burden as well. This burden can be removed by simply integrating mindfulness-based therapy into current PTSD treatment. Mindfulness based therapy is not only cost effective, but is simple to implement. Therapy does not consist of costly medications or complicated medical procedures. It is simply teaching the patient a new way to think and perceive what they are experiencing while guiding them to prioritize and compartmentalize their feelings. Conclusion A primary health care provider’s duty to provide patients with holistic care requires focus not just on physiological issues, but psychological ones as well. The pervasiveness of PTSD is a recognizable testament to this duty. Occurring most often in individuals who have faced life threatening situations, veterans of war are highly affected as many were faced with life threatening situations for months or even years on end. Veterans are a special group of individuals, not just because of the prevalence of this disease in their population, but because many developed this disorder making a sacrifice for this country. Current treatment of prescribing pharmacological interventions and referring for cognitive behavioral therapy is helping, but not solving the issue on its own. If there is anything 193

additional to aid in treatment, then it should be applied rigorously. Research shows that there is additional treatment available that is effectively making a difference. Additional treatment, along with the standard treatment, is aiding to the care of this special population suffering from this terrible disorder. The treatment is mindfulness-based therapy. Mindfulness therapy is a way of becoming more aware of one’s present experiences. It has many components, the most popular of which is meditation. It appears that this therapy is helping the veterans in two ways. The first is helping them become more aware of the present moment. The present moments in which they are no longer involved in those life threatening situations. Those present moments, where they no longer have anything to fear. The second is by helping them through acceptance. It can be safely assumed that the memories of the past, the imprints of the horrors of war, must replay in the minds of these modern warriors. The damage is not done simply with the recalling of the images, but with the judgments that go along with them. Veterans are constantly judging these memories and thoughts leading them to churn up strong, damaging emotions day after day. Turning these thoughts off is near impossible, but by accepting the thoughts, it helps them to experience these thoughts without the damaging judgments that typically go hand-in-hand with them. The research is clear: Mindfulness-based therapy aids in the treatment of PTSD without being a disproportionate burden, therefore it should be implemented as an adjunct to the standard treatment. Although the results of the six studies are explicit, constant research is necessary to continue supporting these findings. 194

References: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed. text rev.). Washington, DC: Author. Hudenko, W., Homaifar, B., & Wortzel, H. (2016). The relationship between PTSD and suicide. Retrieved from Kearney, D. J., McDermott, K., Malte, C., Martinez, M., & Simpson, T. L. (2012). Association of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample. Journal of Clinical Psychology, 68(1), 101–116. Kearney, D. J., McDermott, K., Malte, C., Martinez, M., & Simpson, T. L. (2013). Effects of participation in a mindfulness program for veterans with posttraumatic stress disorder: A randomized controlled pilot study. Journal of Clinical Psychology, 69(1), 14-27. doi:10.1002/jclp.21911 King, A. P., Erickson, T. M., Giardino, N. D., Favorite, T., Rauch, S. A., Robinson, E., & Liberzon, I. (2013). A pilot study of group mindfulness-based cognitive therapy (MBCT) for combat veterans with posttraumatic stress disorder (PTSD). Depression & Anxiety, 30(7), 638-645. doi:10.1002/da.22104 Marzabadi, E. A., & Hashemi Zadeh, S. M. (2014). The effectiveness of mindfulness training in improving the quality of life of the war victims with post traumatic stress disorder (PTSD). Iranian Journal of Psychiatry, 9(4), 228-236. 195

Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare. Philadelphia, PA: Lippincott Williams & Wilkins. Polusny, M. A., Erbes, C. R., Thuras, P., Moran, A., Lamberty, G. J., Collins, R. C., & Lim, K. O. (2015). Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: A randomized clinical trial. JAMA: Journal of the American Medical Association, 314(5), 456-465 10p. doi:10.1001/jama.2015.8361 Possemato, K., Bergen-Cico, D., Treatman, S., Allen, C., Wade, M., & Pigeon, W. (2016). A randomized clinical trial of primary care brief mindfulness training for veterans with PTSD. Journal Of Clinical Psychology, 72(3), 179-193. doi:10.1002/jclp.22241 U.S. Department of Veterans Affairs/Department of Defense. (2010). Clinical practice guideline for management of post-traumatic stress. Washington, DC: Veterans Health Administration.


Nursing & Health Sciences

Neumann University Catalyst: Journal of Student Research and Academic Scholarship Vol 3, Spring 2018

Mandating Cardiac Pre-Participation Screenings in Adolescent Athletes Student Author: Taylor Krupiak Academic Program: Nursing & Health Sciences Faculty Sponsor: Kathleen Neal, Ph.D. The sudden death of a young, seemingly appearing healthy athlete is a rare, yet tragic event. Athletes, especially those who are at the age of adolescence, are expected to be at the greatest physiologic state. The thought alone of one suddenly dying during a sports game or other form of exercise is truly bone chilling. A seemingly more bone-chilling aspect is that this event could potentially be avoided. The most common cause of an athlete’s death on the playing field is sudden cardiac death, or SCD (Schmied & Borjesson, 2014). The phrase “sudden cardiac death” is thought to be an umbrella term that covers many different disorders that all lead to one dying due to their heart stopping abruptly. Morse and Funk (2012) have claimed that, “The most prevalent cardiovascular conditions that contribute to sudden cardiac death are hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, coronary artery anomalies, arrhythmias, and ion channel disorders” (p. 64). These conditions will be further discussed in the paragraphs below.


The question then raised is, if there are conditions that cause the heart to stop abruptly without warning, what can be done to prevent them from occurring? The answer is to revise the requirements of a typical pre-participation sports physical. By incorporating more extensive cardiac screenings into sports physicals, cardiac abnormalities would be detected in time to save a young athlete’s life. This paper will discuss the heart abnormalities that cause sudden cardiac death, screenings currently used, and recommendations for diagnostic tests to be included in sports physicals. One of the most commonly seen causes of SCD is hypertrophic cardiomyopathy (HCM). Spiers and Durrant define hypertrophic cardiomyopathy as “an inherited autosomal condition that results in an increase in the total mass of the left ventricle without compensatory dilatation of the ventricular chamber. This then leads ventricular filling to decrease during the diastolic phase of the cardiac cycle” (p. 72). If ventricular filling is decreased, less blood is then available to be pumped out of the heart and into the circulatory system. A classic sign of HCM is an increase in the size of the septal wall, leaving it disproportionate to the other side of the heart. “Due to this thickening, the ejection of blood into the aorta is reduced, which may cause syncope or temporary loss of consciousness” (Durrant & Spiers, 2012). HCM accounts for 36% of SCD in athletes younger than 36 years old (Funk, Morse, 2012). Upon physical examination, HCM could be detected via auscultation of a systolic murmur. However, this murmur decreases in intensity when a patient is lying in supine position


(Durant & Spiers, 2012). If a physician did not auscultate the patient’s heart sounds while they are sitting up, this murmur could go undetected. However, according to Spiers and Durrant, “ECG findings occur in 90% of patients with HCM. The classic ECG findings include evidence of increased QRS voltages with one or more of the following: left atrial enlargement, left-axis deviation, left-ventricular strain pattern, and pathological Q-waves” (p. 73). This data then supports that with the implementation of an ECG, hypertrophic cardiomyopathy (HCM) could be detected in 90% more patients with the underlying disease (Durrant & Spiers, 2012). Another underlying cause of SCD is arrhythmogenic right ventricular cardiomyopathy, or ARVC. Jason Womack (2015) states “Arrhythmogenic right ventricular cardiomyopathy is an inherited condition that occurs when the proteins that hold the heart together do not develop correctly and cannot keep the heart muscle cells intact. The muscle cells then become detached and fatty deposits build up in an attempt to repair the damage” (p. 209). As a result of this condition, the right ventricular wall of the heart becomes thin and dilated and blood does not circulate as it should. ARVC also causes abnormalities in heart rhythm. This is caused by the interruption of the heart’s electrical impulses as they attempt to pass through areas of damaged myocardium (Womack). ARVC accounts for four percent of all cases of SCD in the United States (Durrant, Spiers, 2012). According to Morse and Funk, “ARVC leads to arrhythmias that are exacerbated during exercise” (p. 64). Although this low percentage shows that the condition is rare, it is a


condition that kills young athletes. It is difficult to detect on a physical exam due to it occurring with little to no symptoms. However, Morse and Funk claim that “A resting 12-lead ECG reveals abnormalities that include T-wave inversion, right bundle branch block, and prolongation of the QRS complex in the right precordial leads” (p. 65). A normal, healthy heart’s anatomy will include a main coronary artery on the right and left sides of the heart. These two arteries originate from the sinuses of Valsalva. To be considered for a diagnosis of a coronary artery anomaly, a deviation from normal anatomy must occur. Coronary artery anomalies account for 17% of SCD in the United States (Funk & Morse, 2012). Coronary artery anomalies can cause SCD by causing a condition called transient myocardial ischemia to occur, most commonly during exercise (Funk & Morse, 2012). Transient myocardial ischemia essentially is a lack of blood flow to the cardiac muscle tissue. When there is little to no blood flow circulating to your heart muscle, or any muscle, the muscle has the potential to die. This is due to the fact that blood carries many nutrients in it that the body needs to survive, especially oxygen. The current physical examination would not detect this abnormality, but a CT scan and a MRI would (Durrant & Spiers, 2012). There are many different types of arrhythmias and ion channel disorders that contribute to the event of SCD occurring. Before the description of these disorders are given, it is important to understand the different parts of an ECG reading. As a whole, an ECG reading describes a PQRST segment of the heart. This segment describes the electrical conduction of a heart’s beat


(Woodrow, 2009). The disorders that can attribute to SCD affect the QT interval and the ST segment. The QT interval shows the ventricular depolarization of the heart (Woodrow). The ST segment shows the ventricular repolarization (Woodrow). To put it simply, both of these segments of the heart affect how the heart beats via its electrical conduction system (Woodrow). If there is an error in either of these, it can affect the how the heart pumps, which will then affect your blood circulation. These errors are then classified into disorders which will be further explained below. Two common dysrhythmias that would appear on an ECG reading are long QT syndrome and Brugada syndrome. Wever-Pinson, Myerson, and Sherrid (2009) state, “Long QT syndrome is an arrhythmia that is caused by ion channel mutations in the cardiac fibers” (p. 920). When an individual has long QT syndrome, the heart beats very rapidly and chaotically. This predisposes a person to ventricular fibrillation and can cause sudden death. Brugada syndrome is also a life threatening arrhythmia. “Brugada syndrome is a genetically inherited condition that results in the loss of function in sodium ion channels” (Wever-Pinson et al., 2009). Due to this condition, ST segments are elevated and subsequent ventricular arrhythmias occur. Both long QT syndrome and Brugada syndrome would only be made evident to a physician via an ECG reading (Durrant, Spiers, 2012). Sudden cardiac death does not occur very frequently in young athletes. However, when it does, it is a traumatic event and leaves an impact on everyone who witnessed the event.


Although it is a rare event, it is a preventable one with the implementation of more thorough screenings at the pre-participation level. Each year, over seven million athletes will participate in high school sports. Estimates vary that there are 0.4-2.3 deaths per 100,000 due to SCD. These numbers yield anywhere from 20 to 200 adolescents dying due to sudden cardiac death this year (Funk & Morse, 2011). According to Spiers and Durrant (2012), “In the United Kingdom, 12 apparently fit and healthy young people, under the age of 35 years-old, will die from undiagnosed cardiac disorders, known as sudden cardiac death. The risk of sudden cardiac death doubles during physical activity and is a 2-3 fold higher in athletes” (para. 2). This is due to the stress that physical exercise puts on the heart. A well-functioning heart can take the stress of exercise, but one with the life-threatening conditions listed above cannot. The preparticipation exam, or PPE, plays a vital role in an athlete’s safety and health. Womack (2015) describes the preparticipation physical exam (PPE) as, “a widespread mechanism that is currently used to detect illnesses or injuries in athletes that may predispose them to further complications in athletic participation” (pg. 209). It is a requirement in the United States for high school athletes to undergo a PPE before being granted permission to participate in sports. The requirement of a PPE was put into place for many reasons, but one primary reason was to detect abnormalities in the cardiovascular system (Womack). The American Heart Association recommends that a PPE include questions that range from personal


questions to family history to gather subjective data. The PPE also will then include a physical exam which will include objective data found by a physician (Maron et al., 2007). The American Heart Association recommends that a patient should be questioned about relatives younger than 50 years-old that may be suffering from heart disease or have died from SCD (Maron et al., 2007). To gather data about a patient’s personal history, questions should be pertaining to a history of “a heart murmur, systemic hypertension, fatigue, syncope, dyspnea, and chest pain” (Maron, et al.). On the physical exam, physicians are required to auscultate for heart murmurs, check femoral pulses, and check brachial blood pressure (Womack, 2015). Any abnormal findings would then encourage the physician to have more extensive diagnostic tests conducted before that athlete would be allowed to participate in sports. How effective is the current PPE at detecting cardiac abnormalities that may result in SCD? A case series conducted by Maron et al. (1996) displayed that “the ability of the PPE to recognize a cardiac abnormality that could cause SCD was 0.9%” (Womack, 2015). Womack (2015) states, “SCD occurs without prior symptoms or family history in 80% of cases” (pg. 209). This statement thus proves the point that the current PPE needs to be reexamined. If 80% of the cases of SCD occur without prior symptoms or family history, then the current requirements of the PPE will not detect the majority of these cases. A study conducted by Maron et al. examined SCD in deceased young athletes. This study examined 156 athletes that died suddenly in the United States over a ten-year period between 1985 to 1995. Of these 156 athletes, 134 of them


had died due to an underlying cardiac condition. The median age of these athletes was 17 yearsold. Identified through an autopsy, 50 out of the 134 athletes had died from hypertrophic cardiomyopathy (Maron, et al., 1996). This study also identified that with the use of the currently required pre-participation physical examination cardiac abnormalities would only be suspected in 3% of them and a diagnosis would only be given to 1% (Morse & Funk, 2012). This study also helps to prove that the current PPE is faulty and in need of change to provide more accurate detection of underlying cardiac conditions that can predispose an athlete to SCD. Morse and Funk (2012) claim, “A focused history and physical will detect 2-6% of underlying cardiac abnormalities. By adding an electrocardiogram as part of the exam, this increases the sensitivity to 50%” (pg. 93). An electrocardiogram is a diagnostic test that has advanced health care in many ways. Moss (2007) defines an electrocardiogram, or ECG as, “a device used to detect evidence of underlying disorders such as HCM, ARVC, long QT syndrome, Brugada syndrome, and manifestations of premature atherosclerotic coronary disease” (pg. 2825). Morse and Funk (2012) provide the information that, “measuring the QT interval allows the clinician to use concrete guidelines to assist in diagnosing cardiac abnormalities” (pg. 66). To further explain this, an ECG will provide a physician with the proper physical data that is needed to diagnose conditions that can cause SCD. If a physician was listening for a systolic murmur, there could be many things that could interfere with the evidence of that. One physician may be able to detect a


murmur easier than another. However, with an ECG, it is a machine that can provide solid data that a physician could then read and detect a cardiac abnormality with ease. There are different types of ECG testing that could be done on an athlete; Both resting and stress ECG testing have been found to detect abnormalities in a heart’s rhythm that would lead a physician to a diagnosis and the ultimate prevention of SCD (Morse & Funk, 2012). Currently the American Heart Association’s requirements for a preparticipation physical exam does not include diagnostic testing with an ECG. However, the addition of an ECG has been endorsed by The International Olympic Committee (IOC) and European Cardiology Society (ECS). “The ECS and International Olympic Committee both recommend a standard 12lead ECG screening of athletes prior to participation in competitive sports in addition to a comprehensive history and physical examination” (Funk & Morse, p. 68). The ESC states that screening should begin when an adolescent begins to take part in competitive sports activity. For the majority of adolescents, this initiation is around 12-14 years-old. After that initial screening, follow up testing with an ECG should be repeated on a basis of at least every two years (Durrant & Spiers, 2012). In 1982, Italy created a law that required all athletes participating in team or individual sports undergo a preparticipation examination by a physician before they could obtain clearance and participate in their chosen sports (Durrant & Spiers, 2012). The preparticipation exam included a subjective history, physical, and 12 lead ECG test (Funk, Morse, 2012). Based on


current data, the rate of SCD in athletes has thus dropped by almost 90%. The rates of SCD in young athletes decreased from 4.0-0.4 per 100,000 (Durrant & Spiers, 2012). This decrease has been attributed to identification and disqualification of athletes with previously undetected cardiac conditions. There is a limited amount of data to determine the cost analysis of adding an ECG test to a preparticipation physical exam (Funk & Morse, 2012). However, a study conducted by Wheeler, Heidenreich, Froelicher, Htalky, and Ashley (2010) argued that, “not only is cardiacfocused preparticipation screening with an appropriately interpreted ECG cost-effective compared to no screening, but screening with a history and physical alone is not cost-effective” (p. 67). The researchers supported this statement by explaining that this is due to the “low sensitivity and specificity of these exams” (Wheeler et al., 2010). To further explain this statement, the thought is that on the rare occasion, a physician detects something that they think might be a congenital heart defect, they will then send the patient for more extensive testing. This more extensive testing could cost thousands of dollars because they might not only do an ECG, but they may do an echocardiogram, and more because of the vague detection. However, if the patient underwent an ECG as a routine test, they could find the abnormality immediately and save the money that further testing would require. Myerburg and Vetter (2007) also made a point supporting the implementation of ECGs by stating, “A result of the large number of cardiac conditions that have a genetic component” (p.


2617). They further went on to explain that with the implementation of an ECG as a routine screening, affected family members could also be identified. If a child went through a preparticipation exam and was found to have a genetically inherited cardiac abnormality, but their parents had no current history of this, the physician could then have the parents undergo testing. If one of the child’s parents did have this condition and was unaware of it, their life could be saved and the correct treatment could be then provided. This idea supports than the implementation of a routine ECG could decrease mortality rates and be cost-effective at the same time. The information in the paragraphs above make it clear that by requiring a conduction of an ECG test along with the current PPE guidelines of a history and physical, SCD could be largely avoided in adolescent athletes. The current American Heart Association guidelines currently only require a history and physical before an athlete can participate in sports. These guidelines need to be reevaluated as evidenced by the success of the Italian law requiring an ECG to participate in sports lowering the rate of SCD tremendously. The study conducted by Maron et al. in 1996 that examined deceased athletes over a ten-year period also provides evidence that the current preparticipation physical exam fails to catch cardiac abnormalities before it is too late. SCD is a rare and tragic event, but it is an event that could be avoided with the implementation of ECG screenings.


References Maron, Thompson, Ackerman, Balady, Berger, Cohen, Dimeff, Douglas, Glover, Hutter, Krauss, Mitten, Roberts, Puffer, 2007. Recommendations and considerations related to preparticipation screening for cardiovascular abnormalities in competitive athletes: 2007 update: A scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation. Circulation. 115:1643-1455. Maron, B. J., Shirani, J., Poliac, L. C., Mathenge, R., Roberts, W. C., & Mueller, F. O. (1996). Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. Jama, 276(3), 199-204. Morse, E., & Funk, M. (2012). Preparticipation screening and prevention of sudden cardiac death in athletes: Implications for primary care. Journal of The American Academy Of Nurse Practitioners, 24(2), 63-69. doi:10.1111/j.1745-7599.2011.00694.x Moss, A. J. (2007). What duration of the QT interval should disqualify athletes from competitive sports? European Heart Journal, 28(23), 2825–2826. Myerburg, R. J., & Vetter, V. L. (2007). Electrocardiograms should be included in preparticipation screening of athletes. Circulation, 116(22), 2616–2626.


Patel, A., & Lantos, J. D. (2011). Can we prevent sudden cardiac death in young athletes: The debate about preparticipation sports screening. Acta Paediatrica, 100(10), 1297-1301. doi:10.1111/j.1651-2227.2011.02337.x Schmied, C., & Borjesson, M. (2014). Sudden cardiac death in athletes. Journal Of Internal Medicine, 275(2), 93-103. doi:10.1111/joim.12184 Spiers, C., & Durrant, J. (2012). Raising awareness of the need for cardiac pre-participation screening in young athletes. British Journal of Cardiac Nursing, 7(2), 71-74. Wever-Pinzon, O. E., Myerson, M., & Sherrid, M. V. (2009). Sudden cardiac death in young competitive athletes due to genetic cardiac abnormalities. Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi, 917-23. Wheeler, M. T., Heidenreich, P. A., Froelicher, V. F., Hlatky, M. A., & Ashley, E. A. (2010). Cost-effectiveness of preparticipation screening for prevention of sudden cardiac death in young athletes. Annals of Internal Medicine, 152(5), 276-286. doi:10.7326/0003-4819152-5-201003020-00005 Womack, J. (2015). Proper screening for sudden cardiac death in the young athlete. Clinical Pediatrics, 54(3), 208-211. doi:10.1177/0009922814527507 Woodrow, P. (2009). An introduction to electrocardiogram interpretation: part 2. Nursing Standard, 24(13), 48-56


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Neumann University Catalyst Volume 3  

Journal of Student Research and Academic Scholarship

Neumann University Catalyst Volume 3  

Journal of Student Research and Academic Scholarship