Robin E Gearing

University of Houston | U of H, UH · Graduate College of Social Work

Despite the critical role of fidelity and the proliferation of intervention manuals and related measures, no comprehensive, structured guide exists, resulting in definitional confusion, varying interpretations of what constitutes core components, and inconsistent application of methods to ensure fidelity. To improve integration of fidelity criteria...

Nonadherence is the Achilles' heel of effective psychiatric treatment. It affects the resolution of mental health symptoms and interferes with the assessment of treatment response. The meaning of the term adherence has evolved over time and is now associated with a variety of definitions and measurement methods. The result has been a poorly operati...

Nonadherence to psychosocial and behavioral treatment is a significant public health problem that presents a barrier to recovery and effective treatment. An estimated 20% to 70% of individuals who initiate psychosocial mental health services discontinue treatment prior to clinicians' recommendations. Empirically supported, evidence-based, stand-alo...

Poor treatment engagement remains a challenge in effectively treating adolescents with depression. This exploratory 2-arm RCT aimed to test the feasibility and acceptability of Tech Connect for promoting treatment engagement among adolescents. Twenty youth with depression were randomized to Tech Connect (treatment) or standard community-based menta...

The Center for Mental Health Research and Innovation in Treatment Engagement and Service (MH-RITES Center) at the Graduate College of Social Work, University of Houston is an international multidisciplinary research center focused on improving treatment engagement and outcomes for those experiencing mental health concerns. Established in 2017, the...

This study employed an experimental vignette design in Jewish communities in the United States (n = 243) to investigate whether public stigma toward target individuals with major depressive disorder or bipolar disorder presenting with either mania or depression was associated with their gender and symptomatology. The Mental Illness Stigma Scale (Da...

According to the World Health Organization (WHO), more than 700,000 people take their own life every year globally. WHO also estimates that for every suicide, there are at least 10–20 acts of self-harm and about a hundred people have suicidal thoughts. Every suicide affects a large number of people in the victims immediate and extended circle of fa...

According to the World Health Organization (WHO), more than 700,000 people take their own life every year globally. WHO also estimates that for every suicide, there are at least 10–20 acts of self-harm and about a hundred people have suicidal thoughts. Every suicide affects a large number of people in the victims immediate and extended circle of fa...

Background The Evidence-Based Practice Attitude Scale (EBPAS) is a widely used measurement tool to assess mental health providers’ attitudes toward adopting research-based interventions. To date, this scale has yet to be used or validated among mental health professionals in Latin America. This study investigated the factor structure, psychometric...

Stigma toward families with members managing mental health problems remains underresearched in Latino communities. Using community-based surveys on mental health stigma and help-seeking attitudes, this study examined the associations between family-level stigma and participant sociodemographic characteristics. Only education level and spirituality...

Despite robust knowledge regarding the socio-economic and cultural factors affecting Latino* access to healthcare, limited research has explored service utilization in the context of comorbid conditions like diabetes and depression. This qualitative study, embedded in a larger mixed-methods project, aimed to investigate perceptions held by Latinos...

Most people in need of mental health services in Mexico do not seek formal support or professional services to address their mental health needs. Understanding help-seeking behaviors is crucial to addressing underutilized mental health services and to leverage health promotion efforts. Data were collected as part of a larger research project on sti...

This study examines the influence of cultural context on social distance and perceptions of stigma towards mental health conditions among Latino populations in Houston, TX, USA and Mexico City, Mexico. We employed a community-based experimental vignette survey to assess perceptions towards individuals experiencing symptoms of alcohol misuse, depres...

Federally funded medical and behavioral healthcare programs often have substantial evaluation outcome tracking and reporting requirements, which can become burdensome to program staff resulting in decreased buy-in, increased chance of staff burnout and turnover, and less rigorous and consistent data collection efforts. To address this issue, a nove...

The reported 20% prevalence rate of diagnosable mental illnesses in China might be underestimated due to individuals’ hesitation to report mental health problems. This study tested whether a person’s mental health diagnosis would lead to endorsement and preference for professional care. A community-based survey was conducted in Shanghai, China (n =...

Assisted Outpatient Treatment (AOT) is a court-mandated program intended to engage adults with serious mental illness who have challenges with voluntary treatment adherence. AOT programs are designed to promote outpatient treatment participation, reduce emergency care, and decrease justice involvement. Research has found AOT programs to be effectiv...

The reported 20% prevalence rate of diagnosable mental illnesses in China might be underestimated due to individuals’ hesitation to report mental health problems. This study tested whether a person’s mental health diagnosis would lead to endorsement and preference for professional care. A community-based survey was conducted in Shanghai, China (n =...

Objective: This study explored factors associated with public stigma toward individuals misusing alcohol in Mexico. Methods: A randomized experimental vignette methodology was used to assess multiple domains of substance use-related stigma and their relationship to the gender of the vignette subject and the sociodemographic characteristics of respo...

This study investigated the needs and attitudes toward EBPs among an interdisciplinary sample of mental health professionals in Puerto Rico. An anonymous survey was distributed to social workers, psychologists, and professional counselors (N=237). Using structural equation modeling, four dimensions of attitudes towards EBPs (openness, divergence, a...

Como la mayor población minoritaria de EE. UU. y también una de las de más rápido crecimiento, es crucial que las/os latinas/os accedan a una atención médica adecuada e integral, incluido el tratamiento de la salud mental. Las investigaciones actuales sugieren que las/os latinas/os tienen baja estima por los servicios de salud mental en general. En...

One hundred and fourteen (N=114) Master of Social Work students completed an online survey to explore whether demographic characteristics, prior international travel, and learning abroad program experience were associated with levels of CSWE competencies, racial attitudes, and attitudes toward mental health. Results indicate that multilingual stude...

Binational research is critical to better understand the health, mental health, and health outcomes of immigrant communities. Binational studies are often difficult to conduct, however, due to cost, challenges with participant recruitment and data collection, lack of appropriate cross-cultural instruments, and challenges ensuring ethical reviews an...

Stigma toward those using cocaine and other substances remains a barrier to treatment and social inclusion. As part of a larger study exploring stigma toward those experiencing symptoms of various DSM5 diagnoses an experimental vignette methodology was used to examine factors associated with stigma toward individuals using cocaine in Mexico. Result...

Public stigma toward those experiencing symptoms of schizophrenia in the general population is high; yet research into such stigma within the diverse Latino communities remains under-investigated. This study employed a randomized experimental vignette methodology to assess various domains of public stigma toward individuals experiencing psychosis a...

Suicide is considered to be a conscious and intentional act that is carried out within a social and cultural context. This study examines the unique phenomenon of a cluster of suicide attempts conducted without perceived intent, ideation, plan, volition, or agency in a remote province in Central Asia. This study investigated the lived experiences o...

Binational research is critical to better understand the health, mental health, and health outcomes of immigrant communities. Binational studies are often difficult to conduct, however, due to cost, challenges with participant recruitment and data collection, lack of appropriate cross-cultural instruments, and challenges ensuring ethical reviews an...

Introduction This study investigated differences in mood disorder public stigma endorsed by Jewish adults. Specifically, it examined the association between public stigma and the symptomatology and gender of individuals with mood disorders and characteristics of respondents. The symptomatology investigated included major depressive disorder and bip...

Stigma is a multifaceted barrier for individuals living with mental illness, contributing to negative stereotypes, prejudice, and discrimination, and is underinvestigated in minority ethnic groups. This study examines the stigma within the US Jewish communities, specifically the following: a) differences in public stigma dimensions based on mental...

While extensive research exists on mental illness stigma, few studies focus on suicide stigma, and even fewer examine stigma in specific ethnic groups that have prohibitions on suicide. The purpose of this study was to examine Jewish individuals’ stigma beliefs about suicide. A convenience sample of 242 Jewish community members completed an experim...

Objectives Despite mental health disorders being a leading cause of disability among Latinos, treatment-seeking behaviors are very low. Latinos are confronted with significant disparities in mental health treatment. This research study sought to examine (1) what are the attitudes toward professional help-seeking for mental health concerns among Lat...

Stigma, perception and beliefs about mental illness can significantly affect the ability of individuals with a mental health diagnosis to access and engage in treatment and, ultimately, their overall functioning. Despite these significant implications, the stigma towards individuals with schizophrenia, a serious mental disorder, in China is under-i...

Background: In China, mental health disorders are considered the leading causes of disability, yet treatment-seeking behaviors among individuals with mental health problems are deficient. Aims: This study sought to examine attitudes and participant characteristics associated with help-seeking among adults residing in China's Shanghai metropolita...

This study explores stigma-related beliefs within the Latino community concerning alcohol misuse. A community-based convenience sample of 251 self-identified Latino adults were recruited to participate in a research study using an experimental vignette methodology. Participants were randomly assigned one of four vignettes about alcohol misuse and a...

Suicide continues to be a significant public health concern impacting all cultural and ethnic groups in the United States. Although prior studies indicate that Latino individuals die by suicide at lower rates than their non-Hispanic White or Asian peers, recent data in this area indicate that suicide rates for Latino individuals are rising. Current...

Mental health problems are one of the leading causes of disability in China. Stigma acts as a barrier to mental health treatment. This research explores the influence of self-stigma and public stigma toward mental health care among Chinese adults. The study investigated which participant characteristics affect stigma toward mental health treatment,...

Objectives: Individuals who have experienced trauma engage more effectively when approached by professionals using a trauma-informed perspective. While trauma-informed (TI) practice has been recognized in legal settings, including immigration law, the nascent concepts are not applied widely or uniformly, and information and training about TI best p...

In Mexico, suicide and suicidal behaviors (SB) have increased 275% since 1990. Prisoners constitute a growing population in Mexico and have been identified as high suicide risk. Using a sample of 194 male prisoners, we measure what demographics and mental health symptomology are associated with suicidal ideation (SI) and SB, and identify what demog...

Background: Depression and diabetes are common illnesses affecting individuals with health challenges and family stress. Research suggested stigma-reduction interventions for families facing health-related stressors. This study examined factors predicting public stigma on depression alone or comorbid with diabetes. Methods: In Shanghai, China, cons...

Depression and diabetes are two of the most common health conditions experienced by those from Latino backgrounds. However, community-based stigma toward these health conditions may discourage those experiencing symptoms of depression or diabetes from seeking professional assistance. To assess stigma in the Latino community toward these common heal...

In the US, many people are excluded from healthcare structures and systems, due to multiple macro and micro factors. Poverty, health ecosystems, mental health, and community amenities are some of the issues confronting those who are not able to access appropriate support. This population is often referred to as ‘high needs, high cost’ (HNHC), a ter...

Religion can exert a powerful influence on human behavior, including suicide. Research has demonstrated that religiosity can potentially serve as a protective factor against suicidal behavior, but may also, at times, serve as a risk factor. In clinical practice with individuals managing suicidality, a clear understanding of the influence of religio...

Background: Public stigma is a form of devaluation by other people's negative reactions to a specific behavior or mental health condition. When dealing with the physical consequences of addiction, substance users experience distress due to negative prejudice against them and their families. Method: In Shanghai, China, a community survey was conduct...

Correctional staff work in demanding job environments that can lead to increased burnout. Research aims were to determine the prevalence of burnout and devaluation of consumers (i.e., individuals in their care) and their families among correctional staff, examine associations between burnout and devaluation of consumers and their families, and dete...

Prisons in Mexico, like other countries, struggle to house and effectively treat individuals with mental illness. This study on 194 male Mexican prisoners managing mental disorders aims to 1) explore what mental health symptomology is associated with self-stigma and 2) identify what mental health symptomology predicts increased self-stigma. Results...

China accounts for an estimated third of the world's suicides, yet individuals experiencing suicidality typically do not seek out or receive treatment. This study examines community perceptions and public stigma toward suicide. In Shanghai, China 186 adults were recruited to participate in a survey with an experimental vignette describing a suicida...

Hablar de salud mental en los espacios carcelarios nos obliga a repensar lo que entendemos por enfermedad mental, discapacidad psicosocial, discapacidad intelectual y locura. Sabemos que las personas en las cárceles o involucradas dentro del sistema de justicia penal tienen mayores tasas de prevalencia de trastornos mentales que las personas fuera...

In recent years, significant policy changes focused on immigrants migrating through the southern United States border have been implemented. To determine if there was an association between time since immigration and increases in negative mental health symptomology, 249 Mexican-American immigrants ages 18–65 were field recruited to participate in a...

Globally, mental illness ranks first among the causes of disability. In China, 17.5% of individuals have a mental illness, with only 150 people per 100,000 people receiving treatment for their diagnosis. To effectively address the growing unmet mental health needs in China, it is essential that China develops and adapts evidence-based and empirical...

This research examines students’ perceptions of how learning abroad programs furthered the development of the nine core EPAS social work competencies. Ninety MSW graduates who participated in a learning abroad course during their graduate program completed an anonymous online survey assessing the association between study abroad participation, cult...

Nearly 1.5 million people die by suicide each year globally. Most suicides occur in Asia, yet research has predominately studied suicide in the West. Suicide in Central Asia is under researched. A systematic review of the current state of literature on suicide and suicidal behavior in Central Asia is needed. The study aims to 1) examine risk and pr...

Suicide rates and risk and protective factors vary across religions. There has been a significant increase in research in the area of religion and suicide since the article, “Religion and Suicide,” reviewed these issues in 2009. This current article provides an updated review of the research since the original article was published. PsycINFO, MEDLI...

The growing literature on the negative effects of large institutions, has not translated into fundamental shifts in models of care in many parts of the world. The current study was part of a larger initiative to develop foster care as an alternative to institutions in the Hashemite Kingdom of Jordan. The primary goal was to assess the early tempera...

Introduction The importance of timely identification and treatment of psychosis are increasingly the focus of early interventions, with research targeting the initial high-risk period in the months following first-episode hospitalization. However, ongoing psychiatric treatment and service utilization after the symptoms have been stabilized over the...

Introduction Motivation and ability to engage with treatment may deteriorate or falter if a patient is not satisfied with their protocols or provider. Improving patient satisfaction may more effectively strengthen treatment engagement. Objectives 1) Determining what patients want from their provider relationship; and 2) identifying means for a pro...

The Community-Family Integration Teams (C-FIT) diversion program was developed to address behavioral and mental health treatment for justice-involved adolescents. The C-FIT pilot study, implemented in Jordan, aimed to (1) evaluate intervention fidelity and (2) assess intervention effectiveness. Adolescent males (n = 19) and their families participa...

Aim: The timely identification and treatment of psychosis are increasingly the focus of early interventions, with research targeting the initial high-risk period in the months following first-episode hospitalization. Ongoing treatment after stabilization is also essential in the years following a first-episode psychosis (FEP), but has received les...

Study objectives: Behavioral health-related emergency department (ED) visits have been linked with ED overcrowding, an increased demand on limited resources and a longer length of stay due in part to patients being admitted to the hospital but waiting for an inpatient bed. The present study examines factors associated with the likelihood of hospit...

Adolescent girls who become pregnant outside of marriage in the Middle East experience increased stigma, risk of social exclusion, and family violence. This study examined whether community-based foster care has the potential to reduce the stigma attached to pregnant girls placed in protective institutional care within an Arab context. Using data f...

After an initial meeting in 2013 that reviewed adherence to disease modifying therapy, the AD@MS group conducted a follow-up meeting that examined adherence to behavioural interventions in MS (e.g. physical activity, diet, psychosocial interventions). Very few studies have examined adherence to behavioural interventions in MS. Outcomes beyond 6 mon...

Youth in institutional care centers have higher mental illness rates compared with community populations. Research examining mental illness among youth in institutional care in the Middle East is lacking. This study examines the prevalence and correlates of depression, posttraumatic stress disorder (PTSD), and suicidality of youth in institutional...

Nonadherence to psychosocial and behavioral treatment is a significant public health problem that presents a barrier to recovery and effective treatment. An estimated 20% to 70% of individuals who initiate psychosocial mental health services discontinue treatment prior to clinicians' recommendations. Empirically supported, evidence-based, stand-alo...

Background To assess the mental health and behavioral problems of children in institutional placements in Jordan to inform understanding of current needs, and to explore the effects of placement change on functioning and staff perceptions of goodness-of-fit.Methods An assessment was completed of 134 children between 1.5¿12 years-of-age residing in...

Treatment early in the course of psychosis can improve prognostic outcomes, facilitate adaptive functioning, and reduce familial and societal burden. However, little is known about the pathway of first episode psychosis (FEP) from the perspective of highly adherent adolescents and young adults. This study sought to understand the pathways in youth...

Stigma is a fundamental barrier to seeking and engaging in mental health treatment for individuals managing depression. This study examines stigma perceptions of mental health treatment for Arab adolescents managing depression using a vignette survey completed by adults in public spaces in Amman, Jordan (n = 108). The vignette was systematically ch...

In this study we explored the ways that mothers and fathers of children who have a chronic health condition coconstructed their parenting roles. We wanted to move beyond the standard focus on individual parenting behaviors and use a grounded theory approach to better capture the dyadic and interpersonal gestalt of how parents worked out their roles...

For children residing in institutional settings, staff act as primary caregivers and often provide assessment of child psychopathology. Minimal research exists on how and when staff-caregivers are best positioned to report on youth mental health. This study examines differences between 60 staff-reported and 60 adolescent-reported Child Behavioral C...

Aim: Parents and caregivers are confronted with many challenges when caring for adolescents experiencing first-episode psychosis (FEP). Understanding and support for parental help-seeking process is essential for adolescents' timely access to treatment. The study aimed to develop a pathway model of parental help seeking for adolescents experiencin...

Background: To investigate the effects of booster sessions in cognitive behavioral therapy (CBT) for children and adolescents with mood or anxiety disorders, whereas controlling for youth demographics (e.g., gender, age), primary diagnosis, and intervention characteristics (e.g., treatment modality, number of sessions). Methods: Electronic datab...

Objective The aim of the study is to examine the impact of diversion program characteristics on social stigma of delinquent adolescents in Jordan.MethodA street survey of adults was conducted in Amman, Jordan. Respondents were randomly assigned to read one of four vignettes involving a delinquent adolescent who participated successfully in one of f...

This study reports the prevalence of emotional and behavioral problems among youths placed in juvenile correctional facilities in Jordan and describes the effect of length of stay on mental health outcomes. The Youth Self Report (YSR) was administered to 187 adolescent males (mean age=16.4, SD=1.0) in all five juvenile detention facilities in Jorda...

Social support for individuals with psychosis is associated with decreased symptom severity, improved outcomes, and recovery. In adolescents, declining social support prior to the first hospitalization has been shown to predict time to relapse, which may have implications for early intervention. Data were collected on adolescents (n=84) following a...

Objectives: This study aimed to establish the prevalence rates of mental health and behavioral problems of Arab youths residing in Jordanian care centers due to family disintegration, maltreatment, or abandonment and to examine how functioning varies by child characteristics and placement history. Methods: Child Behavior Checklist and case histo...

Background: Possible selves describe a personalized future-oriented form of self-concept that is linked to ideas about who we believe we can be (expected selves) and who we are afraid of becoming (feared selves). Research finds that individuals who possess clear ideas and goals about what they desire to do, be, or be like in the future are more lik...

Background: Adolescent girls who become pregnant outside of marriage often face heightened stigma and social exclusion. Within the Middle East, girls may also encounter the danger of increased violence from their families from violating traditional social and gender norms, including extreme acts, such as honor crimes. Consequently, in Jordan at-ris...

Stigma is a fundamental barrier to individuals seeking out mental health treatment in the Middle East. The impact of stigma may be amplified if the engagement in and utilization of mental health services for psychosis further stigmatizes individuals and their families. One hundred four Jordanians (N = 104) participated in an experimental vignette s...

For pre-exposure prophylaxis (PrEP) and microbicides to effectively prevent HIV, optimal treatment adherence is required. Adherence to these strategies, however, has not been sufficiently studied. This investigation systematically reviews oral PrEP and microbicide trials across 4 domains of adherence: 1) definition and measures used; 2) risks for n...

The perceptions and religious beliefs held by family members, mental health and health care professionals, and the community may affect the treatment of individuals with schizophrenia. To better identify and understand the influence of families, professionals and community members on individual's treatment for schizophrenia, this review paper exami...

Aim: All too often, efficacious psychosocial evidence-based interventions fail when adapted from one culture to another. International translation requires a deep understanding of the local culture, nuanced differences within a culture, established service practices, and knowledge of obstacles and promoters to treatment implementation. This resear...

Utilizing an experimental vignette design, this study assessed attitudes in the Hashemite Kingdom of Jordan toward the implementation of foster care as an alternative to institutions for children in need of care and protection. A sample of 111 adults were surveyed in Amman and presented with a vignette describing a 14-year-old boy who came into the...

Psychosocial treatments that address the unique needs of mothers with schizophrenia and their children are sorely lacking. In striving to explore and understand treatment of maternal schizophrenia, this paper focuses on two objectives: 1) to identify and examine specialty psychosocial interventions for parents, notably mothers with schizophrenia an...

As the Internet has become a ubiquitous tool for health information, the use of Internet support groups for mental health concerns has grown. Despite the widespread use of these groups, little research has examined the efficacy and effectiveness of online communities for ameliorating mental health symptoms or factors that prompt people to seek onli...

Poor adolescent adherence to mental health psychosocial treatment significantly undermines effectiveness. Approximately one-third of all youth drop out or prematurely terminate from psychosocial treatment. This study examined youth adherence to psychosocial treatment from the perspective of community-based mental health clinicians (n =34) interview...