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This thesis, entitled Hole, explores themes of family estrangement, connection, loss, and adolescent sexuality. It exists as the bones of an intergenerational novel that follows Iris, her twin sister Didi, their father Marvin, and his mother Yetta. When Iris is eleven years old, she discovers that she can make objects mysteriously disappear when she puts them in her vagina. This power goes away when she is sixteen, around the time that her grandmother dies. Now in adulthood, with a twin sister who seems to be suffering from the onset of mental illness, Iris is compelled to return to this strange period of her childhood, reconnect with her sister, and discover how their story is entwined with that of their grandmother.

Religion fractures families, and therapists working with clients in search of healing have so far had little empirical guidance on how to help. This phenomenological study is the first to explore the experiences of nonreligious Americans using therapy as a way to address religion-related family estrangement. Seventeen participants, all self-identifying as nonreligious but raised in Christian families, were interviewed about their therapy experiences. Most had seen individual therapists and preferred an individual focus but appreciated systemic conceptualizations and interventions. Nondirective, evidence-based, and, when appropriate, trauma-informed approaches were found to be most helpful. Nonreligious, especially non-Christian, therapists were usually but not always preferred. Safety and curiosity were important factors in strong therapeutic relationships and effective therapy. Participants also stressed the harm religious ideology itself can cause. Implications for training and practice, as well as limitations and suggestions for further research, are discussed.

Most crisis stabilization, and mental health treatment in general, is delivered solely to the individual in crisis, by professionals who are careful to protect the individual’s right to privacy. An unintended consequence of this objective, unfortunately, can be the undermining of the potentially significant role played by family members in the treatment, maintenance, and stabilization of individuals with mental illness. Without family involvement, some individuals burdened by mental illness slowly and steadily decline. This study investigates how familial relationships impact mental health problems, specifically psychiatric hospital readmissions. The goal of this study is to determine whether being estranged from one’s family increased the number of times an individual was readmitted to an inpatient psychiatric hospital. This study makes use of de-identified, archival data from Ventura County Behavioral Health (California), to examine the association between family support and inpatient hospital readmission rates. This data set provides information regarding clients’ previous hospitalizations, if any, Crisis Team contacts, number of years of outpatient mental health treatment, and documented family support. Furthermore, this study aims to identify possible recommendations for improving family involvement in an individual’s care in an attempt to reduce the number of inpatient psychiatric hospital readmissions. These treatment recommendations will seek to improve the quality of life for the individual suffering from mental illness, as well as their family; as well as strive to save scarce resources (personal and societal). In summary, this study aims to shine light on a bleak and controversial issue that is impacting millions of Americans. Better research may lead to earlier diagnosis and better treatment of mental illness, leading to longer, happier lives for individuals who are touched by mental illness. The consequences of inadequate treatment for the mentally ill population are too devastating to ignore. May they no longer have to bear the burden of incarceration, potentially avoidable hospital readmissions, homelessness and the stigma that follows them wherever they go. This Dissertation is available in Open Access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu and OhioLink ETD Center, http://www.ohiolink.edu/etd