Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

Ph.D. in Counselor Education


Leadership and Counselor Education

First Advisor

Lori A. Wolff

Second Advisor

Gay M. Barnard

Third Advisor

Mandy L. Perryman

Relational Format



Falender and Shafranske (2004) stated it is “essential for clinicians to develop and understanding of all the influences, from conscious beliefs and culturally embedded values to unresolved conflicts at the margin of awareness, that contribute to clinical practice” (p. 81). The purpose of this study was to meet this professional imperative by developing an instrument designed to assess moral distress among counselors working with children and/or adolescents. Using open-ended surveys and semi-structured interviews, detailed descriptions of participants’ experiences of moral distress were obtained in order to gain an initial understanding of the ways in which the phenomeonon is experienced in the context of counseling. Based on these participants’ experiences, a thematic structure was identified, from which an initial item pool was generated. A 106-item instrument was constructed, which was pilot tested with two samples, one consisting of counselors and counselor educators used to assess item and sub-theme representativeness and acceptability, and the other of laypersons used to assess non-validity issues. Inter-rater agreeability and qualitative feedback was analyzed to arrive at a parsimonious instrument that demonstrated acceptable content and face validity. As a result, a modified instrument consisting of 63 items was finalized, which assesses moral distress across eight domains, and demonstrates promising validiy overall.



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