Electronic Theses and Dissertations

Date of Award


Document Type


Degree Name

Ph.D. in Education

First Advisor

Richard S. Balkin

Second Advisor

Stephanie Lusk Smith

Third Advisor

Amanda Winburn


University of Mississippi

Relational Format



The foundations of mental health and well-being are built in the first five years of life. Early childhood toxic stress (i.e., repeated, excessive, or prolonged activation of the body’s stress response systems) can undermine children’s sense of safety, sense of stability, and ability to form healthy relationships. The damaging effects of toxic stress can disrupt the normal course of brain, immune, and metabolic development, placing children at increased risk for mental and physical health problems that can last into adulthood. Counselors are uniquely qualified to help prevent and treat early childhood toxic stress. Yet, gaps between counseling theory, research, and practice hamper progress towards this goal. In this systematic review and meta-analysis, I aim to bridge the gaps using the following strategic aims to identify effective interventions: 1) focus on the critical/sensitive period of development occurring during the birth to five period; 2) leverage developmental science spanning biological, socioecological, and psychological frameworks; and 3) advance health equity work.


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