Pathways for Healing: An Online Therapeutic Support Group Program (OTSG) is for women, ages 18 to 65 years old, diagnosed with chronic pelvic floor dysfunction (PFD). The program focuses on women living in Texas rural communities with limited access to mental health providers. The aim for this study is to determine if an OTSG program, utilizing narrative therapy (NT) within a biopsychosocial-spiritual lens (BPS-S) will improve overall health-related quality of life (HRQOL). Support groups are provided in English and Spanish, over the course of 12 weeks, facilitated by a licensed marriage and family therapist (LMFT) and licensed pelvic floor physical therapist (PFPT). Administering pre and post-tests (before 1st session, after the 6th and 12th session, and 3- and 6-months post group participation), data is collected utilizing: 1) The Functional Assessment of Chronic Illness Therapy Measurement System (FACIT-SP), 2) Pelvic Floor Impact Questionnaire-Short Form 7 (PFIQ), 3) Pelvic Floor Distress Inventory- Short Form 20 (PFDI-20), 4) Beck Depression Inventory-II (BDI-II), 5) RAND 36-Item Health Survey (SF-36), 6) Check-In, Check-Out Oral Report (CICO), and 7) Survey for Participants. Data will determine if the OTSG program decreases anxiety and depression, improves overall HRQOL, and decreases chronic PFD symptoms.

Keywords: pelvic floor dysfunction, online therapeutic support group, health-related quality of life, medical family therapy, Texas rural communities and therapy, integrative therapy, biopsychosocial-spiritual, narrative therapy.

LLU Discipline

Marital and Family Therapy


Counseling and Family Sciences


School of Behavioral Health

First Advisor

Nichola Seaton Ribadu

Second Advisor

Michelle Howze

Third Advisor

Zephon Lister

Degree Name

Doctor of Marital and Family Therapy (DMFT)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Narrative therapy; Online Therapy; Pelvic Floor Disorders; Support Groups


Doctoral Project

Page Count

xiii, 172 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives