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When Do Therapist Characteristics Matter Or Do They?, Han Lim Kim
When Do Therapist Characteristics Matter Or Do They?, Han Lim Kim
Theses and Dissertations
This research aims to establish that considerable differences exist between therapists on how much their clients improve in treatment and understand the factors that contribute to such variability. Therapists’ sex, personality, and similarity of their personality with their clients’ personality were examined as moderators of change in treatment outcome. Findings must be interpreted with caution due to limitations of the dataset which make therapists effects hard to separate from client effects. There is variation around the amount of change therapists produce in their clients; however, this variation is much smaller compared to the variance among clients. Female therapists consistently had …
Experiences And Perceptions Of Bilingual Spanish-English Latinx Clients And Bilingual Spanish-English Latinx Therapists In Psychotherapy: A Systematic Review, Irvin I. Navarrete
Experiences And Perceptions Of Bilingual Spanish-English Latinx Clients And Bilingual Spanish-English Latinx Therapists In Psychotherapy: A Systematic Review, Irvin I. Navarrete
Theses and Dissertations
As the bilingual Spanish-English Latinx population in the United States increases, so will the need for culturally and linguistically competent mental health therapists. While past research has focused on providing culturally competent care, the role of language in the process of psychotherapy has received limited attention. This study aimed to comprehensively analyze the existing literature on bilingual Spanish-English Latinx clients’ and bilingual Spanish-English Latinx therapists’ experiences and perceptions within a bilingual psychotherapy setting and identify recommendations to enhance language proficiency. A systematic review was conducted and identified nine studies for inclusion. Results highlight seven themes focusing on bilingual Spanish-English Latinx …
A Systematic Review Of Canine Assisted Psychotherapy For Youth At Risk Or With Mental Health Disorders, Hedieh Hakakian
A Systematic Review Of Canine Assisted Psychotherapy For Youth At Risk Or With Mental Health Disorders, Hedieh Hakakian
Theses and Dissertations
Mental health disorders among youth are often underrepresented in research, resulting in a delay and under-treatment of their needs (Catania et al., 2011). While their needs are frequently under-treated, research suggests that youth often experience mental health problems that subsequently lead to difficulties in adulthood (Carballo et al., 2011) necessitating a need to identify efficacious treatments to these problems. This systematic review used a mixed-methods design to analyze current literature on the use of Canine-Assisted Psychotherapy (CAP) with youth ages 0-20. The aims of the study were to (a) understand the impact of CAP on mental health (i.e., clinical diagnosis …
Client Perspectives On Effective Psychotherapy: A Systematic Review And Foundation For A Consilient Psychology, Sam Han
Theses and Dissertations
This study will explore client perspectives on what works in psychotherapy in an effort to elucidate critical ideas for more consilience, or the unity of knowledge, in the field of clinical practice. The objective is to generate a theory from the data that can serve as a foundation for an eventual unified model of psychotherapy. A qualitative narrative synthesis approach was taken using grounded theory principles to analyze data from common factors outcome research. The results appear to confirm prior findings on the importance of interpersonal dynamics and the therapeutic relationship. The data demonstrates a potential connection between interpersonal factors …
The State Of Psychological Services For People With Physical And Cognitive Disabilities: An Integrative Systematic Review, Megan K. Benton
The State Of Psychological Services For People With Physical And Cognitive Disabilities: An Integrative Systematic Review, Megan K. Benton
Theses and Dissertations
The present study investigated the state of psychotherapy for people with physical and cognitive disabilities in a systematic review. Specifically, this study analyzed qualitative and quantitative studies which examined therapists’ abilities to conceptualize disability as a dimension of cultural competence, the models and conceptualizations of disability and psychotherapy being used with people with disabilities (PWD) in psychotherapy, and the experiences of PWD in psychotherapy. This study analyzed 18 empirical studies and integrated both qualitative and quantitative methods. Source eligibility criteria for this systematic review was the same for both qualitative and quantitative studies. Eligibility criteria included being: peer-reviewed journal articles, …
Physical Intimate Partner Violence Of African American Women: Promising Practices And Pitfalls In Treatment, Melissa Erinn Duncan
Physical Intimate Partner Violence Of African American Women: Promising Practices And Pitfalls In Treatment, Melissa Erinn Duncan
Theses and Dissertations
Intimate partner violence is a serious health concern among African American women. It is estimated about 41% of African American women experience physical violence from an intimate partner. A number of risk factors, as well as cultural and contextual dynamics (e.g., gendered racism, low socioeconomic status, cultural norms, exposure to family violence, as well as cultural mistrust of the healthcare and legal systems), are associated with the high prevalence rate of African American women experiencing physical abuse. Due to the unique challenges that African American women survivors of partner violence often experience, there is a gap in the current literature …
Couple-Based Therapeutic Interventions Aimed At Treating The Individual And Relational Impact Of Childhood Abuse, Megan A. Maguire
Couple-Based Therapeutic Interventions Aimed At Treating The Individual And Relational Impact Of Childhood Abuse, Megan A. Maguire
Theses and Dissertations
Childhood abuse can have a significant and lasting impact on an individual's mental health and relationships, including their ability to trust, communicate, and form healthy attachments. While the greater literature focuses on individual interventions to address childhood trauma, there is limited research on the potential positive impact of a couple-based therapeutic approach on outcomes of individual mental health and relationship distress. This dissertation sought to summarize empirically researched couples-based psychotherapies designed to address the effects of childhood abuse and review evidence regarding therapeutic outcomes. The dissertation implemented the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to ensure a …
Intergenerational Family Conflict Among Asian American Families; An Exploration Of Its Dynamics, Effects, And Therapeutic Interventions, Lisa Choi
Theses and Dissertations
Experiences of intergenerational family conflict are a prominent concern within the Asian American community. They are at a heightened risk of experiencing intergenerational family conflict compared to other immigrant families. Intergenerational family conflict occurs when an immigrant parent acculturates to a new mainstream culture at a slower rate than the offspring and as a result, an acculturation mismatch is created. Intergenerational family conflict is unique to this population because acculturation-based conflict involves cultural differences that tend to deepen over time, lasting beyond the adolescent stage. According to several findings, Asian American families are experiencing poorer psychological adjustment along with many …
The Oq-45: The Structure Of Mental Health Symptoms During Psychotherapy, Lindsay Arader
The Oq-45: The Structure Of Mental Health Symptoms During Psychotherapy, Lindsay Arader
Theses and Dissertations
The structure of the Outcome Questionnaire-45 (OQ-45; Lambert et al., 2004b) was examined across three time points in a sample of 199 psychotherapy clients at an outpatient community clinic in the greater New York area. Five models—a one-factor model, two-factor (oblique) model, three-factor (oblique) model, two sub-factor bifactor model, and three sub-factor bifactor model—were tested at baseline, 8 weeks, and 16 weeks. The two sub-factor bifactor model fit the data best at baseline, and the three sub-factor bifactor model fit the data best at 8 weeks and 16 weeks. These results demonstrate that the OQ-45 items load onto one general …
Psychologists’ Conceptualizations Of Clients And Their Relation To Psychotherapy Outcomes: A Profile Analysis, Han Lim Kim
Psychologists’ Conceptualizations Of Clients And Their Relation To Psychotherapy Outcomes: A Profile Analysis, Han Lim Kim
Theses and Dissertations
The aims of this research is to 1) quantitatively assess therapist perceptions of prototypically difficult and successful clients and assess whether characterizations of such clients vary as a function of therapist level of experience and sex, 2) examine whether clients who characterize themselves as more similar to the prototype show different rates of change in psychotherapy, and 3) evaluate whether clients’ self-reported personality and attitudes change in psychotherapy become more or less similar to the prototype profiles. There were no differences in prototypical difficult and successful client profiles as a function of therapist sex or level of experience. Clients’ improvements …
Describing Therapeutic Relationship Change And Failure In Group Psychotherapy, Harold Thomas Svien
Describing Therapeutic Relationship Change And Failure In Group Psychotherapy, Harold Thomas Svien
Theses and Dissertations
Objectives. This study reanalyzed data from Burlingame and colleagues’ (2018) randomized controlled trial on the effect of adding Group Questionnaire (GQ) to Outcome Questionnaire (OQ-45) feedback. These data were assessed for the feedback effect using the amount of GQ alerts in one session reported by the group member to track change in GQ subscales as a measure of reversing therapeutic relationship failure.Methods. 374 participants engaged in 58 psychotherapy groups. Every participant provided GQ measurements after every group session. These GQ measurements formed ‘person-session units’ representing whether or not each type of alert was present following each group meeting. Person-session units …
Does The Scientist-Practitioner Gap Have Ontological Roots?, Eric Alexander Ghelfi
Does The Scientist-Practitioner Gap Have Ontological Roots?, Eric Alexander Ghelfi
Theses and Dissertations
In this thesis, the nature and extent of practitioners' dissatisfaction with the psychotherapy research literature will first be described. A case will be made that a deeper analysis needs to be conducted to fully understand this dissatisfaction. Next, this dissatisfaction will be framed in the context of a particular ontology that seems to have largely contributed to it. Most importantly, several features of this ontology will be described and connected to practitioners' dissatisfaction. Finally, an alternative framework for understanding practitioners' dissatisfaction will be tentatively proposed, and it will be suggested that this alternative could help researchers and practitioners understand their …
Social Reactions To Sexual Assault Survivors Presenting With Ptsd: The Impact Of Survivor Gender And Psychotherapy Treatment-Seeking Status, Shannon Marie Sommer
Social Reactions To Sexual Assault Survivors Presenting With Ptsd: The Impact Of Survivor Gender And Psychotherapy Treatment-Seeking Status, Shannon Marie Sommer
Theses and Dissertations
The present study examined public perceptions of and willingness to provide social support to survivors of sexual assault presenting with posttraumatic stress disorder (PTSD) based on the survivor’s gender (male vs. female), psychotherapy treatment-seeking status (no treatment vs. dropped out after four sessions vs. still in treatment), and participant gender (male vs. female). Participants (n = 178) read one of six vignettes based on a 2 (gender of survivor of sexual assault: male vs. female) X 3 (treatment-seeking status: no treatment vs. dropped out of treatment after four sessions vs. still in treatment) factorial design describing the life circumstances and …
A Meta-Analytic Review Of The Association Of Therapeutic Alliance, Therapist Empathy, Client Attachment Style, And Client Expectations With Client Outcome, Alberto Soto
Theses and Dissertations
The therapeutic alliance has consistently been associated with improved client outcomes across numerous psychotherapy outcome studies. Previous systematic reviews have, however, evaluated the univariate association of the alliance with client outcome. The present meta-analytic review examines the association of the alliance with improved client outcomes after accounting for the presence of therapist empathy, client attachment styles, and client expectations. Across 23 independent studies, the alliance, adjusted for the presence of the other variables, remained as the most robust predictor of improved outcomes r = .258 (SE = .01, p < .001), with a 95% confidence interval of r = .18 to r = .33. After accounting for …
The Development Of A Short Form Of The Clinically Adaptive Multidimensional Outcome Survey, Peter William Sanders
The Development Of A Short Form Of The Clinically Adaptive Multidimensional Outcome Survey, Peter William Sanders
Theses and Dissertations
The Evidence-Based Practice (EBP) movement has gained considerable influence in the healthcare industry, including psychotherapy. The American Psychological Association's (APA) official stance on EBP encouraged clinicians to used standardized outcome measures in routine practice in order to establish the efficacy of their interventions. Routine Outcome Measurement (ROM) systems were designed specifically to accomplish this purpose, and have been shown to improve client outcomes and provide valuable aggregate data that contributes to empirical literature. Despite this research and the endorsement of the APA's official EBP stance, these measures have not been widely adopted by clinicians. Several studies have found that clinicians …
Rates And Predictors Of Adolescent Premature Termination: Applying Clinically Significant Change, Mariah Meaalii Bullock
Rates And Predictors Of Adolescent Premature Termination: Applying Clinically Significant Change, Mariah Meaalii Bullock
Theses and Dissertations
Premature termination from child and adolescent psychotherapy is a prevalent problem for clients, their families, and mental health services. Rates of premature termination have been estimated at a range of 16-72%. Many variables have been examined as potential predictors of premature termination, yielding inconsistent conclusions. Researchers propose that part of this variability in rates and predictors is due to the inconsistent application of definitions of premature termination. The past literature identifies two main categories of definitions in this line of research: therapist judgment and number of sessions. This study aims to incorporate a relatively new definition, clinically significant change, in …
Training Psychologists In The Ethical Use Of Language Interpreters: An Evaluation Of Current Practices, Potential Barriers, And Proposed Competencies, Clay A. Frandsen
Training Psychologists In The Ethical Use Of Language Interpreters: An Evaluation Of Current Practices, Potential Barriers, And Proposed Competencies, Clay A. Frandsen
Theses and Dissertations
Research indicates that general and mental healthcare services have been, and continue to be, underutilized by racial and ethnic minorities. Studies point to the language gap between limited English proficiency (LEP) individuals and mental-health clinicians as one of the factors in perpetuating that gap. Despite the legal and professional mandates that require professionals in healthcare to provide and use language interpreters in giving care, psychologists rarely make use of professional interpreters when conducting psychotherapy. Most clinicians have little experience providing mental-health treatment across differences in language, and it is supposed that clinicians usually receive little or no training on how …
A Randomized Controlled Trial Of An Online, Modular, Active Learning Training Program For Behavioral Activation Treatment For Depression, Ajeng Juwita Puspitasari
A Randomized Controlled Trial Of An Online, Modular, Active Learning Training Program For Behavioral Activation Treatment For Depression, Ajeng Juwita Puspitasari
Theses and Dissertations
This randomized-controlled trial was conducted in 2013-2014 and aimed to evaluate the efficacy of an online, trainer-led Behavioral Activation (BA) training when compared to an online, self-paced BA training. Graduate students (N = 80) in Clinical Psychology, Counseling Psychology, Social Work, and Psychiatry Residency programs were recruited. Participants were randomly assigned to either the trainer-led BA training (N = 40) or the self-paced BA training (N = 40). The trainer-led BA training consisted of four 90-minute trainer-led online sessions guided by a BA trainer and training activities included didactic, modeling, practice, and feedback. The self-paced BA training consisted of four …
Adherence To And Competence In Cognitive Behavioral Therapy For Youth Anxiety: Psychometric Evaluation, Cassidy C. Arnold
Adherence To And Competence In Cognitive Behavioral Therapy For Youth Anxiety: Psychometric Evaluation, Cassidy C. Arnold
Theses and Dissertations
Treatment integrity—the extent to which a treatment is delivered as it was intended—has long been recognized as critically important in treatment evaluation research, but has garnered increased attention in recent years within the context of dissemination and implementation science. However, the field’s development has been hindered by inadequate measurement tools. This project is focused on developing and evaluating the psychometric strength of two measures of treatment integrity. To evaluate the psychometric strength of the Cognitive-Behavioral Therapy for Youth Anxiety Therapist Adherence Scale (CBAY-A)and the Cognitive-Behavioral Therapy for Youth Anxiety Therapist Competence Scale (CBAY-C), 954 psychotherapy sessions from two treatment evaluation …
Unexpected Dramatic Change In Psychotherapy: Comparing Three Methods, Joseph Richard Horner
Unexpected Dramatic Change In Psychotherapy: Comparing Three Methods, Joseph Richard Horner
Theses and Dissertations
Unexpected dramatic changes in psychotherapy have been observed historically and tied to high recovery rates. Many different methodologies that identify these changes are assumed to be capturing similar or identical phenomena. This study compared three methods – Sudden Gains (SG), Percentage Increase – 50% (PI-50%), and Rapid Response (RR) - in a large database looking for similarities and differences. Results suggest that there are significant differences between SG, RR, and PI-50 as methods for operationally defining unexpected dramatic treatment response, and caution should be used when referring to SG, PI-50, and RR as the same phenomenon or interchangeable terms for …
Youth Motivation As A Predictor Of Treatment Outcomes In A Community Mental Health System, Brett M. Merrill
Youth Motivation As A Predictor Of Treatment Outcomes In A Community Mental Health System, Brett M. Merrill
Theses and Dissertations
The role of motivation in relation to youth symptoms and psychotherapy outcomes is not well understood. Some cross-sectional research suggests that motivation predicts youth treatment outcome in low-motivation populations. The purpose of this study was to examine patterns of change in youth motivation over the course of treatment and to elucidate the relation between motivation, youth symptoms, and psychotherapy outcomes in a routine community mental health setting. Participants and their caregivers were from three community mental health outpatient clinics and completed youth or parent forms of the Youth Outcome Questionnaire (Y-OQ) and Treatment Support Measure (TSM) at frequent intervals throughout …
Parenting Skills As Predictors Of Child And Adolescent Psychotherapy Outcomes: Examining Change In Usual Care Settings, Alicia Ann Henderson
Parenting Skills As Predictors Of Child And Adolescent Psychotherapy Outcomes: Examining Change In Usual Care Settings, Alicia Ann Henderson
Theses and Dissertations
Youth psychotherapy literature is in need of more research related to understanding psychotherapy process and outcome in child psychotherapy in community settings. The purpose of this study was to examine how key parenting skills were associated with child and adolescent symptoms and outcomes over the course of treatment in an outpatient community mental health system. Much of the research on child and adolescent outcomes has been conducted in controlled research settings, which raises the importance of more research needing to be done in representative clinical practice conditions (Weisz & Jensen, 2001). Further, few child and adolescent studies have examined potential …
A Qualitative Inquiry Into The Treatment Experience Of Adolescent Females In A Relationally Based Therapeutic Boarding School, Douglas S. Marchant
A Qualitative Inquiry Into The Treatment Experience Of Adolescent Females In A Relationally Based Therapeutic Boarding School, Douglas S. Marchant
Theses and Dissertations
Individualism, the assumption that persons are self-contained and primarily act for the sake of the self, is prevalent in American culture and has arguably perpetuated numerous psychological and societal ills. Relationality, the assumption that persons are always and inextricably constituted by relationships, has been posited as a philosophical and practical alternative to individualist culture. Several scholars, both inside and outside of psychology, have developed relational concepts and practices, including some who have elucidated a relational approach to psychotherapy (e.g., Slife and Wiggins, 2009). This study examines the implications and effects of this therapeutic approach, particularly exploring relationality's therapeutic success in …
Scheduled Healing: The Relationship Between Session Frequency And Psychotherapy Outcome In A Naturalistic Setting, David Mcconkie Erekson
Scheduled Healing: The Relationship Between Session Frequency And Psychotherapy Outcome In A Naturalistic Setting, David Mcconkie Erekson
Theses and Dissertations
The dose-effect relationship in psychotherapy has been examined extensively, but few studies have included session frequency as a component of psychotherapy "dose." Those studies that have examined the effects of session frequency have indicated that it may affect both the total amount of recovery and the speed of recovery. No studies were found examining the clinical significance of this construct in a naturalistic setting. The change trajectories of 16,003 clients were examined using multi-level modeling and including session frequency as a fixed effect. Of these clients, subgroups were identified that were scheduled approximately once a week or approximately once every …
Meta-Analysis Of The Effectiveness Of Biological And Non-Biological Treatments For Postpartum Depression, Sarah Jeung Soon Christian
Meta-Analysis Of The Effectiveness Of Biological And Non-Biological Treatments For Postpartum Depression, Sarah Jeung Soon Christian
Theses and Dissertations
I provided an updated, comprehensive review of treatments for mothers diagnosed with postpartum depression. Studies included in this meta-analysis were single-group pre-posttest, non-randomized and randomized controlled studies published from 1986 to 2010 that included face-to-face psychotherapy and psychopharmacology as well as non-traditional methods such as exercise and nurse-assisted counseling. 53 published studies were analyzed. The randomized studies showed a moderate to large effects (d= 0.72 to 1.25, k= 9) when postpartum interventions were compared to a control condition, and smaller effects (d= 0.3 to 0.57, k = 13) to treatment as usual. When postpartum interventions were compared to each other …
Comparative Psychotherapy Outcomes Of Sexual Minority Clients And Controls, Sasha A. Mondragon
Comparative Psychotherapy Outcomes Of Sexual Minority Clients And Controls, Sasha A. Mondragon
Theses and Dissertations
Research examining the psychotherapy outcomes of sexual minority clients seen in routine clinical care is lacking. No studies could be identified in which sexual minority client outcomes were examined with a standardized measure. The pre-treatment mental health functioning of 600 sexual minority clients was compared with that of a randomly selected group matched to the minority group on male/female ratio. The post-treatment mental health functioning of 596 sexual minority clients was also examined and compared to a control group matched on female/male ratio, initial levels of mental health functioning, age, and marital status. Results indicated that sexual minority clients who …
Social Support And Youth Psychotherapy Outcomes: Examining Change Processes In Usual Care Settings, Robert Virgil Dindinger
Social Support And Youth Psychotherapy Outcomes: Examining Change Processes In Usual Care Settings, Robert Virgil Dindinger
Theses and Dissertations
A prominent need in youth psychotherapy literature includes the examination of factors related to improved psychotherapeutic outcomes within the context of "real world" clinical settings, where the practice of psychotherapy differs significantly from that in controlled clinical trials. In examining those factors related to improved outcomes in youth psychotherapy, variables related to social support are important to consider. The purpose of the present study was to evaluate youth perceptions of social support as a potential predictor of successful treatment outcomes in a traditional community outpatient treatment setting for youth. In addition, this study examined whether perceptions of social support predicted …
The Good Life In Psychotherapy: Implicit And Influential, Emily Lonas Morris
The Good Life In Psychotherapy: Implicit And Influential, Emily Lonas Morris
Theses and Dissertations
The good life, or a flourishing life, is a vision of how people ought to best live their lives. Though this vision is vital to the conduct of psychotherapy, it is generally overlooked, and thus unexamined. The therapist's vision of the good life for the client guides his or her implicit and explicit interventions. Despite this, there is relatively little discussion about this vital topic, and relatively little training into the various approaches to the good life. In this thesis, I argue that this relative lack of examination and training is due to the lack of perceived options regarding conceptions …
Providing Patient Progress Information And Clinical Support Tools To Therapists: Effects On Patients At Risk For Treatment Failure, Mitchell Wayne Harris
Providing Patient Progress Information And Clinical Support Tools To Therapists: Effects On Patients At Risk For Treatment Failure, Mitchell Wayne Harris
Theses and Dissertations
Patient-focused research systems have been developed to monitor and inform therapists of patients' treatment progress in psychotherapy as a method to enhance patient outcome. The current study examined the effects of providing treatment progress information and problem-solving tools to both patients and therapists during the course of psychotherapy. Three hundred seventy patients at a hospital-based outpatient psychotherapy clinic were randomly assigned to one of two treatment groups: treatment-as-usual, or an experimental condition based on the use of patient/therapist feedback and clinical decision-support tools. Patients in the feedback condition were significantly more improved at termination than the patients in the treatment …
The Effects Of Using Clinical Support Tools To Prevent Treatment Failure, Tiffany K. Washington
The Effects Of Using Clinical Support Tools To Prevent Treatment Failure, Tiffany K. Washington
Theses and Dissertations
To date, outcome research suggests that providing clinicians with patient progress feedback and problem-solving tools is effective in improving therapeutic outcome for clients who are predicted to have a negative treatment outcome. To expand upon this body of research, the current study examined the efficacy of using these problem-solving tools (Clinical Support Tools; CST) to reduce the risk of treatment failure and enhance positive outcome with 118 clients who were not identified as at -risk for a negative outcome. Results of this study indicated that the intervention failed to lower the rate of becoming an at-risk case or to enhance …