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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 …
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 …
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 …
Relative Sensitivity To Change Of Psychotherapy Outcome Measures For Children And Adolescents: A Comparison Using Parent- And Self-Report Versions Of The Cbcl/6-18, Basc-2, And Y-Oq-2.01, Debra Theobald Mcclendon
Relative Sensitivity To Change Of Psychotherapy Outcome Measures For Children And Adolescents: A Comparison Using Parent- And Self-Report Versions Of The Cbcl/6-18, Basc-2, And Y-Oq-2.01, Debra Theobald Mcclendon
Theses and Dissertations
This repeated-measures study evaluated the relative sensitivity to change of the Child Behavior Checklist/6-18 (CBCL/6-18), the Behavior Assessment System for Children-2 (BASC-2), and the Youth Outcome Questionnaire-2.01 (Y-OQ-2.01). Participants were recruited from Valley Mental Health, a community outpatient clinic in Salt Lake City, UT. There were 178 participants for 136 cases, with 134 adults and 44 adolescents. Participants provided two through five data points for a total of 548 data points. Hierarchical Linear Modeling (HLM) was conducted for three major comparisons: adult informants, adult and adolescent dyads, and adolescents. Results indicated the Y-OQ-2.01 was the most change sensitive, while the …
Value Conflicts In Psychotherapy: Psychology Graduates' Perspectives, Shannon Vincent Wilde
Value Conflicts In Psychotherapy: Psychology Graduates' Perspectives, Shannon Vincent Wilde
Theses and Dissertations
Although psychotherapy has been viewed historically as value-neutral, developments over the last half-century have led to the generally accepted position that values are inescapable in therapy. However, many questions remain as to how values should be managed in psychotherapy in order to protect client autonomy. These issues are of particular concern to training programs, which bear the responsibility of instructing new psychologists in ethical values management and of helping trainees manage personal values when those values are in conflict with those of their clients or with the values of the field in general. One aspect that has not previously been …
The Group Questionnaire: A New Measure Of The Group Relationship, Julieann Krogel
The Group Questionnaire: A New Measure Of The Group Relationship, Julieann Krogel
Theses and Dissertations
The Group Questionnaire (GQ) is a 30-item, self-report measure of the group relationship that was developed in the present study. It is based off of Johnson's new three factor model of the group relationship which includes Positive Bonding, Positive Working, and Negative Relationship. This study involved two parts, the creation of the GQ followed by the validation and refinement of the GQ using 486 participants from three populations - outpatient university counseling center, inpatient state hospital, and non-patient AGPA process groups. Confirmatory Factor Analysis (CFA) was used to test the goodness-of-fit of Johnson's model to each of the populations separately …
Culturally Adapted Mental Health Treatments: A Meta-Analysis, Derek Griner
Culturally Adapted Mental Health Treatments: A Meta-Analysis, Derek Griner
Theses and Dissertations
In recent years psychologists have increased awareness and concern regarding the quality of mental health services provided to people of color. For several reasons clients of color often find traditional mental health services foreign or unhelpful. To help diminish obstacles faced by clients of color, several authors have advocated traditional mental health treatments be modified to better match clients' cultural contexts. Researchers have also begun investigating outcomes associated with culturally modified mental health treatments, often contrasting them with traditional mental health services. Recently numerous studies containing empirical data have been published. To date there has been no attempt to review …