Digital Commons Network^™

The Implications, Magnitude, And Development Of Traumatic Brain Injury For Individuals Undergoing Treatment For Opioid Use Disorder, Hannah G. Mitchell

Electronic Theses and Dissertations

There is an established bidirectional relation between substance use and traumatic brain injuries (TBIs). Despite the high rate of prescribing opioids for pain management following a TBI and the epidemic of opioid use disorder (OUD) in the United States, scarce research has specifically analyzed the association between TBI and OUD. In a series of three interrelated manuscripts, the present study will first examine the prevalence and features of TBIs among persons seeking treatment for OUD. Next, the present study will evaluate the association between TBI and indicators of risky health behaviors and OUD severity, including the risk of overdose and …

Psychotherapist Awareness And Competence Managing Social Media Concerns, Jing Wen Ong

Electronic Theses and Dissertations

Social media use increased substantially in recent years, spurring the growth of research focused on its association with mental health. Previous research examined the relationship between positive and negative aspects of mental health and social media use. Other studies explored the relevance of social media to professional practice of psychologists including the use of social media to reach populations with limited access to mental health services and ethical dilemmas arising from social media use; however, there is limited understanding of the pertinence of social media to concerns that clients discuss in therapy and therapist competence in handling these discussions. The …

The Effects Of Cultural Responsiveness And Therapy Duration On Black Americans’ Therapy Preference, Katilyn M. Ashley Treem

Electronic Theses and Dissertations

Marginalized groups are less likely to seek out mental health services than non-marginalized groups. There are various reasons why marginalized groups, such as Black Americans, are less likely to seek out mental health services, one of which is the cultural barriers between a clinician and client. Research suggests that Black Americans feel that clinicians struggle to overcome these cultural barriers. Therefore, it is important for clinicians to actively receive training on how to serve clients with diverse backgrounds. Cultural responsiveness, an extension from cultural competence, is the active application of the knowledge and skills obtained in training. Examining people’s therapy …

Working Through Lingering Anger Following Interpersonal Grievances: Examining Mechanisms Of Change In Rumination, Reappraisal, And Identification Of Unmet Needs, Michael Arend Strating

Electronic Theses and Dissertations

Many clients present to psychotherapy with lingering feelings of anger, bitterness, or resentment in response to interpersonal grievances. The current project sought to compare the effects of cognitive reappraisal and needs identification interventions on lingering anger while determining whether intervention effects occur through shared or distinct mechanisms of change. Using an experimental, therapy-analogue design, 197 undergraduate participants (Study 1) completed a brief, self-guided online intervention involving either anger rumination (comparison condition), cognitive reappraisal, or needs identification. This design was replicated in a clinical sample of 31 participants (Study 2) who were recruited from local mental health clinics using the same …

A Phenomenology Of Challenging Psychedelic Experiences: From Relational Trauma To Relational Healing, Leland Guthrie

Electronic Theses and Dissertations

Psychedelic medicine is a re-emerging therapeutic paradigm with potentially significant clinical applications. This study contributes to an understanding of the aspects of challenging psychedelic experiences that may contribute to therapeutic outcomes. Interview and written data from five participants about their challenging Ayahuasca experiences was analyzed using Interpretative Phenomenological Analysis (IPA). The results of this analysis revealed a phenomenological structure of challenging psychedelic experiences consisting of a change process that moved the participants from a sense of disconnection to a sense of connection with themselves, others, nature and the cosmos. Findings from the study suggest that challenging psychedelic experiences may be …

Trainee Attitudes Toward Social Class As Predictors Of Clinical Decision Making: Exploring The Effects Of Classism In Psychotherapy, Jeremy J. Coleman

Electronic Theses and Dissertations

The current study examined the effects of classist beliefs on trainee attitudes toward their client based on perceived social-class status. This study sought to determine whether classist attitudes contribute to meaningful differences in clinical decision making. A sample of mental health trainees (n = 147) attending graduate-level programs in the U.S. were recruited and randomly assigned to one of two clinical vignette conditions. Both vignette conditions included identical data regarding a hypothetical client’s presenting concerns (e.g., sleep disturbance, worry, rumination, loneliness), but differed on indicators of client socioeconomic status (SES). Results showed statistically significant between-group differences on ratings of clinical …

Psychological Factors That Impact White Counseling Trainees’ Responses To Cultural Ruptures, Emma Freetly Porter

Electronic Theses and Dissertations

In the field of counseling and clinical psychology, the last several decades have been characterized by a strengthened recognition of the importance of cultural factors in psychotherapy. While this has been impactful, there is evidence that cultural ruptures, microaggressions, and racial/ethnic disparities in psychotherapy outcomes persist. Aversive racism theory, which provides explanations for the racist tendencies typically associated with progressive White individuals, postulates that a conflict between explicit egalitarian beliefs and implicit negative racial biases impedes White individuals from adequately addressing and acknowledging underlying biases. Therefore, it was hypothesized that psychological factors, such as defense mechanisms, professional selfdoubt and self-compassion, …

Therapeutic Rupture Repair In Treatment Of Military Adolescents., Brent Anthony Luebcke

Electronic Theses and Dissertations

Ruptures in the therapeutic alliance have shown to be a significant predictor of therapy outcomes, with non-repaired ruptures resulting in increased dropout rates of therapy, and repaired ruptures resulting in positive therapy outcomes. This study investigated the impact of alliance ruptures on outcomes of therapy among youth and adolescents, with a specific focus on military youth and adolescents. A sample of 5,640 military adolescents who were treated by 101 therapists were selected for analysis based on inclusion criteria of: a) being aged 13 to 19 years old; and b) attending more than one session of therapy. Each session, clients completed …

The Inheritance Of This Moment: An Exploration Of Temporality, Subjectivity, And Liberation In Non-Dual Contemplative Practice And Psychotherapy, Jeremy Axelrad

Electronic Theses and Dissertations

This dissertation considers the meaning of “present-moment awareness” and its role in psychological healing and transformation. The current conversation around mindfulness, a secularized practice with roots in Buddhist contemplative traditions, has largely unfolded within a dualistic framework in which subject and object are separate from one another as well as from a discrete entity called a moment. While widely appreciated for its capacity to foster well-being and insight, mindfulness as construed above remains disconnected from Buddhist psychology’s non-dualistic view of experience, which radically challenges our ordinary understandings of subjectivity and temporality. In the current project, I sought to explore this …

The Efficacy Of Equine Assisted Therapy In The Treatment Of Autism Spectrum Disorders, Amy Hofmann

Electronic Theses and Dissertations

This study examines the effects of equine-assisted psychotherapies in children with an autism spectrum disorder. The CARS-2 and Children’s Sleep Habits Questionnaire parent-report questionnaires were used for evaluation, as well open-ended questions. A single researcher contacted and visited many PATH-certified centers in the United States. Facilities that participated were all located in the Mid-Atlantic to Northeast region. There were 16 participants, from 11 different farms, that completed both the initial and follow-up questionnaires which were given 7 weeks apart. A $25 Amazon gift card was used as an incentive to increase participation. Participating facilities also completed a questionnaire.

Overall, results …

The Impact Of Sudden Gains And Deteriorations On The Psychotherapy Process, Joanna Mary Drinane

Electronic Theses and Dissertations

Within the field of psychotherapy research, there has been significant evidence to suggest that people change and improve because of treatment (Lambert & Ogles, 2004). One common phenomenon that has been observed when looking more closely at outcome trajectories has been termed sudden gains/deteriorations. These are defined as sudden changes in outcome (either positive or negative) of 25% or more from the pre-change level of symptoms that are in turn sustained over time (Tang & DeRubeis, 1999). Although there are data regarding how people who experience sudden gains end up after treatment, no studies have examined the impact that sudden …

A Meta-Analytic Review Of The Relationships Between The Therapeutic Alliance, Empathy, And Genuineness In Individual Adult Psychotherapy., Jacob B. Nienhuis

Electronic Theses and Dissertations

This dissertation explored the relationship between the therapeutic alliance and perceptions of therapist empathy and genuineness through a systematic review and meta-analysis. Alliance, empathy, and genuineness are each integral parts of the therapeutic relationship. Prior meta-analyses demonstrated that alliance, empathy, and genuineness each had a moderate relationship to therapy outcome. No previous analysis has explored how therapist empathy and genuineness contribute to the therapeutic alliance. Studies for this analysis were obtained through a multi-part search strategy. Out of 2,141 obtained abstracts, 46 studies contained enough data for inclusion in the meta-analysis. Thirty-six studies reported alliance/empathy relationships, six studies reported alliance/genuineness …

Examining The Alliance-Outcome Relationship: Reverse Causation, Third Variables, And Treatment Phase Artifacts, John Paul M. Reyes

Electronic Theses and Dissertations

Psychotherapy research reveals consistent associations between therapeutic alliance and treatment outcomes in the youth and adult literatures. Despite these consistent findings, prospective associations are not sufficient to support the claim that the alliance is a change mechanism in psychotherapy. The current study examined the direction of effect of the alliance-outcome relationship, the contribution of early symptom change in treatment to the development of therapeutic alliance, and the potential for pretreatment interpersonal functioning characteristics to be third variables that account for the association between alliance and outcome. Participants were adolescents with depression and a history of interpersonal trauma that presented to …

A Descriptive Study: Selection And Use Of Art Mediums By Sexually Abused Adults: Implications In Counseling And Art Psychotherapy, Frances Harlow Clukey

Electronic Theses and Dissertations

This research was designed to explore what happens in the process of therapy when clients, having persisting symptoms of sexual abuse and having disclosed that abuse, have access to a wide variety of art materials to select and use in treatment. A blend of qualitative and quantitative research in design, the study is an initial step towards a greater understanding of the potentially transformative experience of art making and the role of art mediums in the practice of therapy. Treatment for abuse is a long, complex and arduous process. Persistent aspects of abusive experience remain deeply buried within the body …