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 …

Harm Reduction In Psychotherapy, Jillian Cramer

Electronic Thesis and Dissertation Repository

With approximately 22 people dying due to opiate-related harms everyday in Canada (Government of Canada, 2023), there is a great need to offer low-barrier, evidence-based services for people who use substances across various disciplines, including healthcare, social services, and psychotherapy. This qualitative study examined the experiences of Canadian social justice-informed counsellors who work with clients who use substances from harm reduction frameworks of care. Seven counsellors were interviewed on their personal experiences implementing harm reduction in psychotherapy. Through a reflexive thematic analysis, five themes surfaced: axiology of harm reduction work, development of therapist surrounding harm reduction, main focuses of harm …

Psilocybin With Acceptance And Commitment Therapy (Act) For The Treatment Of Social Anxiety Disorder (Sad), Aspen E. Allred

University Honors Theses

Social Anxiety Disorder (SAD) is a debilitating mental health condition characterized by an overwhelming fear and anxiety of social rejection that can lead to chronic patterns of social behavioral avoidance. Despite the existence of traditional efficacious treatments, a significant number of individuals either do not respond to treatment or experience a recurrence of symptoms over extended periods, spanning 10-12 years. Acceptance and Commitment Therapy (ACT), a form of acceptance-based behavioral therapy considered part of the "third wave" of cognitive behavioral therapies, has shown promising results in early studies, comparable to those of Cognitive Behavioral Therapy (CBT) that is considered the …

Religion And Gender-Based Preferences In Therapist Selection Among Orthodox Jews, Yehuda L. Rosen

Walden Dissertations and Doctoral Studies

The preferences of Orthodox Jews when choosing a therapist are important to understand, as they can inform practice for individuals, clinics, and referral agencies. The purpose of this study was to determine the preferences for gender-matched therapists, Orthodox Jewish therapists, and specific therapist characteristics among Orthodox Jews. The study was based on Bordin’s working alliance model of psychotherapy, which contends that a strong working alliance is necessary for effective psychotherapy. The research questions were used to explore whether Orthodox Jewish men and women differed in their preferences for gender-matched or Orthodox Jewish therapists, whether religiosity predicted a preference for gender-matched …

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 …

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 …

Telehealth: Visual Adaptations For Acceptance And Commitment Therapy (Act), Caycie Smith

Psychology Doctoral Specialization Projects

The COVID-19 pandemic led to an influx in therapeutic services provided via web-based “telehealth” platforms. Some therapeutic treatments that were traditionally offered in-person needed to be adapted for telehealth platforms. After virtually beginning ACT with a client who struggled to grasp the material, the ACT PowerPoints were created as an adaptation of an in-person treatment to help the client learn and retain the information. In addition to the ACT PowerPoints, in-session worksheets and homework activities were created as well.

This document examines literature involving the effectiveness and benefits of acceptance and commitment therapy (ACT), telepsychotherapy, and visual aids. The goal …

Meta-Method Analysis On Therapists’ Experiences: An Inquiry Into Qualitative Psychotherapy Research Methodology, Javier L. Rizo

Graduate Masters Theses

I conducted a meta-method study to explore the methodological and reporting characteristics of qualitative studies on therapists’ experiences conducting psychotherapy. Articles were identified through a PsycINFO search, and through a review of article text their methodological and reporting features were coded and quantitatively analyzed. Consideration was given to standards of qualitative research in psychology, especially methodological integrity. Results showed increases in the number of these qualitative studies from the 2000s onwards. This rise seems to be above that in psychology, but comparable to other psychotherapy literature. Publication characteristics of this body of literature, namely journal discipline and impact score, showed …

Exploring Predictors Of Healing From An Expressive Writing Intervention About Heterosexism And Why Lgbtq+ Clients Might Withhold From Their Therapists, Ally B. Hand

Graduate Masters Theses

Heterosexism is a cultural system that impacts LGBTQ+ individuals internally, interpersonally, institutionally, and structurally. Exposure to these different levels of heterosexism, whether enacted overtly, covertly, intentionally, or unintentionally, contributes to the well-documented and disproportionate negative mental health outcomes experienced by the LGBTQ+ community (National Academies of Sciences, Engineering, and Medicine [NASEM], 2020). Subsequently, LGBTQ+ individuals seek out professional mental health services at higher rates than cisgender and heterosexual populations, though access to therapeutic care that addresses sexual minority specific stressors, such as experiencing heterosexism directly, is limited (Williams & Fish, 2020). The current study is a secondary analysis of a …

“Is That My Agenda Or Is That Serving The Client?”: Perspectives Of Social Justice-Oriented Counsellors On Working With Clients Who Express Oppressive Views, Lily G. Mackenzie

Electronic Thesis and Dissertation Repository

Current North American public discourse is strongly influenced by widespread sociopolitical divide. Given that sociopolitical events seem to permeate conversations in the therapy room (Farber, 2018; MacLeod, 2013), it is essential that therapists are prepared to navigate conversations with clients who have beliefs different from their own. This qualitative study explored the experiences of Canadian social justice-oriented counsellors who have worked with clients with oppressive views. Seven counsellors were interviewed about their experiences of working with oppression in the therapy room. Through qualitative content analysis, informed by a phenomenological approach, five core themes emerged: effect of personal identities, determination of …

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 …

Social Exclusion And Negative Affect: The Impact Of Mentalized Affectivity, Anna Voicu

Honors Program Theses

Social exclusion has been widely associated with feelings of anxiety, depressed mood, anger, and hostility. Previous literature indicates that mentalized affectivity (MA), a sophisticated form of emotional regulation, may be effective in mitigating emotional experience after social exclusion. In light of this research, our study sought to examine the predictive value of mentalized affectivity and inclusion/exclusion on emotion. Participants (N = 170) completed measures of mentalized affectivity and positive and negative affect, in addition to playing a virtual ball-tossing game that would randomly assign them to an inclusion or exclusion condition. Multiple regression analyses revealed that mentalized affectivity predicted both …

An Exploration Of The Lived Experiences Of Individuals Living With Hiv/Aids In Rural Uganda, Godfrey Ddungu

Walden Dissertations and Doctoral Studies

HIV/AIDS is the most stigmatized health condition globally, yet there are limited studies that have examined the needs of rural Ugandans diagnosed with HIV/AIDS. At a time when Ugandan voices could assist in the development and implementation of prevention and intervention strategies to reduce the spread of the virus, these voices remain unheard and silenced. The purpose of this phenomenological study was to describe the lived experiences of HIV-positive men and women in rural Uganda. A transcendental phenomenological approach provided the framework and design. This research used eight participants who were attending an AIDS health care center in Uganda. In-depth …

An Exploration Of The Lived Experiences Of Individuals Living With Hiv/Aids In Rural Uganda, Godfrey Ddungu

Walden Dissertations and Doctoral Studies

HIV/AIDS is the most stigmatized health condition globally, yet there are limited studies that have examined the needs of rural Ugandans diagnosed with HIV/AIDS. At a time when Ugandan voices could assist in the development and implementation of prevention and intervention strategies to reduce the spread of the virus, these voices remain unheard and silenced. The purpose of this phenomenological study was to describe the lived experiences of HIV-positive men and women in rural Uganda. A transcendental phenomenological approach provided the framework and design. This research used eight participants who were attending an AIDS health care center in Uganda. In-depth …

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 …

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 …

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

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 …

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, …

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 …

Therapists’ Demonstrated Multicultural Competence In Treating Latinx Immigrants, Dulce Diaz Benitez

Graduate Theses and Dissertations

Studies suggest that health disparities occur when people from marginalized communities receive care that is inadequate based on their cultural needs (USDHHS, 2011). Multicultural competence (MCC) models have been proposed to provide a framework of the competencies that therapists should develop to work with multicultural populations (Sue et al., 1992). Researchers have questioned the validity of measures, which are mostly based on therapist self-report (Cartwright, 2008). The multicultural case conceptualization ability task has been used in previous studies as a measure of demonstrated cultural competence using a vignette to assess case conceptualization abilities (Ladany et al., 1997). However, it has …

The Impossible Situation? Impasse As Psychotherapeutic Paralysis, Possibility, And Progress, Leo Cancelmo

Dissertations, Theses, and Capstone Projects

Psychotherapeutic impasse has long been understood in the clinical literature as treatment stagnation and even failure, both from one-person and two-person psychodynamic perspectives. However, there is a dearth of empirical research that delves deeper to understand this complex and rich phenomenon. Using semi-structured interviews with nine psychodynamic therapists speaking about individual adult patients, this study examined experiences of impasse to better understand treatments that become embroiled in a kind of paralysis. Qualitative analyses revealed dyads where patients were conceptualized as struggling chronically with negative feelings about themselves and others, and who experienced traumatic personal histories. Impasse in and of itself …

Attachment And Older Adults In Psychotherapy: A Latent Profile Analysis Of Psychological Distress Across Treatment, Brian Michael Stran

Dissertations

Older adults have been largely underrepresented within the psychotherapy literature. Given the unique social and emotional changes associated with older age (Carstensen et al., 1999) and the perceived gap in training that trainees report in working with older adults (Woodhead et al., 2015), there is a pressing need for research that can aid mental health practitioners in the conceptualization, treatment planning, and treatment of their older adult clients.

In the first part of this manuscript, an integrated theoretical model, consisting of socioemotional selectivity theory (SEST; Carstensen et al., 1999) and attachment theory (Bowlby 1969), was developed to provide psychotherapists with …

The Relationship Between The Quantum Consciousness And Depression, Yarone Grabiner

Dissertations

Depression is a prominent issue in mental health. This research will attempt to improve the quality of available therapies by offering additional helping options and introducing a new perception of depression. Different fields (psychology, quantum mechanics, and Kabbalah) have been integrated with data collection through personal interviews to support the research hypothesis. The subject sample consisted of five people with Kollel experience or similar educational experience in the present or in the past. All participants were orthodox Jewish men, 30 years old or older, married with children, with a high level of education. Participants presented attitudes, life conduct, and perceptions …

Marketing And Branding For Counseling Interns And Residents In Private Practice, Madeline Grove

Educational Specialist, 2020-current

For interns and residents in mental health counseling beginning their careers in a private practice setting, building a full-time caseload of clients is challenging. The process of marketing and branding outpatient psychotherapy services is not generally covered in clinical training programs, leading to a gap in practical knowledge upon departure from higher education. Since the COVID-19 pandemic, rates of behavioral health disorders have increased, leading to a sense of urgency to providing care for communities in need. Effective marketing and branding of services allows for clinicians to work with populations they are most well suited to serve, and potentially allows …

The Relationship Between Therapist Adverse Childhood Experiences, Personal Therapy, Resilience, And Treatment Outcomes, Elizabeth J. Nunez

Doctor of Psychology (PsyD)

With the development of the Adverse Childhood Experiences (ACE) questionnaire, Felitti et al. (1998) established that childhood trauma has a wide-ranging impact on adult health. Subsequent studies have identified a myriad of relationships between childhood adversity and negative physical, psychological, social, vocational, educational, and developmental outcomes in adulthood (Centers for Disease Control and Prevention, 2020; Hughes et al., 2017; Kalmakis & Chandler, 2015). New research has uncovered higher rates of ACEs among those in helping professions (Butler et al., 2018; Harris, 2019; Thomas, 2016), but it is unclear how these experiences impact their work as helpers. This study investigated the …

Applying Deliberate Practice To Learning Psychotherapy Techniques, Nikyra Jenkins

Honors Theses

Deliberate practice has commonly been used in areas such as music, chess, and medicine, but there is a lack of deliberate practice found in psychotherapy. The purpose of this study was to examine whether deliberate practice can be applied to learning psychotherapy techniques in a novice learner (the author of this study). The study also aimed to research the anxiety and reactivity levels of the subject in response to performance during and after the session. The author independently learned modules from the Unified Protocol manual and then engaged in role-play sessions with an expert. Before beginning each exercise, the subject …

Therapist Facilitative Interpersonal Skills In Simulated Text-Based Telepsychotherapy With Cultural Minority Clients, Carly Max Schwartzman

Legacy Theses & Dissertations (2009 - 2024)

Objective: The prevalence of mental health difficulties has increased, yet the availability and use of mental health services remains low, particularly in traditionally underserved groups. Telepsychotherapy via videoconferencing has been advertised as a means of mitigating barriers to accessing mental healthcare for these populations, though less attention has focused on text-based approaches. Indeed, although text-based telepsychotherapy is currently widely available, its efficacy in treating folx from cultural minority identities is unknown. Additionally, no research to date has studied the adaptation of multiculturally competent psychotherapy practice to a text-based platform. Thus, this project aimed to examine therapist facilitative interpersonal skills via …

The Effects Of Therapist Attachment On The Process And Outcome Of Psychotherapy, Kristin Elizabeth Roberts

Dissertations

Researchers have demonstrated that therapist attachment is associated with therapeutic relationships and client outcomes (Steel et al., 2018). Yet, results have varied and, at times, seemed contradictory. This study explores how therapist attachment might influence the working alliance and symptom change throughout psychotherapy and uses the recently validated, transcript-based Therapist Attunement Scales (TASc; Talia & Muzi, 2017). The TASc was developed to measure in-session attachment-related verbal behavior. The third session from each pair of 23 therapists-in-training and their clients was transcribed and coded. Clients completed the OQ-45.2 and the Working Alliance Inventory prior to each session.

Growth curve modeling was …

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 …