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Making Sense Of Missing Sessions: Attendance Patterns In Posttraumatic Stress Disorder And Substance Use Disorder Treatments, Margaret Rauen

Dissertations, Theses, and Capstone Projects

The current study examined the diverse ways individuals with co-occurring Posttraumatic Stress Disorder and Substance Use Disorders (PTSD-SUD) attend treatment. The study was a secondary analysis of a randomized controlled trial for PTSD-SUD (Ruglass et al., 2017), in which participants meeting criteria for both PTSD and SUD (N=82) were randomized to either Concurrent Treatment of PTSD and SUD using Prolonged Exposure (COPE: n=39) or Relapse Prevention Therapy (RPT: n=43). Latent class growth analysis (Muthén & Muthén, 2000) revealed three distinct classes of attendance as the model of best fit. Diagnostic, but not demographic, variables were significantly associated with treatment attendance …

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 …

Social Worker Perceptions Of Equine Assisted Psychotherapy, Melanie Woolen

Electronic Theses, Projects, and Dissertations

This research study examines factors that influence a social worker’s willingness to utilize animals in therapy, specifically equine assisted psychotherapy. Equine assisted psychotherapy is an experiential therapy involving horses for the treatment of mental and behavioral health issues. The study uses quantitative data. The sample population is Bachelors of Social Work (BSW) and Masters of Social Work (MSW) students attending a University in Southern California. The participants were provided an electronic self-administered survey through their University email account. The data collected was analyzed and the results were provided to the University. The results indicate a relationship between several variables, such …

The Dialogical Principle In Counseling And Psychotherapy: An Exploration Of Martin Buber's "I And Thou", Matthew Martin

Educational Specialist, 2009-2019

The relationship has become increasingly decentralized as counselors and psychotherapists continue to turn towards evidence-based techniques and manualized intervention strategies. Although counselors must learn to incorporate appropriate technique and therapeutic strategy during the process of therapy, these interventions must be predicated on an understanding of the real meeting between counselor and client. Dialogical theory, based on the philosophical anthropology of philosopher Martin Buber, emphasizes the client-counselor encounter as the fundamental source of healing in counseling and psychotherapy. This paper will explore the Dialogical principle found in Martin Buber’s philosophy of “I and Thou,” and how these can be related and …

Making & Sustaining Change From Psychotherapy: A Mixed Method Study, Kelsi Dankey, Heather Karson, Arielle R. Yahnke, Sara Lemon, Tricia Downing, Danae Hoffman, Natia Wilcek

Master of Social Work Clinical Research Papers

This mixed method study explored both (1) how changes are made and (2) what encourages the maintenance of change after psychotherapy. Literature has called for further exploration into what helps clients to make and sustain change from their perspectives. While the effectiveness of approaches such as: psychodynamic, cognitive behavioral, and other disorder-specific treatments has been demonstrated broadly, less is known about individual variables, and specifically about how individuals participate in and support their recovery. This study used a mixed method sequential design. Wampold & Imel’s (2015) contextual model was used as a conceptual framework throughout the study. Using secondary data …

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 …

Cost Outcomes For Major Depressive Disorder And Bipolar Disorder Across Professional License Types And Modalities, Julia H. Jones

Theses and Dissertations

The purpose of this study was to compare outcomes for patients with Bipolar Disorder or Major Depressive Disorder based on severity of diagnosis. This study also compared psychotherapy providers and therapy modalities on total cost, number of sessions, and dropout. Our data set (N=136,439) came from Cigna, a national health care company. Results showed significant differences by severity of diagnosis. The comparison of providers showed that psychologists had higher costs and session numbers, while the other providers were not significantly different. However, all providers successfully provided low cost treatment on both MDD and BD. There is no support for the …

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 …

"As If" : An Exploration Of The Relationship Between Clincians' Theoretical Orientations And Their Conceptualizations Of Patient-Generated Metaphors In Psychotherapy, Joe Berlin

Theses, Dissertations, and Projects

The present qualitative study explored the relationships between psychotherapists’ theoretical orientations, phenomenological understandings of their own clinical practice, and the metaphoric language used by patients in psychotherapy. This study is based upon interviews with 12 Licensed Independent Clinical Social Workers who are presently practicing psychotherapy. This sample was selected using a quota method, whereby three distinct psychotherapy theoretical orientations were represented in the sample: psychodynamic, narrative, and cognitive-behavioral therapy.

The findings suggest that psychotherapists actively consider the metaphors patients use in therapeutic dialogue, and that these clinicians regularly draw upon their theoretical knowledgebase in doing so. This study finds that …

Implications Of Psychotherapy And Low-Dose Medication Following First-Episode Psychosis, Alyssa Woolley

University Honors Theses

Schizophrenia, a mental disorder characterized by hallucinations, delusions, and disorganized thoughts and speech, is typically treated using antipsychotic medication and therapy. Randomized trials focusing on schizophrenia have provided evidence that early intervention, which entails talk therapy combined with low-dose antipsychotic medication directly following onset of psychosis, is most effective in treating symptoms. The literature review detailed in this paper is intended to help better understand the relationship between low-dosage antipsychotic medication, pair with regular psychotherapy, and how that relationship can help patients to adhere to treatment for long-term remission.

The Problem Of Evidence : Philosophy Of Science And Evidence Based Practice In Clinical Social Work, Bronwyn DepréS

Theses, Dissertations, and Projects

Evidence Based Practice is one of the most prevalent concepts in social work today, guiding social workers across the world. This theoretical thesis examines Evidence Based Practice, its theoretic foundations, and its application in social work, using the theories of Logical Positivism and Critical Rationalism from Philosophy of Science. Philosophy of Science is a branch in Philosophy that studies and theorizes about precisely what science is, how science works, the implications of science, and the logic behind it. This thesis argues that Logical Positivism is the scientific foundation that Evidence Based Practice rests on, and uses Critical rationalism to dispute …

"If You Lived In Your Body, You'd Be Home By Now" : Clincians' Perspectives On Somatic Practices In Psychotherapy, Natasha Sunil Jeswani

Theses, Dissertations, and Projects

While the 21st century has seen increased popularity in somatic practices, there is little cohesive understanding of how these practices are effective and what common value their various branches bring to psychotherapy. This qualitative narrative research study compiles clinicians’ perspectives on their use and understanding of somatic practices in psychotherapy, along with challenges they have experienced in using such methods. The study qualifies such practices as meditation-based, trauma related, or movement-based and ultimately necessitates the inclusion of somatic practices in psychotherapy.

Classism In The Therapeutic Alliance : Implications For Clinical Social Work Practice, Taylor Millard

Theses, Dissertations, and Projects

This qualitative study was an exploration of the impact of classism in the therapeutic alliance, specifically from a power, privilege, and oppression framework, and with attention to participants’ salient intersecting identities. Twelve clinicians, who identified with working class backgrounds and who had engaged in therapy as both clinicians and clients, engaged in semistructured qualitative interviews. The findings indicated that classism was salient to participants’ intersectional subjectivities and to their experiences in the field. Significantly, participants all named experiences in which a systemic lack of attention to classism and/or social class identities led them to feel alienated and silenced as students, …

A Correlative Analysis Of Mystical Experiences And Lasting Symptom Improvement From Mdma-Assisted Psychotherapy For Treatment-Resistant Ptsd : A Project Based Upon An Investigation Sponsored By Multidisciplinary Association For Psychedelic Studies (Maps), Michiko A. Mitsunaga-Whitten

Theses, Dissertations, and Projects

Before the Controlled Substance Act of 1985 categorized psychedelic substances as criminalized schedule I drugs, psychiatrists used ±3,4-methylenedioxymethamphetamine (MDMA) as a catalyst to psychotherapy. Over two decades later, this project seeks to contribute to the renaissance of psychedelic research. Specifically, this study focuses on participants’ experience of treatment in the recent FDA approved Phase 2 clinical study, “A Randomized, Triple-Blind Phase 2 Pilot Study Comparing 3 Different Doses of MDMA in conjunction with manualized psychotherapy in 24 Veterans, Firefighters, and Police Officers with Chronic, Treatment-resistant PTSD.” The current study presents results from correlation analyses of the Mystical Experience Questionnaire …

Exploring Clinical Best Practices For Working With The Co-Occurrence Of Psychosis And A Trauma History, Sierra Leah Black

Theses, Dissertations, and Projects

This qualitative research study explored clinical practices most effective in helping people who experience co-occurring psychosis and a trauma history. The research was conducted through interviews with nine mental health professionals, who reported they created their own skill base in working with clients with a co-occurrence of psychosis and trauma. Although every respondent reported this co-occurrence as common, they all expressed a lack of confidence and expertise in treating the population. Best practices for treatment were found to be a combination of psychiatric medication, psychotherapy, and community support. Themes of treatment included the need to establish trusting relationships, appreciate client …

Understanding The Working Alliance And Alliance Ruptures In Online Psychotherapy From The Therapist's Perspective, Laura Kortz

Legacy Theses & Dissertations (2009 - 2024)

Online psychotherapy using text-based technologies has become increasingly popular in the last two decades, and a burgeoning literature attests to its efficacy as a treatment for a variety of mental health concerns. Moreover, evidence suggests that the working alliance is rated as highly online as it is in face-to-face therapy, yet little is known about how psychotherapists develop strong alliances with their clients in text-based environments. This qualitative study was conducted to investigate psychotherapists’ experiences forming therapeutic relationships with their clients in online environments, identifying and repairing alliance ruptures, and their perceptions of differences and similarities between these processes online …

Two-Sided Healing : An Exploration Of Jewish Women Psychotherapists' Experience, Aviva Bellman

Theses, Dissertations, and Projects

This study examined the subjective identities of Jewish women psychotherapists, as well as the ways in which they give meaning to their psychotherapeutic practice. Twelve narratives by Jewish women psychotherapists were utilized as secondary data, originally published in an edited book by Greene and Brodbar (2010). The study used a Jewish feminist epistemological stance, an intersubjective understanding of the therapeutic relationship, and an interpretive (hermeneutic) phenomenological approach, which led the researcher to self-reflect over the course of the analytical process (Ginsberg, 2002; Lopez and Willis, 2004). Narratives were analyzed for recurrent themes and sub-themes (Smith, Flowers, & Larkin, 2009). Implications …

From Yellow Peril To Model Minority : ǂB Deconstruction Of The Model Minority Myth And Implications For The Invisibility Of Asian American Mental Health Needs, Lynda Anne Moy

Theses, Dissertations, and Projects

The model minority myth is a racial stereotype imposed upon Asian Americans, often depicting them as a successful and high-achieving monolithic group in the United States. This paper examines sociopolitical functions of the term “model minority” and implications for this broad and diverse racial group by reviewing existing literature and conducting an analysis of qualitative interviews with 12 Asian Americans. The findings of this study suggest that while the model minority myth appears to be a positive stereotype, it may lead Asian Americans to experience distress through (a.) a sense of confinement, (b.) treatment as foreigners, and (c.) …