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Full-Text Articles in Psychology

The Implications, Magnitude, And Development Of Traumatic Brain Injury For Individuals Undergoing Treatment For Opioid Use Disorder, Hannah G. Mitchell May 2024

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 …


Listening To Transgender And Autistic Voices: Reflecting On Affirming Research And Mental Health Practices, Kameron Bm Kirbyson Apr 2024

Listening To Transgender And Autistic Voices: Reflecting On Affirming Research And Mental Health Practices, Kameron Bm Kirbyson

Electronic Thesis and Dissertation Repository

Those who are both autistic and transgender/gender diverse, an often-overlooked group, face difficulties accessing gender-affirming care and appropriate therapy and have higher rates of mental health complications. This study focused on listening to the voices of people who live with both of these identities through semi-structured interviewing and by centring the writer who is also autistic and transgender. Seven participants shared their experiences and highlighted issues they have come up against while trying to access care. Thematic analysis revealed several themes that were sorted into barriers and strengths. Barriers included autism symptoms, complex medical factors, interactions with institutions, traumatic events, …


Harm Reduction In Psychotherapy, Jillian Cramer Apr 2024

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 Mar 2024

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 Feb 2024

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 …


Religion And Spirituality In Psychotherapy: A Personal Bedrock Of Faith, Edward Shafranske Feb 2024

Religion And Spirituality In Psychotherapy: A Personal Bedrock Of Faith, Edward Shafranske

Psychology Division Scholarship

Personal beliefs and values conjoin with professional training to influence clinical practice. This article examines the role of religion and spirituality (R/S) through the lens of the author’s personal experiences and illustrates the confluence of faith, belief, identity, and practice in professional life. An autobiographical “glimpse” introduces the author’s formative experiences as a Roman Catholic and illustrates how religious narratives furnished conceptions of suffering, forgiveness, and transcendence that contributed to authentic hope for the client. Although often seemingly silent, R/S may influence psychotherapy practice. Clinical supervision provides a context to examine these personal factors.


Psychotherapist Awareness And Competence Managing Social Media Concerns, Jing Wen Ong Jan 2024

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 Jan 2024

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 …


Lived Experiences Of Counselors: Navigating The Changing Role Using Emotional Intelligence, Marissa Joelle Stelzer Nov 2023

Lived Experiences Of Counselors: Navigating The Changing Role Using Emotional Intelligence, Marissa Joelle Stelzer

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to describe the lived experiences of counselors during the transition from traditional face-to-face counseling to a teletherapy format during the COVID-19 pandemic and how counselors were able to utilize emotional intelligence skills/abilities during this time. The theories that guided this study were the ability model of emotional intelligence and social constructivism. The following questions guided this study: How did counselors experience their changing role from primarily face-to-face counseling to teletherapy during the COVID-19 pandemic? How did counselors experience emotional intelligence during the transition from traditional face-to-face counseling to teletherapy during the COVID-19 pandemic? …


Christian Latino Therapists’ Experiences In Integrating Psychology And Theology While Maintaining Client Autonomy, Luis F. Ramos Sep 2023

Christian Latino Therapists’ Experiences In Integrating Psychology And Theology While Maintaining Client Autonomy, Luis F. Ramos

Doctoral Dissertations and Projects

This qualitative, phenomenological study aimed to examine Christian Latino therapists' experiences integrating psychology and theology while providing therapy in New York City and maintaining client autonomy. The theory guiding this study was Martin Heidegger's phenomenological analysis of these lived experiences. The questions in the study were to determine: (a) how the participants understood their role in the provision of therapy, (b) how the participants described their experiences in providing therapy, (c) what the participants learned about themselves in the provision of therapy, (d) what methods the participants used in the integration of psychology and theology, and (e) how the participants …


Applying The Self-Determined Learning Model Of Instruction To The Psychotherapeutic Context For People With Intellectual/Developmental Disabilities, Richard Chapman, Jessica Schuttler, Karrie Shogren, Sydney Walls, Hannah Adams, Aderonke O. Oyetunji Jul 2023

Applying The Self-Determined Learning Model Of Instruction To The Psychotherapeutic Context For People With Intellectual/Developmental Disabilities, Richard Chapman, Jessica Schuttler, Karrie Shogren, Sydney Walls, Hannah Adams, Aderonke O. Oyetunji

Developmental Disabilities Network Journal

The Self Determined Learning Model of Instruction is an evidence-based intervention for supporting self-directed goal setting and problem solving. Traditionally, the SDLMI has not been applied in the psychotherapeutic context, however we propose that the SDLMI is an approach that could be integrated into such a context to support self-determination, goal setting, and goal attainment. In this paper, we specifically focus on connections between the SDLMI and cognitive behavior therapy (CBT) and how the approaches can be used jointly, during psychotherapy to support teens and young people with intellectual and developmental disabilities to set, work towards, and reach goals. Implications …


Telehealth: Visual Adaptations For Acceptance And Commitment Therapy (Act), Caycie Smith Jul 2023

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 …


The Impact Of Childhood Adversity On Career Decision-Making In Licensed Mental Health Clinicians: Aces And The Helping Profession, Lindsay Rose Seeger May 2023

The Impact Of Childhood Adversity On Career Decision-Making In Licensed Mental Health Clinicians: Aces And The Helping Profession, Lindsay Rose Seeger

Doctoral Dissertations and Projects

Traumatic experiences can have lasting impacts on an individual across the lifespan. Areas of adult functioning that are impacted by trauma may include but are not limited to mental health, physical health, relationships, communication style, attachment tendencies, and so on. Traumatic experiences in childhood can yield dysfunction in areas of intrapersonal functioning and interpersonal functioning. Childhood adversity has been studied in detail over the last two decades, with notable research done in the areas listed above. What is less studied is the impact of childhood adversity on career choice. Factors influencing career choice are endless; research points to socioeconomic status, …


Meta-Method Analysis On Therapists’ Experiences: An Inquiry Into Qualitative Psychotherapy Research Methodology, Javier L. Rizo May 2023

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 May 2023

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 Mar 2023

“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 Jan 2023

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 Jan 2023

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 …


Racial Healing In The Church: The Usefulness Of The Interpersonal Process In Therapy Model, Winston Seegobin Jan 2023

Racial Healing In The Church: The Usefulness Of The Interpersonal Process In Therapy Model, Winston Seegobin

Faculty Publications - Doctor of Psychology (PsyD) Program

Racial disunity is a major challenge facing the Christian church. This article examines psychological factors that contribute to and maintain both racial disunity and racial unity through the lens of the Interpersonal Process in Therapy model (Sullivan, 1968; Teyber & Teyber, 2017). It looks at how early interpersonal relationships in childhood influence interpersonal relationships as adults and how the therapeutic relationship as a healing influence can be applied to racial healing as adults. Spiritual factors that contribute to and maintain racial disunity and racial unity are also discussed. Understanding that it is the relationship that heals, specific strategies such as …


An Exploration Of The Lived Experiences Of Individuals Living With Hiv/Aids In Rural Uganda, Godfrey Ddungu Jan 2023

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 Jan 2023

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 …


Couple-Based Therapeutic Interventions Aimed At Treating The Individual And Relational Impact Of Childhood Abuse, Megan A. Maguire Jan 2023

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 …


A Systematic Review Of Canine Assisted Psychotherapy For Youth At Risk Or With Mental Health Disorders, Hedieh Hakakian Jan 2023

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 Jan 2023

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 Jan 2023

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 …


The State Of Psychological Services For People With Physical And Cognitive Disabilities: An Integrative Systematic Review, Megan K. Benton Jan 2023

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, …


Effects Of Peer-Supported And Self-Guided Exercise On Self-Reported Anxiety And Depression Among Young Adults - A Pilot Study, Xihe Zhu, Michael D. Kostick, Justin A. Haegele Jan 2023

Effects Of Peer-Supported And Self-Guided Exercise On Self-Reported Anxiety And Depression Among Young Adults - A Pilot Study, Xihe Zhu, Michael D. Kostick, Justin A. Haegele

Human Movement Sciences & Special Education Faculty Publications

Mental health conditions such as anxiety and depression became heightened issues for college-aged young adults during the global pandemic. The main purpose of this study was to examine the effects of a peer-supported exercise intervention on young adults (vs. self-guided exercise) who reported elevated levels of anxiety and/or depression. A parallel group design was used where young adults (n = 27) were randomly assigned to either a peer-supported or self-guided exercise group which lasted for eight weeks. The generalized anxiety and depression subscales of the Counseling Center Assessment of Psychological Symptoms (CCAPS-34) were measured for a baseline and then at …


Client Perspectives On Effective Psychotherapy: A Systematic Review And Foundation For A Consilient Psychology, Sam Han Jan 2023

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 Dec 2022

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 Sep 2022

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 …