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Articles 1 - 30 of 107
Full-Text Articles in Psychoanalysis and Psychotherapy
Wisdom In Counseling And Psychotherapy: A Conceptual Model For Practice, Mitchell Waters
Wisdom In Counseling And Psychotherapy: A Conceptual Model For Practice, Mitchell Waters
Papers
Wisdom is increasingly recognized as a critical construct in counseling and psychotherapy, yet it remains conceptually diffuse and underdeveloped for clinical application. This article proposes an integrative conceptual model of wisdom that extends the Dialectical Behavior Therapy (DBT) WISE MIND framework by incorporating temporal and self-transcendent dimensions. Wisdom is defined as a dynamic, context-sensitive capacity to coordinate cognitive, affective, temporal, and spiritual processes in response to complex life demands. The model includes four components: (a) cognitive–affective integration, reflecting the synthesis of emotion and reason; (b) temporal integration, involving adaptive coordination of past experiences and future possibilities; (c) self-transcendent orientation, conceptualized …
Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef
Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef
Theses and Dissertations
Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …
Attachment Style, The Working Alliance, And Client Self-Disclosure In Individual Psychotherapy, Jennifer S. Baar
Attachment Style, The Working Alliance, And Client Self-Disclosure In Individual Psychotherapy, Jennifer S. Baar
Dissertations
Client self-disclosure is a core component of the psychotherapy process and increased levels of client self-disclosure have been shown to predict more positive therapeutic outcomes (Pattee & Farber, 2008; Sloan & Kahn, 2005). Similarly, the working alliance and attachment are constructs that have been studied in psychotherapy research and are consistently associated with therapeutic outcomes. Specifically, stronger working alliance ratings and higher levels of secure attachment have been found to predict more positive therapy outcomes (e.g., Flückiger et al., 2018; Mallinckrodt et al., 2005; Sauer et al., 2010). As these three constructs have been found to influence psychotherapy outcomes, the …
An Attachment Perspective For Help-Seeking Intentions Among Emerging Adult Women Child Sexual Abuse Survivors, Dominique Giroux
An Attachment Perspective For Help-Seeking Intentions Among Emerging Adult Women Child Sexual Abuse Survivors, Dominique Giroux
Dissertations
Child sexual abuse (CSA) is an adverse childhood experience and a global health issue. Approximately one in four girls encounter CSA per year. Research evidence suggests approximately 50% of CSA survivors encounter sexual revictimization during adulthood (Walker & Wamser-Nanney, 2023), but formal help and intervention can mitigate further psychosocial harm experienced by CSA survivors (Widom et al., 2008). Attachment theory has provided a theoretical framework for identifying individuals at risk for revictimization and help-seeking patterns, such that individuals who have insecure attachment styles report more revictimization frequency, but the literature is mixed about attachment styles and help-seeking (Brenner et al., …
Exploring How Therapist Trainees’ Mentalization, Attachment Styles, And The Working Alliance Impact Treatment Outcomes In Psychotherapy, Hanali Gilbert
Exploring How Therapist Trainees’ Mentalization, Attachment Styles, And The Working Alliance Impact Treatment Outcomes In Psychotherapy, Hanali Gilbert
Dissertations
A burgeoning area of research within the past 30 years has sought to identify which specific therapist factors contribute to differential treatment outcomes (Barkham et al., 2017). The purpose of the current naturalistic study was to explore how two personal characteristics of therapist trainees, mentalization capacity and attachment styles, impact early treatment outcomes at two Midwestern psychology training clinics. This study also examined whether therapist mentalization and the working alliance interacted to influence client outcomes. Therapists completed the Mentalization Scale (MentS; Dimitrijević et al., 2018) and the Experiences in Close Relationships scale (ECR; Brennan et al., 1998), while the Working …
Influence Of The Discipline Of Authentic Movement Practice On Interpersonal Relationships, Joy Ruben Welts
Influence Of The Discipline Of Authentic Movement Practice On Interpersonal Relationships, Joy Ruben Welts
Educational Studies Dissertations
This mixed methods study explored how practicing the Discipline of Authentic Movement impacts relationships. This research was conducted to fill in the gaps around attunement and use of the Discipline of Authentic Movement as an intervention to support healthy relationships. Five self-selected adults met on Saturday afternoons for eight weeks to practice the Discipline of Authentic Movement. They completed a pre and post Revised Adult Attachment Scale and reflected weekly on their experience through journaling. Participants reported that it was the structure of the Discipline of Authentic Movement that allowed them to feel more comfortable being themselves with others. The …
Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.
Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.
Journal of Appalachian Health
Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …
Bridging Worlds Of Care: A Qualitative Exploration Of Integrating Non-Western Healing Modalities With Mental Health Counseling, Douglas Valdez
Bridging Worlds Of Care: A Qualitative Exploration Of Integrating Non-Western Healing Modalities With Mental Health Counseling, Douglas Valdez
Antioch University Dissertations & Theses
The aim of the study is to explore the experiences of practitioners who treat individuals presenting with depression and anxiety using culturally integrative non-Western healing modalities. Participants included 15 experienced practitioners (minimum five years of practice) who identified as Traditional Chinese Medicine providers (e.g., acupuncturists, herbalists) and/or Curandero/x/as. The approach was qualitative, utilizing open-ended survey responses collected electronically and analyzed with thematic analysis. Results indicated six primary themes: (a) Philosophies in Healing, highlighting culturally grounded conceptualizations of depression and anxiety; (b) Traditional Chinese Medicine Interventions, including acupuncture, botanical, nutritional, manual, and movement-based practices; (c) Curanderismo Pláticas and Integrative Western Healing …
"Why Don't I Talk To A Therapist?": Motivations And Reflections Of Female-Identifying Chinese Immigrants Seeking Psychotherapy For Depression, Qiuyi Wei
Antioch University Dissertations & Theses
This phenomenological study explored the lived experiences of Chinese immigrants and temporary residents struggling with depressive symptoms and their process of seeking and accepting psychotherapy support. The study aimed to describe the factors that motivated participants to enter therapy for depression while also addressing their internal concerns about treatment. Nine female-identified Chinese immigrant adults with such experiences were recruited. Participants’ perceptions of their depressive symptoms and the factors contributing to their decision to seek professional therapy were explored through in-depth, semi-structured qualitative interviews conducted in Mandarin. The interview transcripts were analyzed in Mandarin using interpretative phenomenological analysis, through which four …
Navigating Family, Culture, And Well-Being: A Qualitative Study Of First-Generation Adult Children Of Middle Eastern Immigrants In The United States, Ramona Amely
Antioch University Dissertations & Theses
The purpose of this study is to explore the lived experiences of first-generation adult children of Middle Eastern immigrant parents/caregivers living in the United States. This was a phenomenological study with reflexive thematic analysis. Participants (N=10) were interviewed via Zoom, and transcripts were analyzed using Reflexive Thematic Analysis (RTA). The results included four themes: (1) Migration Contact and Cultural Formation, (2) Bicultural Identity Development, (3) Family System Adaptation, and (4) Emotional Socialization and Psychological Impact. This study highlights how first-generation adult children of Middle Eastern immigrants navigate complex, interwoven processes of bicultural identity development, family adaptation, and emotional socialization shaped …
The Effects Of Meditation On Compassion And Cultural Humility In Mental Health Professionals, Jamie Kostek
The Effects Of Meditation On Compassion And Cultural Humility In Mental Health Professionals, Jamie Kostek
Antioch University Dissertations & Theses
The purpose of this study was to examine the effects of a brief, secular, Buddhist-inspired meditation program on self-compassion, compassion for others, and cultural humility on mental health professionals. Using a single-group pretest-posttest design, licensed clinicians (N = 13) participated in a five-week Anytime Anywhere Meditation (Tergar International, 2024) program. Results indicated statistically significant increases in mindfulness, self-compassion, and cultural humility. Additionally, strong positive correlations were found between mindfulness and self-compassion, and between self-compassion and compassion for others. Findings suggest that brief, secular meditation programs rooted in traditional Buddhist practices may support both clinician well-being and culturally responsive practice.
The Lived Experience Of Survivors Of Narcissistic Abuse, Jessica Williams
The Lived Experience Of Survivors Of Narcissistic Abuse, Jessica Williams
Antioch University Dissertations & Theses
The purpose of this study is to explore the lived experiences of narcissistic abuse survivors through a grounded theory approach to generate a model that can assist people in recognizing patterns and traits of narcissistically abusive relationships. Guided by relational-cultural theory, this study further seeks to examine the ways narcissistic abuse damages relational connections and to highlight elements of healthy, growth-fostering relationships. The population of focus included self-selected narcissistic abuse survivors who are adults over the age of 18 (N = 8). The results indicated three themes, each with additional subthemes, which include: (a) early behavior – performative displays and …
Beyond The Diagnosis: A Qualitative Exploration Of Men Living With Hiv, David R. Romanelli
Beyond The Diagnosis: A Qualitative Exploration Of Men Living With Hiv, David R. Romanelli
Antioch University Dissertations & Theses
This qualitative study explored the lived experiences of men (18+ years old) living with HIV to better understand how they navigate identity, mental health, relationships, and healthcare systems after diagnosis. The method included a qualitative thematic analysis with 10 participants. Eight themes emerged from the data: (1) reactions, reflections, and meaning-making after diagnosis; (2) managing medication, treatment, and co-occurring conditions; (3) stigma, disclosure, and negotiation of identity; (4) substance use, housing instability, and socioeconomic stressors; (5) navigating the changing HIV landscape; (6) experiences with family and intimate relationships; (7) implications for mental health counseling; and (8) the role of community …
Accessing Campus Mental Health Services In A Nigerian Southwestern University: Barriers To Academic Success, Caroline Dada
Accessing Campus Mental Health Services In A Nigerian Southwestern University: Barriers To Academic Success, Caroline Dada
Electronic Theses and Dissertations
Mental health disorders are a significant health concern among higher education institutions in sub-Saharan Africa, including Nigeria. A substantial treatment gap exists in the Nigerian healthcare system, and this gap is further worsened by cultural and religious barriers, which reinforce stigma that discourages students from seeking professional help. This qualitative narrative inquiry explored the barriers students encountered when accessing mental health services at a university in Southwestern Nigeria, to increase service access. Qualitative semistructured interviews were conducted with seven professional mental health providers at a university counseling center between March and April 2025. Inductive thematic analysis was used to identify …
The Progression Of Deinstitutionalization And Its Effects On The American South: A Judicial Analysis Of 20th-Century United States Supreme Court Decisions, Eva-Marie V. Jones
The Progression Of Deinstitutionalization And Its Effects On The American South: A Judicial Analysis Of 20th-Century United States Supreme Court Decisions, Eva-Marie V. Jones
Honors College Theses
This thesis explores the effects of four landmark Supreme Court cases on the deinstitutionalization movement in the American south. Previous literature frequently discusses the legislative implications of this era; however, no law is applicable without the interpretation and application of the judiciary, which so often contextualizes the greater public perspective. Rarely has an analysis of judicial decisions involving psychiatric care merged with regional focus, and certainly not in a format accessible to the average individual.
From unmarked graves to abandoned infrastructure, the legacy of historic psychiatric care in the United States has been largely obscured – yet its consequences continue …
Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano
Psychological Treatment Behind The Walls:Insights From The Inside, Rogelio Serrano
Psychology Division Scholarship
Repeated eras of mass incarceration, criminalization of marginalized communities, and substance use policies have created a revolving door of justice involved populations. The ever-increasing prison population has repeatedly become the largest contingency of mental health clientele for an overburdened mental health system. Those who work with formerly incarcerated individuals in the community often don’t know the unique set of challenges faced by practitioners within the system. Increased understanding and coordination of care can offer opportunities for sustained recovery and reduced levels of recidivism. In this presentation participants will learn about the unique insights on mental health treatment that can be …
Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp
Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp
Mindfulness Studies Theses
This study presents research about the nature and prevalence of adverse childhood experiences (ACEs), the mental and physical impacts to individuals exposed to ACEs, and incorporating mindfulness practices into therapeutic approaches to treating them, particularly Mindfulness-Based Narrative Therapy (MBNT). It is important because ACEs have become a global crisis, with the potential for interfering with psychological and physical development, early mortality, and other harmful life outcomes. This thesis provides critical information for mindfulness teachers and practitioners, therapists, educators, regulators, parents, and individuals subjected to ACEs.
The methodology includes extensive literature searches for narrative therapy and mindfulness-based interventions (MBIs) in peer-reviewed …
Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi
Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi
Social Work Dissertations - Archive
This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …
Mindfulness & Mental Health: Balanced Time Perspective As A Mediator, Eddie Trueblood
Mindfulness & Mental Health: Balanced Time Perspective As A Mediator, Eddie Trueblood
Masters Theses
Mindfulness is a practice of intentionally paying attention to the present moment in a nonjudgmental way. Being more mindful can decrease symptoms of anxiety, depression, and stress, among other mental and physical health improvements. (Donald et al., 2016; Hofmann et al., 2010; Kabat-Zinn et al.,1992). This study examined if balanced time perspective (BTP) is one of the mechanisms of action of mindfulness in its relationship with depression, anxiety, and stress. BTP refers to a person’s ability to flexibly adapt their time perspective (attention to the past, present, or future, and positive or negative attitudes toward each) to suit the current …
Inheriting Power And Pain: An Examination Of Intergenerational Influences In The Stories Of Black Women In Professional Leadership Positions, Angela Banks
Antioch University Dissertations & Theses
This study aimed to explore the stories of Black women in professional leadership roles. Grounded in a Black feminist perspective (Crenshaw, 1989) and informed by historical and intergenerational trauma (Brave Heart, 1999), this study utilized Black storytelling as a methodological framework and employed thematic analysis to examine the narratives of participants. A total of nine Black women in leadership positions across various industries participated in one-on-one interviews. The findings revealed four key themes: (1) What I saw and what others saw in me: Community leadership, (2) Instilled values: The Strong Black Woman Schema, (3) The only one: Sole representation and …
More Than Meets The Eye: A Phenomenological Study Of Self-Concept, Identity, And Meaning-Making In Adults With Acquired Vision Loss, Melinda M. Szilva
More Than Meets The Eye: A Phenomenological Study Of Self-Concept, Identity, And Meaning-Making In Adults With Acquired Vision Loss, Melinda M. Szilva
Theses and Dissertations (Comprehensive)
The qualitative research project examines the lived experience of acquired vision loss in adulthood and its impact on the way participants see themselves and the world around them, both sensorially and metaphorically. The research question, “What are the lived experiences of adults with acquired vision loss as they relate to identity and conceptions of self?” is informed by the researcher’s clinical practice as a psychotherapist in a low vision clinic. The dissertation includes a literature review focussed on the psychosocial aspects of vision loss to provide insight into the intended population and context for the study. Data for the phenomenological …
Outside Of The Counseling Room: Whiteness And Antiracism, Carlee D. Smith
Outside Of The Counseling Room: Whiteness And Antiracism, Carlee D. Smith
Antioch University Dissertations & Theses
This dissertation explores the lived experiences of white counselors as they integrate antiracism practices into their non-clinical lives. Rooted in the Multicultural and Social Justice Counseling Competencies (MSJCC) framework, this study addresses the gap in literature surrounding how white counselors embody antiracist ideologies outside of the counseling room. Through narrative qualitative methods, the research examines the challenges, strategies, and reflections of white counselors committed to antiracist practices; practical integration into personal life often encounters barriers related to internal biases, social resistance, and limited educational support. Insights from this research highlight the critical need for ongoing self-reflection, community accountability, and structural …
Inside The Circle 2025: Exploring The Ontario Cpe Supervisors' Lived Experience Of The Interpersonal Relations Group Process Portion Of Cpe, Kelly L. Collins
Inside The Circle 2025: Exploring The Ontario Cpe Supervisors' Lived Experience Of The Interpersonal Relations Group Process Portion Of Cpe, Kelly L. Collins
Theses and Dissertations (Comprehensive)
This research used a philosophical phenomenological (primarily Gadamer) methodology and asked the question, “What is the lived experience of Ontario Clinical Psychospiritual Education (CPE) Supervisors in the Interpersonal Relationships (IPR) group process portion of CPE?” It used a 90-minute, semi-structured interview format as it sought to understand the supervisor experience of safety in the group. 11 Ontario Certified Supervisors were interviewed and explored this question in relationship to participant supervisors’ experience as students and/or as educators. In the history of CPE, there has been significant harm done to students by some supervisors who were well-meaning, but unaware of their impact …
Subthreshold Depression In The National Epidemiologic Survey On Alcohol And Related Conditions Iii (Nesarc-Iii): A Quantitative Analysis Of Prevalence, Characteristics, And Burden In A Nationally Representative Sample, Scott T. Young
Antioch University Dissertations & Theses
While subthreshold depression (subD) is relatively young for a diagnostic concept at a mere half century old, it has burdened individuals and societies for far longer. Research has established that it is a highly prevalent, clinically important entity with clear links to personal distress and impairment (including increased suicidal ideation and behavior), societal burden (e.g., increased reliance on public assistance programs), and economic costs (both personal and public). Research has also demonstrated that it represents a significant risk factor for incident major depression (MD) and that it likely represents both a prodromal and residual state in the normal course of …
Learning To Be An Autistic Therapist: Personal Steps Towards An Autism-Affirming Psychotherapy, Sasha D. Strong
Learning To Be An Autistic Therapist: Personal Steps Towards An Autism-Affirming Psychotherapy, Sasha D. Strong
Ought: The Journal of Autistic Culture
How can Autistic therapists understand and support themselves, and how can this help them support their clients? In this paper, I recount my personal journey of healing and growth as an Autistic psychotherapist, 16 months after self-identification. Here is an overview of conceptual frameworks from #actuallyautistic authors, critical theory, queer theory, and social justice that I have found helpful. I also share some of the therapeutic and wellness approaches that have been important to me, including mindfulness and bodyfulness. Organic knowing has been pivotal for me in discerning between masking and aliveness, and regaining a choice around masking behaviors. This …
A Confirmatory Factor Analysis Of The Psi-4-Sf In Parents Of Children With Autism Spectrum Disorder, Paige Weir
A Confirmatory Factor Analysis Of The Psi-4-Sf In Parents Of Children With Autism Spectrum Disorder, Paige Weir
LSU Doctoral Dissertations
The factor structure of the Parenting Stress Index - Short Form (PSI-4-SF) was evaluated among parents of children with autism spectrum disorder (ASD). Two hypotheses were tested: (1) the original PSI-4-SF model would yield an unsatisfactory fit, and (2) a three-factor alternative model would improve fit compared to the original and other models. A sample of 205 parent-child dyads was analyzed using confirmatory factor analysis (CFA) with the lavaan package in R Studio. Preliminary analyses included descriptive statistics, normality checks, and assessments of skewness and kurtosis. Results supported the first hypothesis, showing poor fit indices for the original PSI-4-SF model. …
Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,
Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,
Library Philosophy and Practice (e-journal)
Background: As technology continues to advance, individuals' interactions with digital platforms have become integral to daily life. Amidst this technological evolution, a novel concern emerges—Digital Phobia, hereafter referred to as “Digiphobia.” This phenomenon, although not previously explored in scholarly literature, necessitates an in-depth investigation due to its potential impact on individuals' well-being. Our research employs a two-step methodology to investigate its existence, implications, and manifestations.
Introduction: This research paper introduces and proposes the term "Digiphobia" as a comprehensive conceptualization of anxiety arising from interactions with digital spaces, applications, and environments. The proliferation of digital technologies has led to the emergence …
Productivity In Private Practice: Experiences And Best Practices Of Mental Health Counselors, Mark C. Pilger
Productivity In Private Practice: Experiences And Best Practices Of Mental Health Counselors, Mark C. Pilger
Antioch University Dissertations & Theses
The purpose of this study is to understand how mental health counselors in private practice conceptualize, approach, and manage productivity, including key strategies and best practices employed through a qualitative study of lived experience. Inclusion criteria for participant eligibility included being a licensed counselor with a degree from a CACREP-accredited counseling program, working primarily in a private practice setting, and with primarily adult clients. Nineteen participants (N = 19) met these criteria and were included in the study. A thematic analysis was utilized by a team of researchers, which resulted in seven primary themes. The primary themes relate to the …
Emdr Gaming Recovery And Insight Protocol (E-Grip): An Approach For Treating Video Game Addiction, Manjit Bath
Emdr Gaming Recovery And Insight Protocol (E-Grip): An Approach For Treating Video Game Addiction, Manjit Bath
Antioch University Dissertations & Theses
The prevalence of video game addiction has escalated with the advancement of digital technologies, posing significant psychological and social challenges. This dissertation introduces the eye movement desensitization and reprocessing (EMDR) Gaming Recovery and Insight Protocol (E-GRIP), a novel therapeutic approach designed to address the complexities of video game addiction. Grounded in the principles of EMDR therapy and incorporating insights into video game culture, E-GRIP aims to treat individuals struggling with problematic gaming behaviors by integrating their gaming experiences and preferences into the therapeutic process. The E-GRIP methodology extends the conventional EMDR framework by including an in-depth exploration of the client’s …
Expressive Arts Therapy To Support Positive Experiences Of Embodiment Among Rural Lgbtq+ Adults: A Literature Review, Ann Stromgren
Expressive Arts Therapy To Support Positive Experiences Of Embodiment Among Rural Lgbtq+ Adults: A Literature Review, Ann Stromgren
Expressive Therapies Capstone Theses
This paper investigates the use of expressive arts therapy to support LGBTQ+ adult clients in rural communities. Caring professionals in rural areas often lack training on how to work with LGBTQ+ clients, and best practices for clinical mental health counseling with rural LGBTQ+ clients have yet to be defined. Some evidence suggests that using “metronormative” best practices with rural clients may be irrelevant or cause harm (Giano et al., 2020). Although some recommendations exist for using expressive therapies with LGBTQ+ clients, they are rarely evidence-based, as very few empirical studies exist evaluating the effectiveness of expressive therapy interventions with LGBTQ+ …