Psychoanalysis and Psychotherapy Commons^™

Seasoned Psychotherapists' Experience Of Difficult Clinical Moments, Kirk J. Honda

Antioch University Dissertations & Theses

Purpose: This phenomenological study was concerned with the clarification of the experience of the difficult clinical moment which is defined as a discrete moment in which the psychotherapist experiences distress as a result of his or her work with a client. Method: Retrospective descriptions of experience of difficult clinical moments were obtained from a diverse sample of ten seasoned psychotherapists in the Seattle area. The interviews were transcribed, analyzed, and summarized, and these summaries were confirmed by each participant as being an accurate representation of their experience. Results: Thematic analysis revealed six themes of experience during a difficult clinical moment: …

Ways Of Being In Trauma-Based Society: Discovering The Politics And Moral Culture Of The Trauma Industry Through Hermeneutic Interpretation Of Evidence-Supported Ptsd Treatment Manuals, Sarah Peregrine Lord

Antioch University Dissertations & Theses

One hundred percent of evidence-supported psychotherapy treatments for trauma related disorders involve the therapist learning from and retaining fidelity to a treatment manual. Through a hermeneutic qualitative textual interpretation of three widely utilized evidence-supported trauma treatment manuals, I identified themes that suggested a particular constitution of the contemporary way of being—a traumatized self—and how this traumatized self comes to light through psychotherapeutic practice as described by the manuals. The manuals included: 1) a trauma focused cognitive-behavioral therapy for children; 2) an eye-movement desensitization and reprocessing therapy for adults; and, 3) an early intervention and debriefing therapy series for post-traumatic stress …

The Relationships Between Attachment Style And Boundary Thickness, Dore Lavering

Antioch University Dissertations & Theses

Despite the multitudes of research on attachment and many different aspects of relational structures, only one study to date has researched the relationship of adult attachment to boundary thickness. The possible benefits to understanding this relationship would provide therapists and clients a better conceptualization of individual's internal working model of attachment. This study investigated the relationship between the Hartmann Boundary Questionnaire (HBQ), a measure of boundary thickness, and an adult romantic attachment measure, the Experiences in Close Relationships Inventory-Revised (ECR-R) two dimensions of attachment. This study theorized that attachment anxiety would be related to thinner boundaries and conversely attachment avoidance …

Big Five Personality Traits, Pathological Personality Traits, And Psychological Dysregulation: Predicting Aggression And Antisocial Behaviors In Detained Adolescents, Katherine S. L. Lau

University of New Orleans Theses and Dissertations

This study tested the utility of three different models of personality, namely the social and personality model, the pathological personality traits model, and the psychological dysregulation model, in predicting overt aggression, relational aggression, and delinquency in a sample of detained boys (ages 12 to 18; M age = 15.31; SD = 1.16). Results indicated that the three personality approaches demonstrated different unique associations with aggression and delinquency. The psychological dysregulation approach, composed of behavioral dysregulation, emotional dysregulation, and cognitive dysregulation, emerged as the overall best predictor of overt aggression, relational aggression, and delinquency. After controlling for the Big Five personality …

Motivational Interviewing Assessment And Behavior Therapy As A Stepped-Care Approach To The Treatment Of Adolescent Depression, Tanya N. Douleh

Dissertations

Depression is a significant public health concern with a lifetime prevalence of 24.01 for adolescents in grades 9-12 (Lewinsohn, Hops, Roberts, Seeley, & Andrews, 1993) and a point prevalence of 4-6% (Kessler, Avenevoli, & Ries, 2001). The risks associated with adolescent onset depression include comorbidity, depressive episodes continuing into adulthood, and suicidality. These risks make it imperative to develop effective treatments to address adolescent depression. Stepped care is an approach to treatment which involves treatment of illness using the least invasive measures first and moving toward more invasive treatment as indicated by ongoing assessment. Through a single-participant design, the current …

Les Enfants Dans Les Coins: Une Comparaison D’Autisme En France Et Aux Etats Unis, Danya J. M. Rubin

Scripps Senior Theses

The year 2012 was a year of great controversy surrounding autism in France. Thus it is an ideal time for an investigation of the treatment of and attitudes about autism in France, specifically in comparison with the United States. This investigation encompass several specific categories, and the Freudian psychoanalytic method against the behavior modification method, the French education system and the identification of autism, "Maternal Madness" - the connection between sexism and autism, the philosophy of humanity and the history of medical experimentation and psychiatry in France. This paper questions how is it that all these categories influence the opinions …

Psychologists And Medications In The Era Of Interprofessional Care: Collaboration Is Less Problematic And Costly Than Prescribing, William N. Robiner, Tim R. Tumlin, Tanya Tompkins

Faculty Publications

Increasing emphasis on interprofessionalism and teamwork in healthcare renders psychologists’ collaborations critical and invites reexamination of psychologists’ roles related to medications. The Collaboration Level outlined by the APA’s Ad Hoc Task Force is more achievable and in synch with health reform than prescription privileges (RxP). RxP remains controversial due to training and safety concerns, lacking support from health professionals, psychologists, and consumers. Differences in educational preparation of psychologists relative to prescribing professionals are discussed. Enactment of only three of 170 RxP initiatives reveals RxP to be a costly, ineffectual agenda. Alternatives (e.g., integrated care, collaboration, telehealth) increase access without risks …

My Journey From Physician To Psychologist: Relational Touch In Psychotherapy, Brita S. Reed

Antioch University Dissertations & Theses

A physician's armamentarium includes the presence of the tool of touch which is used not only to diagnose and to heal, but also to reassure patients that they are safe and well cared for in the hands of the physician. The use of touch in the practice of psychology, however, is relatively proscribed. In this essay, I examine how we, as psychologists, can best "hold" our clients without the use of touch. In the first part of this essay, I explore some theoretical considerations on relational touch in psychotherapy. I define relational touch as touch that occurs between people and …

Equine-Assisted Psychotherapy: A Descriptive Study, Erica Jex Gergely

Dissertations

The current study seeks to examine the program operations and treatment practices of individuals and organizations providing equine-assisted therapy services nationwide. Currently, there are several hundred programs across the United States that utilize equine-assisted therapy to treat common mental health problems in children, adolescents, and adults. Not all equine therapy programs function under the same theoretical model and therefore do not deliver treatment services using equivalent principles or techniques. In addition, program policies, procedures, and ethical guidelines of each provider vary. To date, there exists a paucity of research regarding equine-assisted therapy including both qualitative and quantitative data.

The present …

Suicide Rates Among Young, Married Women In Nepal, Kirra L. Hughes

Capstone Collection

In 2009, a Maternal Mortality and Morbidity (MMM) report carried out in Nepal by the Family Health Division of the Department of Health Services accidently stumbled upon a surprising leading cause of death in Nepali women of reproductive age (15 - 49). The result: suicide. And the numbers are still on the rise. There have since been no comprehensive follow-up studies and none, to my knowledge, that are currently ongoing. This leaves an urgent need for research to be done on the causes of these suicides (Benson and Shakya, 2011; Bertolote et al, 2005; Pradhan et al, 2009).

Globally, there …

Individualism And Collectivism As Moderators Of Affect And Attributional Style In Predicting Life Satisfaction, Jo M. Holmquest

Graduate Theses

The present study examined the effect of person-level individualism and collectivism on attributional style and frequencies of positive and negative emotions as predictors of life satisfaction. Participants were 224 individuals (age range 18 to 78, M= 39.63, SD = 13.78; 73% women; 56% Filipinos) who answered an online survey. Results from regression analyses showed that attributional style is not a statistically significant predictor of life satisfaction. The analyses also showed that across all participants, and among those who did not score high in individualism and low in collectivism, the frequency of positive emotions, as compared to the frequency of negative …

The Development And Validation Of The Preference For Adherence To Theoretical Orientation Scale, Tiffinee S. Hamilton

Counseling & Human Services Theses & Dissertations

One of the most common criticisms of undergraduate and master's level graduate programs is that students lack the ability to define their view of human nature. One effective means of assisting students in their desire to identify their preference in orientation is the use of a validated psychometric instrument developed for mental health trainees. Thus, the purpose of this study is to develop and initially validate a new assessment tool, the Preference for Adherence to Theoretical Orientation Scale (PATOS). PATOS provides a theoretically grounded method for assessing a counselor's preference for a particular orientation(s) as well as adherence to a …

Psychotherapy As Cultivating Character, Mike W. Martin

Philosophy Faculty Articles and Research

Duff R. Waring argues that, in some instances, psychotherapy should be viewed as healing (or alleviating) mental disorders and also as cultivating good character in patients (Waring 2012). In these instances, psychotherapists should understand their patients as having character faults that are manifested as mental disorders, as having nascent virtues they can build on during therapy, and as moving toward goals that can be specified in terms of both improved mental health and greater moral virtue. Waring’s discussion is deeply illuminating, but it suffers from a major difficulty: the failure to take adequate account of the differences between the perspectives …

An Intergenerational Study: Mirrors As A Tool For Self-Reflection, Susan Ridley

Expressive Therapies Dissertations

Globalization and advances in technology have resulted in a loss of cultural, community, and individual identity. Having a strong sense of self can be a protective factor in resisting peer pressure and involvement in negative behaviors, and a determining factor in the formation of one’s coping skills, and resiliency to life’s challenges. This was especially important for adolescents who are negotiating the developmental growth from childhood to adulthood, and older adults who are transitioning from the independence of adulthood to the dependence of old age.

This was a qualitative intergenerational study on the process of self-reflection on identity. Mirrors have …

The Role Of Defense Mechanisms Of Israeli Society In Relationship To The Israeli–Palestinian Conflict: From “1948 Repression” To Artistic Sublimation, Keren Shechter

Expressive Therapies Dissertations

Although many researchers have examined the concept of defense mechanisms, almost none have done so from a societal and cultural point of view. The author investigated the following research questions: (1) Which defense mechanisms are used in Israeli society within the context of the Israeli–Palestinian conflict? What changes, if any, have occurred in these defenses over the years? (2) What are the reasons for the use of these defenses? What are the consequences of the use? (3) How can a transition(s) from the use of a lower-level defense mechanism(s) to a higher-level one(s) occur? What is the role of the …

A Task Analysis Of Metacommunication In Time-Limited Dynamic Psychotherapy, Theodore Matthew Austin

Antioch University Dissertations & Theses

This study examined how successful metacommunication unfolded in time-limited dynamic psychotherapy (TLDP) using the task-analytic paradigm developed by Greenberg (2007). Specifically, the purpose of the study was to discern the elements, themes, and temporal sequences that were common to effective metacommunication. In accordance with the paradigm, this was accomplished by the creation of a rational model, which combined existing theoretical literature on metacommunication and anecdotal clinical evidence. Next, the distilled components of metacommunication in six high-quality (HQ) sequences were contrasted to the distilled components of six low-quality (LQ) sequences in order to generate an empirical model. These sequences were selected …

Descending Into And Out Of The Maelstrom: Soma And The Survival Struggle, Rachel M. Urbano

Antioch University Dissertations & Theses

The purpose of this qualitative phenomenological study is to highlight the ways “surviving therapists” adapt to the inner-spaces in which they are still affected by their traumas. Surviving therapists are defined as therapists who identify as having experienced a trauma caused by another human being while maintaining an observational stance in relation to their body and self-experience. Therapists are not immune to the lasting effects of trauma: they may experience somatic reactivity and painful affective states in working with trauma patients. As surviving therapists have experienced events they may unconsciously choose to keep out of awareness, they may rely on …

First Elderly Client In Therapy: Factors That Influence Student Interest In Geropsychology, Cristina E. M. Filippelli

Antioch University Dissertations & Theses

In the coming decades, the elderly population in United States (U.S) is expected to grow significantly (U.S. Bureau of the Census, 1996). Consequently, the number of older individuals seeking mental health services will be greater than at any other time in the history of the U.S. The field of clinical psychology, however, is unable to meet the mental health needs of the current elderly population, and this gap is expected to widen in coming years. There is an ongoing discussion within the field of professional psychology as to how to train more clinicians to work with the elderly population (Gatz …

David Grove's Metaphors For Healing, David Pincus, Anees A. Sheikh

Psychology Faculty Articles and Research

Within the ever-expanding list of approaches to psychotherapy, there is a tendency to overlook deep imagery approaches. The current article reports on one such metaphor-based therapy developed by David Grove (Grove & Panzer, 1989). The approach is analyzed within the context of mainstream contemporary psychotherapy in general, the state of empirical understanding of common processes to psychotherapy, and in relation to other deep imagery-based approaches to therapy. Next, a step-by-step description of the techniques used within metaphor therapy are presented, along with a case example demonstrating the use of these techniques on a case involving pain symptoms. Finally, it is …

Transitioning From First Episode Psychosis Treatment To Prodrome: Lessons And Outcomes From The East Program In Oregon Usa, Ryan P. Melton, Robert Wolf

Regional Research Institute for Human Services

This presentation discusses the outcomes of the Early Detection in Preventing Psychosis (EDIPP) model.

Client/Therapist Feedback And The Role Of The Alliance On Psychotherapy Outcomes, Elizabeth Preston Cisneros

Loma Linda University Electronic Theses, Dissertations & Projects

Through a system of patient-focused outcomes research which has employed a quality assurance system for tracking client progress in therapy, there has been consistent evidence that utilizing the system to identify those who are not responding to treatment and warning their therapist about the client’s risk significantly improves client outcomes in psychotherapy. Although outcomes have been improved, significant proportions of clients have treatment failures or see no improvement in therapy. Moreover, feedback to therapists appears to be most effective in improving outcomes for the minority of clients who are already at risk of treatment failure.

Attempts to augment the feedback …

Therapeutic Alliance And Client Satisfaction From The Client’S Perspective, Colleen Peterson, Armeda Stevenson, Katherine M. Hertlein, Stephen Fife

Graduate Research Symposium (2010 - 2017)

This was the second phase of a two phase mixed methodology study. Presented is the qualitative portion consisting of semi-structured phone interviews conducted with past clients in order to examine the relationship of the therapeutic alliance and client satisfaction with client retention and termination status.Findings were classified into three main categories: therapist characteristics, treatment structural characteristics and process characteristics.

Defining Intimacy In Diverse Asian Cultures, Blendine Hawkins, Katherine Herlein

Graduate Research Symposium (2010 - 2017)

America has continued to diversify as a nation, welcoming people from every race, culture and continent. The US Census Bureau (2004) reported that there were 13.5 million Asians in America and these numbers are increasing (US Census Bureau, 2004). This indicates that there is a greater demand for competent and effective mental health care to meet the needs of this heterogeneous group. Asian Americans can be best helped by a therapist who is sensitive, knowledgeable and has an understanding about the core values which are present in many Asian cultures. There are limited resources and treatment guides for this population …

Early Psychosis Intervention In Oregon: Building A Positive Future For This Generation, Ryan P. Melton, Tamara Sale

Regional Research Institute for Human Services

The article focuses on the importance of early Schizophrenia intervention.

Inpatient Group Psychotherapy: Predicting Attendance And Participation, Sharon E. Silverberg

Counseling & Human Services Theses & Dissertations

Inpatient group psychotherapy is one of the primary talk therapy interventions offered to patients necessitating acute psychiatric treatment. Research indicates that patients who attend and participate in group psychotherapy sessions while admitted to psychiatric hospitals have a lower rate of recidivism and are more successful in the community utilizing lower levels of psychiatric care. Unfortunately, not all patients attend group psychotherapy while admitted to a psychiatric facility and therefore do not benefit, possibly contributing to non-compliance with community-based treatment and readmissions to inpatient psychiatric institutions for stabilization and safety. This lack of participation in group psychotherapy deprives the patient the …

Attachment: The Antidote To Trauma, Joshua Straub

Faculty Publications and Presentations

Trauma and loss in life are inevitable. And all too often the traumatic experience itself can be enough to paralyze the mental, emotional, and spiritual state of any given person. Unable to interpret the traumatic experience, many instead are left defined by it. Helping clients discern the objective experience and their subjective reactions to it will help free them from the emotions and beliefs that subsequently control their lives. Based on the most relevant attachment theory research and clinical techniques, this workshop teaches the attentional strategies necessary to helping clients overcome trauma.

Comparison Of Rationally-Derived And Empirically-Derived Methods For Predicting Failure In Residential Treatment, Jennifer Pester Grattan

Loma Linda University Electronic Theses, Dissertations & Projects

Patient-focused research methods have been used in adult mental health treatment to improve outcomes by tracking individual treatment response and comparing it with expected recovery patterns. One such approach has used rationally- and empirically-derived methods to analyze data from the OQ-45 and identify patients who are not responding as expected to treatment. Treatment is then adjusted, improving outcomes and lowering overall costs.

Similar but less extensive research has shown analogous methods can be used with children and adolescents. This would be particularly useful in residential treatment, which is an expensive and inadequately researched approach. This study used archival data gathered …

Accuracy Of A Rationally-Derived Method For Predicting Failure In Residential Treatment, Jennifer Pester Grattan

Loma Linda University Electronic Theses, Dissertations & Projects

Recent studies of adult mental health treatment have used patient-focused research methods to improve outcomes, by tracking treatment response and comparing it with expected recovery patterns. One such line of research has used rationally-derived and empirically-derived methods to analyze data gathered by the OQ-45 and identify patients who are not responding as expected to treatment. This allows for adjustment of treatment, which results in improved outcomes and lower overall costs.

Similar but less extensive research has provided evidence that these approaches may also improve outcomes in outpatient treatment for children and adolescents. These approaches might be particularly useful in residential …

Examining Adolescent Suicide: How To Identify The Risks, Kelsey Moellering

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.

The Effects Of Visual Media On Participants' Boundary Expectations, Joy P. Brock

Psychology Theses & Dissertations

The purpose of this study was to examine participants' expectations of psychotherapeutic boundaries and the influence of the media in the creation of these expectations. Four hundred forty seven Old Dominion undergraduates completed an online survey consisting of five separate scales: Exposure to Cine therapy Scale, Exposure to Cinematic Boundary Infringements Scale, Boundary Expectation Scale, Past Therapy Experiences Scale, and Demographic Questionnaire. Bivariate correlations were calculated and exposure to cine therapy was found to be significantly, positively related to participants' perceptions of the frequency of various boundary infringements. A principle components analysis was also computed to examine the underlying structure …