Psychoanalysis and Psychotherapy Commons^™

The Multicultural Orientation Framework In Couple Therapy, Jasmine R. Davis

Electronic Theses and Dissertations

Couples’ cultural values and beliefs are important to their relational connection. Cultural values and beliefs can be sources of strength in relationships, but they can also lead to impasses. As such, clinicians and researchers could benefit from a cultural framework to inform conceptualization and treatment when working with couples. The Multicultural Orientation (MCO) framework has three pillars: cultural humility, cultural comfort, and cultural opportunities. The MCO framework is empirically supported for use in individual and group psychotherapy but has not been applied to couple therapy. This dissertation includes two parts. First, we outline a conceptual framework for the application of …

A Clinical Pathway For Differential Diagnosis Of Adhd Vs Trauma: Early Childhood Recognition And Intervention, Maria Neiers

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Distinguishing Attention-Deficit/Hyperactivity Disorder (ADHD) from Complex Posttraumatic Stress Disorder (C-PTSD) presents significant diagnostic challenges due to overlapping symptom presentations, shared neurobiological impacts, and frequent comorbidities. This paper explores the nuanced clinical differentiation between ADHD and C-PTSD, and other trauma disorders, in pediatric populations, emphasizing the importance of trauma-informed assessment, early identification, and integrative clinical reasoning. The discussion highlights how structured diagnostic reasoning can reduce uncertainty, enhance diagnostic clarity, and support effective treatment planning. As a central contribution, this paper introduces an original clinical reasoning flowchart and a case conceptualization to illustrate its practical application in real-world diagnostic dilemmas. The need …

The Journey Of Psychotherapy: Understanding Therapeutic Technique Through Ultralight Thru Hiking, Emma Bossier

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper explores several principles of ultralight backpacking as metaphors for developing one’s therapeutic technique. The tenets of ultralight thru hiking, when interpreted through a clinical lens, offer early clinicians insight into the importance of moving through fear and leaning into exploration, discomfort, and authenticity while on the journey of becoming a therapist. The experiences of numerous thru hikers are synthesized into five principles: Don’t Pack Your Fears, Be Present for the Journey, Slow Simplicity, Embrace the Suck (and The Stink), and Trail Legs. These principles do not define ultralight as carefreeness but rather offer a metaphor for the careful …

Representation Of Diseases And Health Care In Selected African Gyno-Texts, Rachael K. Aderoju

Electronic Theses and Dissertations

This study explores the interdisciplinary field of literature and medicine through a feminist psychoanalytic lens, focusing on how Nigerian female writers represent illness, healthcare, and medical ethics in post-independence gyno-texts. Traditionally, scholarship in this field has centered on andro-texts (literary works authored by men), leaving a critical gap in the exploration of women’s perspectives. This research addresses that gap by analyzing nine prose works authored by Nigerian women, including texts by Chimamanda Ngozi Adichie, Ayobami Adebayo, Lola Shoneyin, and Samira Haruna Sanusi. These texts are examined for their portrayal of diseases such as infertility, cancer, bipolar disorder, and renal failure, …

An Examination Of Early Termination From Trauma-Focused Treatment For Posttraumatic Stress Disorder: A Literature Review And Mixed Methods Study Proposal, Laura M. Lathrop

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The high rate of early termination from evidence-based, trauma-focused psychotherapy treatments for posttraumatic stress disorder (PTSD) impedes maximum benefit from trauma-focused treatment, making it an on-going concern for clinicians. This paper consists of a literature review regarding the problem of early termination from evidence-based, trauma-focused treatment for PTSD in adults. It then proposes a mixed methods study to investigate re-engaging veterans in trauma-focused PTSD treatment, analyzing completion rates, and evaluating participants’ experience using qualitative interviews.

Evaluating Trauma-Informed Design In A Mental Health Setting: A Community-Based Research Case Study, Marie Spence

Electronic Theses and Dissertations

This case study utilized a community-based research framework to explore how the Trauma-Informed Design framework can be implemented in a mental health setting. This study focused on the site of Empower Therapy Practice, a private mental health practice in the Denver Metro Area, to engage clients and staff to participate in advisory boards and inform the interior design of a new office space. To explore the application of Trauma-Informed Design, participants engaged in a variety of research activities, including an evaluative questionnaire, Photovoice, and focus group. Advisory board members identified various aspects of Trauma-Informed Design which meaningfully translate to therapeutic …

Music Performance Anxiety: A Comparative Analysis Of Treatment Options For The Vocalist, Brooklyn Becker

Musicology and Ethnomusicology: Student Scholarship

Music Performance Anxiety (MPA) is a multifaceted social anxiety disorder that affects a significantly large population of practicing and professional musicians. If untreated, it can have detrimental effects on the performer and their career. MPA is multifaceted in that it encompasses cognitive, physiological, and behavioral symptoms. Because of its multifaceted nature, there is not one specific intervention or treatment option for MPA, but multiple interventions that have been studied and tested as potential treatment options. While the body of research on MPA has expanded since the 1970s, there is a disparity of research in the literature that focuses solely on …

Parental Misattunement And The Production Of Shame Of Existing: How To Address The Shame Of Existing Through An Intersubjective Systems Approach, Tal Ginsburg

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Shame is at the root of many commonly encountered psychopathologies. Its development has often been attributed to early childhood emotional misattunement. In severe cases, individuals can develop an extreme form of shame called the “shame-of-existing”. This paper primarily intends to contribute to the limited research about the shame-of-existing, which includes psychoanalytic perspectives from 1950-1990s, and theoretical analysis in 2014. The concept of shame of existence will be explored through an in-depth case study analysis of a 31-year-old, heterosexual, cisgender, white male who presented to psychotherapy with low-self-worth, and shame in acknowledging his own emotions and needs. This client was treated …

Stagnation In Psychotherapy: A Transtheoretical Approach, Kristine Mccormick

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Doctoral training in clinical psychology emphasizes the importance of utilizing empirically supported psychotherapy methods in pursuit of effective psychotherapy. When treatment is stagnant or ineffective, the focus of training and supervision is often geared toward searching the evidence-base for alternative psychotherapy approaches, or referring to a provider with expertise in a specific method. Using a case example, this paper offers guidance on possible roadblocks to effective psychotherapy treatment, and clear areas to explore before concluding whether psychotherapy is the most helpful intervention for a patient.

Feminist Therapy With Severe Mental Illness And Complex Trauma: A Case Example, Mimiko Watanabe

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Feminist therapy emphasizes empowerment through an egalitarian therapeutic relationship and collaborative approach of understanding symptoms and treatment. Feminist therapy can be used with all types of clients, including those with severe mental illness (SMI) as well as complex posttraumatic stress disorder (complex PTSD) which refers to the unique presentation of those who have experienced chronic developmental trauma (Herman, 1992). This case example focuses on a feminist therapist’s work with a young woman who has both SMI and complex PTSD, resulting in struggles across several domains. Feminist therapeutic interventions of developing an egalitarian relationship, exploration of intersectional multicultural dynamics, building empowerment, …

Telebehavioral Health Program Needs Assessment Conducted At Aurora Mental Health Center, Iwei Wang

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The purpose of this project was to conduct a needs assessment for a Telebehavioral Health Program at Aurora Mental Health Center (AuMHC) to determine how telebehavioral health aligns with the organization’s interests, needs, services, target population, and readiness for telebehavioral health services. This investigator used survey and content analysis methods to conduct this investigation. Findings of this assessment showed that both literature and existing programs at AuMHC were supportive of moving forward with telebehavioral health services. Considerations of AuMHC’s contextual conditions and recommendations for successful implementation are provided.

A Behavior Analytic Translation Of Erving Goffman's Frame Analysis, Tim Chi

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The sociologist Erving Goffman's 1974 work, "Frame Analysis," is an attempt to account for how people construct and organize meaning in their experiences. The central principle in this approach is that of the frame: An abstractive concept that refers to the totality of environmental events and stimuli exerting some influence on how people behave in a particular setting and time, with respect to the expectations, roles, and norms to be observed.

Though Frame Analysis was developed within the discipline of sociology, it converges in apparently useful ways with the work of clinical psychology, both in its content and epistemology. Goffman's …

Utilizing Music Therapy To Enhance Competency Restoration Treatment, Cory Linder

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

In Dusky v. the United States (1960), the Supreme Court ruled that the U.S. Constitution requires all defendants to be competent to proceed before the judge issues a verdict. Specifically, to stand trial, defendants must have a factual and rational understanding of court proceedings and the capacity to work with their attorneys. Those who are found incompetent to proceed frequently have severe and persistent mental illness and often exhibit cognitive deficits (Mossman et al., 2007). Competency restoration utilizes therapeutic services to treat symptoms that inhibit defendants from being opined competent to proceed. Existing research suggests music therapy can be used …

Becoming A Better Therapist: Eight Lessons From Running, Kelsey Hyde

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper seeks to identify lessons that can be taken from the sport of running to serve as a map for learning skills needed to become a better therapist. The practice of running mirrors the practice of learning therapy skills. This paper takes the lens of how to practice to become a better runner and applies it as a new approach to skill development for therapists. Additionally, this paper incorporates self-reflection and disclosure as I myself identify as a female runner and therapist. I will use personal examples to highlight the ways that lessons from running have served as a …

An Exploratory Study Of Session Limited Models Of Therapy Outcomes In An Employee Assistance Program, Ivy C. Donaldson

Electronic Theses and Dissertations

Employee Assistance Programs (EAPs) have grown increasingly popular over recent years. The prevalence of organizations utilizing and investing in EAP services for their employees has grown; however, companies that purchase EAPs are not well-informed as to which session-models are most effective for various diagnoses. The current study is the first to explore treatment outcomes of session-limited models (measured by Therapist Perception of Change, TPC) for diagnoses (anxiety and depression) in an EAP delivery system. Outcomes were measured by TPC ratings including: a) Regressed, b) remained at Baseline, c) Improved, and d) issue was Resolved. Analyses (Chi-Square and =t-test) were used …

The Impact Of Sudden Gains And Deteriorations On The Psychotherapy Process, Joanna Mary Drinane

Electronic Theses and Dissertations

Within the field of psychotherapy research, there has been significant evidence to suggest that people change and improve because of treatment (Lambert & Ogles, 2004). One common phenomenon that has been observed when looking more closely at outcome trajectories has been termed sudden gains/deteriorations. These are defined as sudden changes in outcome (either positive or negative) of 25% or more from the pre-change level of symptoms that are in turn sustained over time (Tang & DeRubeis, 1999). Although there are data regarding how people who experience sudden gains end up after treatment, no studies have examined the impact that sudden …

Horses In Therapy: The Practice Of Equine Facilitated Psychotherapy, Mandi J. Turner

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Horses are being used in psychotherapy at increasing rates despite a lack of evidence establishing efficacy of the practice (Anestis, Anestis, Zawilinski, Hopkins, & Lilienfeld, 2013; Selby & Smith-Osborne, 2013). Without common and consistent practices based on a working theory of how Equine Facilitated Psychotherapy (EFP) creates change, it is unknown how varied the practice is across the United States (Anestis et al., 2013). A lack of studies establishing efficacy leaves providers to determine effectiveness based on anecdotal evidence that may be at risk for bias (Lilienfeld, Ritschel, Lynn, Cautin, & Latzman, 2014). The American Psychological Association (APA) provides recommended …

Cinematherapy With Inside Out: A Theoretical And Practical Guide, Jessica Rosenfeld

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Since its release in 2015, the Disney/Pixar film "Inside Out" has received widespread critical and commercial acclaim. Despite the film's basis in established psychological theories, little has been published regarding its clinical applicability, particularly for adolescent and adult clients in traditional talk therapy. Through the use of cinematherapy, a deeper examination of the film is offered, and suggestions for treatment use are provided. Via the lens of modern psychodynamic (Intersubjectivity) and behavioral (ACT) techniques, this paper offers diverse options for integrating "Inside Out" in psychotherapy and proves that it contains clinical applicability for a wide range of practitioners.

Development Of A Psychological Assessment Battery To Measure Client Beliefs About The Effectiveness Of Psychotherapy, Christopher Peavey

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The author attempted to develop a brief scale to measure clients' beliefs about the effectiveness of psychotherapy. The study is an early pilot study to determine if the scale can predict therapy outcomes. While the scale did differ significantly between clients who were active in therapy and those who were not, higher scores on the instrument were not indicative of greater involvement. Possibilities for future research to refine the instrument are discussed.