Psychoanalysis and Psychotherapy Commons^™

Impact Of Traditional (Non-Affirming) Black Church Affiliation On Exploration Of Sexual Identity For Black Assigned Female At Birth Lgbq+ Individuals And The Associated Mental Health Risk, Aurielle J. Sutton

Doctoral Dissertations

This dissertation explored the impact of Black traditional church upbringing on the sexual and religious identity development, including the subsequent mental health risk, for Black assigned female at birth (AFAB) LGBQ+ individuals. Studies conducted on Black AFAB LGBQ+ individuals are limited, especially in terms of  assessing their experiences in sexual identity development based on religious upbringings. Studies have overlooked the experience of LGBQ+ Black AFAB individuals navigating sexual orientation development and religious and racial identities. Studies have greatly favored Black gay men and supported health risks such as HIV. In the present study, twelve Black AFAB Queer individuals participated in …

The Development And Piloting Of A Novel Client-Rated Trans And Gender Expansive Clinical Competence Scale For Mental Health Providers, Karen Abraham

Dissertations, Theses, and Capstone Projects

Transgender and gender expansive individuals (TGEI) are people who encompass a broad and comprehensive set of experiences of gender diverse individuals and identities that exist both within and beyond a binary framework. In the United States, the Williams Institute identified a proportion of 0.5% of American adults identifying as transgender (Herman et al., 2022). TGE samples report poorer physical and mental health than their cisgender counterparts across the lifespan (Rastogi et al., 2025; Reisner et al., 2015; Reisner, Poteat, et al., 2016). Health disparities of TGEI relative to their non-TGE counterparts can be seen in the prevalence of mood disorders …

"Help Me Live It The Way You Do": Grounding Singaporean Responses To The Rorschach Situation, Casey Y. Lee

Electronic Theses and Dissertations

Contemporary research on the Rorschach and culture is striking for the latter’s disappearance as a variable of significance (Meyer et al., 2015; Meyer et al., 2007; Mihura et al., 2013; Viglione & Hilsenroth, 2001). This erasure is chronicled and reproduced in the narratives of universal objectivity, of extensive international meta-analyses, of replications, of standardized norms (Ritzler, 2004; Smith et al., 2018; Smith et al., 2020; Weiner, 2004). A different story emerges, however, when we ask, how has culture disappeared? The proposed study is a multimethod qualitative analysis of Singaporean responses to the Rorschach, aimed at generating sensitive yet critical discourses …

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 …

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., …

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 …

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 …

Evaluation Of Neuroplastic Changes In Psychological Intervention And Contemporary Treatments Of Depression, Taylor Severance

Dissertations

Major depressive disorder is one of the most prevalent mental health disorders worldwide. There is a vast range of treatment options for depression, with varying levels of effectiveness. Recent treatments for depression have expanded, increasing alternative treatments, and it is unknown which treatments have the largest impact on depression. This research was designed to examine the treatments of depression, with a focus on psychotherapy and contemporary treatments such as ketamine, psilocybin, and transcranial magnetic stimulation. A literature review was conducted to assess treatment outcomes and neuroplastic changes in these interventions, as well as combinations of the interventions. Data were evaluated …

Addressing Mental Health Issues And The Effectiveness Of Cognitive Behavioral Therapy And Mindfulness-Based Interventions Among Athletes, Shelby Jones-Stachnik

Dissertations

This literature review identifies mental health concerns among competitive athletes and evaluates psychological interventions to address these challenges. Specifically, the review explores the mental health concerns experienced by athletes engaged in high-level sport. It examines whether cognitive behavioral therapy and mindfulness-based interventions are effective approaches for improving psychological outcomes in this population. A systematic review of peer-reviewed research was conducted, and findings were synthesized to evaluate the effectiveness of cognitive behavioral therapy and mindfulness-based interventions. The review included randomized controlled trials, quasi-experimental studies, and meta-analyses examining psychological interventions in athletic populations. Findings across the literature indicate that both cognitive behavioral …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

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 …

Enhancing Resilience And Reducing Burnout In Oncology Nurse Practitioners Through The “Three Good Things” Intervention, Ernestine A. Muanya

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Burnout among oncology nurse practitioners (NPs) threatens clinician well-being, care quality, and workforce retention. The World Health Organization (2019) defines burnout as a workplace condition caused by chronic unmanaged stress. Nationally, over half of healthcare professionals report burnout symptoms, with high rates in oncology (Deriglazov et al., 2025). In Texas, nearly 48% of advanced practice providers report emotional exhaustion and job-related stress (Patel et al., 2024). Objective: This single-group pre–post quality improvement project evaluated an eight-week, app-based Three Good Things (3GT) intervention to reduce burnout and enhance resilience among 19 breast medical oncology nurse practitioners at a comprehensive …

Survivors Of Historical Intergenerational And Familial Trauma Scale For Black American Descendants Of Enslaved People: A Development And Initial Validation Study, Loryn Chás Kimbrough

Graduate Research Theses & Dissertations

Despite extensive research documenting cultural and racialized trauma, no validated assessment tool had previously captured the intrafamilial mechanisms of trauma transmission specific to the BADEP population, whose trauma lineage is rooted in slavery. The present study addresses this gap through the development and initial validation of the Survivors of Historical Intergenerational and Familial Trauma Scale (SHIFTS), a culturally grounded instrument designed to measure the transmission of historical trauma (HT) and ongoing intergenerational trauma (IGT) among Black American Descendants of Enslaved People (BADEPs). The SHIFTS examines how HT gives rise to the continued transmission of two interrelated legacies: survival-based and trauma-rooted …

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 …

Art Therapists' Experience Utilizing Virtual Reality’S Multibrush In Group Art Making With Young Adults., Lidice Cohen

Expressive Therapies Dissertations

Young adults aged 20-35 experience disproportionately high rates of mental health conditions yet exhibit low treatment-seeking behaviors, creating a significant care gap. Digital interventions—particularly Virtual Reality (VR)—show promise for reaching this tech-savvy group. The primary research question explored art therapists' insights utilizing this modality, while a secondary aim examined whether creating VR response art (VRRA) enhanced understanding of the group process. Three credentialed art therapists and nine young adults participated, sharing insights via interviews after VR group sessions and VRRA creation. Thematic analysis revealed that adaptation to VR influenced group dynamics, self-expression through embodiment, collaboration, boundary management, sensory stimulation, and …

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 …

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 …

Transgender Individuals’ Experiences Of Ruptures And Repairs In Group Psychotherapy, Gabrielle W. Kaufman

Electronic Theses and Dissertations

As the political climate across the United States worsens for transgender and gender diverse (TGD) individuals (Harmon, 2025), it has become increasingly important to attend to the mental health needs of this population (James et al., 2016). Group therapy is a widely used treatment modality that is often more accessible than individual therapy (Burlingame & Strauss, 2021) and provides unique interpersonal opportunities (Burlingame et al., 2016). While it is expected that TGD individuals face unique challenges in group therapy due to their gender identities (Chen et al., 2020), very little is actually known about the experiences of TGD individuals participating …

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 …

A Program Evaluation: Insomnia In Adults With Major Depression Disorder With Cognitive Behavioral Therapy For Insomnia (Cbt-I), Taylor E. Wilson

Dissertations

Abstract

Problem: In 2023, Compass Health Network (CHN) data analysts found that 91% of CHN patients in the United States who have died by suicide reported problems with sleep, which was the highest risk factor for suicide. The objective of this program evaluation project is to evaluate CHN CBT-I effectiveness on patients ‘suicidality by improving their insomnia.

Methods: CHN quality improvement (QI) project used a quantitative method pre/post score design. Quantitative aggregate data was collected on the participants who met the inclusion criteria via retrospective and prospective chart review prior to CHN implementing the intervention. CBT-I clinicians collected PHQ-9, Columbia-Suicide …

Evaluating The Predictive Value Of Basc-3 Anxiety Scale And Working Memory Index Scores For Clinically Significant Test Anxiety: A Comprehensive Analysis Of Non-Classifiable Cases, Des'tiana S. Williams

Electronic Theses and Dissertations

This dissertation will explore how test anxiety (TA) affects working memory (WM) and whether certain factors can help predict higher levels of test anxiety. Anxiety has been defined as a common experience that can show up in various forms—like general worry, social fears, panic attacks, and specific phobias (APA, 2022). It was described as often triggering our natural “fight-or-flight” response, which can impact our ability to focus, think clearly, and remember things. For students, test anxiety has been especially challenging, affecting how they perform in high-stakes academic settings. Using data from a university based psychological assessment center, this study will …

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, …

The Dialectic Of Airless Space, Ophelia Arc

Masters Theses

The Dialectic of Airless Space is a cumulative, cross-disciplinary research project that explores ‘airless space’ as a somatic and psychological condition shaped by institutional environments. Unfolding over time through five interrelated books, the project weaves together writing, ephemera, textile sculpture, and drawing to archive the invisible architectures of bodily and mental experience.

Icanfeel: A Digital Art Activity To Support Distress Detection In Adult Oncological Patients, Marie J. Deschamps

Expressive Therapies Dissertations

Considered the 6th vital sign, distress, a combination of hopelessness, anxiety, fear, and depression, can impact patients’ quality of life, treatment adherence, and mortality. While screening is required in oncological centers, distress remains under-detected. This study examined the use of Icanfeel, a novel digital art-based tool, to complement traditional psychometric assessments such as Edmonton Symptom Assessment System (ESAS), to support patients’ expressions of symptoms and distress detection. Hospitalized adult oncological patients (N = 22) engaged twice with Icanfeel and with an active control condition. At various time points during the protocol, patients self-reported symptom burden using ESAS, self-disclosure …

Culturally Concordant Dbt Steps-A Intervention In Orthodox Jewish Schools, Arielle Hershkovich-Elgavi

Theses, Dissertations and Culminating Projects

Existent research indicates that Dialectical Behavioral Therapy (DBT) is an efficacious treatment for mental health issues in many adult and adolescent populations, yet there is little research on the effect of DBT on culturally diverse, underserved populations (Mercado, & Hinojosa, 2017). Orthodox Jews are a culturally diverse, understudied, and underserved population (Schnall et al., 2014), that contends with strong stigmas against mental health treatment (Gearing et al., 2022). Orthodox Jewish community teachings are governed by religious values and precepts with a resistance to secular influence (Freund & Band-Winterstein, 2017). The social-emotional learning that is occasionally taught in some community schools …

Useful Measures Of Adult Attachment And Object Relations In Psychotherapy, Matilde A. Torallas Huerta

Dissertations

This is a literature review of objective and projective measures of attachment and object relations in adults, with the objective of reviewing outstanding research to identify the key factors for adult attachment assessment considered within attachment and object relations theories, what measures of adult attachment styles and dysfunction work best, and to provide key themes of assistance in the measurement of attachment and object relations in adult clients in psychotherapy. Theoretical foundations of attachment and object relations theory are reviewed as well as objective and projective instruments grouped by format. The 10 themes found to be useful in the assessment …

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.

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

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 …