Clinical Psychology Commons^™

Empowering Providers To Empower Their Patients: One Model To Expand Knowledge, Competency, And Awareness For The Perinatal Substance Use Workforce, Jacqueline Jacobs

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Perinatal substance use (PSU) is a serious and growing public health concern. It is associated with a variety of adverse health outcomes for both mother and child and has been shown to negatively impact the parent-child relationship. Despite the growing prevalence of PSU, there are notable deficits in provider knowledge regarding, and comfortability with, PSU. Moreover, providers report feelings of judgment, resentment, fear, and hesitancy related to their work with women with PSU. Subsequently, women with PSU struggle to find appropriate, compassionate, and effective treatment for their substance misuse. Widespread and accessible training is needed to bolster provider knowledge base, …

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 …

Providing Effective Assessment Feedback To Patients: Lessons Learned From Feedback After A Severe Injury, Kelsie Mcquinn

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper seeks to articulate lessons learned from feedback received after a severe injury in order to help guide neuropsychologists provide effective feedback to patients. Given that there is no agreed upon conceptual framework for providing neuropsychological assessment feedback, parallels are drawn from what works in clinical psychology – the working alliance. I use personal examples to highlight how the working alliance, as well as other psychological principles, can help inform neuropsychologists provide the most effective feedback to patients.

Attachment Theory To Inform Intervention In Correctional Populations With Adverse Childhood Experiences And Substance Use Disorders, Samantha Mendoza

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Research shows a correlation exists between Adverse Childhood Experiences (ACEs) and poor mental health such as psychiatric and substance use disorders (Adshead, 2018). Research further suggests a correlation between ACEs and insecure attachment in adults (Adshead, 2018). The National Institute on Drug Abuse (2020) estimates 85% of the correctional population either has a substance use disorder or was incarcerated for a drug-related offense. This paper theorizes that those involved in the correctional system with a history of high ACE scores and substance use also experience insecure attachment, which is not currently addressed in correctional SUD programs. Attachment theory moderates the …

Mothers Know Best: Guidance For Healthcare Providers On Early Identification Of Perinatal Mental Health Disorders, Klarissa I. Garcia Orellana

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Introduction: The perinatal period has been associated with an increased risk of developing psychiatric disorders among women. Perinatal mental health disorders (PMHD) are highly prevalent, yet highly underrecognized and untreated. The involvement of medical providers, especially obstetrics/gynecology and pediatric providers, in the early identification of PMHD is critical to ensure women with PMHD receive appropriate supports. However, providers lack the education, training, and ability to identify and screen for PMHD as well as the knowledge of appropriate referrals. Objective: This study explores the existing issues with healthcare providers’ early identification practices of PMHD from the perspective of ten mothers and …

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.

From Military Service To Diakonia: A Training Program For Clergy Ministering To Veterans, Danielle Xanthos

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Many veterans opt to seek the support of clergy before mental health professionals. Most clergy, however, are unfamiliar with the nuances of the veteran culture and experience. Mental health professionals who specialize in working with the veteran population can collaborate with clergy to bridge this gap of care to mutually develop a better understanding of veteran culture and symptoms of mental health conditions common among the veteran population, and by equipping clergy with basic tools that promote psychological and spiritual wellbeing. Special consideration is given to the concept of moral injury and the application of Acceptance and Commitment Therapy, illustrating …

Canine-Assisted Exposure Therapy, Stephanie B. Bono

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Fear and anxiety are natural reactions to actual threat conditions but can become “pathological” when over-generalized avoidance interferes with long-term wellbeing and valued living. Pervasive experiential avoidance hinders natural extinction processes as it reduces repeated contact with feared stimuli, a condition necessary for extinction to occur. Exposure therapy (ET) is a clinical analogue of extinction, and one of the best evidence-based treatments for fear and anxiety. However, ET’s usefulness suffers in real-world clinical conditions. The current conceptual paper proposes that ET’s limitations may be overcome through a tailored approach that integrates animal-assisted therapy (AAT), specifically the use of dogs, to …

Co-Constructing Stigma: Treating Trauma In Adolescence, Isabelle Sanderson

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Public stigma and self-stigma are major factors that impede the seeking of mental health treatment as well as the development of an effective therapeutic alliance. This paper explores the co-creation of stigma dynamics from an intersubjective systems theory lens suggesting these dynamics may play a role for adolescent clients who have experienced significant trauma. Specifically, the potential overlooking and/or misdiagnosis of trauma-related experiences and symptoms often occurring with adolescents diagnosed with ADHD may be contributing to a co-constructed dynamic between the therapist and client to avoid an exploration of trauma that would be experienced as more stigmatizing, more threatening, and …

The Risks For Eating Disorders/Disordered Eating In Refugee & Immigrant Experiences And The Imperative Of Culturally Alert Screening, Chantal A. Bushelle

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Eating Disorders (ED)/Disordered Eating (DE) largely remain outside of global mental health agendas. There are limited data on the epidemiology EDs/DE in refugee and immigrant populations, and there is a paucity of research on refugee and immigrant experiences of EDs/DE. Study of acculturation issues in refugee and immigrant populations have historically missed investigating what role and impact experiences of stress and trauma (e.g., historical, chronic) along with cultural change and transition may have on their food attitudes and eating behaviors. While there has been some study of eating habits within refugee and immigrant populations, the focus is typically on food …

Fostering Trauma-Informed Schools By Considering The Experiences Of Teachers In Working With Trauma-Exposed Students, Allison A. Stiles

Electronic Theses and Dissertations

High rates of trauma exposure among youth in the United States and the detrimental effects of trauma on students’ psychosocial and academic outcomes are well-established. Such findings have engendered the emergence of trauma-informed schools across the nation. While research regarding trauma-informed schools has understandably focused on the needs of students, shockingly little is known about teachers’ experiences in working with trauma-exposed students. In particular, very few studies have examined the relationship between teachers’ indirect exposure to student trauma and related symptoms of secondary traumatic stress (STS), as well as factors that may predict STS levels or explain variation in the …

The Role Of Awareness In Traumatic Brain Injuries: Interviews With Experts, Dominique Chao

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Approximately 2.8 million US citizens sustain a traumatic brain injury (TBI) annually, with more than 275,000 requiring inpatient rehabilitation (Taylor, Bell & Breiding, 2013). As rehabilitation techniques are refined and adapted to increase the speed of recovery and functional independence following TBIs, there is an ongoing need for better prognostic assessment tools. Research has shown that a lack of self-awareness following TBI is associated with poorer outcomes (e.g. employability, community reintegration) following discharge from inpatient hospitalizations (Cheng & Man, 2006; Robertson & Schmitter, 2016) and can result in decreased motivation (Simmonds & Fleming, 2003), compromised safety, poor community re-integration, and …

Treating Substance Use Disorders Through An Attachment Lens: A Case Example, Kathleen Locker

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Substance use treatment addresses addiction behaviors, increasing coping skills, and sobriety but current modalities do not address the insecure attachment styles that may contribute to substance use for many individuals. Insecure attachment styles seemingly have a bidirectional relationship with substance use and are therefore are likely an important aspect of treatment. This case example focuses on an attachment therapist’s work with a young man with a substance use disorder and attachment insecurity. Attachment theory interventions are proposed to address potential contributors of continued substance use. This paper proposes that using attachment theory in combination with existing treatment modalities for substance …

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, …

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 …

The Utility Of Neuropsychological Measures On The Differential Diagnosis Of Adhd-Inattentive Type Versus Anxiety In A Pediatric Outpatient Behavioral Health Population, Emily Stapleton

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This study examined the differences in inattention and executive function between a group of children diagnosed with ADHD and a group diagnosed with anxiety disorders to establish differential profiles for these two disorders. This study evaluated the differences among children with ADHD and anxiety disorders, using parent-report and performance-based measures of inattention and anxiety. A retrospective chart review was completed for a total of 58 patients who met the criteria for an anxiety disorder or for ADHD-C and ADHD-I at the completion of the neuropsychological assessment. Analyses compared the ADHD group and the Anxiety group on select scales and subscales …

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.

A Qualitative Evaluation Of A Substance Abuse Treatment Program For Athletes, Megan K. Lavoy

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The focus of this study was to examine the experiences of two past participants of an athlete­-specific drug and alcohol rehabilitation program. Researchers have discussed the vulnerability of an athlete population and prevalence of substance use among athletes ( e.g., Turrisi, Mastroleo, Mallett, Larimer, & Kilmer, 2007; Martens, Watson, Royland, & Beck, 2005). Some rehabilitation programs and specific approaches to treating substance abuse in athletes have started to emerge and are beginning to be discussed in the literature (Donahue et al., 2014). However, there remains a gap in the research of studies examining the experiences of these athletes who have …

The Caregiver–Child Relationship, Youth Mental Health, And Placement Stability In A Child Welfare Sample, Laura A. Rindlaub

Electronic Theses and Dissertations

Objective: Healthy relationships between adolescents and their caregivers have been robustly associated with better youth outcomes in a variety of domains. Youth in contact with the child welfare system are at higher risk for worse outcomes including mental health problems and home placement instability. A growing body of literature points to youth mental health problems as both a predictor and a consequence of home placement instability in this population; the present study aimed to expand our understanding of these phenomena by examining the interplay among the caregiver-child relationship, youth mental health symptoms, and placement change over time. Method: The sample …