Clinical Psychology 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: …

Coping Responses And Mental Health Symptoms In Incarcerated Juvenile Males, Jennifer Renae Newhard

Antioch University Dissertations & Theses

Coping responses develop throughout the lifespan of an individual. Unfortunately for some, difficult life circumstances may lead to the use of maladaptive forms of coping. This study investigated coping responses amongst male incarcerated juvenile offenders and examined which specific mental health symptoms may occur with specific coping responses. The goal of this study was to determine whether male incarcerated juvenile offenders utilize avoidant coping responses over approach coping responses. Also, this study investigated whether specific mental health symptoms, such as depression, anxiety, anger, and disruptive behaviors, were more prevalent amongst those who utilize avoidant coping responses. De-identified, archival data for …

Factors In Optimal Collaboration Between Psychologists And Primary Healthcare Physicians, Margaret A. Drewlo

Antioch University Dissertations & Theses

This survey study explored factors in optimal collaboration between registered psychologists and primary healthcare physicians (PHCP). With rising costs of healthcare, healthcare funding cuts, and changes in the way healthcare delivery is perceived, interprofessional collaboration is timely to explore. In particular, the attitudes of registered psychologists about salient factors noted in the collaboration literature, such as education and training, accessibility, and communication factors are important to the practice of psychology. As part of the exploratory nature of the study, questions about gender and hierarchy were also presented. While most data were quantitative, qualitative data were gathered on 6 of the …

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 …

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

LSU 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 …

Randomized Clinical Trial Examining Duration Of Voucher-Based Reinforcement Therapy For Cocaine Abstinence., Kimberly C Kirby, Carolyn M Carpenedo, Karen L Dugosh, Beth J Rosenwasser, Lois A Benishek, Alicia Janik, Rachel Keashen, Elena Bresani, Kenneth Silverman

College of Science & Mathematics Departmental Research

BACKGROUND: This is the first study to systematically manipulate duration of voucher-based reinforcement therapy (VBRT) to see if extending the duration increases abstinence during and following VBRT.

METHODS: We randomized cocaine-dependent methadone-maintained adults to Standard (12 weeks; n=62) or Extended (36 weeks; n=68) VBRT and provided escalating voucher amounts contingent upon urinalysis verification of cocaine abstinence. Urinalysis was scheduled at least every 2 weeks during the 48-week study and more frequently during VBRT (3/week) and 12 weeks of Aftercare (2/week).

RESULTS: Extended VBRT produced longer durations of continuous cocaine abstinence during weeks 1-24 (5.7 vs 2.7 weeks; p=0.003) and proportionally …

Treatment Of Psychiatric Inpatients With Relationship Dysfunction Using A Short Term Cognitive Interpersonal Intervention: A Pilot Study, Tamra Rasberry

Doctoral Dissertations and Projects

Relationship conflict for the psychiatric patient can have significant detrimental effects. There are specific types of interactions that can increase conflict and predict the potential for relapse; these have been identified by research and designated as components of Expressed Emotion (EE). Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have been very effective when targeting specific psychiatric diagnoses, but less effective when addressing relationship conflict. The majority of studies addressing relationship conflict have taken place in an outpatient, long-term setting. There is limited research that utilizes an inpatient short-term intensive therapy with relationship conflict as its sole focus, targeting areas …

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 …

Does Emotion Invalidation Cause Emotion Dysregulation? Evidence From A Healthy Sample Of College Students And Implications For The Development Of Borderline Personality Disorder, Melissa Jean Zielinski

Graduate Theses and Dissertations

Linehan's BioSocial theory is a widely accepted model of the development of borderline personality disorder (BPD). However, the tenet that experiences of invalidation causally influence the development of the emotion dysregulation that characterizes BPD has been subject to relatively little empirical attention. The purpose of this study thus was to experimentally investigate the effects of validation and invalidation on indices of emotion dysregulation including self-invalidation, distress tolerance, and Social problem solving. The current study used a laboratory-based emotion induction procedure in which ninety college students participated in validating or invalidating conversations about emotional events with a peer confederate. Contrary to …

Research Brief: "Combat Exposure And Suicide Risk In Two Samples Of Military Personnel", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the relationship between suicide risk and combat exposure among veterans who are receiving mental health care and those not receiving mental health care. For policy and practice, veterans who are not receiving mental health care should be monitored for depression and PTSD; mental health professionals should understand the relationship between risk factors and suicide, and the VHA should encourage post-9/11 veterans to use their mental health care benefits provided to them by the VA. Suggestions for future research include using a more representative sample, analyzing the sample over time, and relying on methods other than self-reporting.

Expression Of Borderline Personality Disorder Symptoms Across The Ovulatory Cycle: A Multilevel Investigation, Tory A. Eisenlohr-Moul

Theses and Dissertations--Psychology

Borderline Personality Disorder (BPD) is a disabling condition characterized by chronic emotion dysregulation and behavioral impulsivity. Prospective studies that test proposed mechanisms of within-person change in BPD hold the key to improving symptom predictability and control in this disorder. A small body of evidence suggests that fluctuations in estradiol such as those occurring naturally at ovulation during the monthly female reproductive cycle may increase symptoms in women with BPD (DeSoto et al., 2003). Furthermore, there is preliminary evidence that both self-esteem and feelings of social rejection are highest at ovulation, when estradiol peaks (Durante and Hill, 2009; Eisenlohr-Moul et al., …

The Ticking Of The “Biological Clock”: Worry About Future Fertility In Nulliparous Women, Karen E. Kersting

Theses and Dissertations

Abstract

Title: The Ticking of the “Biological Clock”: Worry about Future Fertility in Nulliparous Women

By: Karen Kersting, M.A., M.S.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University.

Virginia Commonwealth University, 2013.

Major Director: Kathleen M. Ingram, J.D., Ph.D.

Associate Professor of Psychology

Department of Psychology

Modern women are waiting until later in their lives to have children than women of previous generations, a trend influenced by a number of factors including financial stability, dating norms, and career goals and responsibilities. As women age, their fertility may decline …

A Brief Motivational Intervention For Heavy Alcohol Use In Dental Practice Settings: Rationale And Development, James A. Neff, Scott T. Walters, Abby L. Braitman, Michelle L. Kelley, Michele L. Darby, Margaret F. Lemaster

Psychology Faculty Publications

Although brief alcohol interventions have proven effective in a variety of health care settings, the present article describes the development of the first brief intervention for heavy drinkers in dental practice. Elements of motivational interviewing and personalized normative feedback were incorporated in a 3- to 5-minute intervention delivered by dental hygienists. The intervention is guided by a one-page feedback report providing personalized normative feedback regarding the patient's current oral health practices, their drinking in comparison to others, and oral cancer risk associated with current smoking and drinking. Future publications will present data regarding intervention effectiveness from an ongoing randomized trial.

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 …

The Role Of Acquired Capability As A Differentially-Specific Risk Factor For Disordered Eating And Problematic Alcohol Use In Female College Students: A Measure Development And Validation Study, Christa D. Labouliere

USF Tampa Graduate Theses and Dissertations

Traditional college students are members of an age bracket noted for high levels of risky behavior, and research has shown that certain risky behaviors, such as disordered eating and problematic alcohol use, are particularly common among undergraduates. It is well established that certain events in the learning history predispose vulnerable persons to engage in maladaptive risky behaviors. What is less clear is why some persons facing these events go on to develop maladaptive behavior while others do not, or why people facing similar events develop different varieties of maladaptive behaviors. Current research has focused extensively on risk factors that are …

Research Brief: "Impact Of The Seeking Safety Program On Clinical Outcomes Among Homeless Female Veterans With Psychiatric Disorders", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the effect of the Seeking Safety program's services on improvement in PTSD, psychiatric symptoms, and social support among homeless female veterans. In policy and practice, clinicians should be trained on how to use the program to better serve homeless female veterans, and policymakers should push for clinician training for those who work with homeless veterans. Suggestions for future research include applying this study and the Seeking Safety program to non-VA healthcare systems, assessing substance use within the program, and assessing the long-term effects of the Seeking Safety program.

Does Psychopathy Predict Future Risky Sexual Behavior?, Jessica Jade Fulton

Dissertations

Risky sexual behavior (RSB), such as having sex with an unknown partner, is associated with a variety of negative consequences including sexually transmitted diseases and unplanned pregnancy. Previous research (e.g., Fulton, Marcus, & Payne, 2010) suggests that psychopathic personality traits as assessed by the Psychopathic Personality Inventory (Lilienfeld & Andrews, 1996) are associated with RSB. Self-Centered Impulsivity (SCI), which is characterized by impulsivity, irresponsibility, and reckless behavior, was positively associated with RSB among men and women. In contrast, Fearless Dominance (FD), which is characterized by fearlessness, manipulativeness, and social dominance, was positively associated with RSB among men but not women. …

Culture Ontogeny: Lifespan Development Of Religion And The Ethics Of Spiritual Counselling, Glen Milstein, Amy Manierre

Publications and Research

The counsellor has an ethical obligation to treat the whole person. Humans are cultural beings and the foundation of most cultures is religion. Religion and culture are received from our early relation~ ships and modified through later relationships across the lifespan. The paper introduces the term "culture ontogeny" to emphasize that this is a biological process wherein abstract ideas of culture and religion become material in the developing neurophysiology of each brain. A framework and methods are offered to examine the changing roles of religion in clients' emotional self~ structure, inclusive of those who describe themselves as spiritual, not religious. …

Capp: A Comprehensive Preventative Program Model Addressing Alcohol Misuse Among College Freshmen, Laura Tsotsis

Antioch University Dissertations & Theses

Alcohol consumption by college students in the United States has increased in quantity and frequency over the past five years. With this increase, there has come evidence of a rise in negative consequences caused by alcohol misuse. To help reduce these problems, colleges and universities nationwide have begun implementing alcohol programs for their undergraduate students. The vast majority of these programs are intervention programs for students who have previously displayed dangerous drinking habits, often seen through campus judicial violations. Research shows that preventative program models, as compared to intervention programs, provide longer lasting changes in individuals and groups. Thus, a …

Bracing For Idiopathic Scoliosis: Improving Adherence Through Psychological Intervention, Shoshana J. Fagen

Antioch University Dissertations & Theses

Poor treatment adherence is increasingly being recognized as a significant problem in pediatric medicine. For the condition Adolescent Idiopathic Scoliosis, poor adherence rates to the most non-surgical intervention, orthotic bracing, have become a well-established fact. This treatment modality has been correlated with multiple psychosocial areas of difficulty, including low self image, suicidal ideation, feelings of isolation, social discomfort, depression, an external locus of control, increasing risk taking behavior, high levels of stress, anger, fear, shame, and eating disorders. Since the orthotic bracing has been linked to both poor adherence and to psychosocial problems, an intervention is created to increase adherence …

The Collaborative Role Of Psychologists In Rural Pediatric Primary Care Settings, Kimberly M. Russo

Antioch University Dissertations & Theses

In this dissertation I discuss research conducted to gain a greater understanding of the unique collaborative needs and desires of medical professionals working with pediatric patients in rural communities. Specifically, I researched the following question: Do medical professionals working in rural areas desire more in-depth collaborative relationships with mental health professionals than they currently have? I acquired information on this subject by mailing surveys to primary care physicians, nurse practitioners, and family practice doctors to learn more about their opinions regarding collaboration with mental health professionals. I collected data over a one-month period, resulting in 11 completed surveys being returned. …

The Phenomenology Of Court-Ordered Treatment: From The Perspective Of Methamphetamine Dependent Adults, Justin Steffener

Antioch University Dissertations & Theses

This phenomenological study was designed to explore with a sample of methamphetamine dependent adults their perceptions of the process involved in their experiences of court-ordered treatment. The motivation for this study derives from the researcher's wish to unearth ways to better understand and support the needs of adults suffering from addiction. A significant amount of research has already been conducted in regards to the treatment of methamphetamine addiction from the standpoint of quantitative measurements of treatment outcomes, but limited information is presently available from the perspective of the suffers. The stringent selection of the sample was composed of six individuals …

College Student Mental Health: The Relationship Between Depression And Emotional Intelligence Using The Student Relationships Assessment, Andre George Broquard

Graduate Theses and Dissertations

The purpose for conducting this study was to investigate the relationship between emotional relational intelligence (ERQ) and depression in college students. The significance of this study is based on the additional support that can be provided to students with increased information and understanding of emotional relational intelligence and depression. In an effort to help college students achieve their educational goals and aspirations, the researcher suggests that emotional relational intelligence can be beneficial. The relationship between depression and emotional relational intelligence may provide insight on how to support and care for college students who are struggling with depressive symptomology. The results …

Impact Of Exercise Partner Attractiveness On Mood, Enjoyment, And Exertion, Thomas G. Plante, Sarah Gregg, Jaclyn Rubbo, Thomas Favero, Ashley Morisako, Jessica Cuadra

Psychology

Social comparison theory was used to examine if males exercising with a female research confederate posing as either attractive or unattractive would alter their exercise mood, exertion, and enjoyment. A total of 101 college students (51 males and 51 females) were randomly assigned to one of three conditions: biking alone, biking with an attractive female confederate, or biking with the same female confederate appearing unattractive. All participants were instructed to complete 20 minutes of exercise at 60%-70% of their maximum target heart rate. Standard exercise mood measures (e.g., Activation-Deactivation Adjective Check List) were administered immediately prior to and immediately following …

Effectiveness Of A Motivational Enhancement Group Treatment In A Community Treatment Program With A Substance Abusing Population, Matthew S. Willerick

Dissertations

Motivational interviewing (MI) is a directive, client-centered intervention to elicit behavior change by assisting clients in the exploration and resolution of ambivalence toward change. MI-inspired approaches have been used in an attempt to facilitate change in a wide variety of domains including alcohol and drug abuse, safe water handling practices, dual diagnoses, gambling, spousal abuse, health related areas, mood and anxiety disorders, and parental engagement. MI seeks to resolve ambivalence in the direction of change by increasing the client's self-efficacy. This is accomplished by combining clientcentered (e.g., reflective listening) and directive strategies (e.g., attending selectively to change statements). The origins …

Understanding Psychosocial Rehabilitation Workers' Perceptions Of Difficult Psychiatric Situations, James B. Arnold

Walden Dissertations and Doctoral Studies

Psychosocial rehabilitation (PSR) is a community-based service that addresses the challenges faced by people diagnosed as having psychiatric disabilities. While working with co workers and clients, PSR workers may harbor perceptions that could lower the effectiveness of their work and hinder recovery by their clients. Although cognitive-behavioral theory has suggested an association, research has not yet connected PSR worker attitudes about psychiatric situations to their feelings and behavior. In this nonexperimental factorial design, 196 PSR workers were surveyed about the frustrations presented by stressful interpersonal job situations using the Psychiatric Situations Scale to identify whether occupation (case workers, residential workers, …

A Conceptualization Of Treatment Stigma In Returning Veterans, Jason B. Flick

Antioch University Dissertations & Theses

The dissertation project combines three theoretical models that inform conceptualizations of the origins, manifestations, and consequences of stigma: the Social Psychological model (SPM), the Sociological model (SM), and the Cognitive-behavioral model (CBM). These models merge into a single, integrative lens, through which stigma can be examined on both cultural and individual levels. This lens is then applied to the cultural and individual manifestations of the stigma of seeking psychological treatment experienced by veterans who have served in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). Through this lens, an understanding of the inception, maintenance, and effects of this treatment …

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 …

A Concept Mapping Needs Assessment Of Young Families With Parental Cancer, Richard P. Durant

Antioch University Dissertations & Theses

The purpose of this research is to investigate the support needs of young families living with and beyond a parental diagnosis of cancer. The sample includes 56 participants comprised of 31 professional stakeholders and 25 patient stakeholders affiliated with the Charles R. Wood Cancer Center. It was hypothesized there would be differences in how the groups of stakeholders rated needs in terms of importance, satisfaction, and utilization. Differences in ratings are thought to be barriers to effective program development. While not a formal research hypothesis, it was anticipated other program development barriers germane to naturalistic clinical settings would emerge from …

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 …