Open Access. Powered by Scholars. Published by Universities.®

Clinical Psychology Commons™

Open Access. Powered by Scholars. Published by Universities.®

Articles 121 - 150 of 158

Full-Text Articles in Clinical Psychology

Exploring Shame And Guilt In Hiv-Positive Women In Southern India, Mitra L. Lebastchi Nov 2016

Exploring Shame And Guilt In Hiv-Positive Women In Southern India, Mitra L. Lebastchi

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Limited research exists examining shame and guilt among HIV positive populations and across cultural contexts. This study addresses this gap in the literature by considering shame and guilt, and potential associations with mental health symptoms, among a sample of 20 HIV positive women in Southern India. Results indicate that most women experienced high levels of shame and guilt, based on responses to items from an adapted version of the State Shame and Guilt Scale (Marschall, Saftner, & Tangney, 1994). Although correlations were not significant between shame and PTSD or depression, guilt was significantly correlated with both. Future research should focus …


Why Therapists Bite Their Tongue In Therapy And What To Do About It, Ingibjorg Thors Nov 2016

Why Therapists Bite Their Tongue In Therapy And What To Do About It, Ingibjorg Thors

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Most therapists agree that therapy should be a place where the unspeakable is speakable, and the role of the therapist should be to help the client find a way to change by exploring the patterns of behavior that are no longer working for the client. Being blunt in therapy seems to be one of the key factors needed to promote immediacy, to challenge habitual ways of thinking that are not productive for our clients, and to create a relationship that is different from social and professional relationships. However, many therapists have distorted beliefs about using bluntness in therapy to stimulate …


Center Of Attention: A Qualitative Study Of The Responses Of Lgbq Students To A Graduate-Level Lgbtq Diversity Training Course, Shoshana N. Aal Aug 2016

Center Of Attention: A Qualitative Study Of The Responses Of Lgbq Students To A Graduate-Level Lgbtq Diversity Training Course, Shoshana N. Aal

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The focus of this study is to examine the difficult situations LGBQ students experience as they complete a training course on LGBTQ issues at a predominantly non-LGBQ doctoral-level psychology program. Questions have arisen over the use of a diversity training course in preparing graduate students for their future as psychologists. Since diversity training courses are currently mandatory for APA accredited graduate psychology programs and are the primary means of training students for treating a diverse array of clients, it is important to ensure that these courses are effective for all graduate students. The purpose of this pilot study is to …


Attitudes, Beliefs, And Behaviors Of Practicing Psychologists Regarding Psychological Assessment, Jason Turret Jun 2016

Attitudes, Beliefs, And Behaviors Of Practicing Psychologists Regarding Psychological Assessment, Jason Turret

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Recent research has documented the effectiveness, benefits, and value of psychological assessment, yet the use of psychological assessment is declining. To better understand why an effective treatment intervention is being underutilized, this project sought to understand the attitudes, beliefs, and behaviors of practicing psychologists regarding psychological assessment. The investigators of this study surveyed 26 psychologists who are members of a statewide association of psychologists in the western United States. Results revealed that 96% of participants enjoyed their graduate training in psychological assessment and 93% of participants view psychological assessment as valuable, yet 78% believed that psychological assessment was underutilized. Participants …


Transgender Awareness Within State Hospitals: Addressing Gaps In Training, Rose Ruoxi Yang Jun 2016

Transgender Awareness Within State Hospitals: Addressing Gaps In Training, Rose Ruoxi Yang

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Individuals in the transgender ("trans") community continue to face stigmatization, discrimination, and violence in the United States (Benson 2013; Bradford, Reisner, Honnold, & Xavier, 2013; Lombardi, Wilchins, Priesing & Malouf, 2001; Shipherd, Green, & Abramovitz; 2010). They remain underserved in many domains, including housing, healthcare, and employment (Bradford et al. 2013). This paper focus on the needs for trans-specific training within the U.S. state hospital system. Although many institutions, including state hospitals, are implementing diversity initiatives to increase the sensitivity of their employees to a broad range of identity statuses, transgender affirmative trainings are often non existent or inadequate; trans-specific …


Relational Frame Theory: Implications For Training Perspective-Taking And Empathy In Children With High Functioning Autism, Lyssa Haase Jun 2016

Relational Frame Theory: Implications For Training Perspective-Taking And Empathy In Children With High Functioning Autism, Lyssa Haase

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Perspective-taking involves the ability to shift one's visual-spatial and affective stance relative to contextual cues. Empathy responses leading to socio-emotional reciprocity depend intimately on perspective-taking processes. Deficits in perspective-taking have been widely documented in individuals with Autism Spectrum Disorders (ASD), and are commonly regarded to underlie impaired interpersonal functioning in this population. The most widely used frameworks for understanding ASD derive from a cognitive science program called Theory of Mind (ToM), and from an applied behavior analytic program based on Operant Theory (OT). Recent research interest has centered on a contemporary contextual behavior analytic approach to perspective taking drawing upon …


Intercultural Communication Between Forensic And Clinical Psychologists, Brittany Schmeck Nov 2015

Intercultural Communication Between Forensic And Clinical Psychologists, Brittany Schmeck

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

While working in clinical and forensic psychology settings, a communication difficulty between the two professions became apparent. Forensic psychologists often appeared cold and callous from the clinical psychologist’s perspective, while clinical psychologists often appeared naïve or too client centered from the forensic psychologist’s perspective. I wondered if viewing each subfield of psychology as a culture could facilitate better communication through intercultural communication. Guided by Intercultural Communication in Contexts (Martin & Nakayama, 2010) in approaching intercultural communication between the two professions, I explored factors contributing to each profession’s cultural identities. Once this was established, I attempted to explore the different ways …


Therapeutic Assessment In Sport Psychology, Fernando Frias Aug 2015

Therapeutic Assessment In Sport Psychology, Fernando Frias

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper outlines the history of assessment in sport psychology and provides a summary of controversies and criticisms of psychological testing in athletics that have persisted throughout the development of the field. Such concerns include the use of personality inventories and tests for talent identification, the misuse of tests and related ethical concerns, cultural sensitivity of tests, and debates about the validity and reliability of assessment measures. In spite of these concerns, interest and demand for psychological assessment in sport remains. Therapeutic Assessment, an emerging but not yet well-known model of collaborative psychological assessment, addresses many of these criticisms and …


Creating A Digital Community In Colleges Through An Interactive Theater Intervention: Guidelines For Cyberbullying Prevention During Freshmen Orientation Week, Benjamin Hindell Aug 2015

Creating A Digital Community In Colleges Through An Interactive Theater Intervention: Guidelines For Cyberbullying Prevention During Freshmen Orientation Week, Benjamin Hindell

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Cyberbullying has created a demand for trainings and workshops that propose “digital citizenship” in schools. These trainings focus on respect for one’s self, peers, and community on and offline (Collier, 2012). Most research in the area has been on junior-high and high-school-age students. However, studies have shown that college age youth also experience cyberbullying. Freshmen may begin college with the psychological trauma of bullying and/or cyberbullying experienced in junior high and high school. They may be perpetrators, victims or both. I propose an interactive cyberbullying prevention program designed for incoming college freshmen that addresses the dynamics of traditional and cyberbullying, …


Living With Dignity: A Pilot Study Implementing Dignity Therapy With Allogeneic Blood Or Marrow Transplant Recipients, Emily Newman Aug 2015

Living With Dignity: A Pilot Study Implementing Dignity Therapy With Allogeneic Blood Or Marrow Transplant Recipients, Emily Newman

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Dignity Therapy is a relatively novel therapeutic intervention designed to address psychosocial and existential distress among those facing life threatening circumstances. This narrative psychotherapy approach invites patients to reflect and speak about issues that are most important to them and hopes to elicit feelings of purposefulness and autonomy, characteristics that are typically waning when nearing end of life. Dignity Therapy consists of a ten question semi-structured interview designed to integrate themes of accomplishments and sources of pride, things that may feel unsaid, and/or particular lessons or wisdom that the patient hopes to pass on to loved ones. The interview is …


Visual Hallucinations Differential Diagnosis Annotated Decision Tree, Shelly D. Davis Aug 2015

Visual Hallucinations Differential Diagnosis Annotated Decision Tree, Shelly D. Davis

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Differential diagnosis of the etiology of visual hallucinations is challenging. Although visual hallucinations can be symptomatic of psychiatric disorder, they more commonly indicate neurological or medical disorders, sensory impairment, or substance intoxication or withdrawal. Accurate diagnosis and treatment is crucial given that misdiagnosis and incorrect treatment intervention can have profound consequences. The purpose of this paper is to summarize the most prevalent causes of visual hallucinations, review the DSM-5 hallucination decision tree, and provide an annotated visual hallucination differential diagnosis decision tree.


Human Trafficking & Commercial Sex Exploitation: Treatment Recommendations For An Invisible Population, Abigail K. Wolfe Aug 2015

Human Trafficking & Commercial Sex Exploitation: Treatment Recommendations For An Invisible Population, Abigail K. Wolfe

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This article addresses the issue of human trafficking, also termed modern slavery, specifically focusing on the treatment of survivors of Commercial Sexual Exploitation (CSE). Treatment recommendations are made based on a trauma-focused, relational model aimed at reinstating psychological well-being in the survivor. This article reviews the literature on three related bodies of research due to the absence of direct psychological literature. Literature on captivity, control and torture, literature on the treatment of refugees and asylum seekers, and literature on sexual abuse treatment for those who have been victimized through the sex trade. Additionally, practical aspects of human trafficking are discussed …


Clinical Psychology Students’ Perceived Training In Working With Transgender Clients: An Exploratory Study, Vanessa Zimmerman Aug 2015

Clinical Psychology Students’ Perceived Training In Working With Transgender Clients: An Exploratory Study, Vanessa Zimmerman

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Literature on appropriate psychological care for the transgender population has been sparse (American Psychological Association [APA], 2009; Carroll, Gilroy, & Ryan, 2002; Israel, Gorcheva, Walther, Sulzner, & Cohen, 2008; Korell & Lorah, 2007; Maguen, Shipherd, Harris, & Welch, 2007; Walker & Prince, 2010). Historically, the focus of research has been on medical care for transgender individuals, and this literature has tended to pathologize the population (APA, 2009). More recently, individuals who identify as transgender have been included under the umbrella of lesbian, gay, bisexual, and transgender (LGBT) studies, where their unique needs are often overlooked or ignored (APA, 2009; Carroll …


Apples And Oranges: An Argument For Psychopathy As A Formal Diagnosis, Katherine K. Mcmann Aug 2015

Apples And Oranges: An Argument For Psychopathy As A Formal Diagnosis, Katherine K. Mcmann

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

When one thinks of the psychopath, an image of one of the notorious serial killers of the 1980s generally pops in their head- Ted Bundy, Jeffrey Dahmer, or the Green River Killer. While still rare, psychopaths encompass much more than just serial killers, and they have a unique presentation that lies outside the confines of any current diagnosis. Characteristics such as lack of empathy, impulsivity, grandiosity, and poor behavioral controls are included in various personality disorders. The Narcissist will show lack of empathy and grandiosity while the Borderline will have poor behavioral controls and impulsivity, for example. However, the construct …


Acceptance And Commitment Therapist Views On The Sacred, Amal Abuzalaf Mull Aug 2015

Acceptance And Commitment Therapist Views On The Sacred, Amal Abuzalaf Mull

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Spirituality and/or religion (S/R) continue to be an important topic in mental health treatment, especially regarding their relationship to a psychotherapist’s theoretical orientation and practice with clients. Given the increased relevance of spirituality to third-wave cognitive behavioral therapies, the current study explores the S/R of Acceptance and Commitment Therapy (ACT) psychotherapists and how their S/R is associated to their attitudes and behaviors within mental health and their use of ACT. Online surveys were administered, producing a sample of 97 ACT psychotherapists in the United States. Results indicated low levels of religiosity and high levels of spirituality among ACT psychotherapists in …


Integrating Clinical Training & Self-Care: Overview, Analysis & Recommendations For Relieving Stress Among Clinicians In Training, Erich Haezebrouck Aug 2015

Integrating Clinical Training & Self-Care: Overview, Analysis & Recommendations For Relieving Stress Among Clinicians In Training, Erich Haezebrouck

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Numerous studies over the past two decades have highlighted the prevalence of stress, mental health disorders and interpersonal problems among psychologists. These statistics parallel those for students currently enrolled in clinical psychology graduate programs where such problems have become even more severe. This results in a significant ethical issue in that clinician competency is negatively impacted by emotional problems. This paper seeks to provide an analysis of current self-care literature. The importance of addressing graduate student self-care is first explored and followed by a literature review on interventions that have been successful in maintaining trainee wellness and competence. Recommendations to …


Best Practices In Team-Based Treatment Termination, Leslie Minna Aug 2015

Best Practices In Team-Based Treatment Termination, Leslie Minna

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Termination of psychological treatment is a necessary part of the therapeutic process, but it can pose complex clinical, ethical, legal, logistical, and social challenges. This complexity becomes even more evident in the current era of treatment delivered by a team of healthcare professionals. Appropriate termination will usually involve a team decision and synthesis of the various team members’ recommendations for appropriate follow-up, medications, or transfer of care into an integrated formal document to be communicated to the patient. The healthcare team may also face other considerations such as record keeping and communication responsibilities when the patient (or the patient’s insurer) …


Soldiers Returning From Deployment: A Qualitative Study Regarding Exposure, Coping, And Reintegration, Lisa A. Brenner, Lisa M. Betthauser, Nazanin Bahraini, Jaimie L. Lusk, Heidi Terrio, Ann I. Scher, Karen A. Schwab Aug 2015

Soldiers Returning From Deployment: A Qualitative Study Regarding Exposure, Coping, And Reintegration, Lisa A. Brenner, Lisa M. Betthauser, Nazanin Bahraini, Jaimie L. Lusk, Heidi Terrio, Ann I. Scher, Karen A. Schwab

Graduate School of Professional Psychology: Student Scholarship

Purpose/Objective: The purpose of this study was to qualitatively explore exposure to deployment-related physical and/or emotional trauma and associated symptoms among Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) soldiers. Interviews also focused on in-theater- and reintegration-related experiences. Research Method/Design: OEF/OIF soldiers (N = 103) participated in semistructured interviews, and a qualitative descriptive methodology was used to analyze the data. Results: Themes were identified regarding (a) common experiences related to emotional and physical traumas and associated symptoms and strategies for coping and making meaning of experiences and (b) how combat and reintegration experiences affected soldiers’ senses of self, relationships with others, …


Perceptions Of Child Wellbeing And Attitudes Towards Polygamy Between Members And Non-Members Of The Lds Church, Mccall Bowcut Lyon Jul 2015

Perceptions Of Child Wellbeing And Attitudes Towards Polygamy Between Members And Non-Members Of The Lds Church, Mccall Bowcut Lyon

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Perceptions of the wellbeing of children in polygamous families and attitudes toward polygamy in general were examined in this study, with comparisons between individuals who have a history of membership in the Church of Jesus Christ of Latter-Day Saints (LDS) and individuals who have never been members of the LDS church. No significant differences were found between members and non-members. Comparisons were also made between current and past members of the LDS church, resulting in only one significant difference: support/opposition for the legalization of polygamy. These results suggest that having a recent religious history of practicing polygamy does not necessarily …


Exploring Mindfulness As A Culturally Sensitive Intervention For The Deaf Community, Barrymore R. Rosellini Jun 2015

Exploring Mindfulness As A Culturally Sensitive Intervention For The Deaf Community, Barrymore R. Rosellini

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Mental health issues are as prevalent in the deaf community as the hearing community, if not more. Yet, Deaf individuals are often treated by mental health professionals less frequently and less effectively. Many systemic barriers exist that influence the lack of services provided to the Deaf community, primarily related to a lack of cultural understanding rooted in perceptions of Deaf individuals. However, the Deaf community may be best understood as a cultural minority, a unique community sharing a distinct culture, history, and language. This paper investigates the effects of systematic barriers and cultural misunderstanding among mental health professions regarding the …


The Clinical Utility Of The Adult Attachment Projective Picture System: A Clinician's Perspective, Ashley Gunterman Jun 2015

The Clinical Utility Of The Adult Attachment Projective Picture System: A Clinician's Perspective, Ashley Gunterman

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The Adult Attachment Projective Picture System (AAP) is the first performance-based measure of adult attachment to be developed. The purpose of the measure is to provide a clinical understanding of an adult client's attachment status and associated coping mechanisms. The AAP is a relatively new measure that has yet to be examined from a utility perspective. In the current study, seven psychologists completed a structured survey in order to identify their perspectives of the AAP and its utility as a clinical instrument. A phenomenological qualitative analysis of the data was conducted to derive themes about the AAP and its clinical …


Development Of A Psychological Assessment Battery To Measure Client Beliefs About The Effectiveness Of Psychotherapy, Christopher Peavey Jun 2015

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.


Health Coaching For Chronic Disease Management: A Program Evaluation Conducted At Denver Health Managed Care, Adam Altschuh Jun 2015

Health Coaching For Chronic Disease Management: A Program Evaluation Conducted At Denver Health Managed Care, Adam Altschuh

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The purpose of this study is to evaluate health coaching at Denver Health Managed Care Center. We evaluated patients with diabetes and obesity who received a telephonic, motivational-interviewing intervention. Our hypothesis was that patients who received health coaching would have improved health outcomes compared to patients who received standard medical care alone. This research benefits this specific program in clarifying effectiveness (i.e. improvement in health and efficiency, indicated by length of treatment). Health coaching is a growing area of study. This research also adds to a broader conversation about what professionals best serve in the role of health coaches, what …


Understanding Change In A Therapeutic Community For People With Severe Mental Illness: An Interpretive Phenomenological Study, Julie Caroline Keys Jun 2015

Understanding Change In A Therapeutic Community For People With Severe Mental Illness: An Interpretive Phenomenological Study, Julie Caroline Keys

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

In order to gain better understanding of how therapeutic communities instigate change, this interpretative phenomenological study explores the recognized agents of change as reported by current and recent community members of a particular therapeutic community. Four superordinate themes were discovered: the structure of the program, engagement in the community, intentionality/mindfulness, and applied knowledge. While the results from this study are similar in several ways to the current literature, they also expand the literature about therapeutic communities in one important way. The change agents reported as leading to healing strongly resemble current best practice for the treatment of trauma. Limitations and …


The Effects Of Inclusion Classrooms On Students With And Without Developmental Disabilities: Teachers’ Perspectives On The Social, Emotional, And Behavioral Development Of All Students In Inclusion Classrooms, Allison E. Evins Jun 2015

The Effects Of Inclusion Classrooms On Students With And Without Developmental Disabilities: Teachers’ Perspectives On The Social, Emotional, And Behavioral Development Of All Students In Inclusion Classrooms, Allison E. Evins

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

In education settings, inclusive or mainstream classes are resisted at the secondary level and there is little research about the possible positive aspects of including students with and without disabilities or an Individualized Education Plan in classes together. In order to better understand the potential benefits of mainstream classrooms, it is important to understand the perspectives of teachers who work within these high school settings. The purpose of this study was to tell the stories of teachers and describe the development that teachers see in inclusive classrooms. Interviews with four teachers revealed insights on mutual learning between the two groups …


Using Yoga Practice To Empower Psychotherapists’ Interpersonal Process, Jennifer Paz Mar 2015

Using Yoga Practice To Empower Psychotherapists’ Interpersonal Process, Jennifer Paz

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Yoga practice promotes awareness and acceptance, and serves as a body-centered medium for developing deepened self-understanding. Among patient populations, a growing body of evidence suggests that the benefits of yoga practice extend to both physical health and psychological well-being. However, the psychological impact of yoga practice on psychotherapists’ interpersonal responses, while potentially promising, has received little attention in the literature. This paper provides a historical overview of contemplative practices and discusses the role that yoga can play in developing certain interpersonal characteristics of the psychotherapist that are hypothesized to empower the therapeutic relationship and facilitate constructive behavior change on the …


Guidelines For Forensic Report Writing: Helping Trainees Understand Common Pitfalls To Improve Reports, Meghan E. Brannick Mar 2015

Guidelines For Forensic Report Writing: Helping Trainees Understand Common Pitfalls To Improve Reports, Meghan E. Brannick

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

A forensic report is the primary work product of a forensic psychologist. The aim of a forensic report is to inform and influence the court. Unlike a clinical report, a forensic report influences the outcome of a legal conflict. This means that greater care must be taken in writing the report. The following errors (Grisso, 2010) were used to discuss best practices in forensic report writing: failure to answer the referral question, organization problems, language problems, mixed data and interpretation, inclusion of irrelevant data, over-reliance on a single source of data, improper psychological test use, failure to consider alternative hypotheses, …


Interpreting Empirical Assessments From A Behavioral Perspective: A Rationale For Why And How, Tiffiny Mccain Mar 2015

Interpreting Empirical Assessments From A Behavioral Perspective: A Rationale For Why And How, Tiffiny Mccain

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper provides a rationale on why and how to utilize assessment tools effectively within the behavioral framework through idiographic assessment. Empirical assessment instruments can provide guidance to the behaviorist that may prove useful in the idiographic formation of a behaviorally-based treatment plan. The paper will focus on two of the major traditional instrument tools, the Minnesota Multiphasic Personality Inventory and the Rorschach inkblot test.


A Parametric Description Of Modern Military Culture For Civilian Mental Health Practitioners To Better Serve Those Who Serve, Ruthann R. Lester Aug 2014

A Parametric Description Of Modern Military Culture For Civilian Mental Health Practitioners To Better Serve Those Who Serve, Ruthann R. Lester

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Many mental health practitioners will have therapeutic encounters with veterans at one point or another during the course of their training or career. To meet the therapeutic needs of those who have served or are serving our country through combat or non-combat military service, it is essential that these practitioners are able to provide effective interventions for this population. Effective treatment entails culturally competent care, however, few resources are available to help civilian mental health practitioners become educated about military culture and translate that cultural competence into efficacious treatment. Therefore, the purpose of this paper is to respond to the …


The Importance Of The First Psychotherapy Case In The Development Of The Therapist's Professional Self As Viewed Through The Lens Of Self Psychology, Kaitlyn Eichenberger Aug 2014

The Importance Of The First Psychotherapy Case In The Development Of The Therapist's Professional Self As Viewed Through The Lens Of Self Psychology, Kaitlyn Eichenberger

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper explores the gap in the literature between what is herein referred to as the "first psychotherapy case" and its impact on the development of the trainee psychotherapist's professional self. The self psychology concepts of identity development, selfobject needs and fulfillment, narcissism, shame, countertransference, and structuralization are incorporated into the theoretical framework from which this developmental milestone is viewed. The theory's emphasis on early experiences and the development of self highlight the distinctiveness of the first case for the therapist. The beginning psychotherapy case poses a unique context for selfobject experiences and the developing self, involving both the therapist's …