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Full-Text Articles in Clinical Psychology

Attachment Theory To Inform Intervention In Correctional Populations With Adverse Childhood Experiences And Substance Use Disorders, Samantha Mendoza Jan 2022

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 …


An Assessment Of Adhd/Ld Support In Psyd Programs From The Perspective Of Faculty Advisors, Mac Zimdars Jan 2022

An Assessment Of Adhd/Ld Support In Psyd Programs From The Perspective Of Faculty Advisors, Mac Zimdars

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Among psychologists and doctoral psychology students, 14.3% and 10.7% reported having Attention Deficit Hyperactivity Disorder (ADHD) or learning disabilities (LD), respectively; 67.3% of those with any disability experienced disability-related impediments and discrimination during graduate school or the application process (Lund et al., 2014). This paper is focused on assessing current PsyD program supports for students with ADHD/LD from a faculty advisor perspective. Specifically, this research assesses the faculty advisor-advisee relationship, as well as available support services and resources. Data was collected from an anonymous survey and utilized an empirical mixed-methods approach. Three themes emerged from the study: (1) Advisors lack …


Unique Types Of Angel And Ghost Memories In Low-Income, Diverse Pregnant Women, Rebecca Spear Jan 2022

Unique Types Of Angel And Ghost Memories In Low-Income, Diverse Pregnant Women, Rebecca Spear

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This study examined the associations between three types of angel memories, defined as recollections of loving moments with childhood caregivers, and pregnant women’s reported childhood adversity and current PTSD symptoms. Angel memories were coded from the Angels in the Nursery Interview (Van Horn et al., 2008) into three subtypes: protection in the context of harm, rupture in the protective shield, and sensory memories. Participants were 175 ethnically-diverse pregnant women (M age = 28.07, SD = 5.68, range = 18-40 years; 61.1% non-White) who completed the Angels Interview, the Adverse Childhood Experiences scale (ACEs; CDC, 2021) for childhood adversity, and …


It Takes A Village: Tribalism As A Premise To Understand Societal Responsibility And Impact Of Mass Violence, Paige D. Schultz Jan 2022

It Takes A Village: Tribalism As A Premise To Understand Societal Responsibility And Impact Of Mass Violence, Paige D. Schultz

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

What is a mass shooter? This is difficult to answer as there is no single definition. The definition of a mass shooter depends on contextual factors including victim count, setting, and motivation (Gramlich, 2019). The Federal Bureau of Investigation (FBI) defines active shooters as “one or more individuals actively engaged in killing or attempting to kill people in a populated area” (Federal Bureau of Investigation, 2021, page 1). While other definitions are used to identify a mass shooter, given the breadth of study in this area by the FBI, this paper will use the FBI definition.


The Impact Of A Relationship Education Program On Health Disparities Among Pregnant Women, Anne Clara Biermann Jan 2022

The Impact Of A Relationship Education Program On Health Disparities Among Pregnant Women, Anne Clara Biermann

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Health disparities amongst pregnant individuals of color have long been documented and yet, they persist. While there is growing recognition, the search continues for solutions to close the health disparity gap between White women and women of color. This research is a follow-up to a 2022 study exploring the impact of the MotherWise program on birth outcomes. MotherWise provides an individual-oriented relationship education program and case management service for minority and low-income pregnant women in Colorado. This research further explores a positive trend of the program's impact on preterm birth rates by examining differential effects of participation by race. In …


"Stay Strong": Internalized Stigma, Religiosity And Black Mental Health In Colorado, Breigh Jones-Coplin Jan 2022

"Stay Strong": Internalized Stigma, Religiosity And Black Mental Health In Colorado, Breigh Jones-Coplin

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

While the societal stigma on mental illness deters people from seeking mental health services, there is limited research on how Black personality and cultural practices may impact stigma and Black mental health (NAMI, 2020). In an attempt to identify protective and risk factors for internalized stigma and Black mental health, the present study examined 416 Black adults in Colorado and identified significant relationships between African Self-Consciousness, internalized stigma of mental illness, religiosity, and mental health functioning. Results showed that having a strong African-centered identity and religious grounding are associated with less internalized stigma and difficulty in functioning and mental health …


Psilocybin And The Psychologist: A Proposed Methodology For Exploring The Effects Of Clinicians’ Psychedelic Experiences On Their Clinical Practice, Brian N. Iliescu Jan 2022

Psilocybin And The Psychologist: A Proposed Methodology For Exploring The Effects Of Clinicians’ Psychedelic Experiences On Their Clinical Practice, Brian N. Iliescu

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper proposes a phenomenological exploration of the perceived influence of psychedelic experiences on clinical psychologists’ practice of psychotherapy. The goal of the proposed study is to open-endingly explore the psychedelic experiences of psychologists to identify common themes, underlying phenomena, and the impact that those experiences may have on their individual practice of psychotherapy. At present, no published studies have explored or identified how the perceived long-term effects of psychedelics influence professional mindsets and practices. This paper aims to synthesize the current literature, identify a gap, provide rationale for future queries into the non-clinical uses and effects of psychedelic medicines, …


A Missing Narrative: The Creation Of A Trauma-Informed Children’S Book For Children In The Foster Care System, Elizabeth Hoff Saunderson Jan 2022

A Missing Narrative: The Creation Of A Trauma-Informed Children’S Book For Children In The Foster Care System, Elizabeth Hoff Saunderson

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This article includes a review of literature relevant to the experiences of children in the foster care system including demographics, trauma and stressful experiences, attachment challenges, and useful interventions. Limited research has been conducted to inform resource tools for children in foster care. The aim of the present study was to create a trauma-informed resource tool for children in the foster care system in the form of a children’s book. A review of children’s books related to foster care yielded four major themes including the importance of mindful language, the need for a resource tool, a focus on safety, and …


Can Brazilian Jiu Jitsu Be A Viable Treatment Option For Law Enforcement Officers With Ptsd?, Megan Rinderer Jan 2022

Can Brazilian Jiu Jitsu Be A Viable Treatment Option For Law Enforcement Officers With Ptsd?, Megan Rinderer

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Law enforcement officers (LEO) are more likely to experience symptoms of PTSD when compared to the general population yet are less likely to seek mental health treatment (Jetelina et al., 2020). Given that LEO face unique occupational stressors and repeated exposure to traumatic events, treatment for PTSD among law enforcement populations poses unique challenges for clinicians. The combination of these variables precludes officers from seeking and receiving mental health services. Research regarding the efficacy of Brazilian Jiu Jitsu (BJJ) as a psychotherapeutic intervention is limited. To date, no studies have examined the use of BJJ to mitigate symptoms of PTSD …


Mindfulness And The Relationship Between Connectedness To Nature And Affect, Mathew Stewart Jan 2022

Mindfulness And The Relationship Between Connectedness To Nature And Affect, Mathew Stewart

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Exposure to in-vivo and virtual nature has been shown to increase a person’s positive affect from a variety of mechanisms. Natural settings and green-spaces allow for the recovery of attentional resources whereas urban environments elicit opposite effects. Individuals who practice mindfulness in general exhibit greater attentional resources and potentially could see added benefit to their well-being through exposure to natural environments. This research investigated whether those who are more mindful receive greater benefits from exposure to virtual restorative natural environments compared to individuals who do not practice or engage with mindfulness regularly. Subjects viewed an urban, urban/nature, or nature representative …


Cancer Related Cognitive Impairment In Breast Cancer Patients: Guidelines For Neuropsychological Evaluation And Management, Ali Al-Humadi Jan 2022

Cancer Related Cognitive Impairment In Breast Cancer Patients: Guidelines For Neuropsychological Evaluation And Management, Ali Al-Humadi

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Current literature indicates there is still some debate regarding the scope and severity of cancer treatment related cognitive impairment (CRCI), with a wide variety of complex factors contributing to cognitive decline and discrepancies between objective findings and patient self-report. This paper aims to provide guidelines for neuropsychological evaluation, management, and rehabilitation of CRCI in breast cancer patients based on current research. This paper also aims to discuss current research on proposed mechanisms of action for CRCI, the cognitive domains affected in CRCI, and significant bio-psycho-social risk factors impacting CRCI.


“It’S Right Below The Surface”: Clinicians’ Experiences Of Shame In Therapy Work With Adult Clients With Body Shame, Body Image Concerns, Or Eating Disorder(S), Tess Carroll Keeley Jan 2022

“It’S Right Below The Surface”: Clinicians’ Experiences Of Shame In Therapy Work With Adult Clients With Body Shame, Body Image Concerns, Or Eating Disorder(S), Tess Carroll Keeley

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Shame–understood as a feeling in which one believes that they are inadequate, or wrong to their core–is a painful emotional experience that seems to be at the crux of many mental health concerns. Despite the pervasiveness of shame as an emotional experience, little research has demonstrated if shame is a clinical theme in therapy, and if so, how it is identified and treated. The purpose of this qualitative study was to explore if, and how, shame manifests during therapy sessions with clients who are experiencing eating disorders and/or body image concerns. A secondary purpose was to discover how clinicians’ training …


Psychologists’ Graduate Training Experience And Attitudes In Religion And Spirituality, Kristi Santiago Jan 2022

Psychologists’ Graduate Training Experience And Attitudes In Religion And Spirituality, Kristi Santiago

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

In a nationwide poll, 76% of the population of the United States identifies with a formal religion of some kind (Gallup Organization, 2021). Despite the prevalence of religion and spirituality (R/S) throughout the country, graduate programs appear to neglect training on this multicultural issue. The purpose of this paper is to better understand psychologists’ attitudes toward the quality and depth of their graduate training in R/S, determine how competent psychologists feel at managing discussions of R/S within psychotherapy, and recommend necessary improvements to graduate training in R/S. Data was collected using a 24-item, online survey, which was circulated throughout college …


An Analysis Of Military Service Academies Sexual Harassment And Sexual Assault Through Reports, Research, And Media Coverage, Lisa “Tana” Youn Kyung Sharp Jan 2022

An Analysis Of Military Service Academies Sexual Harassment And Sexual Assault Through Reports, Research, And Media Coverage, Lisa “Tana” Youn Kyung Sharp

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Military Sexual Trauma (MST) at the United States Military Services Academies (MSA) remains at a concerning rate despite the MSAs’ proactive educational steps towards addressing this issue. One of the most influential factors is the very culture of the MSAs. This paper analyzes publicly-accessible governmental research and reports, peer reviewed articles, a legal publication, and media coverage. The analysis shows that there remain significant barriers to change which continue to play a role in the high frequency of MST. These barriers are low rates of accountability, difficulty in access to cadets/midshipmen by outside researchers, and the overall MSA cultural trends …


Unreality And Loss Of Self: Dissociative Experiences In Buddhist Practitioners, Jill Loving Jan 2022

Unreality And Loss Of Self: Dissociative Experiences In Buddhist Practitioners, Jill Loving

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

On the surface, the Buddhist idea of emptiness and experiences of depersonalization and derealization seem to have significant overlap. Meditations on emptiness in the Buddhist tradition seek to lead meditators to observe the ego as illusory and empty of inherent content as one step in the journey to liberate oneself from suffering. Conversely, dissociation is generally an involuntary, automatic response to severe trauma that can become more common or chronic in an individual over time. Topographically, these experiences may look similar; both include a sense of unreality of the self and often of the broader world. However, differences in stimulus …


Asexuality And Demisexuality: Clinical Implications Of Sexual Identity, Michael Scott Fiorini Jan 2022

Asexuality And Demisexuality: Clinical Implications Of Sexual Identity, Michael Scott Fiorini

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper considers demisexuality as an identity and sexual orientation for use by psychologists using historical, sociological, and psychological perspectives. It discusses the clinical implications of demisexuality as an identity and orientation distinct from asexuality. The paper discusses applications and limitations of defining and identifying demisexuality in a clinical population and it's social, scientific, and contextual significance. The paper compares what can be observed with existing diagnostic guidelines present in the DSM-5 for the identification of Female Sexual Interest/Arousal Disorder (FSIAD) and Male Hypoactive Sexual Desire Disorder (MHSDD). The paper proposes guidelines for the diagnosis and the ethical clinical treatment …


Working With Families With Refugee Experiences In The United States: The Impact Of Forced Displacement On Parent-Child Relationships After Resettlement, Sakshi Kapur Jan 2022

Working With Families With Refugee Experiences In The United States: The Impact Of Forced Displacement On Parent-Child Relationships After Resettlement, Sakshi Kapur

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Refugees resettled in high-income countries like the United States have a unique set of challenges ranging from great psychological disturbance to acculturation challenges. With recent changes to policies related to immigration and refugee resettlement in the United States after the 2016 presidential elections, the refugee diaspora was left with resettlement services focused more on ensuring national security and economic independence rather than services that catered to re-integration beyond economics like acculturation stress, family functioning, and cultural adjustment. This systemic literature review explores the impact of forced displacement and migration on individuals, with an emphasis on family systems and parent-child relationships. …


Therapist Self-Disclosure With Mandated College Students: A Case Study, Zachary Lattanzio Jan 2022

Therapist Self-Disclosure With Mandated College Students: A Case Study, Zachary Lattanzio

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Facing the stark reality of a disturbing mental health crisis present in the college populations of the United States, college counseling centers (CCC) must figure out ways in which they can utilize all of their available limited resources, especially regarding potential high-risk students who are unlikely to seek treatment and those that pose a danger to self or others. In certain cases, mandated treatment can potentially mitigate or eliminate crises, and may serve as an effective intervention to students whose risky behavior may be normalized within the culture of colleges across the United States. However, while this course of treatment …


The Risks For Eating Disorders/Disordered Eating In Refugee & Immigrant Experiences And The Imperative Of Culturally Alert Screening, Chantal A. Bushelle Jan 2021

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 …


Canine-Assisted Exposure Therapy, Stephanie B. Bono Jan 2021

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 …


Encountering Death: A Training Proposal For Psychologists Addressing Death Anxiety And End-Of-Life Care, Bridget Kromrey Jan 2021

Encountering Death: A Training Proposal For Psychologists Addressing Death Anxiety And End-Of-Life Care, Bridget Kromrey

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Inward reflection and knowing the self are an essential element to becoming a psychologist and is crucial when encountering themes of death and dying in psychotherapy. There are significant gaps in curriculum and training regarding death anxiety and end-of-life care for psychology trainees and psychologists despite psychologists’ growing presence in this type of work. The following paper will explore historical and current day theories of death anxiety and death education. It will also demonstrate the gaps in training for psychologists in the areas of death anxiety and end-of-life care and describe the need for this type of training to be …


From Military Service To Diakonia: A Training Program For Clergy Ministering To Veterans, Danielle Xanthos Jan 2021

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 …


Lived Experience: The Training Of Therapists, Actors & Human Beings, Richard Williams Jan 2021

Lived Experience: The Training Of Therapists, Actors & Human Beings, Richard Williams

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

There is much in common between theater and therapy. Both happen live. Both are explorations of human experience. Both require participants to be emotionally and mentally present. Both are hard to do well (and easy to do poorly). Training to be a clinical psychologist requires hours of coursework, administrative work, supervision, and on the job clinical experience. Training to be a professional theater maker or actor requires hours of rehearsal. The elements of acting are deconstructed during training so that rehearsal consists of voice-work, physical theater, scene study, etcetera. Training to be an actor entails much more practice of the …


Mothers Know Best: Guidance For Healthcare Providers On Early Identification Of Perinatal Mental Health Disorders, Klarissa I. Garcia Orellana Jan 2021

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 …


A Culturally And Structurally Sensitive Approach To Working With Suicidal Latinx Individuals: Recommendations For Clinicians, Jessa Navidé Jan 2021

A Culturally And Structurally Sensitive Approach To Working With Suicidal Latinx Individuals: Recommendations For Clinicians, Jessa Navidé

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Latinx individuals are the fastest growing racial/ethnic group in the U.S. and confront numerous challenges living in the U.S. that can impact their mental health. While their overall suicide rates are relatively low compared to non-Hispanic Whites, it is concerning to note suicide rates of Latinx individuals living in the U.S. are significantly higher compared to most countries in Latin America. The predominant approaches to treating suicidal individuals often fail to consider the sociopolitical climate and systemic challenges that exacerbate mental health concerns for Latinx individuals. This paper examines cultural considerations, racial and ethnic identity models, and unique protective and …


Resilience In Cancer Patients, Lori A. Gardner Jan 2021

Resilience In Cancer Patients, Lori A. Gardner

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The phenomenon of resilience has long been identified as a key talking point within the realm of overall mental health, but the concept’s specific meaning, qualities, and sources remain somewhat elusive. For those with chronic health conditions, resilience is often identified as essential to coping effectively with significant disruptions to daily activities. The purpose of this study was to better understand the concept of resilience and to determine themes that underlie resilience, specifically within a cancer patient population. This goal was addressed by using a qualitative approach to elicit commonalities among the experiences of cancer patients representing varying types and …


Clinical Considerations For Treating Adult Survivors Of Child Sexual Abuse: A Proposal For Integrating Intersubjective Systems Theory And Feminist Perspectives, Kristen Schrijver Jan 2021

Clinical Considerations For Treating Adult Survivors Of Child Sexual Abuse: A Proposal For Integrating Intersubjective Systems Theory And Feminist Perspectives, Kristen Schrijver

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The goal of this paper is to offer clinical considerations for clinicians working with adult survivors of extrafamilial child sexual abuse (CSA) by 1) defining the stages of sexual abuse grooming of the child and their entire family system, 2) defining and integrating intersubjective and feminist approaches to treatment, and 3) providing methods for depathologizing CSA survivors’ experience of shame. These three objectives aim to increase awareness and knowledge of sexual abuse grooming, as well as offer an integrative theoretical framework for individual therapy with adult survivors of CSA.


Urban School Violence Prevention: A Suggested Intervention Utilizing Liberation Psychology, Meghan K. Hogan Jan 2021

Urban School Violence Prevention: A Suggested Intervention Utilizing Liberation Psychology, Meghan K. Hogan

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

In the past decades, numerous programs have been developed in attempts to reduce the rates of violence facing students in American schools. The spotlight on these programs have increased since horrific mass shooting events have taken place throughout the country. Many of these programs have utilized varied methods in their attempt to reduce school-based violence, from the implementation of hardline policies meant to act as violence deterrents to the development of risk assessment teams aimed at identifying and intervening against potential threats; however, few of the existing programs have shown substantial efficacy rates. Additionally, several of the violence prevention programs …


Co-Constructing Stigma: Treating Trauma In Adolescence, Isabelle Sanderson Jan 2021

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 …


Stagnation In Psychotherapy: A Transtheoretical Approach, Kristine Mccormick Jan 2021

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.