Clinical Psychology Commons^™

Doubled Up With Pain: Applying A Relational Framework To The Primary Care Provider - Chronic Pain Patient Relationship, Rebecca Hillel

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Treatment relationships between primary care providers (PCPs) and chronic pain patients are often rife with difficult interpersonal dynamics and experienced by both parties as being noncollaborative. It is important that PCPs are provided with recommendations to make these treatment relationships more collaborative. Relational psychological frameworks, such as intersubjectivity, can teach PCPs how to improve their relationships with chronic pain patients. This paper focuses on how to strengthen the working alliance between PCPs and chronic pain patients using intersubjective principles. Conceptualizing the working alliance from an intersubjective lens gives PCPs guidance about where to turn if their treatment relationships with chronic …

Wood Or Steel? Six Practices For An Effective Learning Relationship From Martial Arts To Psychology, Jessica Luginbuhl

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Becoming a psychologist is founded on supervision, the practice of learning the craft by doing the craft under the watchful eye of an expert. Becoming a black belt in martial arts is based on a similar principle of endless practice with the guidance of a master. How a teacher, supervisor, or sensei navigates the relationship with their student is crucial to the student’s ability to arrive at mastery of the craft. Methods for creating an appropriate and effective teacher/student relationship are explored by examining parallels between teaching practices used by karate teachers, and teaching practices used by graduate-level supervisors. Relevant …

Families Healing Together: A Multi-Family Group Curriculum Proposal, Loraine Fishman

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper presents evidence that supports the need to create and implement a trauma-focused multi-family group curriculum. The introduction provides a broad definition of post-traumatic stress disorder (PTSD) as well as a definition of complex trauma. The paper also reviews research for trauma-specific evidence-based interventions for individual, group, and multi-family group psychotherapy. A curriculum that involves multi-family support, family therapy, age-specific group treatment, and individual therapy is presented. In addition, limitations and future and multicultural considerations are discussed.

Correctional Staff Attitudes Toward Transgender Individuals, Neilou Heidari

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Compared to the general population, transgender individuals face higher rates of victimization, violence, substance use, physical health issues, and mental health problems. Transgender people are more likely to face barriers in finding and maintaining employment and housing due to discrimination. As a result, they are more likely to participate in illegal economies such as sex work and drug distribution. These factors contribute to the overrepresentation of transgender people in jails and prisons in the United States. Specifically, 16% of transgender adults have been incarcerated, compared to 2.7% of the general population. While under custody, transgender individuals are at risk of …

Bad Boys, Bad Boys: Masculinity, Performance Theory, And Prisoner Re-Entry, Jannae D. Bratcher

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Men and boys commit more crime, are more violent, and are more likely to be involved in the criminal justice system than women and girls (Cohen & Harvey, 2006; Carson, 2018; Zimmerman & Messner, 2010). Within the past two decades, criminal studies have begun to consider masculinity as a social construct to explain the gender gap in crime rates. However, more research is needed to understand its relationship to reentry and recidivism. The lens of masculinity as a performance is valuable and has a proud scholarly history, including the works of Judith Butler and Erving Goffman. This paper conceptualizes prisoner …

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, …

The Zero Suicide Initiative: Implementation Tailored For Individuals With Chronic Suicidality In Community Mental Health Centers, Helen Louise Littrell

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

In 2018, Suicide was the 10th leading cause of death in the United States (Center for Disease Control and Prevention, 2019), and the American suicide rate continues to rise (Hedegaard, Curtin, & Warner, 2018). The lack of impact in reducing the suicide rate highlights the need to further understand how to help suicidal individuals. Nearly one third of suicides are preceded in the previous year by a visit to a mental health physician (Luoma, Martin, and Person, 2002). This paper proposes a tractable and research-validated strategy for Community Mental Health Centers (CMHCs) to appreciably reduce the suicide rate among their …

Clinician’S Resource Guide: A Compendium Of Child Treatment Resources, Carleen Knauf

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

As an early career clinician in a fast-paced field that is dedicated to working with others, saving time and energy where possible is invaluable. When I first started working with children, I was overwhelmed by the amount of time I was having to dedicate to research to find reputable resources to use in my clinical settings. I realized so much of my time and energy was going towards this research that by the time I entered the therapy room with my clients I was tired, frustrated, and overwhelmed by the lack of easily accessible resources. After working with and learning …

Could A Robot Be Your Psychotherapist?, Benjamin Huston

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

As technology has advanced over the years, it has been integrated into psychotherapy and changed the way that people receive mental health care (Schopp, Demiris, & Glueckauf, 2006). Many of these advances, such as telehealth practices, were seen as unsustainable until the public Internet offered broader access to technology-based care in the 1990s (Schopp, Demiris, & Glueckauf, 2006). These technology-based practices have since grown in popularity and with a recent increase in telehealth practices, text-based therapies, and applications to aid in mental health practices, modern therapy looks very different than it did even ten years ago (Fiske, Henningsen, & Buyx, …

Narrative Therapy To Reduce Self-Stigma: Empowering Children, Adolescents, And Their Families, Jillian Baldwin

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The effects of self-stigma on children and adolescents with mental health diagnoses is a documented psychological issue in academic literature; however, no studies or articles to date present strategies for reducing its negative effects. Additionally, very few studies have connected the experience of parental stigma, or courtesy/affiliate stigma, and its effects on child and family well-being. Self-stigma has been conceptualized as existing on the opposite end of the spectrum from empowerment, suggesting that empowerment may serve as a promising approach to tackling self-stigmatization. This paper presents a novel therapeutic intervention for reducing self-stigma in children, adolescents, and their families through …

Exploring Sex And Contact Sport Differences In Baseline Impact Post-Concussion Symptom Scale Scores Among Collegiate Athletes Without A History Of Concussion, Madison Mackenzie

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Introduction: The use of baseline or preseason cognitive testing, including symptom endorsement, to quantify post-injury changes, is a practice supported by most major sports associations. In the absence of baseline data, normative data are used for this purpose and research suggests that those data often fail to accurately represent some groups of athletes, particularly non-concussed female athletes in all sports. In clinical practice, inaccurate normative scores can mask or exaggerate post-injury changes which can result in mismanaged athlete care and inaccurate return-to-play decisions. This study examines differences in baseline symptom scores between male and female athletes in different types of …

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 …

Identifying Gaps In Transitional Care For Adolescent Parents And Their Infants Leaving The Nicu: A Needs Assessment, Stevie Griglak

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Parents of infants admitted to the Neonatal Intensive Care Unit (NICU) are more likely to experience posttraumatic stress, anxiety, feelings of hopelessness, difficulties caring for or bonding with their infants, and financial concerns than parents who deliver full-term, healthy newborns (Ionio et al., 2016). Some NICU admissions may last several months before the premature and/or critically ill infant is stable enough for discharge, and other times the likelihood of discharge is uncertain. Arguably, teen parents with NICU infants are confronted with even more stressors throughout their newborn's hospitalization and post-discharge when they settle into their role as a new parent. …

Educating And Training The Next Generations Of Security Staff In Suicide Risk Assessment In Correctional Settings: Development Of Cultural Competencies, Ashley Christianson

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Cultural competence in suicide risk assessment has become a necessity given the demographic diversity in the U.S. corrections population and the increasing rate of suicidal behavior in jails and prisons. With few exceptions, little attention has been paid to the cultural training of both clinicians and security staff, and the development of cultural competencies in this field. This paper will focus exclusively on examining the case for cultural competence when conducting a suicide risk assessment in a correctional setting. The author reviews factors that are key in the education and training of culturally informed jail-based therapists and corrections officers, including …

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 …

Biology Of Binge Eating Related Disorders And Proposal For Integration Into Treatment, Karlyne Morawe

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

The concerningly low recovery and high cross over rates of eating disorders with binge eating behaviors suggests there might be a missing element in current treatment approaches commonly used to address eating disorders. Research supports the existence of significant biological correlation between disorders that are characterized by binge eating behaviors. This paper examines some of the biological processes in which these disorders show the most significant correlations. These include the organism’s response to caloric restriction, the brain’s response to feeding, the biological drive for reproduction, sensory association to feeding, and habituated responding to the feeding process. Additionally, we will explore …

The Elephant And The Felon: A Look At Criminal Sentencing And Treatment Through The Lens Of Jonathan Haidt's Moral Matrices, Samantha Horkott

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Criminal sentencing in the United States has shifted over the years. This paper outlines the current role morality plays in the sentencing and punishment of criminals. Recent work in moral psychology points the way to a better approach. Jonathan Haidt’s moral matrices, from his book The Righteous Mind: Why Good People Are Divided by Politics and Religion, provide a signpost for more efficacious treatment of those on parole or under community supervision, overall contributing to the reduction of recidivism. In sum, Haidt’s work in moral psychology could lead to fairer sentencing and more effective treatment.

Sex Topics In Therapy: A Literature Review And Proposal For Continuing Education, Courtney Gallagher

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Sex topics should be welcome in the therapy room. Sexual identity, practices, concerns and questions should not be considered a "taboo" subject in the therapy room, yet clients remain reluctant to bring up such topics with their therapists. In order to ensure that clients feel free to bring into the room such themes that are a large part of their life, clinicians need to be trained and competent in sex topics. The following literature review examines the history of femininity and masculinity and what "facts" have continued to permeate into our profession, the history of sex expectations, language about sex …

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 …

Adverse Childhood Experiences, Neuroadaptation, And Resilience: Does Trauma Focused Cognitive Behavioral Therapy Go Far Enough?, Tracie Abbott

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Adverse childhood experiences (ACEs) pose a significant public health risk. Current literature suggests ACEs have the potential to significantly disrupt sensitive periods of neurodevelopment. These neuroadaptations can result in social, emotional, and cognitive impairments that place a child at a significantly greater risk for adopting health risk behaviors and lifestyle factors that lead to the major causes of disease, disability, social problems, and early death in adults. Mental health clinicians have a unique opportunity to intervene by working with families to alter the trajectories of the child’s health risk behaviors and lifestyle factors. Trauma Focused Cognitive Behavioral Therapy (TF-CBT), a …

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.

Therapeutic Alliance Through Person-Centered Therapy: An Influential Factor In Long-Term Utilization Of Mental Health Services Among Asians In The United States, Lahela Ashlee Rice Jorgenson

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

While the Asian population in the United States is growing vastly and there is an abundance of literature regarding barriers to utilization of psychological services for this population, there remains minimal research on positive or facilitative factors for those who do utilize services and do not prematurely terminate treatment. The purpose of this study was to explore possible factors that promote clients' utilization and commitment to mental health services, as reported by Asian clinicians working with an Asian American population. This study was performed through a descriptive qualitative approach consisting of semi-structured interviews with four clinicians providing mental health services …

Training Games: An Application Of Game Theory To Clinical Psychology Graduate Training, Benjamin David Cornell

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Contents

Groundwork - 4

Game Theory - 4

Game Theory and the System of Clinical Psychology Graduate Training - 6

Psychological Payouts, Reconciling Game Theory and Clinical Psychology - 8

Games in the Training of Psychotherapists - 15

Prisoners’ Dilemmas, Internship and Graduate Applicant Selection - 15

The Strategic Implications of Learning, Nash Equilibria - 21

Commitment Moves, “The Frame,” Psychotherapy, Supervision - 24

Mechanism Design, The Match - 27

Intra-systemic Conflict, Program Design - 30

Conclusion - 34

Works Cited - 36

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 …

Recommendations For Developing Video Games To Address Depression Among College Students, John Bodycombe

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Depression is a significant problem on college campuses, and the data shows that prevalence is on the rise (The National Survey on Drug Use and Health [NSDUH], 2014; Stewart, Ricci, Chee, Hahn, & Morgenstein, 2003). Depression impacts the well-being of students and puts them at risk for a variety of issues (Leach, 2009; Adams, Wharton, Quilter, & Hirsch, 2008; Serras, Saules, Cranford, & Eisenberg, 2010; Cranford, Eisenberg, & Serras, 2009; Weitzman, 2004). Many students with depression do not receive care (Blanco, Okuda, Wright, Hasin, Grant, Liu, & Olfson, 20008; Eisenburg and Chung, 2012), or receive care that is not minimally …

The Impact Of Negative Affect And Positive Self-Perception On Acquired Capability For Suicide In The Veteran Population, Clara Luisa Fajardo

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Suicide is currently the 10th leading cause of death among Americans overall and is the second leading cause of death among American adults between the ages of 18 and 34 (Kochanek, Murphy, Xu, & Tejada-­‐Vera, 2016). In addition to the number of people who die by suicide, each suicide death costs $1,287,534 in lost revenue, mental health costs, and medical expenses (Centers for Disease Control and Prevention, 2017). Suicide also takes a toll on people who knew or were close with the person who died. For every one suicide, there are approximately 115 suicide survivors. Put another way, sixty percent …

Understanding Gender Differences In Sports-Related Concussions Among High School Athletes: Implications For Diagnosis, Treatment, And Management, Hillary Grady-Speckhals

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Growing research on both the immediate and long-term effects of sports-related concussions (SRCs) in professional athletes has called attention not only to understanding the impact of concussions in high school athletes, but has also focused on understanding how SRCs may impact female athletes differently than male athletes (Covassin & Elbin, 2011; Kirkwood, Yeates, & Wilson, 2006). There are many studies that have highlighted the neurocognitive, academic, and socioemotional implications of these brain injuries on developing youth, but there are few studies that focus on gender differences in adolescent athletes (Daneshvar, Nowinski, McKee, & Cantu, 2011; Kirkwood, et al., 2006). Understanding …

Perspectives On Personality Assessment Of Children With Limited Cognitive Ability, Jasmine Fayeghi Schnurstein

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Personality assessment can be an important part of diagnosis and treatment planning with children and adolescents. Consequently, research in personality assessment with children and adolescents has received attention; however, there is still limited research in this area with children of below average cognitive capacity. In order to gain better understanding of the current practice of personality assessment of children with below average IQ, this interpretative phenomenological study explores expert psychologists' experience and recommendations for future practice. Structured interviews were conducted with four clinical psychologists with an expertise in personality assessment with children, including children with below average intelligence. Five themes …

A Student's Search For Meaning: The Creation Of An Existential Therapy Models Course For Clinical Psychology Graduate Students, William Y. Hwang

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This writer explores the process of creating a models course which introduces the foundations of existential therapy to graduate students in clinical psychology programs. The first section of this paper presents the rationale for developing such a course, especially in the context of the contemporary call in the field of clinical psychology for evidence-based treatment. This author discusses how this course is pertinent specifically for the Graduate School of Professional Psychology at the University of Denver as well as necessary at large for any clinical psychology program to claim and maintain competency in psychological theory. The second section of this …