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Full-Text Articles in Counseling Psychology

A Trauma-Informed Socially Just Approach To Working With Juvenile Justice-Involved Youth Utilizing Expressive Arts Therapy, Ciara Carr May 2024

A Trauma-Informed Socially Just Approach To Working With Juvenile Justice-Involved Youth Utilizing Expressive Arts Therapy, Ciara Carr

Expressive Therapies Capstone Theses

Youth involved with the juvenile justice system often have a history of trauma and oppression resulting from their positionality and circumstances. Most juvenile justice-involved youth are boys, youth of color, low-income, LGBTQIA2S+, disabled, and traumatized. This literature review explores the history of the juvenile justice system, issues with the present-day model, and trauma-informed and transformative justice approaches to practice. The implementation of socially just, trauma-informed expressive arts therapy programs is proposed as a more equitable practice to replace commonly used punitive practices across the United States. More research is needed to understand the impact of such programs on this population …


Embodied Co-Regulation: A Neuroregulatory-Informed Dance/Movement Therapy Transition Intervention Method For Arousal Regulation For Adolescents In A Partial Hospitalization Program, Anamaria Guzman May 2024

Embodied Co-Regulation: A Neuroregulatory-Informed Dance/Movement Therapy Transition Intervention Method For Arousal Regulation For Adolescents In A Partial Hospitalization Program, Anamaria Guzman

Expressive Therapies Capstone Theses

This thesis introduces a novel Dance/Movement Therapy (DMT) approach, focusing on nervous system arousal regulation during transitions between therapy groups. The core of the method involves a brief 5-minute exercise designed to modulate arousal levels, encompassing alertness and energy, aiming to establish a baseline homeostasis. Rooted in Polyvagal Theory and Developmental Neurobiology, the approach assumes the co-regulation of nervous systems within a group therapeutic setting. Two primary outcomes are self-assessed: 1) somatic experiences documented through narratives and 2) nervous system biodata measured using the Flowtime headband monitoring of brainwaves, heart rate, and other biomarkers. Results indicated that all six sessions …


Utilizing Flow Arts Movement As An Expressive Arts Therapy Tool To Treat Trauma: A Literature Review And Autoethnography, Shannon Mcgrail May 2024

Utilizing Flow Arts Movement As An Expressive Arts Therapy Tool To Treat Trauma: A Literature Review And Autoethnography, Shannon Mcgrail

Expressive Therapies Capstone Theses

This expressive arts-based autoethnography research explores the effectiveness of using flow arts movement as a tool of expressive arts therapy to treat symptoms of trauma for individuals who experienced a traumatic event in their lifetime. While research on the use of flow arts movement to treat mental illness is in its early stage, much can be drawn from the literature on expressive arts therapy and dance/movement therapy research with a range of populations addressing trauma. Through exploration of trauma through neuroscience, mind, body, and integrated mindfulness through flow, this work aims to bring an understanding of using intermodal expressive arts …


Feldenkrais And Music Informed Listening: A Neurophenomenological Perspective On Autism, Arona Primalani May 2024

Feldenkrais And Music Informed Listening: A Neurophenomenological Perspective On Autism, Arona Primalani

Expressive Therapies Capstone Theses

Phenomenologists identify the subjective body and its felt-senses as the basis for human development and consciousness, including mental health. Several mental health disorders, when viewed from a phenomenological perspective, share common symptomology related to varying extents of fractured selves, which in turn hinders dynamic interaction between individuals, their actions, and their relationships with their social and material worlds. Autism is one such condition. Hence, I created an intervention to investigate how listening, which foster subjective and intersubjective experiences, lies at the heart of somatic and arts-based interventions. This thesis, first, begins with a summary of the presenting symptoms observed in …


Re-Member Selfhood A Drama Therapy Intervention, Option 1, Angelique Beauchêne May 2024

Re-Member Selfhood A Drama Therapy Intervention, Option 1, Angelique Beauchêne

Expressive Therapies Capstone Theses

Re-member Selfhood is a specific trauma-informed, drama therapy, intervention designed to meet the needs of adults with exposure to trauma and traumatic stress, who have pertinent adverse childhood experience scores and/or experience persistent trauma cycles over the lifespan concurrent with somatization. The aim of this thesis was to introduce an intervention which could function as indirect exposure and assist in the integration process taking the whole being of trauma sufferers into account, including body, mind, and soul. Additionally, the hope of this intervention is to decrease perceived physical pain, assist in the integration of the rejected aspect of self, and …


The Role Of Acculturation In The Professional Identity Of Art Therapy And Counseling International Students, Ana Marcela Tobar Chavez May 2024

The Role Of Acculturation In The Professional Identity Of Art Therapy And Counseling International Students, Ana Marcela Tobar Chavez

Art Therapy Counseling Final Research Projects

In a country of immigrants, the concept of acculturation needs to be familiar to almost any professional in the mental health field and it is a reality for immigrants and international students. As international and immigrant students continue to join the Art Therapy Counseling profession, it is important to understand how acculturation plays a role in the development of their counseling professional identity. Unlike most master’s students in the art therapy counseling profession, international and immigrant students go through unique experiences such as being born and raised in a different country with difference in cultures, languages, and immigration statuses that …


Utilizing Art Therapy To Address Perfectionism In Patients Suffering From Eating Disorders: The Need To Diversify Treatment Approaches, Zara Goldberg May 2024

Utilizing Art Therapy To Address Perfectionism In Patients Suffering From Eating Disorders: The Need To Diversify Treatment Approaches, Zara Goldberg

Expressive Therapies Capstone Theses

Perfectionistic behaviors are highly common in people with eating disorders. This study investigates the relationship between perfectionism, shame, and the ways in which art therapy can be utilized as a primary tool in eating disorder treatment. Based on the research below and the results of this study, integrating art therapy protocols in combination with talk based theoretical work around perfectionism can improve recovery and decrease struggles with perfectionism in persons with eating disorders. Patients at a residential eating disorder center participated in four consecutive weekly group therapy sessions that integrated art therapy protocols into a preexisting talk therapy based group …


Art Therapy For Bereaved Siblings After Pediatric Cancer Death, Daniela Ramirez-Ibarra May 2024

Art Therapy For Bereaved Siblings After Pediatric Cancer Death, Daniela Ramirez-Ibarra

Electronic Theses, Projects, and Dissertations

Children and adolescents whose siblings die due to pediatric cancer are at an increased risk for several mental health issues and high risky behavior engagement. There is currently very little literature on the topic of a sibling’s grief despite its potentially critical and persisting consequences. Through qualitative research in analyzing art projects made by bereaved siblings, this is an exploratory study of how an art program may help bereaved or grieving children access their feelings using a non verbal modality of expression. The research study was conducted at a community-based non-profit organization which focuses on supporting families of children with …


The Anatomical Embodiment Of Morning Routines In The Reduction Of Anxiety: An Intervention, Natalie Wright Apr 2024

The Anatomical Embodiment Of Morning Routines In The Reduction Of Anxiety: An Intervention, Natalie Wright

Expressive Therapies Capstone Theses

The topic under investigation is whether physically embodying a morning routine that was designed through the lens of Laban Bartenieff Movement Analysis (LBMA) will reduce daily symptoms of individuals diagnosed with Generalized Anxiety Disorder.

Since morning routines play a significant part in one’s preparation for the day, I created an individualized LBMA morning routine for a specific client to embody. In addition to the routine, the client documented the process of their anxiety levels on a weekly basis. This client was a white, female, 19-year-old, lesbian college student who was previously diagnosed with Generalized Anxiety Disorder (GAD). The movement analysis …


The Bloodless Period: A Transfeminine Experience, Rin Nguyen Apr 2024

The Bloodless Period: A Transfeminine Experience, Rin Nguyen

College of Education and Human Sciences: Dissertations, Theses, and Student Research

There is limited research exploring menstruation in transgender and gender diverse (TGD) populations, and studies have primarily examined the relationship between menstruation and gender congruence. Findings revealed menstruating TGD people experienced distress related to decreased gender congruence (Eisenberg et al., 2021), and 88% of TGD people expressed interest in menstrual suppression to manage the distress (Schwartz et al., 2022). By contrast, Lowik (2020) highlighted a transfeminine person who wished to menstruate to achieve womanhood and commented on the “bloodless period” (i.e., menstrual-like symptoms in the absence of bleeding) upon receiving gender-affirming hormone therapy. To the author’s knowledge, there is no …


Supervision Needs Of Novice Behavioral Health Providers In Integrated Primary Care Settings: A Delphi Study, Nicholas D. Schmoyer Apr 2024

Supervision Needs Of Novice Behavioral Health Providers In Integrated Primary Care Settings: A Delphi Study, Nicholas D. Schmoyer

Counseling & Human Services Theses & Dissertations

The integration of behavioral health providers (BHPs, i.e., clinical mental health counselors, clinical psychologists, clinical social workers, marriage and family therapists) into primary care settings has developed as a healthcare practice associated with enhanced patient clinical outcomes, enhanced patient satisfaction, reduced healthcare expenditures, and enhanced provider wellness and satisfaction, known together as the Quadruple Aim. For BHPs practicing in integrated primary care (IPC) settings, researchers have highlighted a variety of challenges they experience when integrating in these settings, with a consistent challenge being a lack of satisfactory training and supervision. Clinical supervision has been hailed as the “signature pedagogy” for …


The Lived Experiences Of Counselors-In-Training Completing Practicum And Internship During Covid-19, Shelby Lauren Dillingham Apr 2024

The Lived Experiences Of Counselors-In-Training Completing Practicum And Internship During Covid-19, Shelby Lauren Dillingham

Counseling & Human Services Theses & Dissertations

COVID-19’s classification as a pandemic in March 2020 changed numerous professions as they adjusted to social distancing expectations. Mental health providers particularly encountered transitions that included higher acuity caseloads, working different hours, and increased exposure to COVID-19. Counselors-in-training (CIT) faced the dilemma of earning their clinical hours in a safe manner, especially CITs working within integrated healthcare settings, such as hospitals or clinics. Despite some research with licensed professional counselors, limited research exists examining CITs' experiences working during the COVID-19 pandemic. This study sought to understand the lived experiences of CITs who completed their clinical hours in an integrated behavioral …


Partners In Crisis: A Phenomenological Exploration Of Collaboration Between Crisis Intervention Team Officers And Mental Health Professionals, Jessica L. Huffman Apr 2024

Partners In Crisis: A Phenomenological Exploration Of Collaboration Between Crisis Intervention Team Officers And Mental Health Professionals, Jessica L. Huffman

Counseling & Human Services Theses & Dissertations

Law enforcement officers (LEOs) are often the first responders to crisis situations, which increasingly include mental health crises. Collaborating with mental health professionals and organizations increases the likelihood that individuals will receive a response that is contextually and culturally informed by an understanding of mental health needs and considerations. For this reason, Crisis Intervention Teams (CIT) have been established to train LEOs and to unite efforts with mental health professionals, advocates, and community constituents. While there is existing and ongoing literature exploring the responses provided by CIT, there is limited research on the experiences of CITs related to their unique …


Navigating Intersectional Identities: Mental Health Challenges And Accessibility To Mental Health Care Among Sub-Saharan Migrant Women In Morocco, Soraya Babahaji Apr 2024

Navigating Intersectional Identities: Mental Health Challenges And Accessibility To Mental Health Care Among Sub-Saharan Migrant Women In Morocco, Soraya Babahaji

Independent Study Project (ISP) Collection

Since the beginning of the 21st century, as Morocco transitions from solely being a transit point to Europe to becoming a destination country for Sub-Saharan migrants, policies have been implemented to improve migrant integration. Morocco launched the National Strategy on Immigration and Asylum in 2015 which strives to ensure accessibility to essential services for migrants, such as education, healthcare, and integration into the workforce. In addition, through the 2013 New Migration Policy framework, King Mohammed VI aims to “include avenues for regularization” to help migrants integrate into Moroccan society.

This paper addresses how intersecting factors of identity can lead to …


Impact Of Equine Interaction During Psychotherapy On Anxiety And Depression For Residential Treatment Program Patients Experiencing Substance Withdrawal, Molly M. Friend, Molly C. Nicodemus, Clay Cavinder, Caleb Lemley, Pauline Prince, Katherine A. Cagle-Holtcamp, Rebecca M. Swanson Feb 2024

Impact Of Equine Interaction During Psychotherapy On Anxiety And Depression For Residential Treatment Program Patients Experiencing Substance Withdrawal, Molly M. Friend, Molly C. Nicodemus, Clay Cavinder, Caleb Lemley, Pauline Prince, Katherine A. Cagle-Holtcamp, Rebecca M. Swanson

People and Animals: The International Journal of Research and Practice

As incidences of substance use disorders (SUD) increase in the wake of the COVID-19 pandemic, there is a need for more effective treatment approaches. Further, treatment approaches currently available struggle to retain patients during the period of substance withdrawal in early treatment due to patients’ withdrawal symptoms including increased feelings of anxiety and depression. Withdrawal symptoms have been linked to dysregulated cortisol concentrations present in this period. Psychotherapy incorporating equine interaction (PIE) has emerged in other populations as a treatment that decreases cortisol concentrations and improves treatment retention. The present study investigated the impact of 4 weeks of PIE on …


Why We Come: Investigating Virtual Clubhouse Engagement, Megan H. Price Jan 2024

Why We Come: Investigating Virtual Clubhouse Engagement, Megan H. Price

Wayne State University Dissertations

Only a fraction of individuals living with serious mental illness (SMI) receive adequatetreatment. This study investigates members’ experiences of a virtual adaptation of the Clubhouse model, a psychosocial rehabilitation program. During the COVID-19 lockdowns, the virtual Clubhouse, referred to as virtual programming, was established to provide an alternative to the traditional brick-and-mortar Clubhouse. This qualitative inquiry utilizes a phenomenological approach to understand participant experiences of the virtual model, including factors related to motivation, recovery, and impact. Data was collected through semi-structured interviews with 15 members of a Clubhouse located in a large metropolitan city in the U.S. The interviews sought …


Explore The Relationship Between Birth Order And Level Of Differentiation Of Self, Ruchika Jain Jan 2024

Explore The Relationship Between Birth Order And Level Of Differentiation Of Self, Ruchika Jain

Graduate Research Theses & Dissertations

Family systems theory has played a primary role in the clinical development of family therapy. This study was conducted to explore the relationship between the variables, level of differentiation of self, and birth order. The researcher wanted to understand and explore the applicability of family systems theory in collectivistic cultures like India. Data from 136 participants from India, aged 18-29 was collected. DSI(R) is a self-reporting questionnaire that was filled up by the participants along with their demographic details and birth order. The results inferred that there was no significant relationship between the studied variables, indicating there are other confounding …


Differentially Unwell: On Mimi Khúc's "Dear Elia", Seo-Young J. Chu Jan 2024

Differentially Unwell: On Mimi Khúc's "Dear Elia", Seo-Young J. Chu

Publications and Research

[...] Inviting readers to reclaim the stigma of unwellness and collectively to "tend to our unwellness, together," Khúc approaches unwellness as a crucial resource for subverting the "wellness and unwellness" dichotomy entirely. After all, the opposite of "wellness" is not "unwellness"; the opposite of "wellness" does not exist. The opposition itself is an artificial framework, one that reductively harms more than it dialogically helps. We need to move away from these simplistic dualisms, Khúc suggests, and towards more generous, trauma-informed epistemologies. [...]


The Experiences Of Religious Students In Counseling Theories Courses, Brian A. Mesimer, Matthew Lyons, Candace Park Jan 2024

The Experiences Of Religious Students In Counseling Theories Courses, Brian A. Mesimer, Matthew Lyons, Candace Park

Journal of Faith Integration Counseling (JFIC)

We explored the experiences of 10 religious counseling students in their theories course. Analysis using transcendental phenomenology showed that the theory acquisition process is multifaceted, consisting of a variety of affective and cognitive experiences which further student growth.


Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau Jan 2024

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …


Fantasia On A Theme Of Purpose: Using A Music-Guided Scribble Technique To Support Meaning-Making In Older Adult Retiree Musicians, Sophia R. Smith Jan 2024

Fantasia On A Theme Of Purpose: Using A Music-Guided Scribble Technique To Support Meaning-Making In Older Adult Retiree Musicians, Sophia R. Smith

Art Therapy | Master's Theses

Within the population of older adults, overall well-being corresponds with the ability to self-actualize and seek meaning, but age-related changes combined with ageism and isolation can negatively impact this capacity to maintain a sense of purpose, especially following retirement. It may be that retired musicians are especially vulnerable to this experience later in life due to a loss of the primary method of creative engagement and community that is facilitated by musical performance in a group setting. Integrating phenomenological and ethnographic approaches, this study utilized a qualitative design to understand how music-guided art-making incorporating the scribble technique could support a …


Individual And Organizational Challenges To Implementing Prolonged Exposure Therapy In The Military Health System: A Systematic Review Of Client And Provider Perspectives, Paris R. Cloutier Jan 2024

Individual And Organizational Challenges To Implementing Prolonged Exposure Therapy In The Military Health System: A Systematic Review Of Client And Provider Perspectives, Paris R. Cloutier

Honors Undergraduate Theses

Military veterans and active-duty service members face high rates of posttraumatic stress disorder (PTSD), a chronic and debilitating condition that is comorbid with other negative psychological and social outcomes. PTSD symptomology in military careers is attributed to unique organizational factors and risks both during and post-deployment. Delivering modern, effective PTSD treatments derived from evidence-based research to the military population is a multi-faceted effort. Among these interventions, prolonged exposure therapy (PE) is a safe and effective trauma-focused treatment for veterans. To yield higher rates of PE success, common challenges faced by both military clients and their clinicians that may be impairing …


The Menstrual Cycle In Psychotherapy: Interventions, Therapist Engagement, And Blind Spots, Rozita Alaluf Jan 2024

The Menstrual Cycle In Psychotherapy: Interventions, Therapist Engagement, And Blind Spots, Rozita Alaluf

Dissertations and Theses

There is a dearth of literature on psychotherapy and menstruation, except for the treatment and diagnosis of issues associated with premenstrual distress. This study aimed to bridge this gap by investigating the frequency and context of discussions about the menstrual cycle, the factors influencing therapists’ engagement with this topic, and the therapeutic approaches utilized to address the menstrual cycle within psychotherapy.

In phase 1, 118 psychotherapists from various theoretical backgrounds completed a survey on menstruation in clinical practice. The data was analyzed using descriptive statistics. In phase 2, semi-structured interviews were conducted with 7 psychotherapists, primarily identifying their theoretical orientation …


Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose Jan 2024

Frozen By Worry And Fatigue? A Mixed Methods Approach To Understanding The Lived Experiences Of Freezing Of Gait, Sarah M. Ghose

Theses and Dissertations

This study utilized a mixed methods emergent, phenomenological approach to (1) understanding the lived experience of freezing of gait for individuals diagnosed with Parkinson’s Disease and (2) determining the role of anxiety and sleep in freezing of gait outcomes. Participants included 13 adults diagnosed with Parkinson’s Disease (N=14 for qualitative data, N=13 for quantitative data; 23.1% female-identifying, 76.9% male-identifying) who were predominantly white (92.3%) with an average age of 69 years (SD = 6.73 years). Data collection consisted of semi-structured interviews, self-report measures, actigraphic sleep data, and salivary alpha amylase biomarker collection. Results are organized into …


Associations Between Childhood Trauma And Tobacco Dependence Among Latine Adults: Testing The Protective Effects Of Compassion For Self And Others, Camila Tirado Jan 2024

Associations Between Childhood Trauma And Tobacco Dependence Among Latine Adults: Testing The Protective Effects Of Compassion For Self And Others, Camila Tirado

Theses and Dissertations

Tobacco dependence has posed a significant public health challenge in the United States and disproportionately affects Latine adults' risk of developing a variety of adverse health conditions. Childhood trauma is a recognized risk factor for dependence, overall health, and mental health concerns. Still, the influence of compassion for self or compassion for others in this context remains unclear. This cross-sectional study investigated the moderating effects of self-compassion and compassion for others on the relationship between childhood trauma and cigarette dependence among Latine adults. Data was collected through questionnaires assessing childhood trauma, self-compassion, cultural values and factors, compassion for others, and …


Life After Discharge: Predicting Longitudinal Trajectories Of Community Integration And Global Functioning In Black Individual With Traumatic Brain Injury, Chimdindu Ohayagha Jan 2024

Life After Discharge: Predicting Longitudinal Trajectories Of Community Integration And Global Functioning In Black Individual With Traumatic Brain Injury, Chimdindu Ohayagha

Theses and Dissertations

The onset of traumatic brain injury (TBI) begins a chronic health pathway that contributes to various impairments and comorbidities across the lifespan. Common consequences of TBI include mental health issues, cognitive impairments, and reduced functional independence, all of which impact how an individual integrates into their community. Community integration is a primary goal for rehabilitation after TBI. Studies show that racially/ethnically minoritized individuals have a higher incidence of TBI, higher rates of mortality, and report poorer functional and community integration outcomes. Limited studies have explored longitudinal outcomes of community integration in a Black-only sample of individuals with TBI. Additionally, no …


Understanding Emerging Adult Mental Health And Attachment: The Roles Of Parental Factors In Childhood, Trauma, And Gender, Christiana A. Howell Jan 2024

Understanding Emerging Adult Mental Health And Attachment: The Roles Of Parental Factors In Childhood, Trauma, And Gender, Christiana A. Howell

Dissertations

Problem

The experience of the parental environment growing up, parental psychopathology in childhood, exposure to trauma throughout the lifespan, insecure adult attachment, and social support have been established as factors that influence mental health in adulthood. These factors have not yet been studied together as a complex model of emerging adult mental health and attachment. The purpose of this study was to develop a theoretically and empirically supported model of these factors to understand how these factors interact to influence mental health in emerging adulthood. Additionally, the purpose was to understand if these factors interact differently based on gender.

Method …


The Lived Experience Of The Covid-19 Pandemic Among Mandate-Resistant Adults In Washington State, Amber N. Peterson Jan 2024

The Lived Experience Of The Covid-19 Pandemic Among Mandate-Resistant Adults In Washington State, Amber N. Peterson

Antioch University Dissertations & Theses

This study examined the lived experience of self-identified, mandate-resistant adults in Washington state. This study explored participants’ experience of the COVID-19 pandemic, from a retrospective framework by uncovering challenges, silver linings, decision-making, and self-reported mental health. Remote interviews were conducted with nine participants. Participants were between 23–31 years old, mostly male, and over half identified as Black. Through semi structured interviews, data was collected and analyzed using Interpretive Phenomenological Analysis (IPA). Participants described their experiences during the COVID-19 pandemic and highlighted significant changes in the way they lived their lives. Most notably, participants described ways in which they defied COVID-19 …


"Why Does This Have To Be So Hard?": Perinatal Experiences From An Ecological Systems Approach, Caitlin Senk Jan 2024

"Why Does This Have To Be So Hard?": Perinatal Experiences From An Ecological Systems Approach, Caitlin Senk

Antioch University Dissertations & Theses

This study examines the lived experience of the perinatal population to understand how they can be supported from the lens of different ecological systems and what counselors can do to better serve people with uteruses during their perinatal experience. Furthermore, this study aims to utilize an inclusive framework for capturing the perinatal experience of people with uteruses and to explore barriers and facilitators to care through an ecological systems framework. Fifteen participants who have experienced infertility, conception, pregnancy, miscarriage, childbirth, stillbirth, and postpartum were recruited through various means throughout the United States. Thematic analysis was used, with semi-structured interviews and …


Productivity In Private Practice: Experiences And Best Practices Of Mental Health Counselors, Mark C. Pilger Jan 2024

Productivity In Private Practice: Experiences And Best Practices Of Mental Health Counselors, Mark C. Pilger

Antioch University Dissertations & Theses

The purpose of this study is to understand how mental health counselors in private practice conceptualize, approach, and manage productivity, including key strategies and best practices employed through a qualitative study of lived experience. Inclusion criteria for participant eligibility included being a licensed counselor with a degree from a CACREP-accredited counseling program, working primarily in a private practice setting, and with primarily adult clients. Nineteen participants (N = 19) met these criteria and were included in the study. A thematic analysis was utilized by a team of researchers, which resulted in seven primary themes. The primary themes relate to the …