Psy. D., Antioch University, 2016, Antioch Seattle: Clinical Psychology

Despite living in a country with a world renowned healthcare system, Canadian Aboriginal children, youth and their families, consistently have poorer access to healthcare as well as higher mortality and morbidity rates, in comparison to non-Aboriginal Canadians (Tang & Browne, 2008). Among factors including their history of residential school and intergenerational trauma, the lack of a culturally specific treatment intervention for complex trauma, is identified as a key factor in maintaining this health disparity. This study used participatory action research within an identified Aboriginal community, to develop a culturally adapted complex trauma intervention model. This was based on an existing model that has been used with primarily non-Aboriginal children living in the foster care system. The result was an adapted model an intervention model that kept culture at the core of the treatment program. The model was adapted using both a Western neurodevelopmental theory and an indigenous framework based on local traditional knowledge. The adapted model will be applied in the community with the potential for further adaptations, and may be generalised for use with other Aboriginal communities.

Committee: Jude Bergkamp Psy.D. (Committee Chair); William Heusler Psy.D. (Committee Member); Aruna Gore Ph.D. (Committee Member); Chuck Geddes Ph.D. (Committee Member) Subjects: Behavioral Psychology; Behaviorial Sciences; Canadian Studies; Counseling Psychology; Ethnic Studies; Mental Health; Native American Studies; Native Americans; Social Psychology

Doctor of Philosophy, The Ohio State University, 2024, Educational Studies

The purpose of this research was to investigate the impact of sandplay therapy on the emotion regulation of children with a history of multiple traumatic events and symptoms of externalizing and internalizing behaviors. This research explored the impact of sandplay therapy on emotion regulation in three ways. First, Heart Rate Variability (HRV) data was examined. Second, data on each participant's mood before and after each session was assessed by the 10-Item Positive and Negative Affect Schedule for Children (PANAS-C-10). Third, the intensity, duration, and frequency of emotion was examined pre-and post-intervention via a self-report survey. The acceptability of the intervention from the perspective of parents and teachers was also explored via a post-intervention survey. Visual analysis of descriptive data of HRV data and the Wilcoxon signed-rank test of the other measures were used to examine intervention effects. Results demonstrate that participation in seven to eight sessions of sandplay therapy were correlated with a significant improvement in positive affect and emotion control. Descriptive results of pre- and postintervention HRV data indicated an increase in HRV for five of the six participants. This study adds to previous research on sandplay therapy. Limitations of the current study, directions for future research, and implications for practitioners are discussed.

Committee: Kisha Radliff (Advisor) Subjects: Clinical Psychology; Counseling Psychology; Developmental Psychology; Early Childhood Education; Educational Psychology; Psychology; Psychotherapy; School Counseling; Social Work; Special Education

Master of Arts in English, Cleveland State University, 2023, College of Liberal Arts and Social Sciences

Topdog/Underdog by Suzan Lori Parks and Is God Is by Aleshea Harris are the two outstanding works in contemporary American theater examined in this thesis. Through their plays, Parks and Harris examine topics of trauma, identity, and mental health challenges in contemporary society. They explore the psychological and emotional effects on their characters, drawing on trauma theory and feminist theory. A critical examination of the central characters in both plays – Lincoln and Booth in Topdog/Underdog and Anaia and Racine in Is God Is examines the traumatic experiences that shape their lives. This study explains the profound influence of societal forces on their identities and actions by exploring how these characters grapple with their pasts using the trauma theory lens. The Oedipal complex emerges, highlighting sibling rivalries, power struggles and legacy issues. Women's representation and agency within male dominated worlds are explored from a feminist perspective in this dissertation.

Committee: Frederick Karem Dr. (Committee Chair); Michael Geither Dr. (Committee Member); James Marino Dr. (Committee Co-Chair) Subjects: Literature

Psy. D., Antioch University, 2023, Antioch Santa Barbara: Clinical Psychology

While not yet an official diagnosis, Complex trauma is considered to be multifaceted and nuanced diagnosis that can include emotional abuse, neglect, physical abuse, sexual abuse, witness domestic violence, ethnic cleansing, and wartime (Herman, 2015; Cook et al., 2005). Perhaps the most distinct consequences of complex trauma lie in its effect on an individual's ability to regulate emotional and affective states (Schore, 2012, Van der Kolk, 2015) as well as one's ability to develop secure attachments (Bosmans et al., 2020; Bowlby, 1988) and ultimately, interpersonal intimacy in adulthood (Schroder et al., 2019). Research has shown that individuals are able to develop secure attachments through mechanisms such as therapy, group support, and therapeutic play (Schwartz, 2013; Syropoulos, 2020; Cossa, 2020). Improvisational Theater has long been revered as an instrument toward psychological healing (Felsman, 2019; Valke, 2018; Bermant, 2013) but little is known about the specific impacts on participants who report a history of complex trauma. This research will serve to bridge a knowledge gap between the serious world of psychology and the playful world of Improvisational Theater by looking at the lived experience of those who participate and report a history of complex trauma. This dissertation is available in open access at AURA, https://aura.antioch.edu/, and OhioLINK ETD Center, https://etd.ohiolink.edu.

Committee: Stephen Southern PdD (Committee Chair); Bruce Brodie PhD (Committee Member); Johanna Hays PsyD (Committee Member) Subjects: Clinical Psychology; Psychology; Theater; Therapy

Doctor of Philosophy (PhD), Ohio University, 2021, Journalism (Communication)

This dissertation will utilize trauma scholarship and feminist standpoint theory as frameworks for understanding how women's accounts of gender-based violence have been—and continue to be—un- and under-valued by (and in) the media, culture, and society. The broad goal of this critical cultural and historical study is to 1) name, identify, and classify a phenomenon known as the first-person industrial complex; 2) examine the phenomenon's history; 3) identify systemic barriers to the phenomenon's elimination, including legal and ethical considerations; and 4) encourage others to partake in similar research and writing, and see their own stories of gender-based violence as valuable. Thus, this dissertation will examine the various flashpoints of women's first-person writing that have contributed to today's digital media landscape and will trace the history of the first-person industrial complex through primary documents containing such writing, including newspapers, magazines and digital media outlets. This work will draw from archival sources in order to trace the history of this phenomenon from 1841 to the present utilizing critical discourse analysis; will include qualitative analyses of legal and ethical structures that keep women's stories from being shared in an equitable way; and will conclude with a normative critique of the current landscape, offering potential solutions and new possibilities for research in this area.

Committee: Aimee Edmondson (Advisor); Patty Stokes (Committee Member); Kelly Ferguson (Committee Member); Katherine Jellison (Committee Member) Subjects: Communication; Ethics; Gender Studies; Journalism; Mass Communications

Psy. D., Antioch University, 2021, Antioch Santa Barbara: Clinical Psychology

This qualitative study on Equine Facilitated Psychotherapy (EFP) utilized a combined methodology incorporating elements from phenomenology and grounded theory to contribute to the existing body of research on equine therapeutic practices by (a) clarifying foundational understandings its mechanisms of therapeutic action and (b) exploring barriers to the growth of the field from a practitioner point of view. Five phenomenological categories were identified and described as interwoven mechanisms of therapeutic action within the practice of EFP: observation, communication, mindfulness, embodiment and connection. Additionally, six phenomena were identified and explored as challenges to the field's growth: funding, awareness, cohesion, clarity, accessibility and measurability. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu).

Committee: Allen Bishop PhD (Committee Chair); Elizabeth Bates Freed PsyD (Committee Co-Chair); Brenda Murrow PhD (Committee Member) Subjects: Behavioral Psychology; Clinical Psychology; Cognitive Psychology; Cognitive Therapy; Counseling Psychology; Mental Health; Occupational Psychology; Physiological Psychology; Psychology; Psychotherapy; Social Psychology

Psy. D., Antioch University, 2019, Antioch New England: Clinical Psychology

This qualitative study explores therapist views of the therapeutic relationship in adolescent residential treatment from an attachment perspective. The therapeutic relationship is a strong predictor of outcomes in adult psychotherapy and a significant body of research has relied on the attachment literature to understand its importance. Research yields comparable results when examining the significance of the therapeutic relationship with children and adolescents; however, there is virtually no literature exploring it from the attachment lens. This is particularly notable for children and adolescents in residential treatment. As treatment intensity increases from outpatient to inpatient to residential, challenges and opportunities within the therapeutic relationship increase, too: therapists form uniquely intense and intimate connections with children and adolescents they may see every day. This study employed constructivist grounded theory data analysis of semi-structured interviews with residential therapists exploring their views of the role of attachment in the therapeutic relationship with their adolescent clients. Key findings include role differences in therapists in adolescent residential treatment; the importance of affect management, attunement, and self-awareness within the therapeutic relationship in adolescent residential treatment; the healing nature of relationship, connection, and feelings of safety with adolescents in residential treatment; and the concept of attachment as fundamental in adolescent residential treatment. Implications for practice and training, limitations, and suggestions for future inquiry are also discussed.

Committee: Martha Straus PhD (Committee Chair); Gina Pasquale PsyD (Committee Member); Cara Bonuso PsyD (Committee Member) Subjects: Clinical Psychology

Psy. D., Antioch University, 2019, Antioch Seattle: Clinical Psychology

The relationship between shame and trauma has been documented in research beginning as early as the 19th century. Not until the second half of the 20th century did extensive research clearly define both trauma and shame, with the addition of Posttraumatic Stress Disorder (PTSD) as an official diagnosis in the field of mental health. Many researchers and clinicians believe an additional diagnosis should be added to the list of trauma-related mental health diagnoses—one that includes repeated traumatic experiences during childhood. Despite the known relationship between shame and various traumatic experiences, direct shame interventions have yet to find a place in standard therapeutic trauma-specific protocols. By implementing a group therapy curriculum designed by Dr. Brene Brown, based on her Shame Resilience Theory (SRT), this study was designed to assess possible empirical support related to the need for, and benefits of, addressing shame directly in participants who suffer from internalized shame and who have experienced traumatic childhood trauma, which has led to complex PTSD. Pre- and post-group measurements were quantitatively analyzed. The outcomes confirmed the initial hypotheses and resulted in significantly decreased internalized shame, a decline in trauma related symptomology, with reason to pursue further clinical treatment for trauma-related issues.

Committee: Dana Waters Psy.D., ABPP (Committee Chair); Mark Russell Ph.D., ABPP (Committee Member); Sherrod Kathryn Ph.D. (Committee Member) Subjects: Clinical Psychology; Psychology; Therapy

Psy. D., Antioch University, 2017, Antioch Seattle: Clinical Psychology

Helping clients develop resources and stability required to tolerate reprocessing memories can be a considerable part of psychotherapy, particularly with clients who are suffering symptoms related to complex developmental trauma or cumulative multiple-event trauma. There is a paucity of research regarding how experienced EMDR Therapy practitioners experience helping their clients to develop resources required to tolerate reprocessing of trauma memories. This dissertation is an in-depth study of five participants, each a licensed mental health practitioner in the State of Washington, who are trained in EMDR and experienced working with clients who are suffering symptoms of trauma. Each participant was interviewed and the interviews were analyzed using Interpretive Phenomenal Analysis. Four primary themes were identified: Therapist Experience, Trauma Conceptualization, Stabilization, and All these Tools. Each participant described their experience in the context of their own motivators, their own conceptualization of what their clients were experiencing, and their understandings of what worked in helping their clients to stabilize throughout the process of therapy. Participants acknowledged the significant role that EMDR Therapy training had in shaping both their understanding and treatment of trauma. They also described the complexity of working with traumatized clients and the importance of common factors, such as relationship, trust, and safety in their work. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/etd.

Committee: William Heusler Psy.D. (Committee Chair); Dana Waters Psy.D. (Committee Member); Kelly K. Brown Ph.D. (Committee Member) Subjects: Clinical Psychology; Counseling Psychology; Psychology; Psychotherapy

Psy. D., Antioch University, 2014, Antioch Seattle: Clinical Psychology

This qualitative, theoretical review and analysis of extant literature explored the sociocultural influences effecting conceptualization of childhood sexual behavior problems. Themes emerged from analysis of peer-reviewed journals that illustrated the complex, multidimensional, and ecological factors influencing child sexual development and problematic sexual behavior. These included major themes of Child Sexuality: Ecological Context, Developmental Context, Complex Trauma, and Ecological Interventions. Specific factors associated with childhood sexual behavior problems included trauma, domestic violence, sexual and physical abuse, psychological and emotional distress, impaired attachment, and the effects of diverse ecological systems such as the family, parents, and sociocultural influences of the greater community. Analysis culminated with an enhanced conceptualization of childhood sexual behavior named Ecological Developmental View. This conceptual model, integrated within the framework of ecological theory, evolved into an innovative approach of clinical assessment for childhood sexual behaviors applicable in outpatient clinical settings. The model, Integrated Developmental Ecological Assessment Approach (IDEAA), recognized the significance of the developing child influenced within the ecological contexts of the child, family, social, and community environments. The IDEAA model intends to help professionals and adults to address concerns related to childhood sexual behavior from an ecological perspective that will enhance and benefit outcomes for children, parents, families, and communities. The electronic version of this dissertation is at OhioLink ETD Center, www.ohiolink.edu/etd

Committee: Mary Wieneke Ph.D. (Committee Chair); Melissa Kennedy Ph.D. (Committee Member); William Luecke Ph.D. (Committee Member) Subjects: Clinical Psychology; Developmental Psychology; Families and Family Life; Mental Health; Psychology

Psy. D., Antioch University, 2015, Antioch Seattle: Clinical Psychology

Program evaluation method was utilized to examine the relationship between vicarious rauma (VT) and organizational policies and practices. VT and secondary traumatic stress (STS) refer to the impact of hearing explicit accounts of people being directly traumatized. Indirect exposure to a traumatic events can cause traumatic stress and changes in the person's way of experiencing the self and the world. The focus of this evaluation was developed collaboratively with the Clinical Director of Monarch Children's Justice and Advocacy Center (MCJAC), the site of the program evaluation. The question of study was How effectively is MCJAC addressing vicarious trauma in staff, volunteers, and multi-disciplinary team members? MCJAC provides free services to victims of childhood sexual abuse and their families through forensic interviewing, psychotherapy, and family advocacy programs. Additionally, MCJAC houses and facilitates multidisciplinary team (MDT) meetings (a case consult group of Child Advocacy Center partners, such as law enforcement, medical examiners, etc.). The purpose of this program evaluation included identifying current levels of VT/STS distress and cognitive changes in current staff, volunteers, and MDT members; and exploring the participants' perceptions and experiences of how MCJAC addressed VT. The evaluator conducted four interviews, developed and administered a qualitative and quantitative measure unique to this site, and administered the Trauma and Attachment Belief Scale (TABS) (Pearlman, 2003) and the Secondary Traumatic Stress Scale (STSS) (Bride, Robinson, Yegidis, & Figley, 2004) to 16 participants. The quantitative results indicated low to average levels of VT/STS in participants. Qualitative data revealed more VT symptoms and both negative and positive impacts of working with the families. This program evaluation found most of the participants experienced most of the practices and the MCJAC culture as intended. Participants reflected trust, respect (open full item for complete abstract)

Committee: William Heusler PsyD (Committee Chair); Elin Bjorling PhD (Committee Member); Tyson Bailey PsyD (Committee Member) Subjects: Clinical Psychology; Occupational Psychology; Organizational Behavior; Psychology

Doctor of Psychology (PsyD), Wright State University, 2015, School of Professional Psychology

This work offers an analysis of the existing literature on trauma, resilience, posttraumatic growth, and sex trafficking. It argues that the field tends to gravitate toward trauma and overlook resilience and the potential for posttraumatic growth amongst survivors of sex trafficking. This work recommends that the field should attend to both abuses endured as well as the courage and strength gained by survivors. Specifically, it argues that it is the task of the mental health professional to step into trauma trajectories with a strengths-based perspective to promote positive, resilient, and growth-oriented outcomes. Resilience and posttraumatic growth theories have been substantiated by empirical support across all gradients of risk and trauma exposure. Survivors of sexual assault, child abuse, trafficking in childhood for genocide soldiers, holocaust survivors, and family crises are among this evidence base; all of which parallel aspects of sex trafficking. However, the field has yet to explore this particular subset of trauma survivors. Research has also demonstrated that when clinicians look for strengths, beginning with the initial interview, they find internal assets and external resources that mark resilience processes in their clients. This type of initial interview then incites a trajectory toward growth-oriented treatment. To apply these concepts, this dissertation proposes resilience and posttraumatic growth guidelines for working with survivors in treatment and research capacities. This work also provides a brief review of how aftercare programs within the United States utilize these guidelines and where they can improve. Finally, phases of treatment and a preliminary model for program components is suggested, which is based on the proposed resilience and growth recommendations.

Committee: J. Scott Fraser Ph.D. (Committee Chair); Nancy Sidun Psy.D. (Committee Member); Julie Williams Psy.D. (Committee Member) Subjects: Behavioral Sciences; Behaviorial Sciences; Clinical Psychology; Counseling Psychology; Gender; Gender Studies; Health Care; Psychology; Psychotherapy; Social Work; Therapy