Ph.D., Antioch University, 2022, Antioch New England: Marriage and Family Therapy

There is ambiguity on what kind of coverage of Hispanic populations in counseling journals is often used by couple/marriage and family therapists (C/MFTs) and researchers. The aims of this study are to identify how these journals consider Hispanic populations and what advice is provided when working with Hispanic populations. An explanatory sequential mixed method content analysis study was conducted. The first quantitative stage used descriptive statistics to analyze 17 journals' articles between 2011-2020 regarding the type of research designs used, the frequency of articles that fit the inclusion criteria for the study, and the use of psychosocial terms (i.e., acculturation, discrimination, immigration, mental health, substance use, and family cohesion) in the articles' components (i.e., title, abstract, and keywords). Statistics were used to determine the relationship strength between the psychosocial terms and journals and articles' components. A random sample from the quantitative data was used to select articles for the quota sampling for qualitative thematic analysis, followed by mixed-method integration and interpretation. This study's analysis of the included articles demonstrated that the most frequently used research design is quantitative. Almost five percent of all the articles published in 17 journals over ten years mentioned Hispanic or relative terms in the articles' components. The articles' components, on average, did not mention the psychosocial terms though the terms either had a moderate or strong relationship. The qualitative thematic analysis supported the majority of the psychosocial terms. Two psychosocial terms, substance use and family cohesion, had divergent findings. The qualitative thematic analysis and mixed-method results indicated the need for C/MFTs and researchers to increase knowledge of Hispanic cultural values and oppression and create more research on Hispanic populations. The results indicate a small number of articles on His (open full item for complete abstract)

Committee: Markie Twist PhD (Committee Chair); Michelle Finley PhD (Committee Member); Bryson Greaves PhD (Committee Member) Subjects: Families and Family Life; Therapy

Doctor of Philosophy, University of Akron, 2016, Marriage and Family Counseling/Therapy

This quantitative research study investigated forgiveness in adult sibling relationships. The goal of this study was to investigate forgiveness in adult sibling relationships and the role of relational ethics and relational satisfaction. A thorough review of the literature on Contextual theory and forgiveness in the MFT field is presented. One hundred and seventy-eight participants were included in the study to address the hypotheses, which include: (1) higher levels of relational ethics in sibling relationships are positively and significantly correlated with higher levels of forgiveness; (2) relational satisfaction in sibling relationships is significantly and positively correlated with forgiveness in sibling relationships; (3) relational ethics in sibling relationships is significantly and positively correlated with relational satisfaction in adult sibling relationships; and (4) relational satisfaction mediates the relationship between relational ethics and sibling forgiveness, such that higher levels of relational ethics will in turn lead to higher levels of relational satisfaction, which would in turn lead to higher levels of forgiveness. A discussion of the findings, limitations of the study, research and clinical implications, and direction for further research are addressed after the conclusion of the study.

Committee: Karin Jordan PhD (Committee Chair) Subjects: Behavioral Sciences; Clinical Psychology; Counseling Psychology; Developmental Psychology; Families and Family Life; Individual and Family Studies; Personal Relationships

Doctor of Philosophy, University of Akron, 2015, Marriage and Family Counseling/Therapy

This qualitative Delphi study explored the importance of training for credentialing of marriage and family therapists and, more specifically, training family therapists to include children in family therapy. The purpose of this study was to understand how the inclusion of children impacts therapy outcomes and why marriage and family therapists need additional training and credentialing standards to work with children. A thorough literature review on children in family therapy, play therapy literature, and a synthesis of these two fields have been provided. Expert panelists provided insight based on theory and experience to address the research question: What training objectives and methods are identified by practicing marriage and family therapists working with children to encourage success in training and including children in family therapy? In addition, this study explored two additional areas: (a) if the inclusion of children in family therapy is essential to the principles of cornerstone family therapy theories; and (b) if training for credentialing of marriage and family therapists needs to change to promote further confidence and competence among family therapists including children in therapy. A discussion of the findings, limitations of the study, and implications for therapists and training programs, and direction for further research are addressed after the conclusion of the study.

Committee: Karin Jordan (Committee Chair) Subjects: Counseling Education; Mental Health; Psychology

Doctor of Philosophy, University of Akron, 2015, Marriage and Family Counseling/Therapy

This qualitative Delphi study explored the impact that a therapy animal may have when integrated into a therapy setting with couples and families. Specifically, this study's goal was to understand how the inclusion of a therapy animal impacts the feminist family therapist's ability to develop a strong therapeutic alliance, empower clients and address power. A thorough review of feminist family therapy literature, animal assisted therapy literature and a synthesis of these two fields have been provided. Nine expert panelists provided insight based on theory and experience to address the research question: How does the inclusion of a therapy animal impact the therapist's focus and application of key feminist family therapy principles, specifically (a) therapeutic alliance; (b) empowerment; (c) power? Results indicated that the inclusion of a therapy animal does enhance the therapist's ability to address these three principles. A discussion of the findings, limitations of the study, implications for therapists and direction for further research are addressed.

Committee: Karin Jordan Dr. (Advisor); Ingrid Weigold Dr. (Committee Member); Rebecca Boyle Dr. (Committee Member); Rikki Patton Dr. (Committee Member); Susan Olson Dr. (Committee Member) Subjects: Counseling Psychology; Families and Family Life; Therapy

Doctor of Philosophy, The Ohio State University, 2024, Human Ecology: Human Development and Family Science

Extant literature suggests that Marriage and Family Therapists (MFTs) in training benefit from multicultural education. In the past 25 years, the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) has developed accreditation standards that emphasize the inclusion of coursework, and educational experiences to ensure that MFTs become “multiculturally informed” through their education. However, very little research has explored specific elements of education (e.g., how a program models engagement with multicultural differences, education and knowledge provided to trainees about diverse cultures, the ways in which trainees are encouraged to apply knowledge clinically, or multicultural self-awareness activities) and how these may be associated with the development of therapist characteristics (e.g., cultural humility or critical consciousness). Furthermore, there is very little research which has connected these characteristics to clinical outcomes (e.g., therapeutic alliance, or progress on presenting issues). This project aimed to explore these research questions while leveraging one data collection from therapists at multiple universities, with one pre-existing data collection from clients at a singular university. The first collected data from therapists in training at nine COAMFTE accredited masters or doctoral programs across the United States and utilized the MTEQ (Multicultural Teaching and Education Questionnaire) to assess student (N = 68) education experiences (i.e., their experiences of 1) program modeling 2) education and knowledge provided 3) encouragement of clinical application and 4) inclusion of self-awareness activities), and explore how each of these were associated with therapist critical consciousness (critical reflection, critical motivation, critical knowledge). Structural Equation Modeling revealed that students who reported experiencing more clinical application practices in their education had significantly higher (open full item for complete abstract)

Committee: Suzanne Bartle-Haring (Advisor); Arya Ansari (Committee Member); Ashley Hicks (Committee Member); Ashley Landers (Committee Member) Subjects: Education; Families and Family Life; Psychology; Psychotherapy; Social Work

Doctor of Philosophy, University of Akron, 2021, Marriage and Family Counseling/Therapy

The purpose of this study was to investigate whether the levels of flow and mindfulness would together predict the levels of Multicultural Counseling Competencies (MCC) among trainees in Marriage and Family Therapy (MFT) programs. One hundred thirty MFT trainees across the United States completed online surveys. The results of statistical analysis indicated that there was no correlation between the levels of flow and MCC. However, the levels of mindfulness and several demographic variables correlated with the levels of MCC. Hierarchical multiple regression was further conducted in order to investigate if the levels of mindfulness would predict the levels of MCC, after controlling for the demographic variables. The results revealed that the levels of mindfulness predicted the levels of MCC even after controlling for the demographic variables. Implications were made to suggest MFT programs, MFT educators and supervisors, and MFT trainees to incorporate mindfulness practice in education and training. Limitations of this study and recommendations for future research were discussed in the end.

Committee: Heather Katafiasz (Advisor); Rikki Patton (Committee Member); John Queener (Committee Member); Yue Dang (Committee Member); David Tefteller (Committee Member) Subjects: Mental Health; Psychotherapy

Psy. D., Antioch University, 2018, Antioch Santa Barbara: Clinical Psychology

Burnout is best defined as a condition consisting of symptoms of emotional exhaustion, depersonalization, and reduced personal accomplishment (Maslach, 1982). It has been characterized as a process that develops through a variety of work and individual factors. Furthermore, it has been shown to impact one's career, physical health, and mental well-being. Much of the literature on burnout has been studied on psychologists, psychiatrists, and social workers, with a paucity of studies focused on marriage and family therapist (MFTs). The lack of burnout literature on MFTs is in spite of their employment in many diverse clinical settings. The purpose of this study was to examine the experiences of Associate MFTs (AMFTs) working in community based agencies and identify factors that contribute to feeling burned out. Moreover, the study sought to identify ways AMFTs recognize, prepare for, and manage burnout. Research has identified risk and protective factors of burnout and self-care is a topic routinely discussed in the mental health field. However, this study attempts to elucidate the burnout phenomenon by unearthing lived experiences of clinicians experiencing work stress and understanding what it is about the nature of self-care that is effective for clinicians in managing its impact. This Dissertation is available in Open Access at AURA: Antioch University Repository Archive, http://aura.antioch.edu and OhioLink ETD Center, http://www.ohiolink.edu/etd

Committee: Brett Kia-Keating Ed.D. (Committee Chair); Christopher Howard Psy.D. (Committee Member); Kyle Killian Ph.D. (Committee Member) Subjects: Behavioral Sciences; Clinical Psychology; Counseling Psychology; Occupational Psychology; Psychology; Psychotherapy

Doctor of Philosophy, The Ohio State University, 2017, Human Ecology: Human Development and Family Science

Romantic relationships continue to be a challenge to many and the break-down of these relationships impacts partners and offspring in many negative ways. Relationship cycling is a relatively common phenomenon, where couples will separate and reconcile their romantic relationship. There is a lack of information on the way that relationship history in general, and relationship cycling in specific, interacts with relational ethics on predicting relational satisfaction and adjustment. According to contextual theory, the perception of fairness and ethical relating in a relationship are connected to couple satisfaction (Boszormenyi-Nagy & Krasner, 1986). Two samples were collected, including an individual response sample (n = 125) and a couple response sample of 68 couples (n = 136). All participants were newly married or engaged heterosexual couples between the ages of 18 and 35. Data were collected using on-line recruitment and surveys. A new instrument measuring relational ethics was used and found to highly correlate with the Relational Ethics Scale. A description of cycling couples was generated, with cyclers most frequently cycling a single time, with the male partners more frequently considered to be responsible for the problems and cycling in the relationship. Differences in relationship satisfaction, vertical relational ethics, and horizontal relational ethics based on cycling status were explored using a MANOVA, with multiple independent t-tests. Structural equation modeling was conducted to test the association between relationship cycling and couple satisfaction, and whether relational ethics accounts for this association. Results suggest that cycling couples are less satisfied with their relationship, and have lower levels of horizontal relational ethics. An SEM model demonstrated that cycling did negatively predict relationship satisfaction, but this association disappeared when relational ethics were introduced. An SEM model was estimated based on contextu (open full item for complete abstract)

Committee: Suzanne Bartle-Haring (Advisor); Keeley Pratt (Committee Member); Anastasia Snyder (Committee Member) Subjects: Individual and Family Studies; Therapy

Ph.D., Antioch University, 2015, Antioch New England: Marriage and Family Therapy

Multiple facets of clinicians' lives are influenced by compassion fatigue including physiological well-being, the perspective of clinicians in relation to the world, and psychological and emotional reactions to trauma triggers (Figley, 1998). Work stress research considers the systemic effects of stress on workers' relationships. Research also shows that romantic relationships are negatively influenced by work stress (Sanz-Vergel, Rodriguez, Bakker & Demerouti, 2012). This phenomenological study investigated the lived experience of three clinicians and how compassion fatigue was experienced in their relationships with their partners and children. Clinicians completed the Professional Quality of Life assessment and those with a score of 23 or higher on the secondary traumatic stress and burnout subscales participated in an interview. The major themes that emerged in this study were: (a) awareness of the effect of compassion fatigue on relationships; (b) awareness of clinician's psychosomatic symptoms related to compassion fatigue; (c) awareness of the effect of compassion fatigue symptoms on the clinician's social interactions; (d) awareness of the importance of clinician's boundaries and self-care after the onset of compassion fatigue symptoms; (e) heightened awareness of spirituality or religiosity after the onset of compassion fatigue; and (f) awareness of the children's presence mitigating compassion fatigue symptoms. This dissertation also addresses the implications of this study regarding self-care, the limitations of this study and future research.

Committee: Kevin Lyness Ph.D. (Committee Chair); Megan Murphy Ph.D. (Committee Member); Amy Blanchard Ph.D. (Committee Member) Subjects: Families and Family Life; Psychology

Ph.D., Antioch University, 2015, Antioch New England: Marriage and Family Therapy

This dissertation consists of two articles. The first article presents a literature review of research on therapists' personal and professional lives as practitioners of Buddhist meditation and psychotherapy in the past ten years. Nineteen articles were reviewed that met the inclusion criteria of a) between 2004 and 2014; b) exploring meditation; and c) studies related to therapist personal or professional lives. The results of the review identified four broad themes: a) presence and acceptance; b) empathy; c) countertransference; and d) self-care/compassion and gratitude. The content analysis indicated a positive association between therapist meditation practice and therapist qualities, both for personal development and enhanced clinical competence. The second article describes a qualitative research study to discover the embodied, lived experiences of practicing therapists as they move between their personal study of Buddhist meditation practices and their professional clinical work. In-depth semi-structured interview data were analyzed, revealing two superordinate themes: a) a way of seeing and being in the world; and b) the personal and the professional in the therapy room. The research findings have clinical implications in gaining an understanding of on-going personal and professional development for experienced therapists and contributing to the literature on professional competence, in particular, therapeutic presence, acceptance, empathy, compassion, and practitioner well-being. The electronic version of this dissertation is available in the open-access OhioLink ETD Center, www.ohiolink.edu/etd.

Committee: Lucille Byno Ph.D. (Committee Chair); Megan Murphy Ph.D. (Committee Member); Susan Dreyer-Leon Ed.D. (Committee Member); Catherine Lounsbury Ed.D (Other) Subjects: Counseling Education; Counseling Psychology; Families and Family Life; Psychotherapy

Doctor of Philosophy, University of Akron, 2015, Marriage and Family Counseling/Therapy

The dissertation is about foster care alumni (adults who had been in foster care at a point during their developmental years) and the long-term implication it has on their adult attachment style. It also explores how these foster care alumni interpreted their foster care experience. For this qualitative study, six foster care alumni were interviewed. Nine themes emerged: trauma, stolen childhood, relationship style, trust issues, anxieties, current parenting concerns, broken system, coping strategies and implications for counseling. The results of this study indicate that there are some attachment implications for foster care alumni and that the experience of being in foster care was generally experienced as negative.

Committee: Karin Jordan Dr. (Advisor); Ingrid Weigold Dr. (Committee Member); Cynthia Reynolds Dr. (Committee Member); Rebecca Boyle Dr. (Committee Member); Rikki Patton Dr. (Committee Member) Subjects: Behavioral Psychology; Behavioral Sciences; Counseling Psychology; Individual and Family Studies; Social Research; Social Work

Doctor of Philosophy, The Ohio State University, 2005, Human Development and Family Science

The price of depression to our society is staggering. When attributable morbidity costs (such as workplace related costs) and mortality are accounted for, it is estimated that depression costs our society $83.1 billion annually (Greenberg et al., 2003). While the monetary cost of depression is staggering, the relational costs of depression may be even more devastating to families and society. Marital relationships appear to be related to both the causes and the treatment of depression. The findings of the causal direction in the relationship between marital satisfaction and depression/depressive symptoms are mixed, however. Some (Whisman, 2001) have stated that a third variable may contribute to the observed relationship between depression/depressive symptoms and marital satisfaction. This research uses Bowen Family Systems Theory, specifically the theoretical construct of differentiation of self, to better understand the relationship between depressive symptoms and marital satisfaction across three sessions of conjoint therapy. Participants in the study were recruited through the on campus Marriage and Family Therapy Clinic at The Ohio State University. Participants completed self-report measures regarding differentiation of self, relationship satisfaction and depressive symptoms at intake. At two follow ups, following the second and third therapy sessions, participants completed self-report measures of relationship satisfaction and depressive symptoms. Hierarchical Linear Modeling (HLM) was used to analyze data. HLM is a multilevel modeling approach which allows researchers to use couple level variables without losing individual differences. This research both confirms and extends past research comparing depressive symptoms and relationship satisfaction. First, depressive symptoms and relationship satisfaction were significantly correlated over time. Second, aspects of differentiation were found to be associated with couple relationship satisfaction and depressive (open full item for complete abstract)

Committee: Suzanne Bartle-Haring (Advisor) Subjects: Psychology, Clinical

Doctor of Philosophy, The Ohio State University, 2002, Human Development and Family Science

The link between relationship variables, psychological health, and physical health has been well established in the research literature; however, understanding the interaction between these variables remains unclear. In particular, partner support and relationship adjustment have remained largely separate and the concepts have rarely been examined together (Acitelli, 1996). As a result, little is known about their relationship and collective role in influencing the adjustment of chronically ill populations, specifically systemic lupus erythematosus (Reisine, 1993; Revenson, Schiaffino, Majerovitz, & Gibofsky, 1991). The objectives for this study were: 1) to identify the levels of psychosocial adjustment to illness and psychological distress among 89 SLE patients, and 2) to assess if partner support and relationship adjustment interact in predicting psychosocial outcomes among SLE patients. Hierarchical regressions were used to predict psychosocial adjustment to illness and psychological distress. Although the objective of finding an interaction effect between relationship adjustment and partner support was not achieved, findings suggest that the context of the relationship does add to our knowledge in terms of partner support. For SLE patients in both distressed and nondistressed relationships, it is not how helpful the partner is, but rather how unhelpful they are that relates to psychosocial outcomes. In this regard, research and clinical intervention must influence one another to promote an effective balance between health, support, and relationship adjustment. Future research and clinical implications for marriage and family therapists are discussed.

Committee: Julianne Serovich (Advisor) Subjects: Health Sciences, Mental Health

Doctor of Philosophy, University of Akron, 2013, Marriage and Family Counseling/Therapy

This phenomenological study explored the lived experiences of couples in long-distance relationships (LDRs) from the perspective of Transgenerational (TG) Theory, a foundational theory in the Marriage and Family Therapy field. Semi-structured individual and conjoint interviews were conducted via web-based communication technology with six LDR couples who were separated due to the demands of work, school, or family care giving. Genograms were constructed in the first interview and used to discuss intergenerational relational patterns in the families of origin of the LDR partners. Eligible couples were those who had been together in the same geographic location for at least one year prior to beginning the LDR, and who had been in the LDR for at least a year. Aspects of TG Theory salient to these LDR couples were identified through analysis of the transcripts using phenomenological methods. Multigenerational patterns were found in the families of origin of participants in work-related travel and/or relocation, being independent, sharing a commitment to caring for the family of origin, and having a strong work ethic. Distance appeared to make some relational processes more overt. The majority of these LDR couples were involved in providing physical and/or financial support to members of their extended families. Families of origin were important sources of support for these LDR partners and couples. The LDR lifestyle allowed the couples and families to give and take relational support in a mutual cycle involving both families and the intimate partners. LDRs offered a way for them to fulfill multiple commitments to each other and their families while living and working in separate locations. Two core themes incorporating individual and relational processes also emerged from the analysis of interview transcripts. First, commitment and trust in the partnered relationship allowed participants to embark on an LDR. The recursive interaction of trust and commitment streng (open full item for complete abstract)

Committee: Linda Perosa Dr. (Advisor); Suzanne MacDonald Dr. (Committee Member); Karin Jordan Dr. (Committee Member); Cynthia Reynolds Dr. (Committee Member); Sandra Perosa L. (Committee Member) Subjects: Families and Family Life; Individual and Family Studies; Personal Relationships; Psychology