Psy. D., Antioch University, 2024, Antioch New England: Clinical Psychology

Empirical research on clinician experience of competency treating borderline personality disorder is scarce, and that which does exist focuses on the negative experiences of those who treat this population. Utilizing an interpretive phenomenological analysis approach, this qualitative research investigation explored the lived experience of feelings of competency in clinicians treating borderline personality disorder using the evidence-based model of Transference-Focused Psychotherapy. To better comprehend this phenomenon and address research questions, data were collected via one, semi-structured interview given to five different clinicians who practice Transference-Focused Psychotherapy. Four themes emerged from the researched data: Positive treatment outcomes for patients, Using negative countertransference for positive therapeutic intervention, Reliability of treatment framework, and Effectively dealing with crisis and suicidality. This dissertation is available in open access at AURA (https://aura.antioch.edu) and OhioLINK ETD Center (https://etd.ohiolink.edu)

Committee: Theodore Ellenhorn Ph.D. (Committee Chair); Gina Pasquale Psy.D (Committee Member); Sabine Dorleans Psy.D. (Committee Member) Subjects: Psychology

Psy. D., Antioch University, 2022, Antioch Santa Barbara: Clinical Psychology

Psychological Mindedness (PM) is a mental capacity for self-observation and reflection originating in psychoanalysis and psychodynamic theory. PM is understood to be vary between individuals and its presence a suitability factor for psychoanalytic treatment. The present quantitative study utilized a single-group pretest/posttest, quasi-experimental design to test the hypothesis that psychotherapy treatment increases an individual's measures of PM. Patients opted-in to self-report PM at the start of treatment and again after 20 weeks. PM was measured with the Psychological Mindedness Scale: a 45-item, Likert scale, self-report instrument. In addition to repeating PM measure at posttest, the Customer Satisfaction Questionnaire-8 was used to measure participant satisfaction with treatment. Participants were recruited from two non-profit treatment providers: a community mental health clinic and a psychoanalytic therapy training institute. 22 participants completed the study and were included in the data analysis. The mean number of sessions was 16; the minimum number of sessions was 5. All treatment was provided by telehealth. The effect of treatment was measured using a paired samples t test: t=2.036, one-sided p=.027, with an effect size of 0.434. PM level at pretest and change in PM was not predictive of satisfaction with treatment when analyzed through linear regression. Demographic factors (e.g. age, sex, gender-identity, race/ethnicity) and clinical factors (reason for seeking treatment, treatment history, diagnosis) also provided no predictive value for PM at pretest. For the sample surveyed, a small to moderate effect of treatment on PM was measured, providing sufficient evidence to support the primary hypothesis of the study. The results did not support the secondary hypothesis. This dissertation is available in open access at AURA, https://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu

Committee: Allen Bishop Ph.D. (Committee Chair); Agnes Regeczkey Ph.D. (Committee Member); Susan Wax Ph.D. (Committee Member) Subjects: Clinical Psychology; Counseling Psychology; Psychological Tests; Psychology; Psychotherapy

Psy. D., Antioch University, 2018, Antioch New England: Clinical Psychology

Presented is a qualitative phenomenological investigation of the experiences and perspectives of individuals who self-identify as consensually nonmonogamous regarding disclosure of that identity in psychotherapy. Members of this rarely-studied group (n=10) shared their accounts through an anonymous open-ended online questionnaire. Their prompted autobiographical accounts were analyzed for recurring themes and unique concepts which were drawn together into a model of disclosure of a nonmonogamous identity in a therapeutic setting. This model suggests that while nonmonogamous clients expect prejudice from their therapists, their desire for personal integrity and their culturally informed conviction that openness is necessary for best results, often leads them to disclose early in the treatment and to select therapists based on the reaction to the disclosure. Results also highlighted a tension between access to knowledgeable and affirmative care and financial considerations, which are largely due to the scarcity of therapists sufficiently informed about nonmonogamy. The findings of this study provide direction for further research and an impetus for systemic changes in the training and practice of mental health professionals.

Committee: Kathi Borden PhD (Committee Chair); Cynthia Whitaker PsyD (Committee Member); Dean Hammer PsyD (Committee Member) Subjects: Clinical Psychology

Doctor of Philosophy, The Ohio State University, 1986, Graduate School

Committee: Not Provided (Other) Subjects: Psychology

Doctor of Philosophy, The Ohio State University, 1983, Graduate School

Committee: Not Provided (Other) Subjects: Social Work

Doctor of Psychology (PsyD), Wright State University, 2016, School of Professional Psychology

Group psychotherapy has become a preferred modality of direct clinical psychological services offered by many University Counseling Centers (UCCs), primarily because of the effectiveness of group psychotherapy in addressing the unique developmental issues that college students experience. However, there is a need for empirically supported data to identify barriers to group psychotherapy among college students, particularly related to multicultural identity variables. The present study examined barriers that college students face when considering joining a psychotherapy group. Participants completed a demographic questionnaire and either the original or the modified version of the Barriers Scale, (Harris, 2012). Participants were divided into three groups, Black/African-American, White/Caucasian or Other Minorities (O.M.). Results showed that group psychotherapy was found to be one of the least desirable methods for distress management among all three groups. However, White college students showed greater willingness to enroll in group psychotherapy when more information was provided about the types of groups. Furthermore, O.M. and White college students endorsed a fear of being judged because of their experiences with people of other race/ethnicities. Results indicated that the fear of being judged negatively impacted White college students' willingness to participate in group psychotherapy, but had no impact for O.M. students.

Committee: Julie L. Williams PsyD, ABPP-RP (Committee Chair); Daniela Burnworth PhD (Committee Member); Robert A. Rando PhD, ABPP (Committee Member) Subjects: Counseling Psychology; Psychology; Psychotherapy

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

In recent years, there have been several ways in which researchers have attempted to integrate psychotherapy and neuroscience research. Neuroscience has been proposed as a method of addressing lingering questions about how best to integrate psychotherapy theories and explain their efficacy. For example, some psychotherapy outcome studies have included neuroimaging of participants in order to propose neurobiological bases of effective psychological interventions (e.g., Paquette et al., 2003). Other theorists have used cognitive neuroscience research to suggest neurobiological correlates of various psychotherapy theories and concepts (e.g., Schore, 2012). These efforts seem to embody broader historical trends, including the hope that neuroscience can resolve philosophical questions about the relationship between mind and body, as well as the popular appeal of contemporary brain research. In this hermeneutic dissertation I examined a popular neuropsychotherapy text in order to explore the historical fit between neuroscience and psychotherapy. The study identifies the possible understandings of the self (i.e., what it means to be human) that could arise from Western therapy discourses that are based on neuroscientific interpretations of psychotherapy theories. The methodology of this dissertation consisted of a critical textual analysis of Louis Cozolino's (2010) The Neuroscience of Psychotherapy: Healing the Social Brain. The primary content, rhetorical strategies, and recurring themes in Cozolino's book were outlined and interpreted from a hermeneutic perspective. This included a historical critique of Cozolino's claims about the origins, purpose, and efficacy of psychotherapy, his assertions about the relationship between self and brain, and examples of his psychotherapy case vignettes. Rhetorical strategies in his writing included analogy, ambiguity, speculative language, and figures of speech such as metaphor and personification. A discussion of these findings addr (open full item for complete abstract)

Committee: Philip Cushman PhD (Committee Chair); Alejandra Suarez PhD (Committee Member); Gary Walls PhD (Committee Member) Subjects: Clinical Psychology; Mental Health; Modern History; Neurosciences; Philosophy; Philosophy of Science; Psychology; Psychotherapy; Science History; Therapy

Doctor of Philosophy (PhD), Ohio University, 2010, Clinical Psychology (Arts and Sciences)

Therapist empathy and the working alliance are two of the most potent predictors of therapy outcome (Horvath & Bedi, 2002; Martin, Garske, & Davis, 2000; Bohart, Elliott, Greenberg & Watson, 2002); yet the relationship among these variables is poorly understood. Using a random subset of 30 clients from the Vanderbilt 2 psychotherapy study (Strupp, 1993; Henry, Strupp, Butler, Schacht & Binder, 1993; and Henry, Schacht, Strupp, Butler and Binder, 1993) sample, the current study tested a mediational model in which empathy was predicted to have an influence on outcome indirectly through the alliance and directly, independent of the alliance. Bootstrap and Ordinary Least Squares regression analysis results supported the mediational role of the alliance in the relationship between empathy and therapy outcome; however, no direct effect of empathy on outcome independent of the alliance was found.

Committee: Timothy Anderson PhD (Committee Chair); John Garske PhD (Committee Member); Benjamin Ogles PhD (Committee Member); Kenneth Holroyd PhD (Committee Member); Patricia Beamish EdD (Committee Member) Subjects: Psychology; Psychotherapy

Doctor of Philosophy (PhD), Ohio University, 2008, Clinical Psychology (Arts and Sciences)

In an attempt to determine whether alliance is a cause of outcome or an artifact of previous outcome, data from a naturalistic study of outcomes in the Psychology and Social Work Clinic at Ohio University are analyzed using regression and multilevel modeling. Clients (n = 43) completed the Outcome Questionnaire before each session and Working Alliance Inventory - Short Form Revised after each session. Regression and multilevel modeling were used to test whether when controlling for previous outcome, alliance predicts subsequent outcome. The two types of statistical analysis gave different results. Multilevel modeling supported the idea that alliance plays a causal role in client improvement, showing both that alliance predicts outcome and that outcome does not predict alliance. Results from regression were more equivocal. Alliance did not predict outcome, but outcome also did not predict alliance. Examination of the results tended to indicate that multilevel modeling is methodologically superior to regression when it comes to assessing the timeline of the relationship between the alliance and outcome. MLM (but not regression) showed initial severity also influences outcome and gave limited support to the possibility that security of attachment plays a role in the relationship between alliance and outcome. Lack of convergence in the literature is discussed in terms of differences in methodology and definitions of alliance. It is recommended that future research on the temporal relationship between alliance and outcome make use of multilevel modeling and incorporate observations at every session. The complexity and interrelatedness of the concepts studied is emphasized, and Hatcher and Barends' (2006) view of the alliance as a concept that is superordinate to specific factors is endorsed.

Committee: Timothy Anderson Ph.D. (Advisor); John Garske Ph.D. (Committee Member); Christine Gidycz Ph.D. (Committee Member); Benjamin Ogles Ph.D. (Committee Member); Karen Carlson Ph.D. (Committee Member) Subjects: Psychology; Psychotherapy

Master of Science (MS), Ohio University, 2005, Psychology (Arts and Sciences)

The therapeutic alliance is consistently related to treatment outcome, and therefore represents an important aspect of how and why psychotherapy is effective. In the present study, security of attachment, quality of object relations, and interpersonal style were measured as predictors of the alliance early in treatment. Forty-eight individual psychotherapy clients were administered the Revised Adult Attachment Scale (AAS), the Bell Object Relations and Reality Testing Inventory (BORRTI), and the Interpersonal Adjective Scales-Revised (IAS-R) prior to their initial therapy session. Participants completed the Working Alliance Inventory (WAI) following their first, second, and third sessions. Security of attachment and quality of object relations were related to the alliance at session one, while quality of object relations was no longer related to the alliance at session two, and none of the predictors were related to the alliance at session three. Early therapeutic alliance appears to be influenced by interpersonal attachment and object relations.

Committee: Timothy Anderson (Advisor) Subjects:

Doctor of Philosophy (PhD), Ohio University, 2005, Psychology (Arts and Sciences)

This study evaluated the effects of parent participation on child psychotherapy outcomes through meta-analytic review. A total of 42 studies (and two follow up studies) were included that offered a direct comparison of an individual child treatment group to either a combined parent-child/family therapy treatment, or a parent-only treatment groups. Results indicate that combined treatments were more effective than individual child treatments, with an average weighted effect size within the moderate range (d = .25). No differences were found between individual child and parent-only interventions. Moderator analysis for the comparison of child-only to combined treatments identified child treatment orientation as a marginally significant unique predictor. However, when all other potential moderators (presenting problem, treatment orientation, methodological quality, difference in number of therapy sessions, outcome measure, and child age) were entered into the regression analysis, methodological quality was identified as marginally significant. Results suggest that including parents in the psychotherapeutic treatment of children is beneficial. More research is needed that offers these specific treatment comparisons to offer more specific treatment recommendations.

Committee: Benjamin Ogles (Advisor) Subjects: Psychology, Clinical

Master of Arts, Miami University, 2004, Psychology

The feasibility of using online psychotherapy process forms and the equivalence of these forms to their paper-and-pencil counterparts was investigated. Participants drawn from a psychology department clinic, a student counseling center, and community agencies visited an online Web site to report on each of their sessions by completing the two brief online rating forms. The feasibility of online psychotherapy process measure usage for therapists indicated they visited the Web site on a regular basis; however, client recruitment and participation was problematic. Equivalence between the online and paper-and-pencil forms was supported, with minor qualifications, by (i) similar underlying factor structures and (ii) comparable distributions of participant responses on the measures' scales. More direct contact with clients might increase their participation.

Committee: William Stiles (Advisor) Subjects: Psychology, Clinical

Master of Arts, The Ohio State University, 1969, Graduate School

Committee: Not Provided (Other) Subjects:

Master of Arts, The Ohio State University, 1971, Graduate School

Committee: Not Provided (Other) Subjects:

Master of Arts, The Ohio State University, 1961, Graduate School

Committee: Not Provided (Other) Subjects:

Master of Arts, The Ohio State University, 2005, Graduate School

Committee: Not Provided (Other) Subjects:

Master of Arts, The Ohio State University, 1971, Graduate School

Committee: Not Provided (Other) Subjects:

Master of Arts, The Ohio State University, 2007, Graduate School

Committee: Not Provided (Other) Subjects:

Doctor of Philosophy (PhD), Ohio University, 2024, Clinical Psychology (Arts and Sciences)

Racial/Ethnic Minority (REM) clients often face disparities in mental health outcomes. A proposed solution has been to train culturally competent practitioners. However, no reliable or valid measures of therapist cultural competency exists. This study examined both the reliability and predictive ability for a newly developed performance-based measure of therapist cultural competency, the Facilitative Interpersonal Skills - Cultural Competency (FIS-CC). Twenty-five therapists from two university counseling centers were administered the FIS-CC and standard FIS as well as a self-report measure of cultural competency, the Cross-Cultural Counseling Inventory-Revised (CCCI-R). The FIS-CC and FIS were found to have acceptable internal consistency and inter-rater reliability. Therapists treated 2,004 clients, who completed symptom measures at each session. A series of 2-level Hierarchical Linear Models (clients nested within therapists) found no effect of FIS-CC or FIS on client outcome, though a marginally significant interaction was found indicating therapists with higher FIS-CC scores trended toward better outcomes with clients who had higher symptoms at intake. Exploratory ANOVAs revealed variation between different FIS-CC stimulus clips as well as FIS-CC items, indicating significant heterogeneity between different skills and simulated clients in the FIS-CC Task. Results are discussed in terms of the importance of a reliable performance based measure of therapist cultural competency. Future use of the measure for predicting client outcomes would benefit from more controlled research designs (e.g., Randomized Control Trials) and inclusion of more diverse client samples are recommended.

Committee: Timothy Anderson (Advisor); Julie Owens (Committee Member); David Nguyen (Committee Member); Paul Castelino (Committee Member); Peggy Zoccola (Committee Member) Subjects: Psychology; Psychotherapy

Master of Arts, The Ohio State University, 1964, Graduate School

Committee: Not Provided (Other) Subjects: