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Caruso, MyahThe Patient-Physician Relationship from the Perspective of Economically Disadvantaged Patients
Psy. D., Antioch University, 2017, Antioch New England: Clinical Psychology
This qualitative study utilized interpretive phenomenological analysis (IPA) to explore the patient-physician relational experience from the perspective of patients of lower socioeconomic status (SES). Research shows that physicians engage in collaborative care less frequently with patients of lower SES than with their more advantaged counterparts and that lower SES patients participate less during office visits. Information on the patient-physician relational mechanisms that inhibit collaborative care from the perspective of low SES patients is a key gap in this literature. Five adult patients from the lower socioeconomic strata, who were established patients of a primary care physician were recruited from a primary care practice in a rural area and interviewed. Data analysis identified six superordinate themes that best capture how patients experience the relational dynamics of the patient-physician relationship. The results show that physician-patient power asymmetry can be experienced by patients of lower SES as reminiscent of further examples of previous experiences of stigma and oppression. Future visits or aspects of a treatment plan may be avoided following an unpleasant medical encounter or a weakened patient-physician alliance. The emotional reactions of patients contribute to their loss of voice, and some disclosures are viewed as too risky to share with treating physicians. These interviews also showed that personable physicians increase patient comfort and physicians who proactively seek out and address patient dissatisfaction mend ruptures and strengthen the patient-physician relationship. The study describes the mechanisms by which patients of lower SES are susceptible to experiences of stigma and psychological oppression during medical encounters. It offers implications for practice and possible pathways for future research to minimize experiences that are barriers for patients and to maximize the great potential of the patient-physician relationship as a factor in improving the health of a very vulnerable population.

Committee:

F. Alexander Blount, EdD (Committee Chair); James Fauth, PhD (Committee Member); Cynthia Whitaker, PsyD (Committee Member)

Subjects:

Clinical Psychology

Keywords:

physician-patient communication; physician-patient relationship; socioeconomic status; rural primary care; power asymmetry in the physician-patient relationship; qualitative research

Hennessy, Carrie OlsenMonitoring Psychiatric Patients’ Preparedness for Hospital Discharge
Psy. D., Antioch University, 2018, Antioch New England: Clinical Psychology
This mixed method study piloted a newly developed tool for monitoring preparedness among youth discharged from New Hampshire Hospital (NHH) and explored its influence on hospital discharge planning and follow-up care. This study spotlighted psychosocial variables in readmission risk for a psychiatric population and introduced a conceptualization of preparedness that included patient understanding of their discharge plan, as well as hope for change and supportive relationships. Quantitative methods were used to examine the relationship between aftercare and hospital readmission and further to explore the relationship between patient preparedness and readmission, as well as adverse events experienced post-discharge. Qualitative methods were used to explore the feasibility and utility of the preparedness tool. Chi-square results indicated that aftercare was associated with reduced readmission risk at 90-days. Regression analyses indicated preparedness scores did not contribute to the prediction of adverse events and hospital readmission. The Preparedness Assessment Tool’s (PAT) three-point rating scale made it difficult to detect a statistically meaningful relationship between preparedness and these outcomes and to effectively track changes in preparedness over time. Overall, the Aftercare Coordinator (AC) considered the PAT to be an invaluable asset to her work with patients. The PAT was found to be user-friendly, modifiable, effective, and efficient. Further, it helped personalize care, guide interventions, increase patient and family collaboration and understanding, and help monitor progress and patient need.

Committee:

James Fauth, PhD (Committee Member); Vince Pignatiello, PsyD (Committee Member); Michelle Mattison, PsyD (Committee Member)

Subjects:

Clinical Psychology

Keywords:

patient preparedness; preparedness tool; hospital discharge; post-discharge care; post-discharge follow-up; hospital readmission; readmission risk, psychiatric hospitalization

Daffon, Jennifer KThe Effects of Gender and Perception of Community Safety on Happiness
Psy. D., Antioch University, 2017, Antioch Seattle: Clinical Psychology
Income-based indicators of happiness have been shown to be limited in their ability to predict happiness. Alternative measures of happiness have been gaining prominence in happiness research, and two predictors of happiness were investigated in the current study. The extent to which happiness (measured by affect, life satisfaction, and psychological well-being) could be predicted by gender and perception of community safety was investigated with 19,644 participant responses to The Happiness Alliance Survey. Multiple linear regression models indicated that gender and community safety are significant predictors of affect, life satisfaction, and psychological well-being. The effect of the predictor variables was similar for all three of those happiness measures. B values indicated that both predictor variables had the greatest impact on psychological well-being and the least impact on life satisfaction. While all three models were statistically significant, they did not similarly predict the satisfaction with affect, life satisfaction, and psychological well-being scores. The results suggest that while gender and perceptions of community safety should be considered as part of the whole picture that supports a full life, there are likely other variables and life domains that have stronger influences on happiness.

Committee:

Suzanne Engelberg, PsyD (Committee Chair); Alejandra Suarez, PhD (Committee Member); Laura Musikanski, J.D, M.B.A (Committee Member)

Subjects:

Mental Health; Psychology; Public Policy; Social Psychology

Keywords:

happiness; positive psychology; community safety; gender; Sustainable Seattle; Happiness Alliance; multiple regression; quantitative; subjective well-being

James, Shemetra LachellPaths Towards Healing: Can Forgiveness Practices Help Survivors of Date Rape Overcome Trauma?
Psy. D., Antioch University, 2018, Antioch Santa Barbara: Clinical Psychology
There is a lack of research in regard to the impact of forgiveness practices in overcoming psychological trauma of date rape survivors. The purpose of this study is to examine the relationship between the use of forgiveness practices and overcoming the trauma of date rape. This study explored the progress of eight women who were survivors of date rape as they process their own personal trauma in relation to forgiveness practices. Qualitative data were collected by semi-structured and follow-up interviews. Data analysis identified five key themes: 1) Forgiveness means letting go of the hurt and pain; 2) Forgiveness is for the benefit of the survivor and not the perpetrator; 3) Forgiveness relieves a survivor from experiencing anger and other negative emotions; 4) Forgiveness shifts one’s view of self from victim to survivor; and 5) Forgiveness empowered the survivor to show empathy towards others. Descriptions of themes are provided along with participant quotes. The results of the study indicate that forgiveness practices can be included in psychotherapy for the benefit of the date rape survivor. Implications of forgiveness practices in a psychotherapeutic environment for date rape survivors, strengths, limitations, and directions for future research are further discussed in this study. This Dissertation is available in Open Access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu and OhioLink ETD Center, http://www.ohiolink.edu/etd

Committee:

Daniel Schwartz, PhD (Committee Chair); Juliet Rohde-Brown, PhD (Committee Member); Claudia David, PhD (Committee Member)

Subjects:

Psychology; Psychotherapy; Therapy

Keywords:

Forgiveness; Date Rape; Trauma; Intervention; Recovery; Psychotherapy; Empowerment

Geoffroy-Dallery, LaetitiaAttitudes of Clinical Psychologists Towards the Reporting of Nonhuman Animal Abuse
Psy. D., Antioch University, 2018, Antioch New England: Clinical Psychology
Research consistently demonstrates that nonhuman animals are capable of cognition and complex emotions, but their legal status in the United States remains similar to that of property. As such, they are not protected under laws mandating psychologists to report suspicions of abuse of populations that are judged to be vulnerable and unable to protect themselves, such as children, the elderly and people with disabilities (American Psychological Association [APA], 2010). Findings from previous research suggest that animal abuse is a relatively common topic encountered in therapy and the majority of clinicians are in favor of allowing voluntary reporting of nonhuman animal abuse (Nelson, 2002; Schaefer, Hays, & Steiner, 2007). However, few psychologists report inquiring about animal abuse and neglect, with lack of education about animals’ welfare and human-animal violence posed as a primary reason for this phenomenon. To fill this gap in the literature, 133 psychologists were surveyed regarding how they viewed animal abuse/neglect, whether they encounter it in professional practice, and how willing they are to report to animal protection agencies or law enforcement. Then, following a brief intervention, participating psychologists revealed their post-intervention willingness to inquire about animals in their clients’ lives and their willingness to report animal abuse/neglect to animal protection agencies or law enforcement, as well as the reason that they agreed or disagreed with reporting animal abuse. Results demonstrated that animal abuse and neglect is commonly encountered by participating psychologists although few inquire about it during intake interviews. Further, the brief intervention significantly increased both disposition towards inquiring about animals in their clients’ lives and willingness to report animal abuse/neglect to animal protection or law enforcement agencies. These findings have important implications for informing APA guidelines towards including voluntary or mandatory reporting of animal abuse and neglect.

Committee:

Martha Straus, PhD (Committee Chair); David Arbeitman, PhD (Committee Member); Laurie Guidry, PsyD (Committee Member)

Subjects:

Animals; Clinical Psychology

Keywords:

ethics code; animals; reporting; nonhuman animal abuse; nonhuman animal research; nonhuman animal congnition; therapists attitude; education; speciesism

Wengerd, Nicole MProtected Area Planning and Management: Supporting Local Stakeholder Participation with an Asset-Based, Biocultural Approach
Ph.D., Antioch University, 2018, Antioch New England: Environmental Studies
Given the uncertainties and risks of anthropogenic climate change, the urgency to conserve biodiversity has renewed urgency that has prompted a number of international forums, treaties, and agencies to advocate for the establishment of new and/or expansion of existing protected areas. One of the most broadly recognized efforts to expand the global protected area network can be found in the Aichi Biodiversity Targets, outlined in the Convention on Biological Diversity Strategic Plan for 2011-2020, adopted in 2010 by 196 countries. Target 11 calls for the expansion of terrestrail and inland water areas, as well as coastal marine areas. While the number of designated protected areas has more than doubled in less than 25 years, how to achieve the more qualitative elements of Aichi Biodiversity Target 11, specifically how to manage protected areas effectively and equitably has been a more challenging task. This research focuses on supporting quality local stakeholder participation in protected area planning and management as a method of achieving these elements. Using key components of a biocultural approach and the principles and methods of asset-based community development, the following articles examine if and how an approach that combines these concepts can be a useful tool in achieving Target 11’s mandate of more effective and equitable PA management.

Committee:

Beth Kaplin, Ph.D. (Committee Chair); Jean Kayira, Ph.D. (Committee Member); George Kajembe, Ph.D. (Committee Member)

Subjects:

Conservation; Environmental Studies

Keywords:

Protected Area; Conservation; Biocultural Diversity; Asset Based Community Development

Porter, John MartinNavigating Uncertainty in Automotive Technology Instruction: The Subjective Experiences of Automotive Instructors During Laboratory Activities
Ph.D., Antioch University, 2018, Leadership and Change
Educational researchers have conducted very few studies on the subjective experiences of both trained and self-taught auto mechanics (Barber, 2003, 2004; Nelsen, 1997, 2010). Further, no present studies explore the subjective experience of the automotive instructor as he or she experiences uncertainty in the automotive lab. This study addresses a gap in the current literature on career/technical instructor development. For this study, data were gathered by video recording automotive laboratory activities at three Midwestern automotive programs. Interpersonal Process Recall (IPR) interviews were conducted with automotive instructors as they observed themselves navigating the lab environment. Data from the IPR interviews were analyzed using emergent thematic analysis. The research revealed that most instructors in this study were aware, after reflection, of the reasoning behind many of the intuitive and improvisational behaviors, and had an awareness of the nuances of skill assessment the importance of modeling behavior. This study also identified transfer of artistry as a concept of advanced skill attainment in automotive subjects. Transfer of artistry is the result of an instructor’s ability to manage several paradigms of the laboratory experience at once, to create the appropriate conditions for a student to develop the cognitive, spatial, and tactile skills necessary for performing advanced automotive diagnostics and repair. This dissertation is available in open access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu/

Committee:

Jon Wergin, PhD (Committee Chair); Elizabeth Holloway, PhD (Committee Member); Stephanie Davis, PhD (Committee Member)

Subjects:

Community College Education; Education; Vocational Education

Keywords:

Post Secondary; Career Technical; Automotive; Technology; Laboratory; Improvisation; Instructor; Mechanic; Technician; Reflection; Artistry; IPR; Interpersonal Process Recall; Thematic Analysis; Schon

Hague, Samantha MarieGraduate Students and Geropsychology: Growing Need and Lacking Interest
Psy. D., Antioch University, 2017, Antioch New England: Clinical Psychology
As the population of older adults continues to grow with time, the need for geropsychology clinicians also grows. Many barriers exist that contribute to why elderly individuals are not receiving adequate psychological treatment. This study explores why graduate psychology students are often disinterested in working with older adults and whether it is possible that student interest could increase with more geropsychology graduate coursework and practicum training opportunities. This study also explores the possible connection between quality of elderly relationships and interest in working with the elderly. The results of this study support that Clinical and Counseling Psychology graduate programs lack quality education for providing mental health services to the older adult population. This general lack of education includes the lacking availability of geropsychology courses, integration of the older adult population in academic courses, training in the assessment, diagnosis, and provision of psychotherapy for older adults, as well as building awareness of attitudes, responses, and biases toward this population. The results of this study also support that graduate programs lack the availability of practicum placements that allow students to work with the older adult population. Participants rated the age group of 65-years-old and beyond as least preferred and a majority felt “minimally competent” to provide psychological treatment to older adults, yet 31% of participants responded that they will likely work with older adults in the future. Correlational analyses showed that the likelihood of graduate students to work with older adults in the future increases as the quality of their clinical training for older adult service provision increases. Also, as the quality of education for older adult service provision increases, the quality of clinical training with older adults increases. No significant correlations were found between emotional closeness to an older adult and likelihood to work with older adults in the future, but many findings in this study support the idea that there exists some impact of experiences with older adults on interest and disinterest in clinical work with this population. Lastly, many reasons for interest and disinterest in working with the older adult population were found in this study.

Committee:

Roger Peterson, PhD, ABPP (Committee Chair); Gina Pasquale, PsyD (Committee Member); Amanda Hitchings, PsyD (Committee Member)

Subjects:

Clinical Psychology

Keywords:

geropsychology; grandparent relationships; older adults; elderly

O'Leary, Kevin RService Members’ Perspectives on Treatment: Bridging the Military-Civilian Divide
Psy. D., Antioch University, 2017, Antioch New England: Clinical Psychology
The difficulties some service members have reintegrating into and reconnecting with civilian society are well established across the literature. Despite the veteran’s voices describing these struggles to connect with civilians and the current zeitgeist in psychotherapy on the therapeutic relationship and multicultural competence, little attention has been given to the implications of the civilian military divide in therapy. This study used a mixed method approach to conduct an exploratory study of 70 service members’ perceptions of working with a civilian and active duty or veteran therapist and what factors contribute to therapeutic alliance. Of interest are service members’ beliefs about what knowledge about the military is important for a therapist, what makes for a good first encounter, and what they look for to determine trust. Statistical analyses looked to explore the impact of combat, homecoming, and military experiences on Working Alliance Inventory scores for an imagined veteran and civilian therapist. Content analysis was used to analyze qualitative data to look for basic themes within service members’ responses. Results indicated no difference between a civilian and active duty/veteran therapist, a strong emphasis on being understood by their therapist, and that interpersonal negative homecoming experiences decrease therapeutic alliance. Based on these findings and the clinical literature, guidelines are proposed for effective ways to work with service members.

Committee:

Roger L. Peterson, Ph.D., ABPP (Committee Chair); Lorraine Mangione, Ph.D. (Committee Member); Elisabeth Parrott, Psy.D. (Committee Member)

Subjects:

Clinical Psychology

Keywords:

Veterans; Military; Therapeutic Alliance; Cultural Competency; Therapist Traits; Therapist Experiences; PTSD; Homecoming

Mark, Margaret WoodrowPracticing Sacred Encounters: A Narrative Analysis of Relational, Spiritual, and Nursing Leadership
Ph.D., Antioch University, 2017, Leadership and Change
This research examined one large health system that has, through a stated mission outcome that every encounter is a sacred encounter, sought to enhance relationships occurring within the health care environment. Seeking to understand the lived experience of sacred encounters through the lens of nurse leaders in one acute care hospital settings this study examined how nurse leaders experienced their leadership role in realizing sacred encounters. Participants were defined as nurse leaders from one hospital setting and included nurse managers, directors and one vice president. A narrative thematic analysis framed by situational analysis was the method of inquiry. Data was gathered through an intensive interview process eliciting an in-depth exploration of the experience of the participants, along with their personal interpretation of that experience. Two questions were asked to each participant, the first to gain an understanding about their personal experience with sacred encounters and the second to allow the nurse leader to reflect on his or her personal leadership behavior as it related to the realization of sacred encounters within their primary area(s) of responsibility. A review of research of current literature focused on relational leadership, spiritual leadership and nursing leadership theory. The major finding was that organizational culture can be defined from the top of the organization and, through well-defined and purposeful leadership behaviors, be realized at the point of bedside care. This study was limited to a one-faith-based hospital. Future research should focus on broadening the scope of inquiry about organizational culture and how espoused culture can be translated into action through purposeful leadership behaviors. This dissertation is available in open access at AURA, https://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu/etd

Committee:

Jon Wergin, Ph.D. (Committee Chair); Elizabeth Hollaway, Ph.D. (Committee Member); Peter Vaill, D.B.A. (Other)

Subjects:

Health Care Management; Nursing; Organization Theory; Organizational Behavior

Keywords:

nursing; nurse managers; leadership; nurses; relational leadership; spiritual leadership; spirituality; organizational culture; narrative inquiry; organizational psychology

Cyr, Serena CrystalSpirituality within Reach: A Pathway through Meditation
Psy. D., Antioch University, 2017, Antioch Santa Barbara: Clinical Psychology
Meditation is an ancient spiritual practice that has been demonstrated to be beneficial in reducing chronic pain, substance use, and eating disorders, as well as aiding in the treatment of sleep disorders, cancer, and psychological distress. In an effort to enhance the benefits, many contemporary meditation practices have been secularized, focusing on the cognitive, the psychological, and the emotional components, while de-emphasizing the spiritual aspects of meditation. However, spiritual meditation practices also demonstrate benefits, including stress reduction, improved emotional well being, increases in pain tolerance, reductions in mental health symptoms, and increased faith. However, little is known regarding the effects of different types of meditation on the reported achievement of a sense of "spiritual height." Further, it is unclear whether age, gender, or months of meditation practice might be related to achieving spiritual height. The present study was specifically designed to determine whether meditation results in achieving spiritual height, and whether the rates of reportedly achieving spiritual height "many times" or "almost always" might significantly differ by various meditation types, including Transcendental Meditation (TM), Relaxation Response (RR), Mindfulness Meditation (MM), Mindfulness Based Stress Reduction (MBSR), Christian Devotion Meditation (CDM) and "Other" types of meditation that do not fit into these categories by analyzing an international database of meditators. Survey data (N = 965) were tested using t-tests, chi square, and logistic regression statistics at the p < .05 threshold for statistical significance. Overall, 53% of the total sample reported achieving spiritual height "many times" or "almost always" during meditation, with 62% of MM practitioners reporting experiencing spiritual height "many times" or "almost always." Additionally, one third or more of secular meditation (MBSR and RR) practitioners reported achieving spiritual height "many times" or "almost always." Combined, these findings indicate that the clinical community needs to be aware that meditation is a viable strategy to achieve spiritual height in clients, even if the meditation is secular in nature, and that MM may provide the best odds of experiencing spiritual height during meditation. This Dissertation is available in Open Access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu and OhioLink ETD Center, http://www.ohiolink.edu/etd.

Committee:

Betsy Bates Freed, Psy.D. (Committee Chair); Brett Kia-Keating, Ed.D. (Committee Co-Chair); Cassandra Vieten, Ph.D. (Other)

Subjects:

Mental Health; Psychology; Religion; Spirituality

Keywords:

quantitative; survey data; meditation; spirituality; spiritual height; meditators;

Krapf, Carissa JeanThe Development of Intrinsic Motivation in Children With Attention-Deficit/Hyperactivity Disorder
Psy. D., Antioch University, 2017, Antioch New England: Clinical Psychology
Attention-Deficit/Hyperactivity Disorder (ADHD) has become a common diagnosis among children today. The numbers have grown exponentially in the last several decades and, despite extensive research and various treatment modalities, many children continue to struggle with its disruptive symptoms. Current research reports a poor prognosis for this population with difficulties continuing into adulthood. One of the difficulties noted is in their ability to develop intrinsic motivation when their behaviors have been managed by extrinsic rewards. Self Determination Theory (SDT) was used to conceptualize the difficulties around developing intrinsic motivation when an individual experiences symptoms of ADHD which impact several areas of functioning. SDT asserts that autonomy, competence, and relatedness are needed in order to develop intrinsic motivation. As such, it was hypothesized that ADHD symptoms and their treatment may be related to motivational difficulties in children with ADHD. The General Scale of the Children’s Academic Intrinsic Motivation Inventory was used to measure the intrinsic motivation of fourth and fifth graders, with and without ADHD, to explore possible differences in intrinsic motivation between groups. A total of 366 recruitment packets were sent home to families and resulted in 61 participants between the ages of 9-11. Test administration occurred within several elementary schools with the support of school principals and guidance counselors. The results of this research yielded only one statistically significant finding which illuminated a relationship of medium significance between age and intrinsic motivation. The lack of results in all other analyses indicate that there is no difference between the development of intrinsic motivation in children with ADHD when compared to their same-age peers. However, due to a small sample size, uneven diagnostic group distribution and the use of a subscale instead of a full measure, this study holds a low power of effect and the results should not be generalized to the population. In considering the numerous limitations of this study, the primary recommendations for future research are replication with a larger sample size and use of the entire CAIMI measure for a more comprehensive data set.

Committee:

Kathi Borden, PhD (Committee Chair); Daniel LaFleur, PhD (Committee Member); Barbara Belcher-Timme, PsyD (Committee Member)

Subjects:

Clinical Psychology

Keywords:

Attention-Deficit Hyperactivity Disorder; ADHD; Self-Determination Theory; autonomy; competence; relatedness; children; intrinsic motivation; CAIMI

Marsh, Megan BrunmierIraqi Refugees and Cultural Humility: A Mental Health Professional Training Program
Psy. D., Antioch University, 2017, Antioch New England: Clinical Psychology
This paper describes the development of a thorough nine-hour professional training program targeting the cultural humility of mental health clinicians who are treating new Iraqi refugee communities. I used the 15-step evidence-based Comprehensive Program Development Model created by Calley (2009) for the design of the structure, curriculum, and materials for this proposed program (Calley, 2011). The training program is informed by conceptual frameworks of cultural competence and humility, ecological systems theory, and social justice with goals of (a) exploring clinicians’ cultural attitudes in order to improve self-awareness at multiple levels (e.g., physiological, psychological, interpersonal), (b) increasing clinicians’ knowledge about Iraqi refugee resettlement, and (c) developing clinicians’ intervention skills with this at-risk population. The impact of personal uncertainty on extremist attitudes and behaviors is described and connected to human physiological fear responses that arise in the context of intercultural encounters. An empirical needs assessment of an exemplary rural New England clinic complements the literature review; the program is designed to be responsive to the needs faced by clinics serving new Iraqi communities. Program structure includes rigorous evaluation and quality improvement mechanisms.

Committee:

Roger Peterson, PhD, ABPP (Committee Chair); Lorraine Mangione, PhD (Committee Member); Dean Hammer, PsyD (Committee Member)

Subjects:

Clinical Psychology

Keywords:

Iraqi refugees; posttraumatic stress; mental health; professional training

Everard, Brie EThe Way We Say Sorry
Psy. D., Antioch University, 2018, Antioch Seattle: Clinical Psychology
People living with autism struggle with social interaction, social play, and communication. Over the last decade, technology-based interventions have been used as a way of teaching social skills to children with autism. To investigate these issues more thoroughly, three topics were the focus of this research: (a) the development of autism, (b) theory of mind, and (c) technology-based interventions. The information gained from studying these topics was used to create a technology-based intervention called The Way We Say Sorry (TWWSS). This intervention was created to help children with autism better understand the way sorry is used in the English language. Individuals with autism frequently experience difficulty appropriately recognizing and responding to nonverbal cues and communication. The Way We Say Sorry uses varying examples of facial expressions, gestures, and speech tone to increase awareness of how the word sorry is used in the English language. The researcher also created a possible research guide to test the validity of the game. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/etd.

Committee:

Alex Suarez, Ph.D. (Committee Chair); William Heusler, Psy.D. (Committee Member); Ilene Schwartz, Ph.D. (Committee Member)

Subjects:

Psychology

Keywords:

autism, theory of mind, technology-based interventions

Gomez, Alex AFeelings of Enlightenment: A Hermeneutic Interpretation of Latent Enlightenment Assumptions in Greenberg's Emotion-Focused Therapy
Psy. D., Antioch University, 2018, Antioch Seattle: Clinical Psychology
The purpose of this dissertation is to explore how a mainstream theory of psychological practice might inadvertently conceal and ignore contemporary values and ideologies and their pathological consequences. Through a hermeneutic approach, I interpreted Leslie Greenberg's Emotion-focused therapy: Coaching clients to work through their feelings (2nd ed), a popular and widely used theory in psychotherapy. As a practitioner with humanistic foundations, this was also an opportunity for the author to understand his own unexamined values as a therapist. Specific EFT constructs and concepts that reflected Enlightenment assumptions and values were examined. EFT was situated within Enlightenment philosophy, particularly it's alignment with European movements for increasing individual freedoms and resisting church and other perceived arbitrary authority. An argument of how Enlightenment perceptions were disguised within EFT's scientific and objectivist frameworks was formed based on this contextualization. One way that Enlightenment philosophy contributed to increasing individual freedom was by relocating moral sources within the individual, which led to a configuration of the self that is reflected in theories like EFT. Broadly, the assumptions that were surfaced reflected philosophical ideas promulgated by Descartes, Locke, Kant and Rousseau, as well as essential ideas from Expressivist and Romantic philosophies in general. Several themes were identified through the interpretation: The Reduction and Reification of Emotion as a Basic Building Block, The Emotional Brain and Interiorized Emotion, Emotion Scheme and the World Inside Our Brain, Immunity from Cultural Influence, Emotion Transformation as a Return to Grace, Internal Guide and the Voice of Nature, and Uniting of the Expressivist and Instrumental Stance. Examining the assumptions of EFT revealed how moral assumptions can become concealed within a mainstream psychotherapy theory, which in turn helped to explore its sociopolitical consequences. The conclusion maintained that EFT perpetuates a one-sided emphasis on individual minds, biological causes, and subjective experience, while deemphasizing social and political problems. In fact, EFT treatment of individual suffering seems to encourage the client to adapt even further to the unacknowledged individualistic ideologies that may have created the suffering. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/etd.

Committee:

Mary Wieneke, Ph.D. (Committee Chair); Phil Cushman, Ph.D. (Committee Member); Sarah Peregrine Lord, Psy.D. (Committee Member)

Subjects:

Clinical Psychology; Mental Health; Philosophy; Psychology; Psychotherapy; Social Psychology; Therapy

Keywords:

hermeneutics; hermeneutic research; qualitative text analysis; psychologists; psychotherapists; clinical psychology; psychotherapy; emotion-focused therapy; EFT; sociocultural psychology; implicit assumptions; implicit values; enlightenment philosophy

Moran, KelseyTrans Gender Identities and Language: Interviews with Recent College Graduates
Psy. D., Antioch University, 2017, Antioch New England: Clinical Psychology
There has been an increasingly pervasive need to gain a deeper and more individualized psychological understanding of how people experience their gender identities, as well as how they navigate the complicated and nuanced language of gender. Words carry meaning and it is vital to gain an insightful understanding of the impact of words, whether supportive or discriminatory, on trans people. The present qualitative study utilized phenomenological methods to hold interviews with three trans individuals, who had recently graduated from college, about their unique experiences with gender. Thematic analysis was used to examine common themes that arose throughout the interviews. Seven thematic clusters emerged: Positive Experiences, Language, Gender Development, Coming Out, Discrimination, Emotional Reactions, and Representation and Visibility. Twenty-one themes were organized under the seven clusters. Some of these themes include (a) fear (“that was a big step for me, and I was so scared”), (b) transphobia (“I’ve gotten `it’[pronoun] a few times”), (c) familiarity with language (“I appreciate it when people either are pretty up on [gendered language], or are really receptive to learning more about it”), and (d) necessity of support (“just knowing that there are other people like you [who are trans] out there is awesome and empowering”). Exploration of the emerging themes emphasized the individuality of trans individuals and their personal experiences with and opinions of gender. Suggestions for navigating the complicated language of gender, as identified by the participants, are provided in hopes of increasing awareness and safety for the trans community. Limitations of the study included the researcher’s identity and her related biases, the small sample size, and concerns regarding one’s personal safety that may have influenced people to participate or to not participate in the study. Directions for future research include gaining additional understanding of a wide breadth of trans individuals’ intersectional identities (sexuality, race, ethnicity, nationality, class, ability, religion/spirituality, etc.), the experiences of trans individuals, generational differences in gender identities, and positive experiences related to trans identities.

Committee:

Gargi Roysircar, Ed.D. (Committee Chair); Barbara Belcher-Timme, Psy.D. (Committee Member); Wendy Vincent, Psy.D. (Committee Member)

Subjects:

Clinical Psychology

Keywords:

trans; language; cisgender; gender identity; gender expression; biological sex; sexuality

Zadeh, Patricia KellyTheoretical Considerations for Understanding the Nature of Relational Trauma and Loss of Interpersonal Self-Esteem of Women in Narcissistic Relationships
Psy. D., Antioch University, 2017, Antioch Santa Barbara: Clinical Psychology
This research addresses the influence of pervasive narcissistic negative behavior among marriage partners. The purpose of this research is to investigate through extensive literature review, if and how individual women experience psychological distress as a result of marrying a narcissistic partner. A review of literature reveals that not enough research on the effects of narcissism in relationships is available. Notwithstanding, research has found that narcissistic personality traits are correlated with dissatisfaction in heterosexual marriage and intimate partner relationships (Links & Stockwell, 2002). There is also evidence that suggests some level of aggression and underlying abuse is related to narcissists in relationships. The behavior of individuals with narcissistic traits may affect the partner for years, during the relationship and post-relationship period. According to Solomon (1992), female partners are more likely to seek treatment for physical and mental disorders during the length of the relationship than male partners. Additionally, these partners who seek help experience emotional distress and psychosomatic symptoms in the form of low-self-esteem, identity-loss, anxiety, and depression. This study employs a theoretical approach to investigate conceptual aspects of women’s experiences, based on literature, in or as a result of their relationships to narcissistic partners. This method is preferred because it is the best model for this type of research. This dissertation is available in open access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu and OhioLink ETD Center, http://www.ohiolink.edu/etd

Committee:

Salvador Trevino, PhD (Committee Chair); Brett Kia-Keating, EdD (Committee Member); Dierdre Morse, PhD (Committee Member)

Subjects:

Mental Health; Psychology; Psychotherapy

Keywords:

Narcissism; narcissistic traits; narcissistic supply; grandiose; entitlement; marriage; couple; partner; relationship; shame; guilt; love; empathy; emotional; damage; abuse; trauma-bond; victim; identity- loss; PTSD; traumatic; identity-loss; self-esteem

Sidhu, GurjeetThe Application of Western Models of Psychotherapy by Indian Psychotherapists in India: A Grounded Theory
Psy. D., Antioch University, 2017, Antioch Seattle: Clinical Psychology
The following study explored the experience of Indian psychotherapists applying Western psychotherapy to Indians. Charmaz’ (2006) Grounded theory methodology was utilized. Seven Indian psychotherapists were interviewed. Interview data yielded the theory of Modification as Resistance. Modification as Resistance captured Indian psychotherapists’ attempts to modify Western psychotherapy to resist the erosion of local ways of healing due to the dominance of Western science. Results add to existing critiques of Western psychotherapy applied to Eastern populations. Recommendations based on results are offered to facilitate evidence-based practice (American Psychological Association [APA], 2006) with diverse populations. This dissertation is available in open access at AURA http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.etd.

Committee:

Jude Bergkamp, Psy.D. (Committee Chair); Michael Sakuma, Ph.D. (Committee Member); Bettleyoun Barbara, Ph.D. (Committee Member)

Subjects:

Asian Studies; Counseling Psychology; Psychology

Keywords:

Ground Theory; Qualitative; Individual Versus Collective Orientation; Internalized oppression; West is Best, South Again Psychotherapists Perspective; Cultural Appropriation

Purify, Betty ASurvey: Exploring Experiences of Christian Clients Integrating Faith In Psychotherapy
Psy. D., Antioch University, 2018, Antioch Santa Barbara: Clinical Psychology
Among some cultures, the Scriptures and spirituality play a major role in help-focusing interactions, offering perspective and support, enhancing coping strategies, and providing guidance to those who adhere to the teachings of the Bible when dealing with problems and getting through life’s challenges. In the U.S. today, Christian therapists working with Christian clients often draw on the Scriptures and spirituality during psychotherapy. However, researchers suggested this practice has not been well-explored in the academic psychological literature, and training in spirituality for therapists may vary, along with their levels of competence, because of work that remains to be done translating spiritual competencies into a practical understanding – how to work with clients’ spirituality. Through a survey, this study sought to explore retrospectively any influence and/or impact the Scriptures and spirituality may have had when implemented by Christian therapists during psychotherapy sessions. Among 112 individuals who responded to an online survey, 82 met full criteria for inclusion in the study. Participants reported having found support through the use of Scriptures in therapy. The themes developed from responses were placed in categories for family, life issues, encouragement, and feelings/emotions. Overall, results suggested the Scripture use was most helpful with life struggles. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/etd.

Committee:

Betsy Bates-Freed, PsyD (Committee Chair); Ron Pilato, PsyD (Committee Co-Chair); William Hathaway, Ph.D. (Committee Member)

Subjects:

Bible; Counseling Psychology; Psychology; Religion; Spirituality

Keywords:

Keywords - Scriptures; psychotherapy; Christian counselor; spirituality; integration;

Harper, Erin KathleenA Review of Factors Contributing to the Shortage of Palliative Care Service for Adolescent and Young Adult Oncology Patients
Psy. D., Antioch University, 2016, Antioch Seattle: Clinical Psychology
Adolescent and young adult oncology (patients aged 15–39 years old) is an emerging group of patients that are recognized to have distinctive qualities concerning their cancer treatment, including intensified psychosocial needs compared to their adult and child counterparts (Bleyer, 2012). The quality of life for adolescent and young adults during and after cancer treatment is disproportionally worse than what is reported by adults and children and the incidence of cancer in this population is steadily growing (Bleyer, 2011, 2012; Pritchard, Cuvelier, Harlos, & Barr, 2011; Rosenberg & Wolfe, 2013; Siegel, Naishadham, & Jemal, 2013; Wein, Pery, & Zer, 2011). Palliative medicine refers to an interventional service that specifically targets improving a patient’s quality of life throughout their care and has been specifically tailored in the oncology treatment guidelines and care principles for adults and children. The healthcare system, however, has been slow to notice how palliative medicine could positively contribute to adolescent and young adult oncology care. Consequently it has been under considered for this patient group. It has yet to be studied in depth as a viable and beneficial service to this cohort. Using a comprehensive literature review, this dissertation explores current shortages in palliative medicine among the adolescent and young adult oncology population. Employing multiple search modalities for key terms of the research topic resulted in 28,832 article returns. Titles and abstracts were reviewed and 36 articles were used in the literature review along with seven grey literature publications. Aspects of palliative care delivery and quality were investigated. Several themes emerged from the literature as well as specific clinical considerations for working with this patient group. Systemic barriers influencing the identified shortages were also examined. Recommendations for remediation are discussed where applicable, as well as the current state of addressing or not addressing each shortage. The role of psychologists in palliative medicine and care of adolescent and young adult oncology patients is also discussed. By illuminating the shortages in palliative care service to the adolescent and young adult oncology population, this dissertation can act as a stimulus to guide the creation of treatment guidelines or assist in future service and program development having proactively identified areas in need of attention. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/etd Keywords: adolescent and young adult, oncology, cancer, palliative care, palliative medicine, AYAO

Committee:

Mary Wieneke, Ph.D. (Committee Chair); Cheryl Azlin, Psy.D. (Committee Member); Ross Hays, M.D. (Committee Member)

Subjects:

Alternative Medicine; Clinical Psychology; Developmental Psychology; Health Care; Oncology

Keywords:

adolescent and young adult, AYA, oncology, cancer, AYAO, adolescent and young adult oncology, palliative care, palliative medicine, palliative services

Baker Christensen, Leslie MichelleArtistic Drawing as a Mnemonic Device
Psy. D., Antioch University, 2016, Antioch Seattle: Clinical Psychology
Despite art-based learning being widely used, existing data are primarily qualitative, and most research has not isolated particular variables such as memory for empirical study. The few experiments that have been conducted demonstrated that drawing improves free recall of unpaired words, and retention improves after lessons integrated with drawing, drama, and narrative exercises. To help fill the gap in the current literature, the present study compared the effectiveness of encoding and the rate of memory decay between a drawing mnemonic and note taking on a paired associates task. Using a within-subjects experimental design, participants were presented with word pairs and asked to complete either a drawing mnemonic (DM) or note taking (NT) to assist memorization. Participants were tested immediately after the word pair presentation and after a 20-minute delay. Results supported the hypothesis that the DM condition would produce superior encoding, as evidenced by greater retention on the immediate test. However, no memory decay was observed in the experiment, and therefore results on the delayed test were inconclusive. In fact, scores for the NT condition improved over time whereas the scores for the DM condition did not, which might imply that note taking results in a different consolidation process than drawing. Findings from this study suggested that arts integration can be an effective method to support memory for learned information. Future studies that examine the effect of rehearsal and the long-term effectiveness of a drawing mnemonic are warranted. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/etd

Committee:

Suzanne Engelberg, Ph.D. (Committee Chair); Jude Bergkamp, Psy.D. (Committee Member); Luke Rinne, Ph.D. (Committee Member)

Subjects:

Education; Experimental Psychology; Experiments; Psychology; Teaching

Keywords:

art-based learning; arts-integration; drawing; experiment; learning; memory; mnemonics; paired associates; quantitative; within-subjects

Gonsalves, Crystal RThe Remembered Experience of Adoption: Factors Supporting Healthy Adjustment
Psy. D., Antioch University, 2016, Antioch Santa Barbara: Clinical Psychology
This qualitative research study is designed to explore ideas, customs, and practices related to adoption from the perspective of adult adoptees. While many studies seek to explain the negative impact of adoption, minimal literature exists with regard to a phenomenological exploration of adoption practices that successfully promote healthy adjustment and a sense of resilience and well-being in adopted children. Existing research on adoption has largely been conducted quantitatively, which can fail to capture the personal, lived experience of a positive adoption experience that leads to healthy adjustment. Specifically, little is known about which factors of the adoption experience adoptees perceive as contributing to healthy adjustment and a sense of well-being. The proposed study located themes and patterns that became apparent through narrative inquiry concerning factors in the adoption experience that contributed to adjustment. Narrative research honors the knowledge held in stories that are retrieved from memory (Fry, 2002). By interviewing adults who were adopted as children, it is hoped that their personal stories can augment clinical conceptualizations of adoption and shed light on positive meaning-making experiences in the context of adoption. These conceptualizations will be of use to persons and professionals who work closely with those involved in adoption, including mental health professionals and paraprofessionals working closely with adoptees and their families. This information is of value for those involved in family dependency treatment courts, child welfare services, and other agencies who wish to promote positive experiences for children and families who become involved in the adoption process. The electronic version of the dissertation is accessible at the Ohiolink ETD center http://www.ohiolink.edu/etd.

Committee:

Steve Kadin, PhD (Committee Chair); Bella DePaulo, PhD (Committee Member); Violet Oaklander, PhD (Committee Member)

Subjects:

Clinical Psychology; Counseling Psychology; Developmental Psychology; Families and Family Life; Psychology; Psychotherapy; Social Psychology

Keywords:

adoption; adopted; attachment; adjustment; resilience; phenomenological; qualitative; biological; adoptive parents; adoption registry; adoption stereotypes; adaptability; age of adoption; disclosure; racial identity; ethnic identity; closed; open adoption

Saiz, Carolina Del CarmenOpportunities for Conversion to More Sustainable Practices by Houses of Worship through Team Performance Enhancing Strategies that Include Leadership with Facilitative Skills
Ph.D., Antioch University, 2016, Antioch New England: Environmental Studies
This research focused on assessing the performance of teams of volunteers in Houses of Worship (HOWs) in the State of Massachusetts that are successfully planning, advancing and completing sustainable initiatives. The sustainable initiatives included solar photovoltaic (PV) installations, city public parks cleaning projects, efficient windows installations, efficient lighting fixtures installations, and building insulation improvements. The goal of this research was to assess the dynamics of a total of eight successful teams, including the relationships among team members and their leaders with facilitative skills that they perceived were instrumental to their effective and efficient performance. The role of team leadership was more relevant than anticipated, and it presented statistical interdependence with team interpersonal processes such as: collaboration, cooperation, cohesion, communication, coordination, trust, and especially conflict resolution. Based on this knowledge and qualitative data from interviews, a set of guidelines on “best practices” was produced, containing recommendations on how to build and manage HOW teams to conduct local sustainability projects. Key words: sustainability best practices, team, leader with facilitative skills, House of Worship (HOW), solar energy, energy efficiency.

Committee:

James Gruber, Ph.D. (Committee Chair); James Jordan, Ph.D. (Committee Member); Robert Pojasek, Ph.D. (Committee Member)

Subjects:

Energy; Environmental Studies; Organization Theory; Organizational Behavior; Sustainability

Keywords:

sustainability; team; leadership; facilitative skills; House of Worship; solar energy; energy efficiency; environment; climate change

Johnson, LuanneThe Behavioral Ecology and Population Characteristics of Striped Skunks Inhabiting Piper Plover Nesting Beaches on the Island of Martha's Vineyard, Massachusetts
Ph.D., Antioch University, 2016, Antioch New England: Environmental Studies
We studied coastal striped skunks (Mephitis mephitis) on the island of Martha’s Vineyard, Massachusetts, USA to gather information on the population characteristics of this mesopredator on Atlantic coast beaches with nesting piping plovers (Charadrius melodus). From 2004 – 2008, we captured and marked 138 skunks and fitted 51 adults with VHF radio-collars. Capture rates ranged from 1 – 7 individuals/100 trap nights (TN) in the spring and 4 – 21 individuals/100 TN in the fall. Spring capture rates were highest at Dogfish Bar (DB), a beach with abundant wrack in the intertidal zone in close proximity to low-density housing, where we estimated a spring density of 8-10 skunks/km2. All adult skunks were residents at this site, and most were initially captured in April/May (100% of males and 67% of females). Spring capture rates were too low for a density estimate at Norton Point/Wasque (NPW), a beach with sparse wrack and farther from development. We initially captured 80% of adult males in April/May but only 1 adult female. Most adult females (88%) were captured in June/July, which coincided with the arrival of anthropogenic food on the beach. While all adult females captured at NPW were residents, 50% of males were non-residents. Half (50%) of all radio-collared skunks died from human-related causes while disease killed another 29%. Female site fidelity was high at both sites, with 40% recurring in subsequent years. While male recurrence at DB was high at 36%, no males recurred at NPW. Similarly, no juveniles recurred in subsequent years at the NPW, but 26% of juveniles recurred at DB. The Martha’s Vineyard skunk population does not exhibit any distinguishing characteristics from mainland striped skunk populations at this time. Skunks captured exhibited all stripe patterns known for the species, but narrow (45%) and short-striped (37%) patterns were most abundant. Adult skunks weighed a mean of 1.47 ± 0.05 kg between April and July and 2.08 ± 0.09 kg between August and November. At beaches where exclusion fencing is not an option for protecting eggs of rare and threatened birds, spring trapping could be effective in reducing skunk densities for most of the nesting season because our data indicates that female territories would remain vacant until late summer. Future research tracking the temporal and spatial variation in wrack line fauna availability on beaches with sparse vs. dense wrack lines will increase our understanding of the factors influencing interactions between piping plovers and predators that share foraging habitat with them, such as skunks and crows. On beaches that are seasonally urban habitats (SUH), research using experimental designs to investigate the influence of predictable anthropogenic food subsidies (PAFS) on the activity and density of generalist predator species during the summer could provide valuable data for management efforts and public outreach aimed at reducing predation on rare and threatened beach species.

Committee:

Jonathan Atwood, Ph.D. (Committee Chair); Stephen DeStefano, Ph.D. (Committee Co-Chair); Rachel Thiet, Ph.D. (Committee Member)

Subjects:

Wildlife Conservation; Wildlife Management; Zoology

Keywords:

striped skunk; Mephitis mephitis; maritime mammals; mesopredators; skunk resource use; skunk habitat selection; beach-nesting bird predators; predictable anthropogenic food subsidies; piping plover; egg predators; skunk densities;seasonally urban habitat

Scroggins, Marissa JoySurvey of Compassion Fatigue Education in APA-Accredited Clinical and Counseling Psychology Programs
Psy. D., Antioch University, 2015, Antioch Seattle: Clinical Psychology
The purpose of this study was to examine the present state of compassion fatigue (CF) education in APA-accredited clinical and counseling doctoral level training programs. It also sought to identify the number of training programs that require CF training or offer it as optional, attempted to discern the type of setting in which it is taught (class, supervision, etc.), as well as identified some of the reasons why it may not have been included (cost, time, interest, etc.) in programs without CF training. A researcher-developed survey was designed and consisted of a mixture of yes/no and multiple choice questions. Program chairs in 287 programs served as representatives of their programs and were invited to participate in this study. Participants included 69 program chairs from APA-accredited clinical and counseling programs that met study criteria. Descriptive and inferential statistics were used to analyze the data. In response to the first question of “Does your program offer any form of compassion fatigue prevention training,” the majority of participants (75.4%) indicated that they did not have any formal CF prevention training though several indicated that CF training likely occurs in spontaneous class and supervision discussions. In response to the question “if no CF training exists, why not,” the majority of participants sited “other” (58.5%) or “lack of time” (34%). The results and interpretations are explained; contributions to the current literature, implications, and limitations are discussed; and recommendations for future research are provided. The electronic version of this dissertation is at Ohiolink ETD Center, www.ohiolink.edu.

Committee:

Suzanne Engelberg, Ph.D. (Committee Chair); Colin Ward, Ph.D. (Committee Member); Kelly Brown, Ph.D. (Committee Member)

Subjects:

Behavioral Sciences; Clinical Psychology; Continuing Education; Counseling Education; Counseling Psychology; Ethics; Psychology

Keywords:

quantitative; descriptive; exploratory; APA-Accredited; clinical psychology; counseling psychology; doctorate programs; program chairs; compassion fatigue; vicarious trauma; secondary trauma; preventative training

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