M.A. (Psychology) / Please refer to full text to view abstract

M.A. (Clinical Psychology) / Please refer to full text to view abstract

Gaping holes are present in the professional literature in the responsible use of intuition: a vocabulary is not present for discussion, ethics are barely addressed, guidelines are not available for effective use of techniques either for practicing therapists or those in training. This study explores how a small number (7) of therapists discovered and developed their intuitive capacities, the types of intuition they utilize within the counseling milieu, and the ethical and other concerns which accompany its use. The study was designed to be a preliminary exploratory investigation, based on semi-structured in-depth interviews. Therapists were selected based on their purported use of intuition during therapy, and were contacted based on word of mouth referral. All are either in the process of licensing or fully licensed in the state in which they practice. Data is reported in profiles of each individual with a thematic analyzation of the material, in part, based on guidelines suggested by the interview. The most significant of the findings indicates the following: none of the therapists developed their intuitive abilities through traditional university settings; all felt that it is impossible to be a good therapist without the use of intuition; all use their intuition in responsible, ethical and professional manners which are individually established and monitored; the ability to use intuition for five of the seven, created some discomfort and image issues; major shifts in belief systems were created with the awareness of universal laws; there is a lack of consistency in vocabulary in professional literature; various types of intuitive techniques exist for each of the respondents; and the word psychic is pejorative. The conclusions suggested are tentative, yet do suggest areas in which future studies can be addressed.

A small group of patients with chronic illnesses and primary care doctors participated in a structured, facilitated dialogue about chronic illness. Using a dialogue model adapted from the Public Conversations Project (Becker, Chasin, Chasin, Herzig and Roth, 1995; Herzig, 1998) that emphasizes experience-based knowledge and the sharing of experiences across differences, participating patients and doctors learned about the influence of chronic illness in each other's lives and work. Particular emphasis was placed on areas where improvement is needed in doctor-patient relationships. The study design was based on a participatory action research approach. It employed pre-dialogue interviews to develop a dialogue focus that would address participants' concerns and orient potential participants to the attitudes and values of talking across differences. The interviews also served as a screening tool to assess the ability and willingness of potential participants to engage in a cooperative dialogue process. Through follow-up interviews and questionnaires the participants reported outcomes and assessed the utility of the dialogue as a clinical method. Narrative analysis of the data emphasized the spoken and written words of participants and provided a means to bring their voices into the ongoing national conversation about healthcare. Most topics discussed in the dialogue focused on doctor-patient relationships, including what patient participants find helpful in their relationships with their doctors and what is missing that they wish was available to them. Major issues raised through the dialogue included: differences in what patients need and doctors can provide in chronic as compared to acute illnesses, ways diagnosis functions in doctor-patient relationships in chronic illness, the occurrence of "depression" in chronic illness and effects of witnessing illness. Participants were also interested in aspects of chronic illness that appear to be common across various diseases. Some patients noted the caring of the doctor participants and contrasted it with how they understand experiences with their own doctors. Over a two-hour dialogue, the participants moved the tone from one of interest and curiosity to one of deeply felt connection that facilitated learning and generated hope. Implications for patients, doctors and chronic illness care were addressed.

Quantitative studies have shown that anti-bisexual, gay, and lesbian (BGL) hate crimes have greater psychological impact on BGL victims than do non-hate-motivated crimes of similar severity (Herek, Gillis, & Cogan, 1999), contribute to psychological distress in BGL people (Mays & Cochran, 2001; Meyer, 1995), and can cause BGL people to remain closeted (D'Augelli, 1992; Pilkington & D'Augelli, 1995). The present study explores the possible mechanisms and sources of the greater impact of hate crimes on BGL victims. In this qualitative research, I investigated the psychological effects of anti-BGL hate crimes through in-depth interviews with 10 BGL people who perceived that they were victims of hate crimes based on sexual orientation bias. Interviewees were 4 lesbian women, 2 bisexual women, and 4 gay men, and 9 of the 10 were White. They ranged in age from 20 to 50 and represented a wide range of degree of sexual orientation disclosure. Each participated in one or two interviews of one to two hours, which were audiotaped, transcribed verbatim, and analyzed thematically, using qualitative analysis software (NVivo) that facilitated coding and sorting of data. Victimization experiences included violent crimes (3), harassment at work and school (2), harassment in the neighborhood (2), and multiple incidents of harassment (3). Results are 10 case studies that elucidate the effects that hate crimes had within the context of each individual's life and history. Each case study presents the participant's coming-out history, and previous traumatic and bias-related experiences, as well as hate-crime experience(s) and perceived sequelae. Three case studies also include accounts of relevant judicial proceedings, and two include reviews of results by the participants. Findings within and across cases are discussed, as well as strengths and limitations of the study and implications for future research. Results suggest factors that may contribute to the relatively more severe psychological impact of hate crimes, including: lesser availability of family support; disruption of BGL identity and coming out processes; intrusion into romantic relationships; damaged expectations of how one will be viewed and treated as a BGL person in the world; a generalized sense of anger about the victimization; and secondary victimization.

The diagnosis, treatment and side effects of childhood cancer have been described as extremely stressful experiences in the life of a child. Children must learn to cope with painful procedures, fears of mutilation, loss of body parts, treatment side effects, and the uncertainty of treatment outcomes. Anecdotally, children report that a sense of humor helps them cope with the daily experiences of living with cancer, however no research has examined sense of humor and childhood cancer stressors. According to Lazarus and Folkman's (1984) theory of stress, appraisal, and coping, outcomes are influenced by the moderating effect of personal factors. This study investigated the moderating effect of sense of humor on the relationship between cancer stressors and children's psychosocial adjustment to cancer, immune function, and infection. Subjects (N = 43) were selected from a population of school-age children with cancer. Sense of humor was assessed using a modified and tested version of a Multidimensional Sense of Humor Scale (Dowling & Fain, 1999) and its factors of humor appreciation, humor creation, and coping humor. Cancer stressors and psychosocial adjustment were measured using the Childhood Cancer Stressors Inventory and the Children's Adjustment to Cancer Index (Hockenberry-Eaton, Manteuffel, & Bottomley, 1997). Immune function was measured using salivary IgA levels and absolute neutrophil counts. The incidence and severity of infections were assessed over a subsequent month. A moderating effect was observed for incidence of infections. As childhood cancer stressors increase, children with high coping humor scores reported fewer incidence of infections than low scorers. A direct relationship was observed between sense of humor and psychosocial adjustment to cancer, such that children with a high sense of humor had greater psychological adjustment, regardless of the amount of cancer stressors. Additional analysis of a subset of items on the Childhood Cancer Stressors Inventory revealed that coping humor moderated the daily hassles of living with cancer for psychosocial adjustment, SIgA levels, and incidence of infections. Results of this study provide information on one factor, sense of humor, and its influence on childhood cancer stressors, that can help nurses recognize individual differences and develop supportive interventions for the children entrusted to their care.

This study examined patterns of comorbidity in 232 girls in state-operated juvenile justice facilities. It was hypothesized that the more depression and/or anxiety a girl reported, the more substance use, family discord, and suicidal ideation she would also report. Simple findings revealed that both depression and anxiety were related to the three dependent variables. However, upon controlling for the relationships among depression, anxiety, and externalizing behaviors, more specific relationships were revealed: depression independently predicted substance use and suicidal ideation; anxiety alone did not predict any of the three dependent variables; and externalizing behaviors independently predicted substance use and family discord. Age, ethnicity, lifetime traumatic events, and levels of delinquency were explored as potential moderating variables, but no interactions were found. The current research helps clarify relationships among the targeted problems, and it provides some initial information for developing multifaceted treatment programs for girls in the juvenile justice system.

Historically, aggression among girls has not been regarded as a problem worth studying due to the cultural assumption that aggression is a male phenomenon. Recently, however, the juvenile justice system has documented increasing rates of violent offending among adolescent girls. Girls now account for one out of four arrests, with non-traditional and/or violent offenses among those showing the greatest increase. Unfortunately, little is known about physically violent girls. The current study sought to advance our understanding of the nature of girls’ aggressive behavior by differentiating girls in the juvenile justice system adjudicated on violent versus nonviolent offenses while attending to racial and ethnic differences. Participants included 242 girls who had been committed to or detained within a Massachusetts Department of Youth Services (DYS) residential facility and referred for a psychological evaluation between the dates of 1996 and 2003. Results indicated that among the entire sample, girls who identified as Black and had a lack of positive parental support were significantly more likely to be classified as “violent” based on their criminal offense histories. Results also revealed significant racial differences in the pathway to violence among White and Black participants. Findings from the current study highlight the importance of treating girls in the juvenile justice system as a heterogeneous group and attending to issues of diversity in future research and interventions.

This exploratory study examined assimilated American Jews who became more ethnically identified. The goal was to identify social and intrapsychic factors which influenced the return to Judaism. Returning Jews served as a natural laboratory for studying the process of ethnic identification and cultural change. Ten young adults, ranging in age from twenty-five to thirty-nine years old, were interviewed. A case study methodology was used and common themes which related to factors in the return process were identified. The interpretation of the case studies utilized a conceptual framework which integrated psychosocial developmental theory, family systems theory, and psychoanalytic object relations theory. Subjects were influenced by feelings of family loyalty. It was hypothesized that invisible loyalties in Jewish families may regulate self differentiation and impose upon children missions involving continuity and preservation of traditions. Returning to Judaism in the context of a highly assimilated family was found in some cases to be a form of rebellion. It was noted that this avenue for self differentiation also constituted an implicit declaration of family loyalty. Subjects observed religious rituals but did not adhere to orthodox theology. Their religiosity emphasized ritual practice over belief. Religious observance was found to be used both as transitional objects, for the purposes of self-soothing and fantasy play, and as ritualizations to facilitate adult identity formation. The findings suggested that ritual structure is both psychologically and developmentally useful. Like many neo-orthodox Jews, the returning Jews in this sample were alienated young adults with counter-cultural leanings. These subjects, however, had not made dramatic life changes and they associated their increased ethnic identity with maturation and the need to make adult commitments. This study suggested that ethnic identity may be a source of transitional objects and ritualizations in our society. It was conjectured that ethnic identity will be more likely to be used in these ways if the ethnic culture provides concrete rituals and symbols which can be incorporated into daily living. Directions for future research include investigating the return to Judaism on a larger scale and extending this study to cross-cultural research on emergent ethnicity.

This study investigated the reliability of the cognitive-developmental classifications derived from Ivey's Developmental Theory and the predictive validity of the intervention strategies designed in accordance with this therapeutic model. Further, the cognitive-developmental styles of long- and short-term depressives were also examined. Reliability and predictive validity were addressed by researching the following questions: (1) Can the cognitive-developmental level of patients be assessed reliably? (2) If a clinician asks a specific set of questions aimed at eliciting patient verbalizations at varying cognitive-developmental levels, do patients respond at the predicted levels? The data gathered were also analyzed to examine whether the two subgroups of depressed patients differed in their cognitive styles. Specifically, the questions researched were: (1) Do long- and short-term depressives differ in predominant cognitive-developmental style during the assessment phase of an interview? (2) Do short-term depressives respond more predominantly to intervention strategies designed to elicit movement through the eight cognitive-developmental levels espoused by Ivey? Theory and research from the major models of depression etiology and treatment were reviewed and integrated with the Developmental Therapy model. This review indicated that the concepts of the cognitive-developmental model are most compatible with cognitive models of depression and offer the potential of being useful tools in the treatment of these disorders. The sample population consisted of twenty, consecutively admitted, consenting inpatients with diagnoses of mood disorders or adjustment disorders with associated depressed features. Each patient was administered the Beck Depression Inventory, completed demographic data, and participated in a structured interview, the Standard Cognitive-Developmental Interview (SCDI), which is based on Ivey's model. Interview results, as categorized by the companion Cognitive Developmental Classification System (SCDCS), were analyzed using the Pearson product-moment coefficient for reliability, percentages for predictive validity, and t-tests of significance for differences between subgroups. The resulting data indicated that Ivey's model, as operationalized through the SCDI and the SCDCS, does possess strong reliability and predictive validity. The differences in cognitive styles between long- and short-term depressives were, however, not found to be significant. Implications and suggestions for future research and therapeutic utilization were discussed.