My passion as a student at the Claremont Colleges is to help children with Autism Spectrum Disorder grow and learn as normal children and to help prepare them for life outside the Autism Center at Claremont McKenna College. In my thesis project, I am exploring the concept of silhouettes through photography and my perceptions of the stories told to me by the children I teach. Esthetically, I am inspired by Kara Walker’s installation of large cutout silhouettes but I am using different mediums to accomplish my project: Artistically, I am inspired by the detailed descriptions of the obsessive stories and information provided to me by the children at the Autism Center. Primarily, I will be using photographs that I have taken of the children and creating silhouetted images of them through Photoshop. Afterwards, I will paint my perceptions of the detailed and creative descriptions of the different information relayed to me by each individual child. Secondary, there will be some life size black cutouts, on black paper, of different imagined scenarios with the children. In the spring, I see this as an installation with many separate pieces that contain different sizes, depth, and simplicity.

Post-stroke fatigue is a common problem that may limit participation in everyday activities. Emerging evidence suggests that group-based training in fatigue management may be an efficient means of reducing the effects of post-stroke fatigue. This mixed methods, quasi-experimental study proposed to determine whether a group-based educational program could be successful in relieving post-stroke fatigue and improving participation in daily activities. A convenience sample of stroke survivors (n=20) from retirement communities in southeastern PA were invited to participate in the research. Participants were screened for depression, motor and cognitive recovery, and sleep quality. Fatigue was measured using the Fatigue Severity Scale (FSS) and activity participation was measured using the Physical Self-Maintenance Scale- Instrumental Activities of Daily Living (PSMS-IADL). The measures were administered in a double pre-test, double post-test format over three seven-week phases; a non-intervention period; a group-based intervention period, and a post-intervention period. Qualitative information was gathered using a self-made Intervention Satisfaction Survey. Data analysis involved measures of central tendency for the demographic information. Tabulations of the survey responses were completed to judge the effectiveness of the group-based program or its’ components from the participants’ perspectives. Results indicated a statistically significant reduction in reported fatigue post-intervention (p= .022), which continued for seven-weeks (p= .240). There was a strong effect size for the post-intervention reduction of fatigue (r= .69). There was a trend toward improved participation in daily activities. Distribution across groups for presence of social support, age, sex, and level of care was found to be equivalent after one-way chi square analysis. There was no significant influence of these variables on fatigue or participation when used as grouping variables in RM-ANOVA. Participants reported feeling most confident scheduling activity to include rest periods and least confident managing sleep problems. Limitations include small sample size, demographics not being representative of the general stroke population, use of self-report measures with possible ceiling effect of PSMS-IADL, instrumentation effect given multiple administrations, and history effects as groups occurred at different time of the year. Overall, the results indicate that participation in a group-based educational program was effective in reducing post-stroke fatigue in chronic stroke.

Children exposed to trauma experience many negative outcomes including posttraumatic stress disorder (PTSD). Fortunately, cognitive-behavioral therapy (CBT) is an effective treatment for PTSD. Theoretically it may be that not only do children do better in treatment when their parents are involved, but that there is also a reciprocal relationship such that as children improve their parents feel better as well (and vice a versa). Using data from a randomized trial (Scheeringa & Weems, 2014), this thesis used Hierarchical Linear Modeling (HLM) to test if change in child PTSD symptoms mediates change in parent depression symptoms, and vice a versa, across treatment sessions. Results indicated that maternal depression mediates child PTSD symptoms, and that the reciprocal relationship is present. However, this was only true when child PTSD symptoms were measured by parent report. The addition of this reciprocal relationship finding to the literature and future directions are discussed.

Submitted by Fabricia Fialho Reginato (fabriciar) on 2015-07-23T00:20:08Z No. of bitstreams: 1 MarindiaBrandtner.pdf: 535266 bytes, checksum: 44b2e59858f1e72c770653a7c499c7af (MD5) / Made available in DSpace on 2015-07-23T00:20:08Z (GMT). No. of bitstreams: 1 MarindiaBrandtner.pdf: 535266 bytes, checksum: 44b2e59858f1e72c770653a7c499c7af (MD5) Previous issue date: 2012 / Nenhuma / Esta Dissertação de Mestrado aborda o processo de mudança terapêutica na Terapia Cognitivo-Comportamental (TCC), com ênfase na patologia do comprar compulsivo. A dissertação compõe-se de uma revisão sistemática sobre psicoterapia para casos de compras compulsivas e de um estudo empírico do processo de mudança em um caso de TCC. A revisão sistemática da literatura partiu do tema das compras compulsivas e suas opções psicoterapêuticas. Para tanto, foi efetuada uma busca nas bases de dados MEDLINE (NLM), Social Sciences Citation Index (Web of Sciences), Science Citation Index Expanded (Web of Science) e American Psychological Association (APA) com as palavras-chave psychotherapy (psicoterapia) and (e) compulsive buying (compras compulsivas), compreendendo o período de 2002 a 2012. Foram excluídos artigos de teóricos, de revisão e que avaliavam exclusivamente tratamento psicofarmacológico. Do total de 96 encontrados, apenas seis preencheram os critérios de inclusão. Os estudos encontrados, apesar de poucos, apontaram que existem estudos sendo desenvolvidos com propósito de testar e validar intervenções efetivas para o tratamento das compras compulsivas. Apesar dos indícios de efetividade de abordagens psicoterápicas no tratamento do comprar compulsivo, a escassez de estudos, a ausência de estudos comparativos entre diferentes psicoterapias, entre outros aspectos, indicam a necessidade de implementar pesquisas sobre a efetividade do tratamento psicológico face a face com este tipo de psicopatologia. O estudo empírico teve como objetivo avaliar resultados do tratamento psicoterápico de uma compradora compulsiva e descrever o processo terapêutico. A pesquisa foi realizada em uma clínica privada do interior do Estado do Rio Grande do Sul. As participantes foram uma terapeuta, psicóloga e especialista em Terapia Cognitivo-Comportamental, com mais de dez anos de experiência na área e uma paciente, adulta, casada, com sintomas de comprar compulsivo, aliados a depressão. Foram realizadas 12 (doze) sessões de psicoterapia, utilizando o enfoque da TCC. Todo o tratamento foi gravado em áudio e posteriormente transcrito e avaliado por uma dupla de juízes independentes, através do método Psychotherapy Process Q-Set (PQS) para a obtenção de descrições quantitativas de elementos que caracterizaram o processo terapêutico, considerando fatores da paciente, da terapeuta e da interação entre ambas. A avaliação dos resultados foi obtida através de medidas antes, durante e após o tratamento, de sintomas de comprar compulsivo (YBOCS-SV), ansiedade (BAI), depressão (BDI-II) e de ajustamento social (EAS). Este estudo apontou que a TCC foi efetiva no tratamento de comprar compulsivo, promovendo a redução de comportamentos disfuncionais típicos desta patologia, a reestruturação de cognições disfuncionais da paciente e a melhora dos sintomas de depressão e de ajustamento social. Os achados não permitem generalizar quais fatores foram mais importantes para estes positivos resultados, porém, a aliança terapêutica, as tarefas comportamentais, a motivação da paciente e a atitude de apoio da terapeuta, foram fatores essenciais para este processo. / This Master´s Dissertation discusses the process of therapeutic change in cognitivebehavioral therapy (CBT), with emphasis on pathology of compulsive buying. The dissertation consists of a systematic review on psychotherapy for cases of compulsive buying and an empirical study of the change process in a case of CBT. A systematic review of the literature came from the theme of her compulsive buying and psychotherapeutic options. The search found 96 articles, only six of which met the inclusion criteria. The articles found, though few, have pointed out that there are studies being developed for the purpose of testing and validating effective interventions for compulsive buying treatment. Despite the evidence of effectiveness of psychotherapeutic approaches in the treatment of compulsive buying, the scarcity of studies, the lack of comparative studies between different psychotherapies, among other things, indicate the need to implement research on the effectiveness of psychological face to face treatment with this type of psychopathology. The empirical study aimed to evaluate psychotherapy results of a compulsive buyer and to describe the therapeutic process. The research was conducted in a private clinic in the state of Rio Grande do Sul. Participants were a therapist, psychologist and expert in Cognitive Behavioral Therapy, with over ten years of experience in the field and a patient, adult, married, with symptoms of compulsive buying, coupled with depression. Twelve (12) sessions of psychotherapy were performed, using the approach of CBT. All treatment was recorded on audio, transcribed, and evaluated by a pair of independent judges with the method Psychotherapy Process Q-Set (PQS) for obtaining quantitative descriptions of elements that characterize the therapeutic process, considering patient’s, therapist’s and interaction’ factors. The evaluation of results were obtained through measurements of compulsive buying symptoms (YBOCS-SV), anxiety (BAI), depression (BDI-II) and social adjustment (EAS), performed before, during and after treatment. This study showed that CBT was effective to treat compulsive buying, promoting reductions of dysfunctional behaviors that are typical of this condition, restructuring patient´s dysfunctional cognitions and improving depressive symptoms and social adjustment. The findings do not allow generalizing what factors were most important to these positive results. However, therapeutic alliance, behavioral tasks, patient´s motivation, and therapist´s supportive attitude were essential factors to this process.

An alarming portion of youth experience traumatic events during childhood, and there is a robust body of literature documenting the adverse consequences of trauma exposure on the developing child. Fortunately, numerous empirically-supported phase-based interventions have been developed for youth that target the deleterious effects of trauma. While several of these interventions have demonstrated symptom reduction from the baseline to completion of treatment, much less is known regarding the trajectory of posttraumatic stress symptoms (PTSS) during the course of treatment. Information in this regard may have important implications for service delivery and help to illuminate the mechanisms of change responsible for treatment outcomes. Furthermore, gender-related differences in the prevalence and expression of PTSS following trauma exposure have been observed, but the reasons for these differences is unclear and there is a paucity of research concerning whether boys and girls may progress differently through trauma-focused treatment. As a result, the aims of this study were to (1) examine the progression of PTSS during the various components of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT); (2) assess whether symptoms progress differently for males and females; (3) examine whether (a) sexual abuse history or (b) age moderates any gender-related symptom differences identified; and (4) explore the trauma narratives of boys and girls. This study utilized an embedded sequential mixed methods design. For the quantitative strand, aggregate scores on the UCLA Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) were mapped for the entire sample and then according to gender at baseline, during various components of TF-CBT, and at termination among a sample (N = 138) of polyvictimized youth ages 7-18 who completed TF-CBT at a university-based child trauma treatment clinic. Mixed Analysis of Variance (ANOVA) analyses were conducted for each of the outcome measures (UCLA-PTSD RI overall, arousal, avoidance, and intrusion scores) to examine whether there were symptom differences between males and females from baseline to completion of TF-CBT, and 2 X 2 full factorial ANOVAs were conducted to determine whether sexual violence history or age moderated the relationship between gender and symptom severity during any phase of TF-CBT. For the qualitative strand, trauma narratives (N = 16) completed during TF-CBT were analyzed through the use of thematic analysis. Findings revealed that males and females reported differences in PTSS symptoms from baseline to termination of treatment, and during various phases of treatment. Additionally, thematic analysis of the trauma narratives augmented findings from the quantitative strand and revealed variations in the narratives of males and females. Although further investigation is warranted, study findings help to further understand the complex interplay between gender and the progression of PTSS during treatment. Implications for practice, policy and social work education are discussed.

The studies presented in this thesis sought to investigate a number of developmental factors that influence the efficacy of preventive intervention for child anxiety disorders. Preventive intervention has emerged as a vital step forward in clinical research following data indicating anxiety disorders are among the most common forms of psychopathology in youngsters (Kashani & Orvaschel, 1990; Mattison, 1992). Several risk and protective factors associated with childhood anxiety disorders have been identified, along with effective treatment protocols (Kendall, 1994; Howard & Kendall, 1996; Barrett, 1998, 1999; Silverman et al., 1999a, 1999b), as prerequisites to the development of preventive programs for child anxiety problems (Spence, 2001). The first objective of this research was to add to the literature on risk and protective factors by investigating the role of peer interaction in the development of child anxiety problems. Study one examined developmental differences in the influence of peer interaction on children's anxiety-related cognition and behaviour. One hundred and sixty two children enrolled in grade 6 (n = 96) aged between 9 and 10 years, and grade 9 (n = 66) aged between 14 and 16 years participated in the study. Participants were stratified into either an at risk group or to a healthy group, based on their anxiety scores on the Spence Child Anxiety Scale (SCAS; Spence, 1997), and further allocated to a peer group comprising of 3 'healthy' (non-anxious) and 3 'at risk' (high anxious) children. Prior to and following a peer discussion, participants completed a standardised self-report measure of threat interpretation and response plans to two ambiguous vignettes (Barrett, Rapee, Dadds, & Ryan, 1996; Dadds, Barrett, Rapee, & Ryan, 1996). Results showed all participants evidenced changes in threat interpretation and response plans following the discussion with peers (p < .001). Overall, findings highlight the potential importance of peer interaction in the development of anxiety-related cognition and behaviour. The findings of study one have important implications for the future development of school-based intervention programs; specifically those conducted in the classroom. Study two sought to advance the current research on preventive intervention for child anxiety by establishing the age at which youngsters benefit the most from the FRIENDS program as a classroom-based universal intervention. Study two presents the results of a longitudinal study evaluating the effects of a universal school-based intervention for child anxiety at two developmental stages. The study involved a cohort of 733 children enrolled in grade 6 (n = 336, 45.6%) aged between 9 and 10 years, and grade 9 (n = 401, 54.4%) aged between 14 and 16 years, Participants were allocated to either a school-based cognitive behavioural intervention or to a monitoring group. Participants completed standardised measures of anxiety, depression and coping style. Participants identified as 'at risk' of an anxiety disorder were assessed for a clinical diagnosis with a structured diagnostic interview. Results indicated the universal intervention effective in significantly reducing anxiety (p < .001), depression (p < .001) and behaviour avoidance in children at post- intervention and 12-month follow-up intervals. Grade 6 children reported significantly higher anxiety at pre-intervention and greater reductions in anxiety at post intervention compared with the grade 9 (p < .001), although both primary and secondary school participants showed equal reductions in anxiety at 12-month follow up. Overall, findings suggest universal intervention potentially successful in reducing symptoms of anxiety and increasing coping skills in children. Primary school children reported the greatest changes in anxiety symptoms, suggesting earlier preventive intervention potentially more advantageous than later intervention. Developmental differences in anxiety, depression and coping strategies are discussed in addition to the implications and limitations of this study and directions for future research.

<p>The purpose of this essay is to perform a comparative study of first a pedagogical/rhetorical and then a therapeutic method, to help students overcome their speech anxiety. My choice stayed at focusing on the academic world and the benefits offered to mainly students. I have chosen two institutions with long experience of work with speech anxiety: Instutionen of Swedish, rhetoric and journalism at Södertörns Högskola and Student Health at Uppsala University. I want to find the advantages and disadvantages of the two universities and in no way define what is more favorable.</p>

The present dissertation consists of three empirical studies on children and adolescents presenting with various specific phobias in Stockholm, Sweden and in Virginia, USA. The overall aim was to contribute to our understanding of childhood fears, anxiety and phobias and to evaluate the efficacy and portability of a one-session treatment of specific phobias in youth. Study I tested the dimensionality of the Parental Bonding Instrument, across three generations and for two countries, and examined if parenting behaviors of indifference and overprotection were associated with more anxiety problems in children. The results showed that the four-factor representation of parental behavior provided an adequate fit for the instrument across informants. Perceived overprotection was associated with significantly more anxiety symptoms and comorbid diagnosis in children. Study II explored parent-child agreement on a diagnostic screening instrument for youths. The results indicated that children scoring high on motivation at treatment entry had generally stronger parent-child agreement on co-occurring diagnoses and severity ratings. Parents reported overall more diagnoses for their children, and parents who themselves qualified for a diagnosis seemed more tuned in to their children’s problematic behavior. Study III compared a one-session treatment with an education-supportive treatment condition, and a wait-list control condition for children presenting with various types of specific phobias. The results showed that both treatment conditions were superior to the wait-list control condition and that one-session exposure treatment was superior to education-supportive treatment on several measures. Treatment effects were maintained at a 6-month follow-up. Overall, the above findings suggest that the one-session treatment is portable and effective in treating a variety of specific phobias in children and adolescents.

No description available.

It is important to understand the development of depression, and how a family component to treatment affects early adolescent girls’ depression given the association between depression and negative future outcomes. A potential vulnerability to depression is the cognitive triad, which encompasses beliefs about the self, world, and future and is shaped by early learning experiences. Research indicates that the vulnerability originates from parent-child relationships and family messages, which are important in the development of youth cognitive styles. Previous research also indicates that family variables are important factors to consider in the treatment of depression. The purpose of the current study was to expand previous research by examining the roles of perceived family messages and the cognitive triad in the development of depression for early adolescent girls. The study also explored whether parent gender differentiated how family messages affect girls’ cognitions and depressive symptoms. The study evaluated how the addition of a parent training component to a school-based, group-administered CBT intervention affected change in the model’s variables in comparison to group-administered CBT intervention alone and a monitoring control condition. Participants included early adolescent girls diagnosed with depression and caregivers in the parental treatment component. Girls were randomly assigned to a CBT, CBT+PT, or minimal contact control condition. Ratings of girls’ perceptions of family messages, cognitions, and depressive symptoms were obtained at pre-treatment and post-treatment. Results from structural equation modeling indicated significant effects from perceived family messages to girls’ cognitions. Further, girls’ cognitions mediated the relation between perceived family messages and girls’ depressive symptoms at post-treatment for participants within the CBT and monitoring conditions. No significant differences were evident between parent gender and perceived messages. Results indicated that the addition of a parent component to the CBT intervention did not significantly differ from the CBT intervention alone in its effects on the variable relations within the model at post-treatment. Supplemental analyses highlighted parent attendance as a significant factor, with larger effects from the family messages on girls’ cognitions appearing when parents attended majority (six or more) of the eight parent training sessions. Implications, limitations, and areas for further research are discussed. / text