A rural outpatient mental health center attempted to improve the efficacy of its fee collection procedure by requiring payment for therapy sessions prior to their onset. The main purpose of the change was to increase the total amount of fees collected and potentially increase the number of cancellations with 24-hour notice and decrease the number of failed appointments. These variables were assessed longitudinally over a two-year time span. Results indicated that the change in fee collection procedure alone did not significantly influence these variables. Demographic and therapeutic variables were assessed to determine their relationships to number of cancelled and failed appointments. Several therapeutic variables served as significant predictors of number of cancelled and failed appointments. Frequency of contact was positively correlated with number of cancellations. Total number of sessions was positively correlated with number of failed appointments. Therapist type was significantly correlated with number of failed appointments. The findings indicated that paying for therapy prior to the session was not a more efficient payment system and that there were several therapeutic variables which served as efficient predictors of number of cancelled and failed appointments.

This study examines the transaction of the lived experience of ‘suffering’ in the process of psychotherapy. ‘Suffering’ is conceptualised as having its weight and value transacted between a psychotherapist and his or her client. As a psychotherapist from a family with a disabled member, my fieldwork in a hospital with the parents of disabled children was conducted in Taiwan. The development of our therapeutic relationship was discovered as the process of ‘suffering transaction’: the interaction of lived experience of suffering between my clients and myself. Two clients took part in this study in which eight to ten sessions of counselling or psychotherapy were conducted and transcribed as the research data. The data also included my lived experience, which was made explicit in this field work through records of six sessions of therapeutic supervision and my self-reflective therapeutic diary and research journal. Inspired by Gee’s (2000) work on data presentation, my understanding of client’s stories is represented as poetic form. Reflections from the use of reflexivity explore the inter-correlations of ‘suffering’ between us. The theoretical perspective informing the further analysis of this study is hermeneutic phenomenology and social suffering. The socio-cultural embodiments in language are explored as the hermeneutic horizons of the theme of suffering transaction. Politically, the development of ‘early intervention’ in Taiwan creates as ‘unjust’ context for those encountering medical services, and this shared understanding of the medical bureaucracy influenced the psychotherapeutic encounter. The analysis also explores the influence of Confucian approaches to gender difference and family ethics, and Christian religious beliefs, in relation to the self-identification of my clients in suffering for other. These three horizons indicate that searching for the meaning of suffering is an inter-subjective process that entails taking the responsibility for the ‘Other’ as the symbolic socio-cultural body. The thesis concludes with discussion about the ethics of the therapeutic relationship. I argue that in psychotherapy, both therapist and client are engaged in the Levinasian idea of the primordial responsibility ‘for’ the other. In the context of wider debates about psychotherapy as an ethical practice, I argue that a therapist has the pre-moral position of not only witnessing client’s lived experience of suffering but also being witnessed by the client. This study provides an example in which the context of ‘witness’ is inter-subjectively developed in psychotherapy.

In order to prepare counselor-trainees to practice competently and maximize client outcomes, counselor-trainees must develop a broader understanding and explanation, called a case conceptualization, of their clients presenting problems, personality, and systemic dynamics. There is a limited body of research that examines the effects of training on the ability for counselors to develop an effective case conceptualization. This is the first study to train counselors to develop competence in formulating an integrative case conceptualization. This quasi-experimental study aimed to determine whether an intervention had an effect on the 85 counselors in training that participated in a 2-hour training. Data was analyzed using paired sample t-tests, an independent t-test and correlation methods. Participants’ CCEF scores significantly improved from the training (t = -25.970, df = 84, ES = 3.67, p < 0.001). Participants’ CFCCM scores significantly improved as well (t = -21.693, df = 84, ES = 2.78, p < 0.001). Participants’ scores also significantly improved with their perceptions about case conceptualization (t = -30.828, df =84, ES = 5.47 p < 0.001), for items 1-5. Item 6 resulted in values of (t = -13.295, df = 84, ES = 2.14, p < 0.001). The level of cognitive complexity as measured by the CCQ did not have a significant effect on the quality of the counselors in training case conceptualizations. Compared to the CFCCM, the CCEF is a much shorter and easier instrument for evaluating a case conceptualization. Overall, results of this study provide support that counselors in training can improve their quality of case conceptualization skills in as little as 2 hours. This can aid in understanding and explaining their client’s situation better, which may significantly improve the treatment process and client. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

A quasi-experimental, between groups design was used to evaluate differences in emotional behavior, as measured by the Specific Affect Coding System (SPAFF), between professional therapists and their clients and a master therapist and his client. This coding system also was used to determine how emotional behavior shown by a master therapist changes over the course of six psychotherapy sessions. The research team recorded counseling sessions at a university counseling center in the southeastern United States and coded this video data using SPAFF in real time. Data were analyzed quantitatively to determine whether significant differences in SPAFF codes exist between the master therapist, professional therapists at the university counseling center, and their respective clients. Results indicated that the master therapist showed significantly more neutral and less negative affect than his counterparts at the university in both sessions one and four. The master therapist’s client showed significantly more neutral affect and less negative in session one and significantly more positive affect and less negative affect in session four. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2017. / FAU Electronic Theses and Dissertations Collection

The aim of the study was to measure the presence of work engagement and wellbeing among Gestalt play therapists in South Africa. A literature study was undertaken to examine the concepts of work engagement and well-being, and a conceptual framework was given of the Gestalt play therapist and the work that they do with traumatized children within the South African context. This literature study forms the theoretical framework in which the study was done. After completion of the literature study, the empirical study was conducted. The researcher made use of a biographical questionnaire and four psychometric instruments to compile research data; it is the Utrecht Work Engagement Scale, Satisfaction with Life Scale, Subjective Happiness Scale and Scales of Psychological Well-being. The data obtained was quantatively analysed, research findings were discussed and recommendations were made. The empirical data indicated work engagement and well-being to be statistically significant present in Gestalt play therapists in South Africa. / M. Diac. (Play Therapy) / Social Work

The aim of the study was to measure the presence of work engagement and wellbeing among Gestalt play therapists in South Africa. A literature study was undertaken to examine the concepts of work engagement and well-being, and a conceptual framework was given of the Gestalt play therapist and the work that they do with traumatized children within the South African context. This literature study forms the theoretical framework in which the study was done. After completion of the literature study, the empirical study was conducted. The researcher made use of a biographical questionnaire and four psychometric instruments to compile research data; it is the Utrecht Work Engagement Scale, Satisfaction with Life Scale, Subjective Happiness Scale and Scales of Psychological Well-being. The data obtained was quantatively analysed, research findings were discussed and recommendations were made. The empirical data indicated work engagement and well-being to be statistically significant present in Gestalt play therapists in South Africa. / M. Diac. (Play Therapy) / Social Work

Clinical psychology’s relevance and future viability depend on its ability to render services that are relevant and sensitive to multicultural and minority issues. Lesbian, gay, bisexual and transgendered people are one such group that professional psychology – both in South Africa and abroad - has identified as having unique treatment needs for which psychologists require specialised knowledge and skills in order to render appropriate treatment. Competence to treat non-heterosexual patients has been framed in terms of a gay affirmative paradigm which has as its basic tenet the recognition that same-gender orientation is not pathological but rather a healthy alternative to heterosexuality. From this perspective being “gay friendly” or “gay accepting” is not enough. To implement a gay affirmative approach in practice, practitioners must have resolved their possible prejudice and heterosexist bias and have the requisite knowledge of concerns unique to lesbian, gay, and bisexual (LGB) individuals to be able to apply their skills in a culturally sensitive manner. Although more American post-graduate psychology programmes are addressing sexual diversity, their failure to produce psychologists who feel competent to treat lesbian/gay or bisexual individuals has highlighted the need to develop effective training strategies based on empirical nvestigation. The dearth of comparable data about local South African psychology training prompted this inquiry which had four broad aims namely, (i) to establish to what extent trainees’ prior training had equipped them with the knowledge, awareness, and skills to approach their work with non-heterosexual patients in a gay affirmative manner, and (ii) to implement and (iii) to evaluate to what extent a brief structured training programme is effective in engaging the trainees; in increasing knowledge, in raising awareness, and in changing specific attitudes and imparting specific skills required for treating lesbian and gay patients.; and (iv) what, if any, recommendations should be made for the future with respect to training of sychologists in this area? The field of sexual orientation research has been expanded to include issues pertaining to bisexual, transgendered and intersexed people, but serious time constraints meant that issues pertaining to these groups could not be addressed in depth. Although the exclusion of these groups is problematic and may be seen as reinforcing their invisibility, it was decided to focus primarily on gay and lesbian issues s an introduction to same-sex orientation. It is envisaged that bisexual and transgender issues would be dealt with in depth in more advanced training. Nine trainee psychologists employed at hospitals in the greater Cape Town area volunteered to participate in the programme which comprised a series of two-hour experiential workshops offered once a week over six weeks. The study employed both quantitative and qualitative data analysis methods. The first stage entailed gathering information to better understand trainees’ existing level of competence. Individual interviews were conducted prior to the course to obtain data about their attitudes and perceptions regarding the need for such specialised training, and how qualified they considered themselves to be to treat LGB patients, and their experience in this regard. For the purpose of the over-all analysis information was also gathered about pertinent personal and social characteristics of the trainees, as well as their contact with lesbian/gay persons. In addition, an attitude survey and the Lesbian, Gay, and Bisexual Counselling Self-efficacy Scale (LGB-CSI) were administered to obtain benchmarks against which change could be measured. The second stage involved the implementation of the educational programme and gathering information about trainees’ responses to its various components. This stage concentrated on discovering how individual trainees reacted to material on lesbian, gay, and bisexual issues and how they used the programme to improve their self-awareness and skills. The results indicate that local psychology training might not address same-gender orientation adequately, thus reinforcing trainees’ belief that sexual orientation is irrelevant, and that their generalist training equips them to work with gay/lesbian/bisexual patients. While the training strengthened existing positive attitudes, it was less effective in changing blatant antigay prejudice. However, both quantitative and qualitative data suggest that the programme increased individuals’ awareness and insight into their previously unrecognised heterosexist biases and created greater understanding of the effects of stigmatisation on sexual minority individuals. In addition, the training increased trainee’s sense of competence to provide affirmative treatment as evidenced by the significant differences between the pre- and post-training mean scores on the Relationship, Knowledge, and Advocacy Scales and between the mid- and post-training means scores on the Assessment and Awareness Scales of the LGB-CSI. Despite the limited generalisability of these findings on account of possible sampling bias, the need and value of such training was confirmed by trainees’ recommendation that this programme should be a mandatory offering in the first year of clinical psychology training.