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Research suggests that internalization of the therapeutic relationship promotes a continuation of psychological development in between psychotherapy sessions and after termination. This study explored whether clients being treated by therapists adhering to different therapeutic modalities internally represent their therapists in significantly different ways. The study consisted of an online survey of 212 individuals who had undergone therapy in the past two years, and included questionnaires regarding the nature of their internal representations of their therapists and working alliance with their therapists. The study provided evidence in support of the hypothesis that there are indeed some modality-informed differences in internal representations of therapists, particularly in the themes and affects associated with internalizations.

In this study, I explored marriage and family therapist interns' growth experiences, both personal and professional, and the interplay between them. Participants discussed, using Internet discussion board and chat room formats, different kinds of personal experiences that influenced their clinical growth (as well as the reverse) and how these growth processes came about. Family systems theory provided the theoretical framework and Constructivism theory guided the manner in which the study was conducted. Thirteen marriage and family therapist interns from ten accredited MFT programs participated in the discussion board portion of the study. During the chat room interview, which took place at the end of the study, four participants elaborated upon their growth experiences and the reciprocal influence between their personal and professional lives. This study highlighted numerous personal, clinical, and professional growth experiences that played significant roles in the participants' lives. Participants identified experiences that were categorized as either "sources of growth" (what led to growth?) or "kinds of growth" (how did they grow?). For example, personal therapy and work experiences were noted as influential sources of growth for their clinical work. Family Systems Theory, whether discussed in a classroom setting or implemented in the clinic room, was considered influential on their personal lives. Participants' mentioned various kinds of personal and clinical growth experiences such as self-awareness, perspective-taking, and open-mindedness. To conceptualize and illustrate therapist interns' recursive growth processes, a theoretical model was developed. / Master of Science

The purpose of this research was to explore what women who are, or have been, in therapy for an eating disorder find helpful about that therapy. Since the perspectives and voices of women in therapy are largely absent from the treatment literature, participants were asked to talk about their experiences in therapy, particularly those aspects they identified as helping them change in desirable ways. In-depth interviews were conducted with nine women and one therapist who treated each of them individually. Qualitative methods of analysis were employed that privileged the voices of participants and used the therapist's comments to add depth to the understanding of the results. The results of this research are organized to help clinicians arrange their thinking about how to work with clients who have eating problems. Five categories, or aspects, of helpfulness were created: relationship aspects, self of therapist aspects, within therapy aspects, outside therapy but related to treatment aspects, and having nothing to do with therapy aspects. Participants' voices are used to add depth and details to each of these aspects. Suggestions for therapists are included. / Ph. D.

Premature termination is a substantial problem with significant adverse effects for clients, therapists, and treatment organizations. Unfortunately, it is also a relatively common phenomenon within mental healthcare settings. Across varied mental healthcare settings, rates of premature termination have reportedly ranged from 19.7 % to 40 %. Perhaps not surprisingly, the rate of premature termination in training clinics is substantially higher than in community mental health settings and private practice, with 75 to 80 % of clients ending treatment services prematurely. The purpose of this study was to explore the combined effect of intake therapist continuity or discontinuity, and quality of the therapeutic relationship on premature termination. Intake therapist continuity, measures of working alliance, and termination outcome from 524 clients at the University of North Texas Psychology Clinic were utilized for adults receiving individual therapy services between August 2008 and August 2013. Results of the study suggest intake therapist continuity did not predict subjective termination status (X2(2, n = 524) = 1.61, p = 0.45), nor did it predict change in symptomology status (X2(3, n = 453) = 1.14, p = 0.77). Additionally, working alliance predicted subjective termination status (X2(6, n = 212) = 21.17, p < 0.01), but not change in symptomology status (X2(9, n = 208) = 6.27, p = 0.71). The findings of the current study are discussed, as well as suggestions for further research related to client, therapist, treatment, and procedural variables and their impact on premature termination.

Le « child-therapist » évoque un enfant qui sacrifie son psychisme et ainsi son développement pour la survie du système familial. Cette thèse cherche à explorer son vécu et à mieux comprendre ce qu’il vit. A travers la méthode d’observation et une analyse utilisant la méthode d’IPA (Interpretational Phenomenological Analysis), je questionne son développement psychique, sa mentalisation et la colère latente qu’il peut ressentir envers ses parents. Cette recherche a révélé que certains child-therapists se développent à travers un conditionnement, c’est-à-dire à partir des tâtonnements vers des comportements désirés, ainsi que des comportements qui réduisent les tensions au sein de la famille. Aussi, en présence de ses parents, il démontre de fausses capacités de mentalisation. Enfin, sans exception, il porte une colère envers ses parents défaillants. Cette recherche a donc élucidé le fonctionnement mental du child-therapist. / The child-therapist speaks of a child who sacrifices his own psychical development for the survival of his or her family. This dissertation sets out to understand the mind of the child. Using the observational method and the IPA (Interpretational Phenomenological Analysis) to analyse the data,I set out to investigate his or her development, his or her mentalization capacities and a latent anger that he or she could harbour towards his or her parents. This research showed that the child develops through a form of conditioning. In addition, he or she exhibits false mentalization capacities, but only in the presence of his or her parents. Lastly, the child holds anger and resentment towards his parents that failed him or her. This study helped shed light on the mind of the child-therapist.

Constraint-induced movement therapy (CIMT) has been demonstrated to yield functional improvements for children with spastic hemiplegic cerebral palsy (CP); however, many studies have reported inconsistent findings with regards to the extent of the benefits observed following the intervention. This study sought to examine the effects of CIMT in the context of a day camp in this population; it also examined the child-therapist (C-T) interaction during the assessment sessions as a potential factor influencing the child’s scores on tests of motor performance. This interaction has not yet been formally measured in the literature, and may influence the perceived outcomes of CIMT. Motor Outcomes: Results demonstrated significant improvements in quality of use of the upper extremity following the intervention; the improvements were maintained at the 3-month follow-up. Analysis of each individual participant yielded additional information on clinically significant improvements. C-T Outcomes: Results demonstrated that the strength of the C-T interaction was significantly and positively correlated with the scores obtained by participants on motor assessments. The results of this study indicate that modified CIMT is effective in inducing lasting and meaningful changes in children with spastic hemiplegic CP. They also suggest that the C-T interaction may contribute to a participant’s performance during the assessment session, which may ultimately affect the perceived outcomes of CIMT. / UOIT

The purpose of this study was to explore whether and in what ways an intensive eight-week Mindfulness-Based Symptom Management (MBSM) program might shape the therapeutic experiences of therapists. I used a hermeneutic phenomenological approach to interview and develop in-depth descriptions of four therapists’ experiences in relation to mindfulness and their therapeutic practices. The data collection consisted of: (1) a telephone screening interview; (2) pre-mindfulness training interview; (3) post-mindfulness training interview; (4) field notes based on my observations, subjective experiences, and beginning analyses; (5) and member-checks to verify the accuracy of my interpretations of participants’ interview responses. The results pointed to several common themes indicating the changes therapists described after participating in the mindfulness program. Themes denoting the reported changes were organized into three categories: (1) personal relationship with mindfulness; (2) relationship between mindfulness and therapeutic experiences; and (3) mindfulness-oriented interventions performed in therapy. The findings indicated that mindfulness training is associated with the enhancement of important relational attitudes and skills of therapists, including more acceptance of where clients are at, more presence in therapy, increased capacity to listen, openness and curiosity, and more compassion and empathy. In addition, mindfulness training may be linked to improved reflexive abilities, which has implications for more intentional and ethical decision-making in therapy. Further, the findings also indicated that mindfulness training may be linked to improvements in emotion regulation by decreasing stress, increasing feelings of relaxation and calmness, improving awareness of negative emotional and cognitive states as well as the ability to interrupt these negative cycles. As such, this study pointed to several potential benefits for the inclusion of mindfulness training in therapists’ self-care practices as well as in therapist education.

One of the goals for physical therapist graduates of professional entry-level education programs is development of the ability to practice effectively in the present health care environment. Another goal is for graduates to develop the ability to continue to learn and grow as professionals throughout their careers, and to contribute to the evolution of their profession in the future. The clinical reasoning and associated experiential learning of new graduates can be viewed as a practical demonstration of both of these goals. This research explored student physical therapists? understanding and learning of clinical reasoning during their professional entry education. / PhD Doctorate

Although music therapy work with families has been documented for many years, the focus has remained on techniques and client outcomes rather than therapeutic process. The purpose of this study was to gain understanding and knowledge of the lived experience of music therapists who practice family-based music therapy. This research was conducted within the interpretative phenomenological framework. Three subjects who provided family-based music therapy participated in semi-structured interviews about their experiences. Three main interpretative themes emerged from the analysis of the data relative to the therapists’ expressed experience of their work with families: perseverance, resilience, and faith in the process. Discussion of the results, strengths and limitations of the study, and implications for training and further research are presented. / February 2016