Haslam's (2003) folk psychiatry model asserts that laypersons use three modes of thought (explanatory modes) in explaining the behavior of individuals identified as having mental illness: moralizing, which attributes a reason (motive) - and therefore personal responsibility - for behavior; medicalizing, which attributes behavior to a biological essence outside of the individual's control; and psychologizing, which attributes a reason (motive) for behavior but also offers a cause for the reason itself, thus attenuating personal responsibility. The present research hypothesizes that 1) laypersons (mental health nonprofessionals) will have more stigmatizing reactions to a vignette protagonist who exhibits behavior characteristic of the DSM-IV-TR diagnosis Schizophrenia, compared to a protagonist who exhibits no such behavior; 2) the effect of including in the vignette information on the protagonist's adverse childhood experiences will be moderated such that it has a more stigma-reducing effect in the presence of schizophrenia symptoms that in its absence, and 3) this moderation will in turn be mediated by increases in psychologizing and decreases in medicalizing and moralizing. The design is a 2 x 2 between-participants factorial experiment with symptomatic content (schizophrenia symptoms vs. no symptoms) and childhood experiences (adverse vs. benign) as independent variables. The stigma outcome variables are likability (Scale of General Likability; Anson, in preparation) and perceptions of dangerousness (Attribution Questionnaire (AQ), Fear/Dangerousness Subscale; Brown, 2008). The explanatory modes are measured by the Medicalizing-Moralizing-Psychologizing Coding System (MMPCS), which is introduced in the present study. Results show that schizophrenia symptoms increased perceptions of dangerousness and medicalizing, and reduced moralizing. Adverse childhood experiences increased perceptions of dangerousness and psychologizing, and reduced medicalizing. The predicted moderation effect did not reach significance. The predicted mediation effects were not observed. Findings suggest that efforts to reduce mental illness stigma by providing information about adverse childhood experiences may have the ironic effect of increasing fear and perceptions of dangerousness. Additional implications are discussed and a program of future research is proposed. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2013. / November 20, 2012. / Adverse Childhood Experiences, Folk Psychiatry, Medicalizing, Mental Illness Stigma, Moralizing, Psychologizing / Includes bibliographical references. / Tomi Gomory, Professor Directing Dissertation; E. Ashby Plant, University Representative; Neil Abell, Committee Member.

Using family stress theory, the influences of parenting daily hassles, family coping, sibling warmth, parenting stress, and sense of coherence were examined for their predictive qualities in determining quality of life for mothers of children who have Attention Deficit Hyperactivity Disorder (ADHD). A predictive model was developed using the ABC-X model of family stress. A survey design was used with a sample of 103 mothers. The analysis was conducted using path analysis. For the participants in this study, sense of coherence had the greatest total effect on quality of life, followed by family coping, and parenting stress. Sibling warmth was not found to have a direct relationship with quality of life, but did have an overall effect when mediated by sense of coherence and parenting stress. Overall, this model fit well with the observed data and thus supported the research question for this study; specifically, parenting daily hassles, family coping, sibling warmth, parenting stress, and sense of coherence can be integrated to predict quality of life for mothers of children who have ADHD. This model explained 19% of the variance in quality of life. Pertinent related findings were also discussed relevant to commonly used coping strategies, most frequent and intense parenting daily hassles, and top factors in the sibling relationship. Mothers in the study used passive coping strategies most often in dealing with stressors, and employed more internal coping methods than external coping methods. Mothers were most concerned with and wanted the most help in dealing with arguments, anger, and hostility in the sibling relationship. An exploration of the qualitative parental responses revealed difficulties in accessing support systems. Parents expressed a lack of understanding of ADHD by schools and communities. Suggestions for future research and professional practice were also provided. / A Dissertation submitted to the Department of Family and Child Sciences in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2010. / March 26, 2010. / Quality of Life, Sibling, Sense of Coherence, ADHD, Stress, Attention Deficit Hyperactivity Disorder, Parental Stress / Includes bibliographical references. / Carol A. Darling, Professor Directing Dissertation; F. Donald Kelly, University Representative; Christine A. Readdick, Committee Member.

In the pharmacological treatment of psychotic disorders, evidence-based treatment recommendations suggest the prescription of one antipsychotic (monotherapy) where possible. The simultaneous co-prescription of multiple antipsychotics, known as antipsychotic polypharmacy (APP) has recently been the subject of much discussion and research in the scholarly literature. There are concerns regarding the cost, lack of efficacy, and iatrogenic potential of APP. This study examines clinical and demographic variables related to the prescription of APP among 267 state hospital inpatients. APP was operationalized as co-prescription of ''2 antipsychotics for ''60 days. Inpatients were categorized as recipients of either APP or monotherapy. Monotherapy and APP groups were then compared descriptively across demographic and clinical variables. Demographic variables included age, race, education, and marital status. Clinical variables included seclusion and restraint incidents, number of lifetime admissions, and medical comorbidity, as well as PANSS and GAF scores. There were 95 patients (35.6%) who had at least one episode of APP. There was no clinically significant association between polypharmacy status and race, age, or PANSS scores. Patients prescribed multiple antipsychotics were more likely to be male (OR=2.57), to have been hospitalized over a year (OR=3.12), to have never been married (OR=1.69), and to have ''1 career incident of seclusion and restraint (OR=2.46). Diagnoses of hyperlipidemia (OR=1.5) and adverse neurological effects (OR=1.54) were also associated with an increased risk of APP. Overall, these findings suggest that antipsychotic polypharmacy is a highly individualized treatment decision not well explained by the available clinical and demographic variables. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Summer Semester, 2008. / June 2, 2008. / Includes bibliographical references. / Tomi Gomory, Professor Directing Dissertation; Bruce Bullington, Outside Committee Member; C. Aaron McNeece, Committee Member.

People receiving residential mental health treatment are legally entitled to exercise their rights and freedoms to the extent that is safe and that does not interfere with recovery (Americans with Disabilities Act, 1990; Ford, Rosenberg, Holsten, & Boudreaux, 2003). Despite this, sexual activity in residential treatment settings is often prohibited through both formal and informal means (Buckley, Hogan, Svendsen, & Gintoli, 2013; Wright, McCabe, & Kooreman, 2012). One barrier to lessening restrictions on the sexual liberties of residential clients is the lack of guidelines for determining the capacity to consent to sexual activity (Buckley & Wiechers, 1999; Parker & Abramson, 1995). Providing guidelines for assessing the capacity to consent could provide opportunities for some clients to engage in dignified sexual expression and could help practitioners to identify others who may not be capable of making safe sexual decisions. In a preliminary step toward the creation of such guidelines, this qualitative study explores how administrators, staff, and former clients of residential facilities define and conceptualize the capacity to consent to sex. These stakeholder-endorsed definitions might later serve as frameworks from which guidelines and methods of assessment could be developed. This study also explores factors identified by administrators, workers, and former clients of residential facilities as impacting the capacity to consent, as they define it. This is another important preliminary step toward creating best practices for determining the capacity for sexual consent among clients of residential mental health programs. Nonprobability sampling was used to recruit 15 participants, 5 from each stakeholder group: administrators, staff people, and former clients. An in-person, semi-structured interview with each participant was conducted. Interviews averaged 69 minutes and elicited information about how participants define and conceptualize the capacity to consent to sexual activity as well as the factors perceived to enhance or reduce that capacity. Analysis of interview data used a hierarchical coding process based on Strauss and Corbin's (1990) constant comparative method and Scott's (2004) conditional relationship guide. To enhance the rigor of analysis, a variety of reflexive writing practices were used, and researcher analysis was shared with participants, who were invited to provide statements about where the analysis diverged from their opinions and experiences. The common themes observed in participant definitions of capacity for sexual consent were that capacity for consent includes the ability to give and receive communication about consent, that capacity for consent includes an understanding of contextual information about the sexual encounter, and that capacity for consent includes an understanding of one's own internal desires. Factors identified by stakeholders as affecting residential clients' capacity for sexual consent were intelligence or sexual knowledge, intoxication, confusion, delusions, general mental status, difficulty refusing others, having vacillating feelings about sexual encounters, and using sex as a tool. Participants considered many of these factors transient, indicating that capacity to consent is not viewed as a stable trait. In addition to information directly pertinent to the research aims, stakeholders identified several practical barriers to allowing sex in residential treatment settings. These include the perceived responsibility of providers for the consequences of sex, the lack of private space, the potential to disrupt the treatment environment, and the potential for sex to result in retraumatization or interfere with recovery. This work concludes with recommendations for practice and further research. In particular, the definitions of capacity for sexual consent identified by participants in this study should be evaluated by a representative group of stakeholders in residential mental health to determine their salience and legitimacy more broadly. Further, factors proposed to enhance or reduce the capacity for consent in the study should be empirically investigated to determine whether they do have actual impact on sexual decision making. / A Dissertation submitted to the College of Social Work in partial fulfillment of the Doctor of Philosophy. / Spring Semester, 2015. / March 2, 2015. / capacity to consent, mental health, psychiatric social work, sexual behavior / Includes bibliographical references. / Tomi Gomory, Professor Directing Dissertation; Amy Burdette, University Representative; Jean Munn, Committee Member; LaTonya Noël, Committee Member.

Intimate partner violence (IPV) is estimated to affect over 1.3 million women a year and costs society more than $5.8 billion annually (Centers for Disease Control and Prevention, 2003). Extensive evidence indicates that men and women perpetrate IPV at similar rates (Fiebert, 2010) and a large portion of IPV involves perpetration by both partners in a couple unit (Kessler, Molnar, Feurer, & Appelbaum, 2001). These findings have created a contentious debate among researchers about the nature of IPV and utility of gender in understanding its dynamics. Family conflict theorists contend that IPV is used as an outgrowth of conflict and that societal and family characteristics explain the high rates of IPV perpetration for men and women (Fiebert & Gonzalez, 1997, Straus, 2010). Meanwhile, feminist theorists focus on the role that control plays in understanding violence and how control intersects with gender to create a culture of terror (Stark, 2007) and contend that methodological issues account for the high prevalence of gender symmetry (Kelly & Johnson, 2008). A typology of IPV, which assumes that violence is not used in intimate relationships for one static reason, asserts that there are different categories of IPV that occur within intimate partner relationships and failure to specify the category of IPV being explored has led to confusing and uninterpretable empirical findings regarding the rates of IPV and gender (Kelly & Johnson, 2008). The purpose of this research was to bridge these theories by advancing the typology of IPV perspective using a gender and racially robust sample and identifying the correlates and consequences of each category. Intimate partner violence (IPV) is estimated to affect over 1.3 million women a year and costs society more than $5.8 billion annually (Centers for Disease Control and Prevention, 2003). Extensive evidence indicates that men and women perpetrate IPV at similar rates (Fiebert, 2010) and a large portion of IPV involves perpetration by both partners in a couple (Kessler, Molnar, Feurer, & Appelbaum, 2001). These findings have created a contentious debate among researchers about the nature of IPV and utility of gender in understanding its dynamics. Family conflict theorists contend that IPV is used as an outgrowth of conflict and that societal and family characteristics explain the high rates of IPV perpetration for men and women (Fiebert & Gonzalez, 1997; Straus, 2010). Meanwhile, feminist theorists focus on how control intersects with gender to create a culture of terror (Stark, 2007) and contend that methodological issues account for the high prevalence of gender symmetry (Kelly & Johnson, 2008). A typology of IPV, which assumes that violence is not used in intimate relationships for one static reason, asserts that there are different categories of IPV that occur within intimate partner relationships and failure to specify the category of IPV being explored has led to confusing and uninterpretable empirical findings regarding the rates of IPV and gender (Kelly & Johnson, 2008). The purpose of this research is to bridge these theories by advancing the typology of IPV perspective using a gender and racially diverse sample and identifying the correlates and consequences of each category. This research tested a theory of IPV at the relationship level, conceptualizing categories of IPV as occurring from the interaction of individual behavior within a relationship, forming 10 unique categories. An analysis of secondary data was used; the data were originally collected by Dutton, Goodman, and Schmidt (2006) to develop and validate a measure of nonviolent coercive control under a project entitled "Development and Validation of a Coercive Control Measure for Intimate Partner Violence", which was funded by the National Institute of Justice (Award number 2001-WT-BX-0503). The original sample consisted of 757 participants who were recruited from several locations, which was reduced to 714 participants through data cleaning procedures. Individuals completed a survey which included questions about their own perpetration of violence and control, victimization by violence and control, levels of social/relationship related constructs, mental health related outcomes, and demographic characteristics. Cluster analyses, chi-square tests of independence, multinomial logistic regressions, and multigroup path analyses were used to test the hypotheses. Cluster analyses indicated that elements of IPV (control perpetration, control victimization, violence victimization and violence perpetration) all clustered in a high/low pattern, which intersected to form six unique categories of IPV in addition to the no-IPV category. Chi-square tests of independence indicated that distributions of these categories of IPV were dependent on gender but independent of race. A multinomial logistic regression found that each category of IPV was predicted by a unique combination of demographic and social/relationship variables, and interactions between race, gender, and socioeconomic status to account for intersectionality theory were not useful in the retained model. Finally, a multigroup path analysis revealed that levels of PTSD and depression were higher for individuals in relationships with IPV than without IPV. This research provides empirical support that IPV as previously described and identified by two seemingly competing theoretical orientations exists simultaneously. Support for the FCTs perspective was found because the majority of violence that existed in relationships was bidirectional, suggesting an association with conflict. Several categories of IPV were control-related, in line with feminist theories; most notably a unique category of intimate terrorism was affirmed that could not be explained by any demographic characteristics. This research found support for all four categories of IPV identified under Johnson's (2008) typology of IPV, but also found the presence of two control-related categories: situational control and control resistance. Interpreted cautiously in lieu of the limitations of the study, this new typology of IPV provides a comprehensive framework for understanding the range of violent and controlling experiences within relationships, and gives social workers a common language to describe the variety of IPV present within their client systems which can be used to guide the development and implementation of more responsive treatment modalities. Cluster analyses indicated that elements of IPV (control perpetration, control victimization, violence victimization and violence perpetration) all clustered in a high/low pattern, which intersected to form six unique categories of IPV in addition to the no-IPV category. Chi-square tests of independence indicated that distributions of these categories of IPV were dependent on gender but independent of race. Each category of IPV was predicted by a different combination of demographic and social/relationship variables, and interactions between race, gender, and socioeconomic status to account for intersectionality theory were not useful in the retained model, as indicated by a series of multinomial logistic regressions. Finally, a multigroup path analysis revealed that levels of PTSD and depression were higher for individuals within each category of IPV in comparison to the no-IPV reference group. This research provides empirical support that IPV as previously described and identified by two seemingly competing theoretical orientations exists simultaneously. Support for the FCTs perspective of IPV was found because the majority of violence that existed in relationships was bidirectional, suggesting an association with conflict. Several categories of IPV were identified that were control related, in line with feminist theories; most notably a unique category of intimate terrorism was identified that could not be explained by any demographic characteristics, suggesting there is a type of IPV that cuts across all social identities and is used to maintain power and control in a relationship. This research found support for all four categories of IPV identified under Johnson's (2008) typology of IPV, but also found the presence of two control-related categories: situational control and control resistance. Interpreted cautiously in lieu of the limitations of the study, this new typology of IPV provides a comprehensive framework for understanding the range of violent and controlling experiences within relationships, and gives social workers a common language to describe the variety of IPV present within their client systems which can be used to make decisions about treatment. / A Dissertation submitted to the College of Social Work in partial fulfillment of the Doctor of Philosophy. / Spring Semester, 2015. / April 7, 2015. / domestic violence, feminist theory, gender symmetry, intimate partner violence, typology of intimate partner violence / Includes bibliographical references. / Dina J. Wilke, Professor Directing Dissertation; Joyce Carbonell, University Representative; Melissa Radey, Committee Member; Stephen J. Tripodi, Committee Member; Philip Osteen, Committee Member.

Adoption has changed dramatically in the United States. Recent federal legislation, such as the Adoption and Safe Families Act of 1997, has opened the doorway to an unprecedented increase in the number of foster children eligible for adoption. This has subsequently increased the number of studies on adopted children with special needs (Reilly & Platz, 2003; Smith & Howard, 1999). This research has been dominated by studies whereby adopted children with special needs—which includes but is not limited to those children with histories of abuse and neglect, medical conditions, minority status, older placement age, sibling placement, and learning challenges—are lumped together as one group (Haugaard, 1998; Simmel, 2002). Missing from these studies is a clear understanding of which subgroups are more at risk for unsuccessful adoption outcomes, which variables contribute to adoption risk, and which variables can potentially enhance adoption outcomes. As an unintended consequence of this trend, preadoption and postadoption services are informed by an incomplete knowledge base from which to develop the most effective interventions. The purpose of this study was to address this gap in the adoption research by exploring preadoptive sexual abuse in general and the impact of preadoptive sexual abuse on adopted boys in particular. In doing so, this study also responded to Erich and Leung's (2002) caveat that the "extent of empirical research involving postadoptive placement of those children with a history of sexual or physical abuse remains grossly insufficient" (p. 1046). This study was based on the first wave of data collected through the Florida Adoptive Families study, a longitudinal look at characteristics that allow placements with adoptive families to be permanent, successful, and beneficial for the children and families. This study was guided by the research on preadoptive sexual abuse, the sexual abuse of boys research, the Sexual Abuse of Males model (Spiegel, 2003), and the concept of Restrictive Emotionality described in gender role conflict theory (O'Neil, 1981; O'Neil, Good, & Holmes, 1995; O'Neil, Helms, Gable, David, & Wrightsman, 1986). This study had two purposes. The first purpose described, based on parental report, the extent of preadoptive emotional and behavioral needs, postadoptive externalizing behavior problems, and placement risk among approximately 116 adopted boys with preadoptive histories of sexual abuse compared to approximately 287 non–sexually abused adopted boys between the ages 6 and 18. The second and primary purpose of this study explored the moderating and mediating effects of the parents' perceptions of the boys' strengths in Emotional Exchange (i.e., the ability to express feelings, identify feelings, and reciprocate feelings) and Emotional and Behavioral Regulation on Preadoptive Adjustment and Externalizing Behavior. Multiple imputation and generalized estimated equations were used to enhance the confidence in the validity of the statistical results. A number of compelling findings were revealed. Adopted boys with preadoptive histories of sexual abuse presented with higher levels of Preadoptive Adjustment needs and Externalizing Behavior compared to their non–sexually abused, adopted male peers. As a preadoptive risk factor, adopted boys with preadoptive sexual abuse histories were at greater adoption placement risk compared to adopted boys with physical abuse histories, neglect and/or abandonment histories, or no histories of abuse. The moderating analyses indicated that adopted boys with sexual abuse histories who present with high levels of Preadoptive Adjustment needs and lower levels of Emotional Exchange (i.e., deficits in expressing feelings, identifying feelings, and reciprocating feelings) are at risk for escalated Externalizing Behavior. In addition, Emotional Exchange and Emotional and Behavioral Regulation partially mediated the association between Preadoptive Adjustment needs and Externalizing Behavior. In other words, adopted boys with sexual abuse histories who had elevated levels of Preadoptive Adjustment needs displayed fewer Externalizing Behavior problems, partly as a result of their ability to identify feelings, express feelings, reciprocate feelings, and regulate emotions and behaviors. Although the results suggest that adoptive parents may be overcome with the complex array of adoption adjustment problems experienced by boys with sexual abuse histories, the findings also suggest a pathway to hope for these families. The implications of how preadoption and postadoption services could help support these families are discussed. Adoptive parents may hold the key to helping to facilitate the Emotional Exchange and Emotional and Behavioral Regulation abilities of their sons, heal the wounds of sexual abuse, and ultimately foster successful placement experiences. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2006. / February 17, 2006. / Externalizing Behavior, Emotions, Adoption Adjustment, Preadoption Services, Male Gender Role Socialization, Postadoption Services, Sexual Abuse Of Boys / Includes bibliographical references. / Scott D. Ryan, Professor Directing Dissertation; Joyce Carbonell, Outside Committee Member; Neil Abell, Committee Member; Jim Hinterlong, Committee Member.

Following the 2007 death of Baby Peter, the British Government commissioned an inquiry and subsequent report that recommended comprehensive reforms to social work practice and education. Successful educational reform has been linked to positive attitudes on the part of those individuals tasked with its implementation, attitudes influenced by a variety of personal and organizational cultural factors. This study surveyed social work educators in England ahead of implementation of the reforms, to assess the relationship between their attitudes and intentions towards those reforms, modeled on Ajzen's Theory of Planned Behavior. As predicted, attitude positively predicted intent. Data also showed that female social work educators had more positive attitudes and intentions towards the reforms than did their male counterparts. There was no evidence to suggest that chronological age, number of years' experience teaching in higher education, or the academic associations of the higher educational institution at which the educators worked influenced attitude or intent. The generally positive attitudes and intentions expressed by many educators may suggest relatively successful reform implementation when it occurs. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2014. / February 14, 2014. / Education, England, Reform, Social Work / Includes bibliographical references. / Dina Wilke, Professor Directing Dissertation; Sherry Southerland, University Representative; Nicholas F. Mazza, Committee Member.

Often considered the greatest of losses, a parent is never prepared for the death of a child. In addition to the unimaginable loss, there are practical issues that must be addressed, such as dealing with the belongings of the child. A study of spousal bereavement found that the way widows viewed the belongings of a spouse was related to complicated grief. The Dual Process Model of grief holds that bereaved people oscillate between a loss orientation and a restoration orientation as they deal with the death of a loved one and that this oscillation is a predictor of complicated grief. It was hypothesized that the significance that bereaved parents place on their child's belongings is a partial proxy of loss orientation. The Inventory of Daily Widowed Life was modified to apply to the death of any loved one and was used to measure oscillation. With the sample of bereaved parents, we found that oscillation explained 44% of the variance in scores on the Inventory of Complicated Grief after controlling for other known risk factors. A second analysis was performed, removing oscillation and using the subscale for restoration orientation and a measure of the significance of belongings. This model explained 39% of the variance in complicated grief after controlling for other known risk factors. This research suggests that the significance that parents place on the belongings of their deceased child may provide insight into the potential for complicated grief. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2014. / April 3, 2014. / Belongings, Bereavement, Child, Dual Process Model, Grief, Parent / Includes bibliographical references. / Neil Abell, Professor Directing Dissertation; Sally Karioth, University Representative; Nicholas F. Mazza, Committee Member; Bruce Thyer, Committee Member.

Financial management literature suggests that individuals manage money entering the household in a variety of ways which may be shaped by family composition. This dissertation addresses the influences of marital status, children and grandchildren residing inside and/or outside of the home, and gender on financial decision making. Two aspects of making financial decisions, psychological and sociological, serve as the focus of the study. Both of these important characteristics of making financial decisions were measured utilizing the National Endowment for Financial Education's Life Values study which characterizes psychological aspects as Inner Life Financial Values and sociological aspects as Social Life Financial Values. It was hypothesized that individuals in non-committed relationships, individuals with children or grandchildren residing outside of the home, and men with children or grandchildren outside of the home would demonstrate higher levels of Inner Financial Life Values. It was also hypothesized that individuals in committed relationships, individuals with children or grandchildren residing inside of the home, and women with children or grandchildren inside of the home would demonstrate higher levels of Social Financial Life Values. Results were analyzed utilizing one-way analysis of variance. Post hoc analyses were also examined. With respect to Inner Financial Life Values, results indicated significant differences between groups. This research suggests that psychological aspects of financial values may differ for individuals in committed relationships (i.e. married or living with a partner) as compared to individuals who are in non-committed relationships (i.e. divorced or have never been married). Additionally, the addition of children within a committed relationship may further contribute to the shaping of psychologically-based financial values. An examination of Social Financial Life Values indicated no significant differences between groups. A lack of differences between groups may be indicative of a reliance on social supports, such as extended family and friends, for individuals in non-committed relationships. Further examination of this measure is warranted. / A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy. / Spring Semester, 2014. / April 1, 2014. / Couples, Financial Decision-Making, Financial Management, Financial Therapy, Household Composition, Marriage / Includes bibliographical references. / Thomas E. Smith, Professor Directing Dissertation; David R. Peterson, University Representative; Bruce A. Thyer, Committee Member; Jean Munn, Committee Member.

This dissertation explored the associations between the degree of congruence between therapist and client perceptions about specific sources of power in individual therapy and the quality of the therapeutic relationship. Power bases were conceptualized as being either state-dependent (therapy-specific) or trait-dependent (extratherapeutic). I hypothesized that the more congruent the perceptions of the therapist's and client's therapy-specific and extratherapeutic power, the better the quality of the therapeutic relationship. Adults currently in the working stage of voluntary outpatient therapy and their corresponding therapists completed surveys about the therapist's and client's therapy-specific and extratherapy power bases (N = 47 dyads). The survey packets consisted of modified versions of the Interpersonal Power Inventory (Raven et al., 1998; Anderson, 2008), single-item indicators for extratherapeutic bases (likability, age, intelligence, sex/gender, and race/ethnicity), the Working Alliance Inventory-short version (Horvath & Greenberg 1989; Tracey & Kokotovic, 1989), and supplemental demographic questions. I used difference scores to calculate each dyad's levels of congruence. Results showed no significant correlations between congruence on client or therapist therapy-specific harsh or soft power bases and the quality of the therapeutic relationship. Statistically significant negative correlations existed between congruence on therapist age, intelligence, sex, and the quality of the therapeutic relationship. Statistically significant negative correlations existed between congruence on client age, intelligence, and the quality of the therapeutic relationship. Multiple regression models showed several trends. The model with congruence on therapist power as predictive of the quality of the therapeutic relationship was statistically significant. Congruence on therapist therapy-specific harsh and soft power bases were not significant predictors of quality. The congruence about all extratherapy power bases was a significant (negative) predictor in the models, and when examining the bases individually, congruence on therapist age was a significant negative predictor of quality only when including the client's length of treatment in the model. Models run with congruence on client power as predictive of the quality of the therapeutic relationship were not statistically significant. Congruence on client therapy-specific harsh and soft power bases were not significant predictors of quality. The congruence about all extratherapy power bases was a significant (negative) predictor in the models, but when examining the individual bases, none were significant predictors of the quality of the therapeutic relationship. Findings from this study supported future inquiry into congruence on perceptions of power and the quality of the therapeutic relationship, especially concerning extratherapy power bases. Future researchers should consider a longitudinal design with a larger, more diverse sample to enhance generalizability. Through awareness of how such power resources influence the process of therapy, therapists can help build a better relationship and in turn, better client outcome. / A Dissertation Submitted to the College of Social Work in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy. / Summer Semester, 2011. / June 27, 2011. / Therapy, Counseling, Social Work, Direct Practice / Includes bibliographical references. / Stephen Tripodi, Professor Directing Dissertation; Nicholas Mazza, Committee Member.