This research is a qualitative art-based case study exploring the facilitation of resilience through the observation of a resiliency-building art therapy group with adolescents. The researcher was the subject and utilized both direct and participant observation of a ten-week resilience-based art therapy group to gain a better understanding of how an art therapy group in a school setting is run. Reflective art making that mirrored the art directives given in the group were incorporated by the researcher to gain a deeper and more personal understanding of the resilience building process. The literature review covers a broad range of resilience and a variety of methods for observing therapy. The weekly art directives were based on the resilience literature and designed to develop personal strengths, self-discovery, communication, self-reliance, problem solving, flexibility, and future planning. Themes identified within the analysis include: flexibility, structure, anxiety, cohesive relationships, and creativity. The researcher found that flexibility in the co-facilitators and structure in the art therapy program are key elements in a successful group. Through this study the researcher identified the usefulness of direct and participant observation of therapy for developing clinical skills and highly recommends both be included in therapeutic training programs.

This study discusses the intergenerational impact of mass incarceration on families. The general literature repeatedly described the negative effects of mass incarceration among children who have an incarcerated parent by pointing to the difficulty of educational attainment, social exclusion, stigma, substance abuse, and the exacerbation of mental health issues such as depression, anxiety, and antisocial behavior (Kjellstrand & Eddy, 2011; Miller & Barnes, 2015; Turney, 2014). Unfortunately, most incarcerated individuals are parents and most incarcerated women are mothers (Scudder, A., et al., 2014, and Miller, et al., 2014). Through the use of art, service providers (artists, clinicians, etc.) that facilitate parent based programs in correctional facilities or re-entry programs can alleviate the trauma caused by incarceration that affect the emotional and mental well-being of families. Two organizations that provide art programs to incarcerated parents participated in a qualitative study about the effective use of art in their programs. Themes from the interviews discussed the value of cultural humility, as well as the role of social justice and restorative justice frameworks when providing art-based programs for parents. The lack of trust, compassion, and empathy were barriers in the process of delivering services to families. Since the creative process is inherently inclusive and actively engages its participants (e.g., therapists, patients, observers), the results of this study point to art creation as a vehicle that promotes trusts and supports family relationship restoration in order to intercept the cycles of intergenerational trauma.

This qualitative case study explores the long-term effects of domestic violence through the lens of art therapy treatment. The study is based on a twelve-week long art therapy treatment group for women who have experienced domestic violence. The study includes a literature review and a qualitative analysis of the participants’ artwork and details of their experiences of domestic violence related trauma. The research focuses on two participants and utilizes textual and visual analysis to identify four emergent themes: Family and identity, hope in moving forward, support and connection, and freedom. The findings discuss the value of art therapy in revealing coping skills, strengths and internalized fears related to domestic violence trauma. The women in the study illuminate an increase in awareness of internal resources and hopeful narratives for healing. The study demonstrates the potential of art therapy to make visible the long-term effect of domestic violence, and assist in the treatment of survivors.

Family and Adolescent Balanced Education and Leisure Occupations (FABELO) is a training program designed for occupational therapy practitioners (OTP) who work with learning-disabled adolescents in school and community settings. BACKGROUND: Adolescents with a learning disability are often missing opportunities to engage in play and leisure as essential occupations. The results can be detrimental to sense of freedom, independence, autonomy, self-confidence, meaning, ability to socialize, response to stress, and perceived quality of life. Parents and caregivers may lack awareness of how to address this occupational deficiency. The author’s aim in this project is to pilot-test a prototype program designed to train OTPs to incorporate therapeutic group intervention (TGI) into service provision with clients. OBJECTIVES: By participating in the author’s project, OTPs will learn to incorporate TGI inter-family transactional techniques into their practice that will empower adolescent clients and their parents or caregivers to embrace expanded leisure and recreational possibilities, thus leading to achievement of goals in areas of mental health, well-being, and life satisfaction. METHOD: Evaluation of this single group pilot program with 6–8 carefully selected OTPs is non-experimental. Program delivery will take place through a secured online platform with teleconferencing capabilities. Instruction over 6 weeks will incorporate a training manual, demonstration videos, prompted role-playing exercises, and discussions. Quantitative data will be collected via Likert-style survey questions and performance rating. Short answer survey questions and focus group discussion will yield qualitative information. ANTICIPATED FINDINGS: Findings based on quantitative data will yield a preliminary indication that desired changes have occurred in OTPs knowledge, performance of TGI skills, and in self-perceived rating of competence, confidence, preparedness, and enjoyment. Qualitative analysis will provide information on likes, dislikes, satisfaction, and recommendations. Implications: In the long-term, the author would like to see progress toward filling gaps in OTP service provision for adolescents with LD who have insufficient experiences with play and leisure occupations. Limitations. Program development and program evaluation research are in the initial stages and have not yet been implemented in any practice setting.

Despite negative perceptions of therapy, Black Americans are seeking therapy. I interviewed 8 Black clients about their experience of MFT. I used the Multidimensional Inventory of Black Identity (MIBI; Sellers, Rowley, Chavous, Shelton, & Smith, 1997) to assess their racial identity. Most participants thought it was strange for Blacks to seek therapy. Yet, these participants found the strength to seek therapy to protect their family and individual well-being. Participants found support from family, friends, and/or the church/religious beliefs. All attended church but few sought their pastor for therapeutic support. The participants who initially preferred a Black therapist also strongly viewed race as central to their self-identity. However, participants expressed greater concern for therapist competence, skills, and warmth than for therapist race. Yet, many discussed the benefits of having a Black therapist, which were greater comfort, ease, and openness for Black clients in therapy, as well as greater cultural familiarity for Black therapists. All of the participants reported satisfaction with their therapist and generally reported a positive experience. I also measured the experience of the first and third therapy sessions for Black and White clients, using the Session Evaluation Questionnaire (SEQ; Stiles, 2000). Black clients reported significantly less depth in the first session than White clients, suggesting a unique experience of therapy for Black clients. Also, Black clients that remained in therapy reported less smoothness in the first session than those who terminated. There were no significant findings for the third session. Research and treatment implications from these findings are discussed. / Master of Science

A strong therapeutic alliance is consistently related to successful outcomes in couple therapy. However, most of the research done on therapeutic alliance has been done among non-Latino White individuals and couples, failing to account for other ethnic minorities like Latinos. Latinos tend to share certain commonalities as opposed to non-Latino clients that may alter the relationship between alliance quality and relationship quality. This exploratory study was designed to understand whether Latino clients have higher initial levels of alliance and a stronger alliance-outcome relationship in couple therapy when compared to non-Latino White couples. The sample consisted of 567 couples seeking therapy to improve their relationship (99 Latino and 468 non-Latino White couples). A multigroup moderation model was used to test whether Latino ethnicity moderates the association between alliance quality at session four and relationship quality at the final session. Similar findings of the association previously established between alliance quality and relationship quality were found. Results indicated that there was no statistically significant difference between Latinos and non-Latino Whites on initial levels of alliance quality nor on the relationship between alliance quality and relationship quality.

More than 40 million American adults suffer from anxiety, but only a third receive care despite evidence of effective treatment. This is attributed to lack of access to adequate services, cultural-based myths, and prohibitive symptoms associated with anxiety, especially for marginalized populations such as racial minorities. Since spirituality is often used as a coping mechanism especially for racial groups, psychotherapy has slowly begun incorporating it into treatment. While this has the potential to reduce some barriers to care, the increasing number of Americans who are disaffiliating with traditional faiths or belong to minority spiritualities may not use the same coping mechanisms. The current study sought to contribute to the literature by obtaining a better understanding of whether the use of traditional spiritual activities and perceptions of God are different for spiritual majorities and minorities especially in managing anxiety. Using a nationally representative sample of U.S. adults (n=1525) from the Baylor Religion Study, structural equation models were tested to examine the relationships between anxiety and religious beliefs related to attachment to God as well as between anxiety and spiritual activities that encompass both social, organizational and private, subjective religiosity. Minority stress and attachment theories guided hypotheses that higher levels of anxiety would be associated with status as a spiritual minority but would be positively mediated by participation in spiritual activities such as worship services, prayer and scripture reading as well as mediated by more secure attachment to God. Results indicated that unlike spiritual majorities, spiritual minorities show lower anxiety levels compared with spiritual majorities unless using traditional forms of spiritual activities. Rather than positive or negative perceptions of the relationship with God, inconsistent perceptions were associated with higher levels of anxiety for all participants. Spiritual minorities had lower levels of both positive and negative perceptions of God's persona as well as lower levels of positive perceptions of the relationship with God, none of which correlated to anxiety. The results may indicate that spiritual minorities use other activities to successfully cope with anxiety and that they have greater anxiety when trying to conform to the dominant culture. This has important implications for practice given that many therapists lack training on how to incorporate spirituality into treatment. Distinctions between perceptions of the relationship with God and of God's persona indicate the need for further study of how more nuanced spiritual beliefs influence anxiety outcomes for a diverse range of spiritual practice and of the process by which individuals intentionally use spiritual tools to cope with anxiety. / Ph. D. / More than 40 million American adults suffer from the debilitating impact of anxiety through persistent worrying, obsessive thoughts, fear of social situations, compulsions, and paranoia. Only a third receive care despite effective treatment options because of such disruptive symptoms in addition to a lack of insurance, racial disparities, cultural myths, and concerns that their beliefs will not be valued. This limits access to care especially for those who need it the most, including racial minority groups. Since many Americans use spirituality as a coping mechanism to combat anxiety, psychotherapy has begun incorporating aspects of it. While this could reduce some barriers to care, it is not known whether the increasing number of Americans who are disaffiliating with traditional faiths or belong to minority spiritualities use these same aspects to cope. This study sought to understand whether the use of traditional spiritual activities and perceptions of God are different for spiritual majorities and minorities especially in managing anxiety. Using a nationally representative sample of 1,525 U.S. adults from the Baylor Religion Study, the study examined the relationship between anxiety and spiritual activities such as frequency of attendance at worship services and private prayer and scripture reading. The study also examined how attachment to God through perceptions of the relationship with God and of God’s persona might be associated with spiritual minorities and their anxiety levels. Results show that unlike spiritual majorities, spiritual minorities have less anxiety unless using traditional forms of spiritual activities. This could indicate that they use other activities to successfully cope with anxiety and that they have greater anxiety when trying to conform to the dominant culture. Rather than positive or negative perceptions of the relationship with God, inconsistent perceptions were related to higher levels of anxiety for all participants. Spiritual minorities were more moderate in their attachment to God, with less positive and negative perceptions of God’s persona and less positive perceptions of their relationship with God. However, none of spiritual minorities’ perceptions did not have a significant relationship with their anxiety levels. The study’s results show a need to explore further how a more diverse range of spiritual beliefs influence anxiety and the process by which people intentionally use spiritual tools to cope with their anxiety. Guidance for how therapists can increase their spiritual competence is discussed.

<p dir="ltr">Patient-clinician communication about sexual health facilitates trust, the reporting of clinical symptoms, and improves sexual quality of life (Reese et al., 2017). Unfortunately, very little is known about the spectrum of sexual interests and behaviors throughout a lifespan significantly limiting the information shared during those conversations (Hughes & Wittmann, 2014). The American Psychiatric Association (2022) assumed responsibility and detailed when a sexual interest becomes problematic. However, criteria for psychosexual diagnoses are vague and frequently do not have empirical evidence to demonstrate their existence (Moser, 2019; Randall & Sprott, 2016). The following research used the Delphi method to operationally define and differentiate between a variety of psychosexual concepts. Through this pilot study, a panel of 13 experts defined, categorized, and classified a series of terms as well as an array of non-normative sexual behaviors. Results were analyzed through the lens of queer theory and indicated that while expert consensus can be reached, further research is necessary to systematically destigmatize a wider variety of sexual interests.</p>

The mini-dissertation explains how systems theory provided a healing context for me in my training as a clinical psychologist over two years. The emergence of my authentic voice is narrated in an autoethnography (five act drama) about what happened. The main theoretical bases for the dissertation are – constructivism to understand the learning and teaching I experienced; learning as a collaborative endeavour and the emergence of my authentic voice with help from more skilled others. Systems theory informs the entire study at every theoretical level. Bowen’s family therapy theory is significant for the differentiation of the self and his I-position is equated with the emergence of an authentic voice. Myth, epic narratives, the hero’s journey amplify my interpretation of the differentiation of self. The raw data for the qualitative research were observations, interviews, creative writing, photocollage, a collection of readings, songs and dialogues. The themes emerging from the autoethnography were about obstructions because of the authoritarian nature of my upbringing, life and work. These themes lessened in force in clinical training until my authentic voice emerged in relation to self and as a clinical psychologist. A recommendation from the dissertation is that autoethnography provides a good vehicle for reflection and intense interior scrutiny needed to become a practising clinical psychologist; the autoethnographical exercise could be used by training clinical psychologists more extensively on their journey to maturity. / Psychology / M.A. (Clinical Psychology)

The purpose of this ethnographic study was to examine the process of a family therapist entering and then navigating the cultural system of working with substance abusing Seminole tribal clients. The study also utilized two tribal members sharing their opinions about how Seminoles view therapy. As noted in the interview questions and responses, the research presented guidelines for family therapists to follow when working with tribal members. Because there has been no study conducted with family therapists providing clinical services to tribal members, this study introduced tools for clinicians to keep in mind and utilize when working with tribal clients. The interviews illustrated what specific routes therapists may take with tribal clients in order to join and connect. This study provided the field of family therapy an opportunity to become familiar with the Seminole tribe, and guidelines of how to remain mindful when working with this unique population. These results were supplemented by the researcher providing personal reflections on her experiences with tribal clients.