Cognitive-behavior therapy is a well validated psychological treatment for anxiety disorders. However, less than 15% of people suffering from an anxiety disorder receive CBT or effective medication. One possible explanation is that patients don't have access to CBT therapists. A few studies have shown that videoconferencing can be used to increase the accessibility of validated treatment (i.e., CBT) and that CBT given via videoconferencing is as effective as CBT delivered face-to-face. However, the therapeutic alliance plays an important role in treatment efficacy, including in CBT. It is therefore important to determine if videoconferencing allows the development of a similar therapeutic alliance as observed in face-to-face CBT. The aim of this thesis is thus to compare the quality of the therapeutic alliance obtained via videoconferencing versus face-to-face CBT. Forty-five adults suffering from panic disorder with agoraphobia were SCID-diagnosed in a face-to-face assessment interview. All participants were referrals to a mental clinic in Montreal or Maniwaki (remote sites) or in Gatineau (local site). All participants received 12 individual weekly sessions of CBT. The therapeutic alliance was measured with the Working Alliance Inventory and the California Psychotherapy Alliance Scales after the first, the fifth, and 12 sessions. The efficacy measures were completed at pre- and post-treatment and included the Panic and Agoraphobia Scales and the Agoraphobic Cognitions Questionnaire. The results showed that an excellent therapeutic alliance was observed in both the videoconferencing and the face-to-face conditions and no difference were detected on the total score of the two measures of alliance used. The bond between the patient and the therapist, a subscale of one of the alliance measure, was stronger in face-to-face after the first session. However, this difference disappeared rapidly as there was no significant difference at the fifth session and at post-treatment. As for treatment outcome, significant improvement was observed for participants in both conditions. Multiple regression analyses revealed that the strength of alliance did not predict treatment outcome. The results of the study show that it is possible to develop an excellent therapeutic alliance by videoconferencing using CBT for panic disorder. At the fifth session, there were no significant differences in therapeutic alliances between the two conditions. Also, the results demonstrated that CBT delivered via videoconferencing yield similar outcomes compared to face-to-face therapy on measure of panic attacks and agoraphobic avoidance.

Self-regulation is important for successful functioning. The Self-Regulatory Strength Model (SRSM) proposes that all acts of self-regulation draw on a common and limited pool of self-regulatory energy, leading to self-regulatory failure if it is depleted. In contrast, Self-Determination Theory (SDT) proposes that people can regulate themselves for different reasons, with different consequences for both energy and success. More specifically, intrinsic motivation and autonomous extrinsic motivations for regulation are hypothesized to result in maintenance or increase of energy and successful self-regulation. Only controlled regulation is postulated to be associated with feeling drained. This thesis tests these competing views in a series of five studies (total N=1316). Using survey and laboratory methodologies, results revealed that self-regulation is not depleting to all participants. Participants regulate themselves for different reasons, and these motivational orientations are associated with different consequences for vitality and self-regulation. Intrinsic motivation was found to be associated with an increase in energy, while autonomous extrinsic motivation was associated with maintaining one's energy. Only controlled motivation was associated with a decrease in energy. In addition, intrinsic and autonomous motivations were directly associated with successful self-regulation on all measures: self-relevant activities; schoolwork and exercise; frustrating laboratory tasks and a global measure of success. These findings suggest that the processes proposed by the SRSM may be more closely associated with a controlled form of motivation for an activity. In other words, it is not the self-regulation of an activity itself that depletes energy; rather it is the way an activity is regulated that makes it draining. This suggests that fostering intrinsic motivation and internalization of extrinsic motivation should lead to an increase in vitality and success at self-regulation. In contrast, pressuring people to perform behaviors depletes their energy and indirectly leads to failure at self-regulation.

The central purpose of the present thesis was to integrate the construct of autonomy support postulated by Cognitive Evaluation Theory and the literature on parental behavioral and psychological control. Its first specific objective was to demonstrate that autonomy support (AS), behavioral control (BC), and psychological control (PS) are distinct constructs. Its second specific objective was to ascertain unique associations between parental AS, BC, and PC, on one hand, and youth self-processes, internalizing symptoms, and externalized behaviors, on the other hand. Three studies were designed to achieve these goals. In Study 1A (N=342) and Study 1B (N=300), cross-sectional questionnaires were completed by undergraduate students and the dimensionality of parental behaviors was examined by means of confirmatory factor analyses. Results revealed that AS, BC, and PC are modelized in an optimal manner as distinct constructs. Study 2 ( N=138) consisted of a laboratory experiment designed to test the unique associations between AS, BC, and PC and youth self-processes, internalizing symptoms, and externalized behaviors. Study 3 (N=239) was a prospective field study that also endeavoured to examine the unique contribution of AS, BC, and PC to children functioning. In this study, self-processes, internalizing symptoms, and externalized behaviors were assessed over an 8-month competitive season. Globally, results from Study 2 and Study 3 revealed that AS predicted youth autonomous motivation, positive affect, satisfaction, and lower levels of internalizing symptoms. PC reached significant negative influences on youth functioning (i.e., controlled motivation, higher levels of impaired concentration, manifest anxiety and externalized behaviors). BC revealed positive associations with two beneficial outcome variables (i.e., autonomous motivation and lower levels of intended dropout), and a single negative consequence (i.e., manifest anxiety). Taken together, the findings of the three studies presented here provide support for the importance of distinguishing between AS, BC, and PC as basic functional dimensions that offer unique contribution to our understanding of the influence of socializing agents on youth development and functioning.

Three experiments integrated insights from achievement goal theory, social identity threat, and stress and coping research, to develop a theory-based strategy individuals can use to navigate social identity threat in high stakes achievement settings. In all experiments women were asked to adopt a mastery goal (focus on learning and building skills) or a performance goal (perform well; avoid errors) before a mock job interview. In Experiment 1, women expected their interviewer to be either sexist (creating identity threatening situation) or not sexist (a non-threatening situation). Women who focused on mastery rather than performance goals felt more challenged and less threatened while anticipating a job interview in an identity threatening situation; goals did not affect their appraisals of a non-threatening interview. Moreover, women who focused on mastery rather than performance intended to be more assertive (Experiment 2) and ultimately performed better in the interview (Experiment 3). Mediational analyses showed that a focus on mastery led women to appraise the identity threatening situation as a challenge they could overcome rather than a threat they were helpless to combat; challenge, in turn, enhanced performance.

Addiction has been a problem over the years, with opiate use on the rise. The cycle of using and relapse includes negative emotions and cravings, which are associated with physiological responses and self-efficacy with respect to drinking and drug-taking refusal skills. Interrupting this cycle could help an individual with problematic substance use behavior. The purpose of this research was to study the efficacy of an intervention that could interrupt this cycle. A review of the models of emotional regulation (ER), as well as the complexities identified the need for a tool to support an individual in an acute interaction on multiple levels of his/her experience. This study provided a consolidated conceptual model of process, system, and technology in addressing emotional regulation. The studied intervention has three stages: communicate alternatively (CA), release endorphins (RE), and self-soothe (SS) (CARESS). The purpose of the study was to investigate the acute effects for cravings management and negative affect in a one-time treatment session using CARESS for those with problematic substance use behaviors in comparison to a control group with a treatment as usual intervention. This study was run at a local outpatient hospital, as a randomized control trial with 96 participants. Measures to reflect physiological responses, cravings, drinking and drug-taking refusal skills, and negative affect were used in a pre/post/follow up test implementation. A multivariate analysis of covariance (MANCOVA) showed there was no statistically significant difference on the combined post-test scores between the experimental and control groups. The hypothesis was not supported. Further analysis demonstrated effect sizes in the changes in the pre post-test scores in individual measures were different, with each intervention having a greater effect size on two of the measures. Due to the lack of variance between the outcomes, it was concluded that CARESS as good as Isometric as a change agent for this population. Opportunities for future studies were identified.

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This study examined the effects of using least to most prompting to teach individuals with autism spectrum disorder (ASD) and intellectual disability to order independently at a fast food restaurant. Baseline data were collected across three fast food restaurants, on steps completed independently of a task analysis. Following the baseline phase, training was conducted in all three restaurants until students reached mastery criterion. Probe data were collected on percent of steps of the task analysis between training at each restaurant. / Special Education

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The proposed study extended the author's comprehensive project study completed in 1992. It aimed to accomplish two goals: (1) to compare the effects on binge eating and weight loss of two clinical weight management groups: one following a standard cognitive-behavioral format, and the other modified to encompass the tenets of Developmental Counseling and Therapy (DCT) as described by Ivey (1986, 1991a), to see if the binge eaters and others within the groups thereby differ on several outcome measures; and (2) to analyze patterns of cognitive processing styles to see if trends emerge that might elucidate the nature of the binge eating experience from a DCT viewpoint, and that might therefore suggest new approaches to treatment. The study found significant differences between the standard (control) and modified (experimental) group on measures of binge eating and cognitive developmental level change, while differences in depression inventory scores were less significant. The study therefore offers support for the idea of expanding cognitive behavioral protocols for weight management and binge eating to include a wider variety of cognitive-developmental change strategies. It also implies that people are enabled to change when assisted in broadening their capacity to engage in varied cognitive modes more adaptively and flexibly. Implications for clinical application and future research exploration are proposed.