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Thesis (Ph. D.)--University of California, Santa Cruz, 1986. / Typescript. Includes bibliographical references (leaves 187-196).

A preliminary investigation of the extent to which supportive services contribute to the effectiveness of a methadone treatment program was conducted.

Through the design of supportive housing for adolescent mothers and their children, this practicum project explores the existing issue of teen parenting, and the importance of a supportive environment for teen mothers. Key areas of supportive design examined in the literature review include sense of control, social support, and positive distractions. This practicum also examines the developmental and environmental needs of infants. The comprehensive literature review of the existing challenges adolescent mothers face, the Theory of Supportive Design, and child development has informed the proposed design of House 784. / February 2017

The present research explores a promising therapy – Supportive Expressive Therapy (SET; Luborsky, 1984) – for adolescents with mood and/or anxiety disorders. It has been proposed that therapist expressive techniques (e.g., challenges and interpretations) and client interpersonal mastery (i.e., self-understanding and self-control in relationships) are two elements central to the success of SET (Luborsky, 1984; Grenyer & Luborsky, 1996). The current thesis employs a microprocess approach to examine expressive techniques and interpersonal mastery as potential mechanisms of change in SET. The study first provides preliminary evidence that SET is effective in helping adolescents suffering from internalizing disorders. Clients (N = 10) reported significantly fewer symptoms of depression and anxiety post-therapy. The body of the study then focuses on two research questions pertaining to the microprocesses occurring during SET. First, employing graphical and statistical analyses, the study investigates the notion that SET helps clients develop greater interpersonal mastery. Ten clients’ levels of interpersonal mastery were assessed at four points throughout therapy to determine whether clients demonstrated higher levels of interpersonal mastery over time. Secondly, this dissertation explores the impact of therapist expressive statements on clients' narratives, using a lag sequential analysis. Clients' statements were examined to determine whether higher levels of interpersonal mastery were exhibited following higher-level expressive techniques versus other therapist statements (i.e., supportive statements). Statistical analyses pertaining to the first research question did not reveal significant changes in interpersonal mastery over the course of therapy. However, graphical analyses suggested specific patterns of gains in interpersonal mastery during SET. With respect to the second research question, results demonstrated therapists employed significantly more higher-level expressive techniques in the later stages of SET, in accordance with the guidelines provided in SET manuals. Lag sequential analyses did not, however, provide substantial evidence of gains in interpersonal mastery following higher-level therapist techniques. Despite a lack of evidence supporting a general link between higher-level techniques and increased client mastery, exploratory analyses suggested change-focused expressive statements were linked to fewer client statements reflecting low interpersonal mastery. Future research should examine (1) change-focused statements as potentially important variables fostering improvement, and (2) moderators of client responses to higher-level techniques.

The present research explores a promising therapy – Supportive Expressive Therapy (SET; Luborsky, 1984) – for adolescents with mood and/or anxiety disorders. It has been proposed that therapist expressive techniques (e.g., challenges and interpretations) and client interpersonal mastery (i.e., self-understanding and self-control in relationships) are two elements central to the success of SET (Luborsky, 1984; Grenyer & Luborsky, 1996). The current thesis employs a microprocess approach to examine expressive techniques and interpersonal mastery as potential mechanisms of change in SET. The study first provides preliminary evidence that SET is effective in helping adolescents suffering from internalizing disorders. Clients (N = 10) reported significantly fewer symptoms of depression and anxiety post-therapy. The body of the study then focuses on two research questions pertaining to the microprocesses occurring during SET. First, employing graphical and statistical analyses, the study investigates the notion that SET helps clients develop greater interpersonal mastery. Ten clients’ levels of interpersonal mastery were assessed at four points throughout therapy to determine whether clients demonstrated higher levels of interpersonal mastery over time. Secondly, this dissertation explores the impact of therapist expressive statements on clients' narratives, using a lag sequential analysis. Clients' statements were examined to determine whether higher levels of interpersonal mastery were exhibited following higher-level expressive techniques versus other therapist statements (i.e., supportive statements). Statistical analyses pertaining to the first research question did not reveal significant changes in interpersonal mastery over the course of therapy. However, graphical analyses suggested specific patterns of gains in interpersonal mastery during SET. With respect to the second research question, results demonstrated therapists employed significantly more higher-level expressive techniques in the later stages of SET, in accordance with the guidelines provided in SET manuals. Lag sequential analyses did not, however, provide substantial evidence of gains in interpersonal mastery following higher-level therapist techniques. Despite a lack of evidence supporting a general link between higher-level techniques and increased client mastery, exploratory analyses suggested change-focused expressive statements were linked to fewer client statements reflecting low interpersonal mastery. Future research should examine (1) change-focused statements as potentially important variables fostering improvement, and (2) moderators of client responses to higher-level techniques.

Lung cancer has developed from a rare condition into the leading cause of cancerrelated death in the United Kingdom. Lung cancer patients face a disease with a high symptom burden, increased psychosocial needs and a high mortality. Supportive care needs are often relevant from diagnosis. Despite this there are no clear follow-up structures for lung cancer patients that address both cancer management and supportive care. The aims of this study were to evaluate supportive care needs, assess predictors of such needs and identify factors which could aid service provision within Stobhill lung cancer services. Methods Supportive care needs were measured using an adapted Palliative Outcome Scale (POS), incorporated within a larger questionnaire. All lung cancer patients attending the clinic could complete this questionnaire. Respiratory symptoms, performance status, service usage, preferences and satisfaction were also assessed. Data were stratified to allow evaluation of three clinical groupings: all patients, newly diagnosed patients and patients in the last three months of life. Analyses were phased: descriptive analyses, univariate tests of association and multivariate regression. Results Three hundred and fifty three lung cancer patients completed questionnaires. The high symptom burden in lung cancer was confirmed. Anxiety, pain and dyspnoea were identified as the key issues. Poor performance status was identified to be an independent predictor of increased POS score, increased anxiety, increased pain and increased dyspnoea. There was no independent relationship between POS and survival. Although the majority of patients were satisfied with the care received, there was uncertainty regarding who was in charge of care and some disparity in preferred structure for follow-up. Conclusions Despite recent advances in lung cancer management, improvements are still required to address unmet supportive care needs of patients. Particular attention should be given to those with poorer performance status to effectively identify and meet such needs.

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This study is important because of the high prevalence of mental and physical disorders experienced by American adults. These bring undue strain to those suffering them and to the health care system because research indicates that many of these disorders may be mitigated via supportive conversation, or through the practice of physical exercise. The purpose of this quantitative treatment-control study was to examine the relationship between the practice of walking/talking and resulting mood and satisfaction levels. Self-determination theory and biopsychosocial perspectives were used to provide a framework for the study. The research questions asked whether there was a mood response difference, or a difference in the level of satisfaction, between walking/talking and sitting/talking. Research questions also asked whether correlations existed between mood and satisfaction levels and levels of psychological needs being met during exercise. Participants volunteered from rural New York communities, and they were assigned equal intervals of the 2 different activities for a total of 10 weeks. Data were collected via three scales; scores were compared via use of independent-samples t-test, simple linear regression, Pearson correlation, and analysis of variance to investigate the relationships between the independent and dependent variables. Outcomes showed no significant mood response differences or satisfaction differences between the two different activities. No significant correlations were found between mood scores or session rating scores and levels of psychological needs met in exercise. Knowledge gained through this study may support individuals and practitioners incorporating lifestyle change approaches, and findings may inform further research design development on the topic.

The purpose of the study was to describe the personal experience of individuals undergoing cancer treatment in an outpatient clinic by examining their perceived supportive care needs. The theoretical basis of the study lies in Alfred Adler's holistic view of human beings as unique and indivisible (1927/1954). Six individuals recently diagnosed with cancer were recruited from the same regional outpatient cancer clinic located at a major university medical center. A semi-structured interview process with open-ended questions was utilized to understand how people individually and collectively experience cancer and cancer treatment. The 17 factors of the wellness model (Witmer, Sweeney, & Myers, 1998) were used to assess the perceived supportive care needs of the study's participants. Data were analyzed using Interpretative Phenomenological Analysis (Smith, 1998) to ascertain emergent themes and interpret the meanings of the perceptions patients have of their cancer experience. The data resulted in eight major themes being present including facing mortality; uncertainty about the future; understanding cancer diagnosis and treatment; reliance on faith; maintaining control; love and support from family; physical impact of cancer; and importance of self-care. These themes provide insight into the perceived supportive care needs that patients experience during cancer treatment. With the exception of cultural and gender domains, the holistic assessment process identified patients' needs. The factors of wellness appear to capture the experience of individuals during cancer treatment. As an approach to assessing the coping skills of cancer patients, the wellness model seems appropriate for use by clinical mental health counselors. Implications for counselor theory, training, and practice with this unique client population are discussed.