Little is known about the psychotherapy utilization, presenting concerns, and outcome differences between Black international and African American university students. The aim of this research is to identify potential similarities and differences between the two groups, as well as potential differences between the aforementioned groups and white students. This study examined archival data collected over the course of a 17-year period that focused on experiences of African-American, Black international, and White students at a large university in the Rocky Mountain West, United States. More specifically, archival data were analyzed to identify differences between the aforementioned groups of students in regard to psychotherapy utilization, presenting concerns, distress levels endorsed at intake, and distress levels endorsed at termination. Results indicate significant differences between African-American, Black international, and White student groups in terms of the maximum number of psychotherapy sessions attended and length of treatment in days. We found significant differences between these groups of students on several items assessed in the Presenting Problem Checklist and the Family Concerns Survey. We found no significant difference between African-American, Black international, and White student groups in the severity of presenting distress as measured by the Outcome Questionaire-45. We found a significant difference between groups in treatment improvement as measured by change scores on the Outcome Questionaire-45, with White students experiencing the greatest change, followed by Black international students and African-Americans. Possible explanations and implications for practice will be discussed in the body of the paper.

The current study examined the psychotherapy experiences of Pacific Islander and Asian American students at a large intermountain university on the continental United States. We used archival data collected over a 17-year span to investigate the psychotherapy utilization, presenting concerns, reported distress levels and psychotherapy outcomes of Pacific Islander students compared to Asian American students. In an effort to address the current and problematic practice of combining Asian Americans and Pacific Islanders into a homogeneous category, subgroup outcomes of Pacific Islander students were compared to Asian American students to highlight any significant differences and similarities. Results indicated significant differences between Pacific Islander and Asian American students in terms of amount of psychotherapy sessions attended and length of treatment in days. Asian American students were more likely to remain in therapy during the first 100 days and eight sessions. We found significant differences between both groups on several items assessed in the Presenting Problem Checklist and the Family Concerns Survey. Pacific Islander students reported significantly more traumatic experiences occurring in their family. We also found significant differences in the presenting concerns of both populations. Additionally, on the OQ-45, Pacific Islander students answered questions regarding risk factors significantly different from Asian American students. Clinicians are encouraged to understand the values and nuances of collectivist groups including Pacific Island and Asian cultures. It is recommended that clinicians and counseling centers reach out to Pacific Islander students on their campuses to inform them about mental health services. Counseling centers are encouraged to gather information on the reasons for therapy termination.

This dissertation presents in the form of two distinct chapters conceptually related in nature. The first chapter integrates literature from various fields such as indigenous, womanist, and feminist lenses to propose nine principles when working with Muslim women. The purpose of the second chapter is to examine Muslim women’s experiences in therapy at university counseling centers. The study explores women’s experiences from a social determinants of health perspective and a narrative inquiry method—namely, how intrapersonal, interpersonal, institutional, community, and policy factors inform women’s experiences. Qualitative analysis from interviews with six women suggests Muslim women navigate multiple systems which inform their beliefs about health and their experiences in therapy.

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