Browsing by Subject "psychotherapy"
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Item Client Improvement in a Community-Based Training Clinic: As Indicated by the OQ-45(2014-08-01) Kalpinski, Ryan JamesBy reviewing existing data collected at the Texas A&M Counseling and Assessment Clinic (CAC) in Bryan, TX, the present investigator seeks to better understand client response to therapy. Each client receiving services at the clinic completes the Outcome Questionnaire 45 (OQ-45) before every counseling session attended. The OQ-45 consists of 45 questions related to present emotional and psychological distress. The main goal of this study is to provide information regarding clients? response to therapeutic interventions as measured by their distress levels on the OQ-45. The OQ-45 is an empirically validated measure widely used throughout psychotherapy settings and has been used in the CAC since 2005. Most of the existing research related to dose-response information obtained via the OQ-45 has been implemented at university student counseling centers with a predominantly Caucasian, affluent, and religious population. The present study seeks to expand the knowledge of the field to a more diverse population and unique training setting for budding psychologists. Survival analyses were conducted and results indicate 13 sessions are necessary for a majority of clients from this rural and low-income population to achieve clinically significant change. Additionally, a mere seven sessions are necessary for a majority of clients to achieve reliable improvement. In a country that continues grow in population size and diversity, more information is needed regarding the mental healthcare system and the response of those seeking therapy, this study provides some of that insight.Item Predicting Psychotherapy Client Dropout from In-Treatment Client-Reported Outcome(2012-02-14) Yu, Jason JuijenTreatment dropout is a pervasive phenomenon that can preclude clients from benefiting fully from psychotherapy. Research efforts to understand the phenomenon in the preceding decades yielded few consistent results. The investigation of intrinsic client and therapist factors gave way to the more recent exploration of dynamic therapeutic process factors potentially influencing the dropout process. The availability of periodic treatment outcome measurement instruments has helped client-focused research explore the effects of treatment response as a process factor on aspects of psychotherapy. As an added benefit, real-time treatment response measures, such as the Outcome Questionnaire, offer the possibility of timely adjustment in clinical intervention to meet evolving client needs and enhance therapeutic treatment. This present study primarily sought to explore the relationship between psychotherapy dropout and treatment response patterns in terms of clients' psychosocial well-being as measured by the Outcome Questionnaire. The results suggest that treatment response patterns alone may not effectively predict dropout probabilities. Even so, the measure's sub-component assessing the client's subjective experience of symptom distress is shown to be more accurate in predicting dropout than the composite Outcome Questionnaire measure or any other component scale. This finding conceivably highlights the relative importance of symptom distress in the dropout process for the sampled clients. Those clients reporting higher levels of symptom distress appeared to be associated with greater probabilities of dropout termination. Additionally, prior research has recognized a likely mediated relationship between higher client educational attainment and lower dropout probabilities - a trend also observed in this study's sampled population. As one of its expressed intents, this study examined educational attainment's moderating effect on the relationship between aspects of client treatment response and dropout probabilities. While showing educational attainment to be a relevant factor in assessing dropout risks, the analysis results indicate that this client characteristic variable's interactional effect on the evaluated treatment response pattern feature is weak and statistically nonsignificant. The present study contributes to the research literature through providing some clarification to the importance of treatment response in the prediction of psychotherapy client dropout.Item Religious and Non-religious Therapist Clinical Engagement as a Function of Selected Therapist and Client Variables(2014-09-29) Nelson, Courtney DReligious clients represent a growing population of mental health consumers, and their problem presentations are complicated by their religious beliefs. Leading scholars assert that religious beliefs of clients are not only worthy of clinical exploration but essential for integration into treatment in order for these clients to make therapeutic gains. Yet, relative to the general population, a disproportionate number of psychologists identify as religious, a stable finding over the years and call into question of their capacity to effectively treat religious clients. Consistent with research on clinicians? value imposition, it is speculated that non-religious clinicians may demonstrate bias against religious clients. This study examined the effects of therapist religiousness (religious and non-religious), client problem presentation (religious and non-religious), and client ideation (healthy and unhealthy) on therapist clinical engagement in psychotherapy. The study employed a two-step methodology. First, an instrument was developed to measure therapist clinical engagement in psychotherapy. Second, using an analogue design, several hypotheses were tested regarding the above independent variables and therapist clinical engagement. A national sample of psychologists (N = 154), ages 24 to 80, completed an online survey, consisting of a demographic questionnaire, and after viewing one of four video interview vignettes, also competed the Religious Commitment Inventory and the Clinical Engagement Scale. Using an established classification procedure, participants were separated into two groups: religious and non-religious. Exploratory Factor Analysis (EFA) yielded two factors on the Clinical Engagement Scale: Case Conceptualization and Alliance/Collaboration. Analysis of variance showed main effects for client problem presentation and client ideation but no main effect for therapist religiousness on Case Conceptualization. Post hoc analysis, however, revealed an interaction of therapist religiousness and client problem presentation on Case Conceptualization. Non-religious therapists engaged more with the non-religious client than the religious client. No main effects for therapist religiousness, client problem presentation, and client ideation were found on Alliance/Collaboration. Theoretical explanations of the findings and implications for psychological treatment, training, and further research were discussed.