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A Qualitative Analysis of Client Expressions of Meaning in Psychotherapy

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A Qualitative Analysis of Client Expressions of Meaning in Psychotherapy Pepperdine University Pepperdine Digital Commons Theses and Dissertations 2009 A qualitative analysis of client expressions of meaning in psychotherapy Alexander Michael Bacher Follow this and additional works at: https://digitalcommons.pepperdine.edu/etd Recommended Citation Bacher, Alexander Michael, "A qualitative analysis of client expressions of meaning in psychotherapy" (2009). Theses and Dissertations. 43. https://digitalcommons.pepperdine.edu/etd/43 This Dissertation is brought to you for free and open access by Pepperdine Digital Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of Pepperdine Digital Commons. For more information, please contact [email protected], [email protected], [email protected]. Pepperdine University Graduate School of Education and Psychology A QUALITATIVE ANALYSIS OF CLIENT EXPRESSIONS OF MEANING IN PSYCHOTHERAPY A clinical dissertation submitted in partial satisfaction of the requirements for the degree of Doctor of Psychology by Alexander Michael Bacher November, 2009 Susan Hall, J.D., Ph.D. – Dissertation Chairperson This clinical dissertation, written by Alexander Michael Bacher under the guidance of a Faculty Committee and approved by its members, has been submitted to and accepted by the Graduate Faculty in partial fulfillment of the requirements for the degree of DOCTOR OF PSYCHOLOGY _____________________________ Susan Hall, J.D., Ph.D., Chairperson ____________________ David Elkins, Ph.D. ____________________ Thomas Greening, Ph.D. ___________________________ Robert A. deMayo, Ph.D., ABPP Associate Dean ___________________________ Margaret J. Weber, Ph.D. Dean © Copyright by Alexander M. Bacher (2009) All Rights Reserved TABLE OF CONTENTS Page LIST OF TABLES ............................................................................................................. vi DEDICATION .................................................................................................................. vii ACKNOWLEDGEMENTS ............................................................................................. ix VITA ................................................................................................................................ xi ABSTRACT .................................................................................................................. xvii INTRODUCTION .............................................................................................................. 1 Positive Psychology ....................................................................................................... 2 Historical Background of Positive Psychology ......................................................... 2 Definition of Positive Psychology ............................................................................. 5 Critique of Positive Psychology................................................................................. 5 Meaning ......................................................................................................................... 9 The Construct of Meaning ......................................................................................... 9 Reconciling Situational and Global Meaning .......................................................... 11 Outcomes of Meaning .............................................................................................. 13 Meaning-Making in Psychotherapy ......................................................................... 14 Assessing Meaning .................................................................................................. 16 Purpose of Present Study and Research Questions ...................................................... 17 METHOD ......................................................................................................................... 19 Participants ................................................................................................................... 19 Instrumentation ............................................................................................................ 21 Client Demographics ............................................................................................... 21 Change and Growth Experiences Scale (CHANGE) ............................................... 21 Design .......................................................................................................................... 28 Procedures .................................................................................................................... 30 Transcription ............................................................................................................ 31 Data Coding ............................................................................................................. 31 Procedures Related to Human Subjects ................................................................... 33 Data Analysis ............................................................................................................... 34 RESULTS ......................................................................................................................... 37 Inter-rater Reliability ................................................................................................... 37 Researcher Bias ............................................................................................................ 39 Content Analysis .......................................................................................................... 40 Participant 1 ............................................................................................................. 43 Participant 2 ............................................................................................................. 45 Participant 3 ............................................................................................................. 48 Participant 4 ............................................................................................................. 54 Participant 5 ............................................................................................................. 58 Themes ......................................................................................................................... 61 Themes Across Participants ..................................................................................... 61 Themes Across Other CHANGE Codes .................................................................. 69 DISCUSSION ................................................................................................................. 72 Content Analysis Results Using Modified CHANGE Coding System ....................... 73 Content Analysis ...................................................................................................... 73 Modifications to CHANGE Codes .......................................................................... 75 Proposed Modifications for Future Measurement of Meaning-Making .................. 77 Themes ......................................................................................................................... 79 Themes Across Participants ..................................................................................... 79 Themes Across Codes .............................................................................................. 86 Methodological Limitations ......................................................................................... 92 Potential Contributions of the Present Study and Future Directions ........................... 94 REFERENCES .............................................................................................................. 104 APPENDIX A: Client Consent Form ............................................................................. 116 APPENDIX B: Therapist Consent Form ........................................................................ 123 APPENDIX C: Change and Growth Experiences Scale Training Manual ..................... 127 APPENDIX D: Change and Growth Experiences Scale Coding Worksheet …………. 139 vi LIST OF TABLES Page Table 1. Participant Demographic Information……………...………………………….20 Table 2. Inter-rater Percentage Agreement Pre- and Post-Group Discussions Among Four Coders……………………………………………………………………..………….38 Table 3. Inter-rater Cohen’s Kappa…………………………………….……………..... 39 Table 4. Number and Intensity of Participant Meaning-Making Statements……...….... 41 Table 5. Common Themes Observed Across Participants……………………………....61 vii DEDICATION First and foremost, this dissertation is dedicated to my extraordinary mother, Judith, without whom I never would have begun this long, enriching journey of self- discovery and service to others in the first place, or had the will and means to complete it. Thank you for helping me discover my life’s purpose, always encouraging me to do what I am most passionate about and helping me prove time and again that you can indeed “do anything you set your mind to.” If I am a good psychologist, it is because I had such a wonderful teacher instill early on in me and personify what true empathy, compassion and selflessness is and how it is manifested in one’s interactions with the world around him/her. I can only hope that my practice as a clinical psychologist is half as good as your natural gift for it. I would also like to dedicate
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