DOCSLIB.ORG

Personality Attributes in Clinical Presentation, Measurement, and Treatment

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Personality Attributes in Clinical Presentation, Measurement, and Treatment PERSONALITY ATTRIBUTES IN CLINICAL PRESENTATION, MEASUREMENT, AND TREATMENT by AMBER GAYLE THALMAYER A DISSERTATION Presented to the Department of Psychology and the Graduate School of the University of Oregon in partial fulfillment of the requirements for the degree of Doctor of Philosophy September 2013 DISSERTATION APPROVAL PAGE Student: Amber Gayle Thalmayer Title: Personality Attributes in Clinical Presentation, Measurement, and Treatment This dissertation has been accepted and approved in partial fulfillment of the requirements for the Doctor of Philosophy degree in the Department of Psychology by: Gerard Saucier Chairperson Sanjay Srivastava Core Member Don Tucker Core Member Joseph Stevens Institutional Representative and Kimberly Andrews Espy Vice President for Research and Innovation; Dean of the Graduate School Original approval signatures are on file with the University of Oregon Graduate School. Degree awarded September 2013 ii © 2013 Amber Gayle Thalmayer iii DISSERTATION ABSTRACT Amber Gayle Thalmayer Doctor of Philosophy Department of Psychology September 2013 Title: Personality Attributes in Clinical Presentation, Measurement, and Treatment Psychotherapy is sought for diverse problems, and trust in its efficacy has led to increasing parity in insurance coverage for psychological services. But about half of those who begin therapy drop out prematurely, and only about half of those who complete therapy experience significant improvements. Here issues of efficacy measurement and the potential role of personality differences to better guide and assess treatment are explored. It is hoped this knowledge could lead to increased success rates. In terms of outcome measurement, the use and psychometric properties of the Outcome Questionnaire-45 (OQ-45), a popular, brief measure of psychological functioning and change, are assessed. Factor structure is tested in clinical (Study 1) and student (Study 2) samples. Alternative scoring models test whether dimensions of personality drive responses. Using bi-level models, including a total score factor, fit of the intended structure and three- and four-factor personality models was similar. A seven- factor problems model provided the best fit. About half the variance in OQ-45 scores was accounted for by a Big Six personality inventory. The best items for assessing personality attributes in OQ-45 data are noted. Secondly, the relation between personality attributes and clinical presentation and outcomes is explored. Self-report scores on personality attributes predict virtually every iv life outcome and are highly associated with clinical presentation. Such attributes surely also play a role in treatment, but this association has not been widely studied. In Study 3 the relation of personality attributes to presentation, usage, and outcome is tested in a Couples and Family Therapy clinic sample (N = 222). Neuroticism was strongly associated with initial OQ-45 score, as were other scales (except Openness) to a lesser degree. Being older, more educated, and married predicted attending more sessions, and being older, female, and higher income predicted termination success. Personality scales did not play a role in either outcome. Honesty/Propriety and Neuroticism were, however, associated with steeper decrease in OQ-45 scores over time. v CURRICULUM VITAE NAME OF AUTHOR: Amber Gayle Thalmayer GRADUATE AND UNDERGRADUATE SCHOOLS ATTENDED: University of Oregon, Eugene Southern Oregon University, Ashland Goddard College, Plainfield, Vermont DEGREES AWARDED: Doctor of Philosophy, Psychology, 2013, University of Oregon Master of Science, Psychology, 2008, University of Oregon Bachelor of Science, Psychology, minor in German Language and Literature, Southern Oregon University AREAS OF SPECIAL INTEREST: Personality structure and measurement Cross-cultural issues in personality Mental health treatment PROFESSIONAL EXPERIENCE: Course instructor, Department of Psychology, University of Oregon, Eugene, 2008 - 2013 Teaching assistant and lab instructor, Department of Psychology, University of Oregon, Eugene, 2006 - 2013 Research Assistant, Department of Psychology, 2006 - 2012 Neuropsychological Testing Assistant and Interviewer, Dr. Steve Pethick, Eugene, Oregon, 2010 – 2013 Group Facilitator and diagnostic interviewer, Oregon Research Institute, Eugene, Oregon, 2011, 2013 Data Analyst, Decision Research Institute, Eugene, Oregon, 2009 GRANTS, AWARDS, AND HONORS: Graduate Teaching Fellowship, UO Department of Psychology, 2006 to present Betty Foster McCue Fellowship for Human Performance and Development, UO Graduate School 2012 vi Carolyn Stokes Memorial Scholarship, UO College of Arts and Sciences, 2012 & 2010 Gregores Award, UO Department of Psychology, 2012 Clarence and Lucille Dunbar Scholarship, UO College of Arts and Sciences, 2011 Norm Sundberg Award, UO Department of Psychology, 2011 American Association of University Women, Outstanding Graduating Woman in Psychology 2006 Summa cum laude, Southern Oregon University, 2006 PUBLICATIONS: Thalmayer, A.G. Personality attributes and the Outcome Questionnaire-45. Manuscript submitted for publication. Saucier, G., Thalmayer, A.G., & Bel-Bahar, T. Personality descriptors ubiquitous across 12 languages. Manuscript submitted for publication. Saucier, G., Thalmayer, A.G., Payne, D. L., Carlson, R., Sanogo, L., Ole-Kotikash, L., Church, A.T., Katigbak, M. S., Szarota, P., Szirmák, Z., & Zhou, X. (in press). A basic bivariate structure of personality attributes evident across nine languages. Journal of Personality. Saucier G. & Thalmayer, A. G. (2013). Cultural, contextual, and measurement challenges for the paradigm of personality science. In Christiansen, N. & Tett, R. (Eds) Handbook of personality at work. New York: Taylor & Francis Psychology Press. Thalmayer, A.G., Saucier, G., & Eigenhuis, A. (2011). The comparative validity of brief to medium-length Big Five and Big Six personality questionnaires. Psychological Assessment, 23, 995-1009. vii ACKNOWLEDGMENTS Thank you to my advisor Gerard Saucier for many enriching opportunities, and for helping me learn to think scientifically and with increased depth and breadth. Thank you to committee members Joseph Stevens, Sanjay Srivastava and Don Tucker for their support and assistance with my dissertation and with many other projects. My dissertation studies would not have been possible without the support of Couples and Family Therapy clinic directors Tiffany Brown and Jeff Todhal, who allowed me to collect data and work with existing data in their archives, and without ongoing assistance from clinic staff members Lalla Pudewell, Lindsay Brown, and Caitlin Peoples. This work also depended on the hard work of several undergraduate research assistants, in particular Nathan Baune, as well as Grant Rusin, Brenna Bell, Kristen Ackerman, and Thomas Bradley. Thank you to fellow doctoral students Annemarie Eigenhuis and Zhuo Job Chen for practical advice on aspects of this project, and to them and many others, in particular Ida Moadab, Allison Waters, Philippe Bou Malham, and Kathryn Iurino for camaraderie. I am grateful to many family members and close friends, especially Merilyn Wakefield, Stacy Wakefield Forte, and Elaine Deckelman, for their ongoing enthusiasm, perspective, and support. For sustaining encouragement and support virtually every day of this seven year process, I most of all thank my husband, Erich Mead Thalmayer with whom this accomplishment is shared. viii Dedicated, in memoriam, to my father, John Arthur Wakefield -- a man who revered intellectual achievements and who had more than the usual amount of personality. I think he would have been the proudest of all to have a Ph.D. in the family. ix TABLE OF CONTENTS Chapter Page I. OVERVIEW ............................................................................................................ 1 II. LITERATURE REVIEW........................................................................................ 4 Clinical Use of the Outcome Questionnaire-45: A Psychometric Exploration ..... 4 History and Design .......................................................................................... 4 Convergent and Discriminant Validity ............................................................ 5 Do Personality Differences Drive OQ-45 scores?........................................... 7 Structure ........................................................................................................... 8 Some Goals for Research................................................................................. 9 Personality Attributes in Relation to Clinical Presentation and Treatment ........... 10 Big Five (and Big Six) Relations to Clinical Presentation .............................. 11 Relation Between Big Five/ Big Six Dimensions, DSM Disorders, and Internalizing and Externalizing Disorder Tendencies................................ 13 Neuroticism vs. Emotional Stability/Resiliency (N) .......................... 13 Conscientiousness vs. Disinhibition .................................................... 16 Extraversion ......................................................................................... 17 Agreeableness ...................................................................................... 18 Openness/Intellect................................................................................ 19 Honesty/Propriety ................................................................................ 20 Big Five/Big Six Relation
Load more

Recommended publications
  • Therapist Indicated Premature Termination, but What Did The
    UNIVERSITY OF CINCINNATI _____________ , 20 _____ I,______________________________________________, hereby submit this as part of the requirements for the degree of: ________________________________________________ in: ________________________________________________ It is entitled: ________________________________________________ ________________________________________________ ________________________________________________ ________________________________________________ Approved by: ________________________ ________________________ ________________________ ________________________ ________________________ PREMATURE TERMINATION: THE PATIENT’S PERSPECTIVE A dissertation submitted to the Division of Research and Advanced Studies of the University of Cincinnati in partial fulfillment of the requirements for the degree of DOCTORATE IN PHILOSOPHY (Ph.D.) In the Department of Psychology Of the College of Arts and Sciences 2001 by David J. Reynolds B.S., S.U.N.Y. College at Brockport, 1994 M.A., University of Cincinnati, 1997 Committee Chair: Edward B. Klein, Ph.D. 2 Abstract PREMATURE TERMINATION: THE PATIENT’S PERSPECTIVE David J. Reynolds This thesis compares patients who prematurely terminated psychological services to those who completed or continued treatment. It examines between-group differences in demographic and clinical variables, including patients’ opinions about their therapists as well as their responses to open-ended questions regarding hopes, surprises, and the most and least effective aspects of treatment. Premature terminators
    [Show full text]
  • Client Selected Music Based Effects on Marital and Couples Therapy
    UNLV Theses, Dissertations, Professional Papers, and Capstones 12-1-2014 Client Selected Music Based Effects On Marital And Couples Therapy Kevin Matthew Smith University of Nevada, Las Vegas Follow this and additional works at: https://digitalscholarship.unlv.edu/thesesdissertations Part of the Counseling Commons, Counseling Psychology Commons, Family, Life Course, and Society Commons, and the Music Commons Repository Citation Smith, Kevin Matthew, "Client Selected Music Based Effects On Marital And Couples Therapy" (2014). UNLV Theses, Dissertations, Professional Papers, and Capstones. 2299. http://dx.doi.org/10.34917/7048618 This Thesis is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Thesis in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/ or on the work itself. This Thesis has been accepted for inclusion in UNLV Theses, Dissertations, Professional Papers, and Capstones by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. CLIENT SELECTED MUSIC BASED EFFECTS ON MARITAL AND COUPLES THERAPY by Kevin M. Smith Bachelors of Arts in Psychology and Music Texas State University 2011 A thesis submitted in partial fulfillment of the
    [Show full text]
  • The Impact of Client and Therapist Religious Commitment on Psychotherapy in a University Counseling Center
    Brigham Young University BYU ScholarsArchive Theses and Dissertations 2021-06-01 The Impact of Client and Therapist Religious Commitment on Psychotherapy in a University Counseling Center Brodrick Thomas Brown Brigham Young University Follow this and additional works at: https://scholarsarchive.byu.edu/etd Part of the Family, Life Course, and Society Commons BYU ScholarsArchive Citation Brown, Brodrick Thomas, "The Impact of Client and Therapist Religious Commitment on Psychotherapy in a University Counseling Center" (2021). Theses and Dissertations. 9204. https://scholarsarchive.byu.edu/etd/9204 This Dissertation is brought to you for free and open access by BYU ScholarsArchive. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of BYU ScholarsArchive. For more information, please contact [email protected]. The Impact of Client and Therapist Religious Commitment on Psychotherapy in a University Counseling Center Brodrick Thomas Brown A dissertation submitted to the faculty of Brigham Young University in partial fulfillment of the requirements for the degree of Doctor of Philosophy Patrick R. Steffen, Chair Stevan Lars Nielsen Melissa K. Jones David M. Erekson Jared S. Warren Department of Psychology Brigham Young University Copyright 2021 Brodrick Thomas Brown All Rights Reserved ABSTRACT The Impact of Client and Therapist Religious Commitment on Psychotherapy in a University Counseling Center Brodrick Thomas Brown Department of Psychology, BYU Doctor of Philosophy Religion is important to many Americans and the way they approach life, but psychologists are less likely than the general population to be religious. Because of this, it is important to not only know how religious commitment can influence clients’ outcome and experience in psychotherapy, but also how the level of match between client and therapist religious commitment might impact those variables.
    [Show full text]
  • The Psychometric Properties of an Anger Management Routine Outcome Monitoring Measure
    St. John's University St. John's Scholar Theses and Dissertations 2020 THE PSYCHOMETRIC PROPERTIES OF AN ANGER MANAGEMENT ROUTINE OUTCOME MONITORING MEASURE Jessical Randel Follow this and additional works at: https://scholar.stjohns.edu/theses_dissertations THE PSYCHOMETRIC PROPERTIES OF AN ANGER MANAGEMENT ROUTINE OUTCOME MONITORING MEASURE A dissertation submitted in partial fulfillment of the requirements for the degree of DOCTOR OF PSYCHOLOGY to the faculty of the DEPARTMENT OF PSYCHOLOGY of ST. JOHN’S COLLEGE OF LIBERAL ARTS AND SCIENCES at ST. JOHN’S UNIVERSITY New York by Jessica L. Randel Date Submitted: __________ Date Approved: __________ _______________________ _______________________ Jessica L. Randel Raymond DiGiuseppe © Copyright by Jessica L. Randel 2020 All Rights Reserved ABSTRACT THE PSYCHOMETRIC PROPERTIES OF AN ANGER MANAGEMENT ROUTINE OUTCOME MONITORING MEASURE Jessica L. Randel This study examined the psychometric properties such as the validity and factor structure of a novel Routine Monitoring (ROM) questionnaire, the Anger Management Outcome Questionnaire (AMOQ), for clients experiencing anger problems. Exploratory factor analysis supported a good model fit for a 4-factor structure (Anger-Out, Anger-In, Verbal Coercion, and General Anger). Confirmatory Factor Analysis supported a bi- factor, the 4-factor model with all items loading on one general factor. The anger questionnaire demonstrated acceptable internal consistency on the scale and subscales, suggesting it is a reliable measure. The content validity was established based on theory and clinical practice. The construct validity of the measure was considered, and it had good convergent validity with other measures of disturbed anger. The ROM measure presented discriminate validity with measures of depression; however, the scale had significant associations with measures of anxiety.
    [Show full text]
  • OUTCOME QUESTIONNAIRE-45 MODELS 2 Alternative Models Of
    OUTCOME QUESTIONNAIRE-45 MODELS 2 Alternative Models of the Outcome Questionnaire-45 Amber Gayle Thalmayer February 2014 Please note: This article does not exactly replicate the final version published in the European Journal of Psychological Assessment. It is not a copy of the original published article and is not suitable for citation. For the published article, please see DOI: 10.1027/1015-5759/a000216 OUTCOME QUESTIONNAIRE-45 MODELS 3 Summary The Outcome Questionnaire-45 (OQ) reliably quantifies level of psychological functioning and change during treatment. The three subscales, however, are not well validated. Could alternative scales, based on personality dimensions or other psychological problems scales better explain patterns of response? In Study 1, the intended structure and four alternative models were compared using EFA and CFA in random thirds of a community clinic intake sample (N = 1,822). Oblique and bi-level models were compared. Preferred models were tested for stability in samples from later time points. In Study 2, the models were compared in a non-clinical sample (N = 589). Most bi-level models provided adequate fit per standards previously established for the Outcome Questionnaire-45. The seven-factor model provided better fit than any yet reported for this inventory. Keywords: Outcome Questionnaire-45, psychological assessment, confirmatory factor analysis OUTCOME QUESTIONNAIRE-45 MODELS 4 Alternative Models of the Outcome Questionnaire-45 Psychotherapy is sought for a wide range of problems, and trust in its efficacy has led to increasing parity in insurance coverage. But the majority of clients receive services not based on treatment of a specific disorder (Shafran, et al., 2009).
    [Show full text]
  • Task Force Report on Outcomes and Progress Monitoring in Psychotherapy
    Outcomes and Progress Monitoring in Psychotherapy A report of the Canadian Psychological Association Prepared by the Task Force on Outcomes and Progress Monitoring in Psychotherapy September 2018 OUTCOME AND PROGRESS MONITORING Table of Contents Table of Contents ............................................................................................2 Authors ........................................................................................................3 Executive Summary ..........................................................................................4 Introduction ...................................................................................................6 Contexts for Providing Psychotherapy .................................................................7 Definitions ..................................................................................................8 Ethics and Obligations of Psychologists ................................................................8 Outcome Monitoring .........................................................................................9 Outcome Measures .......................................................................................11 Quality of Life as a Common Outcome for Medical Populations ..................................12 Outcomes in the Context of Third Party Payers in Health Facilities .............................12 Outcome Monitoring in Correctional Facilities ......................................................13 Outcome Monitoring in Schools
    [Show full text]
  • Susan L. Kenford, Ph.D.______Susan L
    A Dissertation Submitted to the Faculty of Xavier University in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology by Elizabeth A. Garcia, M.A. November 9, 2020 Approved: Morrie Mullins, Ph.D. Morrie Mullins, Ph.D. Chair, School of Psychology Susan L. Kenford, Ph.D._______ Susan L. Kenford, Ph.D. Dissertation Chair TREATMENT ENGAGEMENT IN A PSYCHOLOGY CLINIC 2 Effect of Help-Seeking Stigma, Perceived Symptom Severity, and Perceived Mattering on Treatment Engagement in a University Psychology Training Clinic TREATMENT ENGAGEMENT IN A PSYCHOLOGY CLINIC 3 Dissertation Committee Chair Susan L. Kenford, Ph.D. Associate Professor of Psychology Member Jennifer E. Gibson, Ph.D. Associate Professor of Psychology Member Nicholas L. Salsman, Ph.D., ABPP Associate Professor of Psychology TREATMENT ENGAGEMENT IN A PSYCHOLOGY CLINIC 4 Table of Contents Page Table of Contents………………………………………………………………………………….4 List of Tables……………………………………………………………………………...………5 List of Appendices………………………………………………………………………………...6 Abstract…….……………………………………………………………………………...………7 Dissertation……...………………………………………………………………………………...8 References………………………………..………………………………………………………46 Tables……………………………………………..…………………..……………………...…..55 Appendices…………………..………………………………………………………………...…61 Summary……………………………………………..………………………...……………...…77 TREATMENT ENGAGEMENT IN A PSYCHOLOGY CLINIC 5 List of Tables Table Page 1. Sample Demographics……………………………………………………………...…..129 2. Mean Scores of All Study Variables by Sample………………………………………………………………………….……….130 3. Perceived
    [Show full text]
  • Enhancing Therapists' Clinical Judgments of Client Progress Subsequent to Objective Feedback
    UNLV Theses, Dissertations, Professional Papers, and Capstones 8-2011 Enhancing therapists' clinical judgments of client progress subsequent to objective feedback Michael M. Haderlie University of Nevada Las Vegas Follow this and additional works at: https://digitalscholarship.unlv.edu/thesesdissertations Part of the Clinical Psychology Commons, and the Counseling Psychology Commons Repository Citation Haderlie, Michael M., "Enhancing therapists' clinical judgments of client progress subsequent to objective feedback" (2011). UNLV Theses, Dissertations, Professional Papers, and Capstones. 1230. http://dx.doi.org/10.34917/2817208 This Dissertation is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Dissertation in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/or on the work itself. This Dissertation has been accepted for inclusion in UNLV Theses, Dissertations, Professional Papers, and Capstones by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. ENHANCING THERAPISTS’ CLINICAL JUDGMENTS OF CLIENT PROGRESS SUBSEQUENT TO OBJECTIVE FEEDBACK by Michael M. Haderlie Bachelor of Science Brigham Young University 2005 Master of Science Pacific University 2007 Master of Arts University of Nevada, Las Vegas 2009 A dissertation submitted in partial fulfillment of the requirements for the Doctor of Philosophy in Psychology Department of Psychology College of Liberal Arts Graduate College University of Nevada, Las Vegas August 2011 Copyright by Michael M.
    [Show full text]
  • Running Head: the RELIABILITY and VALIDITY of the OQ-45 IN
    SELECTED PSYCHOMETRIC PROPERTIES OF THE OUTCOME QUESTIONNAIRE-45 IN AN OLDER ADULT POPULATION by Kevan LaFrance A dissertation submitted to the faculty of The University of Utah in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Educational Psychology The University of Utah May 2013 Copyright © Kevan LaFrance 2013 All Rights Reserved The University of Utah Graduate School STATEMENT OF DISSERTATION APPROVAL The dissertation of Kevan LaFrance has been approved by the following supervisory committee members: Robert Hill , Chair Nov 20, 2012 Date Approved A.J. Metz , Member Nov 20, 2012 Date Approved Dan Woltz , Member Nov 20, 2012 Date Approved Lois Huebner , Member Nov 20, 2012 Date Approved Catherine Carter , Member Nov 20, 2012 Date Approved and by Elaine Clark , Chair of the Department of Educational Psychology and by Donna M. White, Interim Dean of The Graduate School. ABSTRACT The Outcome Questionnaire 45 (OQ-45), a 45-item self-report measure of psychological distress, was examined for internal consistency, test-retest reliability, concurrent validity, and construct validity in a sample of adults age 60 years and older. Sixty-six community volunteers recruited from local educational and community service workshops participated in the study that included filling out the OQ-45. Of these 66 volunteers, 34 (57%) completed a second OQ-45 by mail approximately three weeks after the first administration. Measures of depression (Geriatric Depression Scale), anxiety (Geriatric Anxiety Inventory) and general functioning (Short Form-12) were obtained at the first administration and OQ-45 scores were correlated with these measures. The OQ- 45 internal consistency estimates were consistent with estimates found in younger adults, though some problematic items were identified.
    [Show full text]
  • Evidence Brief: Use of Patient Reported Outcome Measures for Measurement Based Care in Mental Health Shared Decision-Making
    Department of Veterans Affairs Health Services Research & Development Service Evidence-based Synthesis Program Evidence Brief: Use of Patient Reported Outcome Measures for Measurement Based Care in Mental Health Shared Decision-Making Supplemental Materials November 2018 Prepared for: Investigators: Department of Veterans Affairs Kim Peterson, MS Veterans Health Administration Johanna Anderson, MPH Quality Enhancement Research Initiative Donald Bourne, MPH Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence-based Synthesis Program (ESP) Coordinating Center Portland VA Health Care System Portland, OR Mark Helfand, MD, MPH, MS, Director 4 Evidence Brief: Use of PROMs for MBC in Shared Decision-Making Evidence-based Synthesis Program TABLE OF CONTENTS Search Strategies ............................................................................................................................. 1 List of Excluded Studies ................................................................................................................. 8 Evidence Tables ............................................................................................................................ 14 Data Abstraction of Included Primary Studies .......................................................................... 14 Data Abstraction: Patient, Provider and Treatment Characteristics ...................................... 14 Data Abstraction: Intervention Characteristics .....................................................................
    [Show full text]
  • The Outcome of Psychotherapy: Yesterday, Today, and Tomorrow
    Psychotherapy © 2013 American Psychological Association 2013, Vol. 50, No. 1, 88–97 0033-3204/13/$12.00 DOI: 10.1037/a0031097 The Outcome of Psychotherapy: Yesterday, Today, and Tomorrow Scott D. Miller, Mark A. Hubble, Daryl L. Chow, and Jason A. Seidel International Center for Clinical Excellence In 1963, the first issue of the journal Psychotherapy appeared. Responding to findings reported in a previous publication by Eysenck (1952), Strupp wrote of the “staggering research problems” (p. 2) confronting the field and the necessity of conducting “properly planned an executed experimental studies” to resolve questions about the process and outcome of psychotherapy. Today, both the efficacy and effectiveness of psychotherapy has been well established. Despite the consistent findings substan- tiating the field’s worth, a significant question remains the subject of debate: how does psychotherapy work? On this subject, debate continues to divide the profession. In this paper, a “way out” is proposed informed by research on the therapist’s contribution to treatment outcome and findings from studies on the acquisition of expertise. Keywords: psychotherapy, outcome, excellence, practice-based evidence, therapist variability The progress of science is the work of creative minds. Every creative In the decades preceding Psychotherapy’s appearance, practice mind that contributes to scientific advances works, however, within was mostly limited to physicians, and psychoanalysis and psy- two limitations. It is limited, first, by ignorance, for one discovery chodynamic approaches predominated (Frank, 1992; VandenBos, waits upon that other which opens the way to it. Discovery and its Cummings, & DeLeon, 1992). Beginning in the 1950s, the pre- acceptance are, however, limited by the habits of thought that pertain vailing paradigm came under scrutiny.
    [Show full text]
  • Client Improvement in a Community-Based Training Clinic
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Texas A&M University CLIENT IMPROVEMENT IN A COMMUNITY-BASED TRAINING CLINIC: AS INDICATED BY THE OQ-45 A Dissertation by RYAN KALPINSKI Submitted to the Office of Graduate and Professional Studies of Texas A&M University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Chair of Committee, Daniel F. Brossart Committee Members, Timothy R. Elliott William A. Rae Robert W. Heffer, Jr. Head of Department, Victor L. Willson August 2014 Major Subject: Counseling Psychology Copyright 2014 Ryan Kalpinski ABSTRACT By 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.
    [Show full text]