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California State University Fullerton
Department of Counseling

Fall 2013 Final Project Abstracts

Michael Bergeron 
Caretaking, the Stressful Burden and an Understanding of Mindfulness as an Intervention

Caretakers of the elderly and those with terminal illness may experience stress related to the burden of caretaking.  This burden can result in symptoms that can include anxiety, depression and stress related illness.  For those who accept the role as a caretaker culture, gender, and generational norms may define how this role is assumed.  For many assuming the role of caretaker can become a burden by itself.  Counselors who have encountered these burdens in their work with clients were interviewed.  These counselors use Mindfulness in their work with clients and shared their insight as to what they encountered and how they incorporated Mindfulness as an intervention to help alleviate some of the symptoms experienced with the caretaking burden.

James Brillon
The Counselor’s Process in Addressing Shame with Gay Men Incorporating Mindfulness into Psychotherapy

In order to explore the process counselor’s use to incorporate mindfulness into psychotherapy addressing shame in gay men, this project began with an intensive examination of the research into shame, its manifestations in the lives of gay men and mindfulness as part of therapy.  Two licensed therapists who specialize in these areas were interviewed with questions based on the research.  Salient themes arising from open-ended discussions included the interrelated nature of internalized homophobia and shame, and disruption of a sense of self.  The importance of the therapist as practitioner and the language of shame and mindfulness were common themes.  Participants shared their impressions of clients’ addictive processes, sexual acting out, depression and suicidality as manifestations of internalized shame.  The counselors shared their modes of incorporating mindfulness into psychotherapy, along with some cautionary advice, and explored root elements of mindfulness helpful in addressing shame, emanating from acceptance.

Jenna Calderon
Mourning Interrupted by Consecutive Loss: Counselors’ Use of Sandtray with Clients Grieving Multiple Losses of Loved Ones

This study explores the mourning process for those that have suffered multiple losses of loved ones through death.  Past and current research was examined, and two therapists that use sandtray with clients grieving numerous losses were interviewed.  These two participants were interviewed individually and the results were inspected for content and meaning.  These two therapists expressed the profound effects multiple losses can have on individuals, and how sandtray therapy can bring a different form of healing from this unique trauma.  Some similar themes transpired across the two interviews as well as diverse topics.  The connotation of these findings and practice of sandtray with those processing several losses are discussed in the hope that practitioners can apply the results to helping this population.

Ashley Chisum
Therapists’ Experiences Using Mindfulness to Treat Binge Eating Disorder in Adolescents
Despite high estimated rates of binge eating among adolescents, little research has been devoted to exploring evidence-based treatments for adolescents suffering from binge eating. Two therapists were interviewed regarding their experiences using mindfulness to treat binge eating in adolescents. The interviews were recorded and transcribed, and qualitative analysis methods were used to analyze the data. The therapists reported a strong correlation between adolescent binge eating and parental dieting and weight talk. In addition, both therapists reported that restrictive eating and cultural messages play important roles in the development and maintenance of binge eating in adolescents. The therapists reported successful outcomes using mindfulness and cognitive behavioral techniques to treat binge eating behaviors, as well as significant secondary benefits to using mindfulness, such as improved self-esteem. Treatment themes centered on the use of cognitive behavioral techniques, such as identifying and challenging negative thought patterns, and mindfulness techniques, such as meditation, mindful eating, increased awareness, and acceptance. Implications for therapy and directions for future research are discussed.

Samantha Chiuppi
Counselors’ Experience Incorporating Spirituality in Treatment with Young Adults Who Struggle With Identity

A majority of Americans report having some sort of spiritual or religious belief, and a majority of mental health professionals identify with some kind of spirituality.  However, spiritual issues often go unaddressed in counseling, and few counselors rate religious content as important to therapy. Research has shown that clients and counselors both have begun to show interest in and a desire to incorporate spirituality into secular counseling settings. The idea that spirituality is an integral part of a young adult’s development continues to gain momentum, and because spirituality is so seldom addressed in counseling, it is possible that this pertinent part of a young adult’s identity development is being neglected by those seeking to help young people through the difficult transition of young adulthood. A qualitative study based on comprehensive interviews with two therapists who incorporate spirituality into their work would provide useful knowledge that can address this issue.  How these therapists incorporate spirituality in their work with young adults struggling with identity, the type of formal or informal training they have received, when and why they address spirituality in therapy, and the adjustments that they must make to secular counseling practices are of specific interest in this research. This research suggests that spiritual treatment can play an important role in working with young adults who struggle with identity. Overall, the results of this study imply that using spirituality in therapy is appropriate, useful, and effective in working with young adults who struggle with their identity. 

Regina Collins
An Exploration of Therapists’ Process Using DIR/Floortime when Treating Children with Autism Spectrum Disorder

When looking at treatments for children who have Autism Spectrum Disorder (ASD), there are compelling reasons why the Developmental, Individual Difference, Relationship-based (DIR) model stands out as a quality form of intervention addressing the entire child and their unique needs.  The DIR model uses a form of play therapy called Floortime to treat a child in the context of their family, paying special attention to their developmental capacities and the way they relate to others.  DIR/Floortime focuses on how treatment can impact brain development, improve early attachment formation, and work towards developmental pathways that improve the child’s capacity of functioning.   In this paper, relevant and recent research is reviewed and two therapists are interviewed on their experience of using the DIR/Floortime model in the treatment of ASD in children.

Rebecca Harn
Exploring How Counselors Address Communication Dynamics of Couples in Distress

This is a study that explored the communication dynamics of couples in distress. It incorporated tenets of attachment theory and emotion focused therapy relative to the treatment of couples exhibiting demand-withdraw behavior. Two participants were interviewed who had extensive experience working with couples in private practice as well as personal research that explored couples interaction. Some of the predominant themes included: (a) attachment influence, (b) unconscious fears, (c) recognizing underlying feelings, (d) unmet needs, and (e) treatment exploration. Limitations were also found.

Lee Alison Hathaway
Exploring the Use of Culturally-Adapted Motivational Interviewing with Latinos Experiencing Addiction

This qualitative study examines how culturally adapted Motivational Interviewing (MI) techniques can be used in counseling Latinos suffering with addiction.  Data was gathered from reviewing research articles and interviewing two counselors who use this counseling technique in their counseling.  MI works in a non-confrontational patient-centered manner addressing the client’s resistance and ambivalence (Miller & Rollnick, 2002).  Culturally adaptations of MI have been used and studies of this therapeutic technique are covered in this work.

Tiana Hernandez
A Qualitative Study of Counselors’ Experience Using Cognitive Behavioral Therapy for the Treatment of Disordered Eating Behaviors with Preadolescent Males

This study was conducted to gain a deeper understanding of how preadolescent males differ in their treatment and expression of disordered eating behaviors. The expression of eating disorders, influence of sports, parents, cultural, and diagnosis and treatment of disordered eating behaviors and attitudes in preadolescent males were evaluated. The participants included two therapists specializing in eating disorders. They were asked a series of questions about their experiences working with preadolescent males. Research suggests boys may be reluctant to seek help for body and weight issues, and require more time to build trust in the therapist and treatment process. Preadolescent and early adolescent males were found to demonstrate the full range of disordered eating behaviors including anorexia and bulimia nervosa, feeding disorders, and orthorexia nervosa. Perfectionism, athletics, peer pressure, and parents were found to model, reinforce, and shape eating and body image attitudes in preadolescent males. Boys’ body image was correlated with self-esteem, depression, eating attitudes, anxiety as well as obsessions and compulsions. These finding prove children need more supportive influences and early detection of unhealthy behaviors and self-defeating attitudes. This study provides evidence for the use of CBT with preadolescent males and may be used to support the development of early intervention strategies for this population.

Erin Hulon
The Effects of Adjunctive Martial Arts Training in Counseling for Women Survivors of Domestic Violence

The research was conducted to understand how incorporating martial arts principles, practices, and self defense movements into counseling with women survivors of domestic violence could improve self esteem, feelings of safety, coping mechanisms, and PTSD symptoms.  The study was conducted with two licensed therapists that practice martial arts techniques in counseling, geared towards self-defense and the utilization of martial arts principles and practices.  Separate unstructured qualitative interviews were conducted with both participants answering 26 questions about their personal experiences doing this work.  Results reported by the therapists with clients implied positive outcomes producing effective results in providing better coping mechanisms, increasing positive self esteem, decreasing anxiety and depression, increasing feelings of safety and assertiveness, and creating positive social supports, while integrating more of the mind and body.

Jennifer Johnson
Therapist’s Use of Existential Therapy with Women Who Experience the Psychological Impact of Choosing Abortion

Negative psychological processes were examined in relation to choosing abortion. The purpose of this final project was to research a therapist’s use of existential therapy with women who experience the psychological impact of choosing abortion. Existing literature on the subject was researched and summarized. Two therapists who have worked through existential therapy with women who have chosen abortion were interviewed regarding their experience with treatment. Research questions were developed, interviews were conducted, and results were analyzed. The therapists identified freedom, meaning, and death as key existential components in working with women. The therapists found that implementing counseling services into the abortion process to be beneficial. This project provides insight into how a therapist can effectively work with women who experience the psychological impact of choosing abortion through existential therapy. 

Michelle Kamiak
Life Happens: Exploring the Experience of Therapists Who Work with Distressed Therapists

While therapists are professionals who are known for helping individuals navigate through life’s challenges, they too can encounter distressing circumstances that are similar to what their clients’ encounter. The purpose of this study is to bring awareness to the topic of therapists who are experiencing distress. In addition, this study seeks to explore the experience of therapists who provide counseling to other therapists. There was a review of the available literature on the topic of therapists who are experiencing distress and their personal encounters when undergoing their own therapy. Two therapists who have familiarity working with therapists were interviewed regarding their experience of providing therapy for therapists. Those interviews were then transcribed and reviewed for emerging themes. There were six major themes (a) Sources of distress, (b) Resistance, (c) Special considerations, (d), Seeking Support (e) Spirituality, and (f) Treatment, along with several subthemes that emerged from analysis of the data.

Gitit Kaufman
Exploring How Counselors Improve Relationships Between Parents and Their Adopted and Biological Children

Adoptive parents, either domestic or international, often encounter challenges while dealing with their adopted children and the adoption process. This qualitative study was aimed to explore counselors’ perceptions regarding improving relationships between adoptive parents and their adopted and biological children. In order to obtain data for the study two licensed therapists who have worked with adoptive families for several years were interviewed in person. The participants were asked about their professional experiences with adoptive families and family dynamics.. Seven themes were emerged from the analysis. The seven themes were as follows: education, support system, attachment, trauma, how to make adoption work, establishing relationships, and adoptive parent characteristics. The data was compared to the literature related to topic to explain the findings. Suggestions for future study was given in order to improve the dynamics among adoptive families.

Erica Law
Clinician’s Experience Using Group Therapy to Treat Adolescents Experiencing Clinical Anxiety Disorders

Adolescent anxiety disorders are a pervasive issue that interferes in the daily lives of many teenagers. They are often comorbid with other anxiety disorders, as well as depression and several externalizing disorders. There are also physical manifestations of anxiety that can negatively affect teenagers and lead to increased difficulties socially and academically. A review of current literature with a focus on Generalized Anxiety Disorder (GAD) and Social Anxiety Disorder (SAD) helped to inform the survey instrument. To further understand counselor’s experiences working with adolescents with anxiety disorders using group therapy as treatment, two therapists were interviewed using an instrument consisting of 19 questions. One participant was an LCSW and the other participant was an MFTi. Several themes were found in reviewing the data, including age and developmental differences in anxiety disorders, the effects of parenting styles, comorbidity of anxiety and other mental disorders, and the benefits of group treatment. The present study highlights the importance of addressing adolescent anxiety disorders and the wide benefits of group therapy. These include reduced anxiety, greater self-esteem and improved communication skills. Implications for additional research include changes in social media, incorporating in mindfulness techniques into treatment, and further understanding the role of peer victimization.

Susan Lee
Exploration of Counselor’s Use of Canine-Assisted Interventions in Treatment of Older Adults with Depression

The researcher explored counselors’ use of canine-assisted interventions with older adult populations who suffer from depression.  Two female, marriage and family therapists, one Caucasian and one from Jewish decent, with experience in canine-assisted interventions and older populations were interviewed.  Both transcripts were analyzed for emerging themes.  The main themes that surfaced were, (a) therapists’ regard for dogs, (b) importance of dogs’ breed, temperament and training, (c) important considerations in canine-assisted interventions, and (d) observed benefits of canine-assisted therapy.  The findings indicated benefits for both the clients and therapists, and the need for further study in this area, especially in therapy settings.

Emily Liwanag
Counselors’ Process Using EMDR with Adult Children of Parental Suicide

Losing a loved one to suicide is a difficult and distressing loss.  Losing a parent to suicide is particularly traumatic.  Often the survivor is left feeling guilty and abandoned.  The survivors are frequently left to attempt to put together the pieces of what appears to be a senseless act.  Adult children of parental suicide commonly suffer from depression, anxiety, substance abuse and posttraumatic stress disorder (PTSD).  Eye Movement Desensitization and Reprogramming (EMDR) is a widely studied treatment for trauma that has demonstrated great success.  Two interviews were conducted on the topic of counselor’s process using EMDR with adult children of parental suicide.  These interviews were conduced in the hope that clinicians can apply the findings to helping this vulnerable population.

Michelle Mandell
How Do Therapists Believe Couples Rediscover Intimacy After a Crisis?

Building intimacy is vital for couples to maintain their bond and grow closer in their relationship; yet is one of the most common areas of struggle for couples.  There is a lack of research on the correlation between intimacy and how couples process conflict.  The current body of research shows that crises such as infidelity, sexual dysfunction, and loss can contribute to a disruption in intimacy for the average couple.  Additionally, the literature supports couples counseling as an effective tool for helping couples re-establish intimacy after a crisis.  The present study used a qualitative method to evaluate two therapists’ views on how couples recover intimacy post-crisis.   Both therapists were asked the same series of questions during hour-long interviews.  The results reflected many of the same points as the literature, including the result that crisis often spurs on many intimacy issues for couples.  The study further delves into specific types of crisis and tools therapists can employ for recovery.  Further research about intimacy as a driver to bring couples into therapy would contribute to the current body of research and help practitioners to understand there may be more underlying issues for their clients. 

Sara Nouri
Counselors' Process Using Mindfulness Treatment with Adolescents Experiencing Social Anxiety

A qualitative study of counselors’ experience was conducted examining the treatment of adolescent social anxiety using mindfulness. Two participants with 3 to 5 years of practice were recruited using telephone and email subsequent to Internet search for clinics indicating the target intervention and population. Interview questions were based upon relevant empirical findings including effectiveness of treatment, comorbidities, and the role of family, gender and body image. Results presented the emerging themes based upon the participants’ responses to interview questions describing personal experience and opinions. Discussion compared and contrasted the resulting themes with the relevant empirical findings cited from the review of research literature.      

Jeffrey Park
Working with Male to Female Transgender Survivors of Sexual Violence: Culturally Competent Counseling

Facing discrimination or hate-based violence is a difficult process for anyone who experiences it.  Clinicians who are trained in multicultural competency usually examine race and ethnicity and sexual orientation, but rarely observe gender identity.  Male to female transgender persons have a unique and diverse experience due to their physical, emotional, and mental transition.  In male to female transgender culture, sex work and an overall negative attitude towards this population has exposed this population at a higher risk of sexual violence.  It is common for male to female transgender survivors of sexual assault to feel depression, anxiety, and form suicidal ideation because of the challenges transition creates.  Qualitative interviews with two mental health workers working with the LGBT population were utilized to gather a better understanding of this subculture community.  Through research, therapists and future clinicians can develop a better understanding and scope of skills to work with this population in the future.

Andrea Rubio
Therapists’ Experience Working with School-Aged Boys Experiencing Paternal Incarceration Utilizing Group Therapy

Despite the surge in incarceration rates throughout the country and California having the highest incarceration rate in the nation, there has been limited research as to the interventions available to school aged boys experiencing paternal incarceration.  With a skyrocketing prison population, there is a need for therapists to connect with boys and implement effective interventions.  The purpose of this article if to describe the experiences of therapists who have worked with school aged boys experiencing paternal incarceration, utilizing a group therapy intervention.  Benefits and risks of group interventions, as well as recommendations for considerations and interventions when working with this population are discussed.

Kimberly Salyer
Counselors’ Experience Working with Survivors of Interpersonal Violence Experiencing Posttraumatic Stress Disorder Utilizing Eye Movement Desensitization and Reprocessing

Recent studies indicate that survivors of interpersonal violence who suffer from symptoms of posttraumatic stress disorder suffer a number of physical, psychological, and social symptoms.  Research has also indicated that Eye Movement Desensitization and Reprocessing is an effective treatment for posttraumatic stress disorder.  There has been limited previous research, however, utilizing Eye Movement Desensitization and Reprocessing in the treatment of posttraumatic stress disorder symptoms in survivors of interpersonal violence.  This study examined how clinicians described the use of Eye Movement Desensitization and Reprocessing in the treatment of interpersonal violence survivors’ symptoms of posttraumatic stress disorder.  The methods included the recruitment of two clinicians with experience utilizing eye movement desensitization and reprocessing in their work with survivors of interpersonal violence who had symptoms of posttraumatic stress disorder, and interviewing them.  The interviews were audio taped, transcribed, and analyzed for themes.  The results indicated that eye movement desensitization and reprocessing was an effective treatment for posttraumatic stress disorder in survivors of interpersonal violence.  The results also indicated that eye movement desensitization and reprocessing offers superior outcomes than other treatment methods. 

Katie Spero
An Exploration of Counselors’ use of Yoga Meditation in the Treatment of Women Who Have Experienced Intimate Partner Violence

The present study seeks to explore two counselors’ approaches to using yoga meditation in the treatment of women who have experienced intimate partner violence (IPV). Two separate interviews were conducted using a questionnaire consisting of 20 questions including issues relating to ethical concerns, overall risks, and adjunct treatment methods like medication and talk therapy. Results yielded two overarching themes labeled Clinical Issues and Treatment Focus. The themes were further divided into five subcategories. Clinical Issues: (a) Physical and emotional symptomology of IPV; and (b) Risk of re-traumatization. Treatment Focus was further divided into: (c) Instilling internal resources; (d) Creating safety; (e) Importance of restorative yoga in trauma work; and (f) Focus on here-and-now. In addition, comparable data was revealed in the area of military sexual trauma (MST), and was therefore included in the analysis of yoga meditation in the treatment of IPV.

Anna Spencer-Lonetti
Counselors’ Experience Using Attachment Therapy with Adoptive and Foster Youth Experiencing Attachment Disorders

The author conducted a qualitative study on counselor’s experiences applying attachment therapy approaches to adopted and foster children experiencing attachment disorders.    The literature review examined attachment disorders and disturbances, the emotional and psychological behaviors associated with attachment disorders, and treatment approaches to help children struggling with an attachment disorder.  Interviews were conducted with two psychologists with vast knowledge and experience on the topic of attachment disorders.  Data from both the literature review and the interviews indicated that attachment disorder is linked to various behavioral disturbances both in children and adults.  The data contained in both the literature review and the therapists’ interviews suggest that attachment therapy approaches used when treating attachment disorders have been shown to be effective.

Angelica Vasquez
Counselor’s Process Using Play Therapy in Treatment of Adolescents with Childhood Sexual Abuse Engaging in Self-Harm

Research has shown that harmful effects of CSA includes deliberate self-harm and psychological dysfunctions, however, less research has looked at these damaging effects experienced during the adolescent stage. As deliberate self-harm as also become a growing phenomenon among adolescents, there is a lack of literature looking at the CSA as a precursor with another gap in empirical research looking at play therapy as a treatment approach for these adolescents. A qualitative study was conducted with therapists who use play therapy in treatment with CSA adolescents who engage in self-harm, using in-depth interviews that consisted of survey questions that were open-ended and qualitative in nature. Previous literature suggests that there are gender, ethnic and family dynamic differences among CSA adolescents. Previous literature also suggests that there is not only an association between CSA and self-harm during adolescence, but peer influence has become a factor in this phenomenon.  Results found there is a correlation between childhood sexual abuses as a prevalent precursor to active engagement in self-harm among adolescents. Results also found that through visualization and using concrete approaches, play therapy in combination with cognitive behavioral therapy is beneficial in significantly reducing symptoms stemming from the sexual abuse trauma. The high prevalence rate of CSA and self-harm among adolescents suggests a need for  identifying and defining what  risk factors are regarding CSA and self-harm among adolescents in order to aid in prevention in homes and in schools as well as in psychotherapy treatment intervention

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