Clinical Psychology Graduate Students Research Articles

Low reliability when determining criterion a for posttraumatic stress disorder from self-report descriptions of traumatic events: The need for transparent methods.

Exposure to a traumatic event is a primary criterion (Criterion A) for meeting Posttraumatic Stress Disorder (PTSD). Using self-report to establish diagnostic criteria in research has become more common, especially with internet-based research. However, some individuals may construe events as traumatic when they do not meet Criterion A. There has yet to be a test of interrater reliability (IRR) from self-report of traumatic events. Three graduate students in clinical psychology and three licensed psychologists rated Criterion A using the life events checklist (LEC), as well as the three modified LEC versions (specification of up to three index traumas; extension of part 2 of the LEC) aimed to increase IRR. One hundred participants completed each of the four versions of the LEC (N = 400). Bootstrapped permutation tests were used to estimate differences in IRR and to generate 95% confidence intervals (CIs). Overall, findings indicated fair-moderate IRR (Fleiss's kappa) κ = 0.428, 95% CI [0.379, 0.477]. The other versions of the LEC (including additional clarifying questions in part 2 of the LEC and/or opportunities to describe up to three traumas) did not meaningfully increase IRR. Findings indicate that relying on self-report from the LEC alone and/or single-rater assessment of open-text trauma descriptions is not recommended for determining whether a traumatic event meets Criterion A. We conclude that it is critical when collecting self-reported PTSD symptoms to provide a clear description of how Criterion A was assessed, initial agreement between raters, and how disagreements were resolved. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Health humanities-focused interprofessional education for age-friendly care using photography and the 4Ms framework: A curricular short report

An interprofessional education activity (IPE) using visual art was implemented to develop student empathy for older adults’ lived experiences and understanding of the age-friendly healthcare 4Ms framework. Graduate students in clinical psychology, pharmacy, physician assistant, and physical therapy participated. The activity involved an introduction to the 4Ms, submitting original photographs of older adults in the context of the 4Ms, and a photography exhibition. At the exhibition, students viewed images in interprofessional groups and discussed the images using a modified visual thinking strategy followed by a facilitated discussion. Pre/post surveys for 4Ms knowledge, empathy, interprofessional learning, and satisfaction were completed. Positive changes occurred in empathy, attitudes toward IPE, 4Ms knowledge, and satisfaction. Group discussion themes identified include recognition of the ambiguity of the lived experience; awareness of cognitive bias; and changing perspective. Activities combining visual art and IPE may develop empathy and knowledge of age-friendly care in health sciences students.

Efficacy of a single session mindfulness based intervention: A randomized clinical trial.

Loneliness, perceived stress, depression, and anxiety have increased during the COVID-19 pandemic. Many of existing mindfulness and compassion-based intervention are effective, but are time-intensive, decreasing overall accessibility and scalability. Single-session interventions (SSIs) serve as a promising alternative. The current pre-registered randomized clinical trial evaluated a newly developed, manualized, mindfulness-based single-session intervention. 91 adults were randomly assigned to one of three conditions: (1) one-hour mindfulness only telehealth intervention; (b) one-hour mindfulness and compassion telehealth intervention; or (c) one-week waitlist control (before randomization to an active intervention). Intervention sessions were conducted by graduate students in clinical psychology. The primary outcome was self-reported loneliness; secondary outcomes were self-reported perceived stress, depression, and anxiety. Using Bayesian multilevel models, we found that compared to the waitlist-control, the inclusion of a compassion component led to meaningful reductions in perceived stress b = -3.75, 95% HDI [-6.95, -0.59], anxiety b = -3.79, 95% HDI [-6.99, -0.53], and depression b = -3.01, 95% HDI [-5.22, -0.78], but not loneliness at the 1-week follow-up. Results suggest that a single-session mindfulness and compassion intervention may lead to meaningful reductions in perceived stress, symptoms of anxiety, and symptoms of depression, but not loneliness. Implications of these findings are discussed.

A roadmap to address stress in graduate students: How to develop and disseminate a student-led single-session evidence based intervention

Objective: This manuscript describes an evidence-based, student-led, single-session group intervention to support emotional wellbeing among graduate students. The present objective is to provide a roadmap for other universities. Participants: Key participants include clinical psychology graduate students (leader and workshop facilitators), faculty supervisor, representatives from receiving departments or schools, and institutional advocates. Methods: The two-hour workshop was based on four core transdiagnostic cognitive behavioral skills, including psychoeducation about emotions, mindful emotional awareness, cognitive flexibility, and behavior change. The workshop was designed and continues to be led by trained graduate students. Results: Key steps and lessons learned are presented for the exploration, preparation, implementation, and sustainment phases. Conclusions: This program has the potential to be flexibly replicated at other universities to assist with graduate student mental health. It provides unique supports for recipients and unique training opportunities for student facilitators.

QOL-05. EXPLORATORY ANALYSIS OF COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA (CBT-I) AMONG PATIENTS WITH PRIMARY BRAIN TUMOR: EFFECTS ON DEPRESSION, ANXIETY, AND LIFE QUALITY

Abstract BACKGROUND Sleep disturbance is among the most common complaints endorsed by patients with a brain tumor diagnosis, yet the delivery of behavioral insomnia treatment is not standard practice in neuro-oncology. Our pilot trial of a 6-session group-based telehealth CBT-I program among primary brain tumor patients demonstrated clinically significant improvements in self-reported insomnia, fatigue, and sleep quality. In other cancer patient samples, CBT-I is also associated with improvements in psychosocial outcomes beyond sleep; thus, the aim of this exploratory analysis was to examine change in depression, anxiety, and life quality among primary brain tumor patients enrolled in CBT-I. METHODS This was a single-arm ORBIT Model Phase IIa proof-of-concept trial. N = 40 cognitively-intact participants (Mage = 52.4 + 12 years; 50.0% female) with a primary brain tumor and insomnia enrolled in a 6-week group-based telehealth CBT-I intervention with weekly 90-minute sessions led by graduate students in clinical psychology. Questionnaires (PHQ-9, GAD-7, EORTC-QLQ-30) were completed at baseline and 6 weeks. Within-person clinically significant improvement was calculated for intervention completers (n = 34) based on established cutoffs. RESULTS Approximately one-third of participants experienced clinically significant improvements in symptoms of depression (n = 12, 35.3%) and generalized anxiety (n = 11, 32.3%) following CBT-I, with 0 participants experiencing a clinically significant worsening of symptoms. Thirty-two of thirty-four participants (94.1%) reported clinically significant improvement in at least 1 domain of life quality spanning physical, role, emotional, and/or social functioning. CONCLUSIONS Findings suggest that a brief behavioral intervention for insomnia, CBT-I, may improve depression, anxiety, and life quality in addition to sleep among primary brain tumor patients. RESULTS from this proof-of-concept trial suggest proceeding to a test of CBT-I in comparison to a control group in order to bolster internal validity. In addition, future studies will examine sleep and related psychosocial outcomes over a longer follow-up period to assess maintenance of intervention effects.

Dance/movement therapy pedagogy with Japanese psychology graduate students: facing ‘haji’

The Japanese cultural trait, haji can manifest as a barrier to self-expression in dance/movement therapy (DMT). Fifteen DMT groups were facilitated with three Japanese clinical psychology graduate students over eight months to cultivate Japanese psychology graduate students’ empathic, bodily, nonverbal interactions. A cultural protocol was developed to attend to the participants’ sense of haji: (1) Creating Ba (safe place), (2) Repetition of activities with kata (forms), and (3) Acquiring Kamae (embodied preparedness). The case study illustrates how the manifestation of haji can be used as an indicator to confirm a sense of safety. The importance of conveying the essence of DMT in a manner that takes into account the cultural protocols of the trainees are discussed. The authors recommend that educators pay attention to the blending of various influences in culture rather than dichotomising knowledge and practice.

Perceived barriers to seeking mental health treatment among clinical psychology graduate students.

Perceived barriers to seeking mental health treatment among clinical psychology graduate students.

Clinical psychology graduate students: Lessons learned from a sudden transition to online education.

Clinical psychology graduate students: Lessons learned from a sudden transition to online education.

Award for Distinguished Professional Contributions to Institutional Practice: Gayle Y. Iwamasa.

This award is intended to recognize outstanding practitioners in psychology. Nominations are considered for psychologists working in a wide variety of institutional practice settings (e.g., schools, military, state hospital, Department of Veterans Affairs). Services provided to diverse client groups or patient populations, including but not limited to children/ adolescents/adults/older adults, urban/rural/ frontier populations, minority populations, and persons with serious mental illness, are considered. Contributions are judged distinguished by virtue of peer recognition, advancement of the public's recognition of psychology as a profession, relevant professional association honors, or other meritorious accomplishments denoting excellence as a practitioner, including improvement of institutional service delivery systems or development of psychologically informed public policy. Gayle Y. Iwamasa is recognized for her strong contributions to service delivery to veterans, Black, Indigenous, and People of Color (BIPOC) veterans, and BIPOC mental health providers. Dr. Iwamasa is credited for a lifelong commitment to the advancement of diversity, equity, and inclusion. For example, Dr. Iwamasa coleads the diversity, equity, and inclusion efforts for the Office of Mental Health and Suicide Prevention, and she has received numerous awards and honors for her many contributions. She is also recognized for having founded the Association of VA Psychologist Leaders' Psychologists of Color and Allies Special Interest Group, where she ensures that VA psychology maintains its commitment to diversity, equity, and inclusion. Dr. Iwamasa's research focuses on multicultural mental health across the life span, and she has given national and international presentations, authored many journal articles and book chapters, and coedited Culturally Responsive Cognitive Behavioral Therapy: Practice and Supervision, Second Edition (2018). Prior to her career with the VA, she spent 16 years in academia, educating and training clinical psychology graduate students where she, likewise, made meaningful contributions to advancing education, training, and practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Leveraging the Strengths of Psychologists With Lived Experience of Psychopathology

Psychopathology is a common element of the human experience, and psychological scientists are not immune. Recent empirical data demonstrate that a significant proportion of clinical, counseling, and school psychology faculty and graduate students have lived experience, both past and present, of psychopathology. This commentary compliments these findings by leveraging the perspectives of the authors and signatories, who have personal lived experience of psychopathology, to improve professional inclusivity in these fields. By “coming out proud,” the authors aim to foster discussion, research, and inclusion efforts as they relate to psychopathology experiences in psychological science. To that end, the authors describe considerations related to disclosure of lived experience, identify barriers to inclusion, and provide concrete recommendations for personal and systemic changes to improve recognition and acceptance of psychopathology lived experience among psychologists.

Supplemental Material for Perceived Barriers to Seeking Mental Health Treatment Among Clinical Psychology Graduate Students

Supplemental Material for Perceived Barriers to Seeking Mental Health Treatment Among Clinical Psychology Graduate Students

Evaluating the Working With Older Adults Scale With Clinical Psychology Doctoral Students.

The ongoing workforce shortage in geropsychology requires continued efforts to understand the factors that influence whether or not students choose to enter this field. The current study builds on prior research by replicating the Working with Older Adults Scale (WOAS) model. Further, the scale was expanded to add professional attitudes, adultist concerns, and number of known professionals in the field of aging. Graduate students in clinical psychology (n = 117) completed the WOAS and new items as part of a larger survey of graduate students in an American Psychological Association-accredited doctoral program. Structural equation modeling was used to first replicate the existing WOAS model and then expanded to include new antecedents in a second model. Results were largely similar to past research validating the WOAS, with the exception that Perceived Behavioral Control was not a significant predictor of Intention in this population. In the expanded model, new items improved the overall model fit and exhibited significant indirect paths to predict intention to work with older adults. These findings further validate use of the WOAS and expand scholarly understanding of the factors influencing the choice of a career in aging. Individuals positioned to encourage careers in aging may wish to address adultist concerns, explore attitudes about such careers, challenge unhelpful assumptions, and provide greater exposure and access to mentors in the field as part of recruitment efforts.

Affirmative Stances in Training Programs Toward Sexual and Gender Minority Clients: Views From Clinical and Counseling Psychology Graduate Students

ABSTRACT Despite training recommendations to address mental health disparities among sexual and gender minority (SGM) individuals, the current state of SGM affirmative training in clinical and counseling doctoral psychology programs remains unclear. The present study surveyed 147 clinical and counseling psychology graduate students in the United States. Participants completed surveys on affirmative training stances in their graduate program for sexual minority clients, gender minority clients, and self-reported perceptions of their attitudes, knowledge, and skills related to SGM clients. Results revealed that current graduate students reported more affirmative stances for sexual minority clients compared to gender minority clients. SGM graduate students reported fewer affirmative stances in their programs for both sexual and gender minority clients compared to their heterosexual cisgender peers. Lastly, SGM identity was a significant predictor of perceived SGM clinical competency beyond years of training, program model, or type of graduate program. Implications for training and future research are discussed.

Training Future School and Clinical Psychology Leaders in Consultation for Early Childhood Education Settings

ABSTRACT This paper describes how training school and clinical psychology graduate students in early childhood mental health consultation (ECMHC) has the potential to fill gaps in the ECMHC workforce, enhance the capacity of early care and education (ECE) providers to effectively support the mental health needs of children and families, and help ECE programs provide equitable services to children and families. We first present the need for explicit ECMHC training in school and clinical psychology doctoral programs, and how didactic coursework and practica could align with national competencies for high-quality ECMHC. We then illustrate how graduate programs might aspire to greater impact by 1) shifting to promotion and prevention, systems- and organizational-based practice orientations, and equity and cultural competence principles; and 2) leveraging ECE programming to infuse ECMHC practice. We conclude with a call to action for graduate programs to address this need for mental health professionals with specialized ECMHC competencies.

Supplemental Material for Development and Implementation of an Objective Structured Clinical Examination for Evaluating Clinical Psychology Graduate Students

Supplemental Material for Development and Implementation of an Objective Structured Clinical Examination for Evaluating Clinical Psychology Graduate Students

Casting and scripting: Visibility, responsibility, and legitimacy in transcultural psychiatry apprenticeships in Paris.

Transcultural psychiatry was developed in France to promote cultural and linguistic diversity and address the mental health needs of immigrants who were excluded from accessing other public mental health services. Professionals in health and social services refer patients to transcultural psychiatry consultations when miscommunications arise or when professionals determine that patients need culturally sensitive therapy. In transcultural psychiatry consultations, a group of therapists, composed primarily of psychologists and psychiatrists, as well as other health and social service professionals, receives a patient, the patient's family, and referring professionals. Previous research on transcultural psychiatry has emphasized the importance of culturally diverse therapy teams and the ways that therapists' diversity could permit patients to open up in consultation sessions. This study draws on ethnographic research in two transcultural psychiatry consultations in Île-de-France, and pays particular attention to the experiences of apprentice therapists, who were often graduate students in clinical psychology. Apprentice therapists reported being introduced to patients in ways that they would not choose themselves. As a result, therapists felt that they had to overemphasize their cultures or countries of origin and French therapists questioned their place in the group. This article describes how transcultural therapy groups are a theater in which belonging, identity, and Frenchness are contested and performed. Apprentice therapists proposed more intersectional and inclusive ways of portraying diversity in the transcultural groups.

ALCOHOL USE SCREENING AND INTEGRATED BEHAVIORAL HEALTH IN GERIATRIC PRIMARY CARE IN THE DEEP SOUTH

This longitudinal behavioral health surveillance and integrated care project aims to assess physical and mental health and substance use in a geriatric primary care setting. Approximately 230 patients (mean age = 76; 74% female; 16% African American) attending an interdisciplinary geriatrics clinic in Alabama have taken part in baseline behavioral health screenings since 2014. Behavioral health measures include cognitive status, self-reported mood, subjective and objective health literacy, and alcohol use. All measures are administered by clinical psychology graduate students. Patients had an average of 5.83 medical diagnoses. Only 26.2% of patients had scores indicating cognitive functioning within normal limits; 32.6% had scores indicative of mild neurocognitive disorder, and 41.2% had scores indicative of dementia. Over 80% of patients had adequate self-reported health literacy; however, measurements of objective health literacy indicated a significant number of individuals have difficulty following medical directions independently. Over 30% of patients reported clinically significant levels of depression or anxiety, and 16.5% of patients reported at least one indicator of hazardous alcohol use. Specifically, 50.7% of patients consume alcohol on at least a yearly basis with 38.2% endorsing at least one problematic drinking behavior and 11.6% scoring in the clinically significant range for alcohol misuse. Moreover, 22.7% report use of opioid pain medication. The results of this study demonstrate that routine hazardous alcohol use screening as one component of integrated behavioral health care within geriatric primary care increases detection of hazardous alcohol use among older adults.

Learning Program Evaluation by doing Program Evaluations: A mutualistic contribution to community agencies

This article introduces the special issue, describing the setting for the overall project and providing an overview of the articles.In the eyes of many clinical psychology graduate students, Progra...

Comparing DSM–5-Hybrid, SWAP, and PDM prototype models of personality disorders: Convergent and divergent findings.

Although dimensional models of personality disorders are of great interest, there exist three methods by which personality disorders may be diagnosed for their fit to a predetermined prototype. In this study, we evaluate a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), hybrid model prototype match (modified from the original prototype DSM-5 proposal; Skodol, Bender, Morey, et al., 2011; Skodol, Bender, Oldham, et al., 2011), the Shedler-Westen Assessment Procedure-2 (Shedler, 2015), and the Psychodynamic Diagnostic Manual prototype match (PDM Task Force, 2006). Three hundred twenty-nine clinical psychology graduate students and interns rated patients they currently were treating with each of the aforementioned diagnostic models, as well as completing a checklist of their DSM-IV personality disorder symptoms. Matching a prototype was defined as being a very good match (exemplifying the disorder, a prototypical case) or a good match (has the diagnosis, disorder applies). Frequencies of the prototype assignments are reported. For the SWAP-2 and PDM, depressive and borderline personality disorders were most frequently assigned, whereas avoidant and borderline personality disorder were the most assigned prototypes for the DSM-5 hybrid categories. However, the degree of convergence across methods on similar diagnostic constructs was low. Implications of these findings for personality disorder diagnosis are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Web-Based Transdiagnostic Intervention for Affective and Mood Disorders: Randomized Controlled Trial.

BackgroundResearch increasingly supports a transdiagnostic conceptualization of emotional disorders (ie applying the same underlying treatment principles across mental disorders, without tailoring the protocol to specific diagnoses), and many international researchers are currently investigating this issue.ObjectiveThe aim of this study was to evaluate the efficacy and acceptability of a Web-based transdiagnostic program using a sample of Romanian adults diagnosed with anxiety and/or depression.MethodsVolunteer participants registered for the study and completed a series of online self-report measures. Participants who fulfilled basic inclusion criteria on these measures were contacted for a telephone diagnostic interview using the Structural Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders (SCID-I). Enrolled participants were randomized to either the active treatment group (N=69) or the wait-list control group (N=36) using a 2:1 ratio. The transdiagnostic treatment was based on the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP; Barlow et al, 2011) that addresses common underlying mechanisms of anxiety and depression. Participants randomized to the active treatment condition received 10 weeks of Web-based treatment based on the UP. Throughout treatment, graduate students in clinical psychology provided guidance that consisted of asynchronous written communication on a secure Web platform. After the intervention, participants in both study conditions were invited to complete a set of self-report measures and a postintervention SCID-I interview conducted by a different team of graduate students blinded to participants’ group and diagnostic status. Six months later, participants in the active treatment group were invited to complete an online follow-up assessment.ResultsDuring the intervention, active treatment participants completed on average 19 homework assignments (SD 12.10), and we collected data from 79.0% (83/105) at postintervention and 51% (35/69) at follow-up for self-report measures. Postintervention SCID-I interviews were collected from 77.1% (81/105) participants. Relative to the wait-list control group, the transdiagnostic intervention yielded overall medium to large effect sizes for the primary outcome measures (within-group Hedges g=0.52-1.34 and between-group g=0.39-0.86), and also for anxiety sensitivity (g=0.80), symptom interference (g=0.48), and quality of life (g=0.38). Significant within-groups effects only were reported for the active treatment group on Panic Disorder Severity Scale-Self Report (PDSS-SR, g=0.58-0.65) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS, g=0.52-0.58).ConclusionsInsignificant between-group differences for the Y-BOCS and PDSS-SR could be explained by the small number of participants with the associated primary diagnostic (eg, only 3 participants with obsessive compulsive disorder) by the choice of outcome measure (PDSS-SR was not rated among the evidence-based measures) and by the fact that these disorders may be more difficult to treat. However, the overall results suggest that the transdiagnostic intervention tested in this study represents an effective treatment option that may prove easier to disseminate through the use of Web-based delivery systems.Trial RegistrationClinicalTrials.gov CT02739607; https://clinicaltrials.gov/ct2/show/study/NCT02739607 (Archived by WebCite at http://www.webcitation.org/6yY1VeYIZ)