University Psychology Clinic Research Articles

A qualitative study of clinicians' impressions regarding the implementation of a clinical and research data collection system

AbstractBackgroundSystematically collecting data on clientele databases allows for describing the clientele's needs and addressing various clinical research questions. Conducted in a university psychology clinic, this initiative seeks to improve the overall quality of care provided by integrating evidence‐based practices. This study works to bridge the gap between clinical practice and research.AimsThis study aimed to describe the potential repercussions and clinicians' impressions regarding the implementation of this procedure.Research DesignAn inductive qualitative approach, inspired by Husserl's descriptive phenomenology, was used. To be consistent with this approach, data analysis followed Giorgi's five‐step scientific phenomenological method.Data Collection and AnalysisSemi‐structured individual interviews were conducted with 14 volunteer clinicians using an interview guide. The data were analysed to extract central themes using Giorgi's method, which involves collecting verbal data, reading the data, dividing it into units of meaning, organising the data using the language of the discipline and synthesising the results.ResultsFive central themes emerged: barriers to implementation, potential impacts on therapy, recommendations to enhance participation, perceived utility and an attitude of openness.DiscussionThe pilot project provides valuable insights into the feasibility and acceptability of systematic data collection in a clinical setting. Clinician consultation proves to be essential in the implementation process, highlighting the importance of addressing practical and philosophical obstacles.ConclusionUnderstanding clinicians' experiences can guide future implementations of similar systems and improve clinical practice by supporting the integration of systematic data collection. Enhanced communication and training on the data collection system are suggested.

Open Label Pilot Study on Posttrauma Health Impacts of the Processing of Positive Memories Technique (PPMT).

Processing of Positive Memories Technique (PPMT) was proposed as a novel intervention for posttraumatic stress disorder (PTSD). PPMT comprises of 5 sessions focused on identifying and processing positive memories. As an open label pilot study, we explored PPMT's effects on PTSD severity, depression severity, affect and cognitive processes, and therapeutic alliance. A sample of 12 trauma-exposed participants seeking services at a University Psychology Clinic participated in 5 PPMT sessions (Mage=29.25 years; 58.30% women). We used the reliable change indices and clinically significant change score approach. The following number of participants showed statistically reliable changes: 9 participants for PTSD severity (8 recovered/improved); 6 participants for depression severity (5 improved); 5 participants for positive affect levels (2 recovered/improved); 9 participants for negative affect levels (8 recovered); 9 participants for posttrauma cognitions (7 recovered/improved); 5 participants for positive emotion dysregulation (4 recovered); 11 participants for number of retrieved positive memories (3 recovered); and 5 participants for therapeutic alliance (4 recovered). PPMT may impact certain posttrauma targets more effectively (PTSD, depression, negative affect, posttrauma cognitions). PPMT may be more helpful in improving regulation rather than levels of positive affect. PPMT, if supported in further investigations, may add to the clinician tool-box of PTSD interventions.

Processing of Positive Memories Technique: Feedback From Trauma-Exposed Clients on Processing of Positive Memories Technique Components, Format, and Feasibility.

Although the majority of research and clinical interventions focused on posttraumatic stress disorder (PTSD) centers on traumatic memories, recent literature suggests the importance of considering emotionally laden memories more broadly among trauma-exposed individuals. Specifically, trauma-exposed individuals have difficulties retrieving positive and negative memories, and interventions focused on enhancing the retrieval of both traumatic and positive memories benefit overall well-being. These findings led to the development of a novel Processing of Positive Memories Technique (PPMT) for PTSD. As the next step in treatment development, PPMT was piloted among 12 trauma-exposed community members seeking therapeutic or assessment services at a university psychology clinic. In this study, we summarize participants' quantitative and qualitative feedback on the content, format, and feasibility of PPMT. Next, we outline proposed formative changes that are critical to the iterative refinement of PPMT, based on the obtained feedback to enhance its scalability, feasibility, and effectiveness. Within clinical practice, PPMT, as implemented in this study, may be feasible, and there may be potential benefits to incorporating positive memory processing using PPMT.

Ethnoracial status, intersectionality with gender, and psychotherapy utilization, retention, and outcomes.

Psychotherapy access, utilization, retention, and effectiveness require continued improvement, especially for groups for whom availability and outcomes may be currently suboptimal, including ethnoracial minorities. Further, ethnoracial status' intersectionality with other identity variables (e.g., gender) may relate to structural barriers to care and effectiveness of care, an area in need of further research. The Florida State University Psychology Clinic, a low-cost population-facing treatment center, has routinely collected clinically relevant information on all consenting clients, including severity of clinical presentation at intake and over time, number of therapy sessions attended and of no-shows, premature termination, demographics, etc. A large sample of clients (N = 2,076; 57% women; 67.9% non-Hispanic White) on whom we collected and entered at least some data, though missing data were common, has accrued. We conducted chi-square tests to examine treatment utilization gaps, analysis of variance to measure differences in intake severity, and analysis of covariance to measure differences in treatment effectiveness. Based on the percentages of ethnoracial minority groups with mental disorders in the broader local community, we are falling short in outreach to Black clients, and when we do engage them, we retain them suboptimally. Once well engaged, however, results across groups suggest few differences in outcomes by ethnoracial status, gender, or their intersection. Ethnoracial match was associated with more sessions attended in Black people. Psychotherapy effectiveness has the potential to be optimized for everyone, and a promising direction in this regard is the case conceptualization of a cultural formulation interview and cultural humility mindset. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Mediating the relationship between neuroticism and depressive, anxiety and eating disorder symptoms: The role of intolerance of uncertainty and cognitive flexibility

• IU and CF both mediate the relationship between neuroticism and depression and anxiety symptoms. • IU, but not CF, mediates the relationship between neuroticism and eating disorder symptoms. • Current study extends previous research by examining IU and CF using parallel mediation. • IU should be targeted in the treatment of depressive, anxiety and eating disorder symptoms. • CF should be targeted in treatment of depressive and anxiety symptoms. Research has found that IU (Intolerance of Uncertainty) and CF (Cognitive Flexibility) have separately been associated with depression, anxiety and eating disorders as a transdiagnostic vulnerability. This study evaluated the mediational effect of both IU and CF on the relationship between neuroticism and depressive, anxiety and eating disorder symptoms. We hypothesised that IU and CF when examined together would both significantly mediate the relationship between neuroticism and depression, generalised anxiety, panic disorder, social phobia, PTSD and eating disorder symptoms. Data was collected through advertising the study at a university campus, Amazon Mechanical Turk and a university psychology clinic. Participants included a total of 717 individuals for which data was available. Mediation analyses were conducted using the PROCESS macro in SPSS. IU and CF were found to significantly mediate the relationship between neuroticism and symptom measures of depression, generalised anxiety, panic disorder, social phobia and PTSD. IU, but not CF, significantly mediated the relationship between neuroticism and eating disorder symptoms. All analyses controlled for gender. The study's limitations include the cross-sectional design precluding causality and that participants provided self-report data. IU and CF are transdiagnostic mediators in the relationship between neuroticism and depression and anxiety. IU was also found to be a significant mediator for eating disorder symptoms but CF was not. Findings suggest the importance of focusing on the these factors during assessment and treatment across emotional and eating disorders.

A retrospective chart review of adult insomnia and headaches in an Australian outpatient psychology training clinic: Prevalence and effects on psychological treatment response

ObjectivesSleep dysfunction and headaches are common and disabling conditions which are frequently comorbid with psychiatric disorders. Furthermore, there is a growing body of literature linking sleep dysfunction to the frequency and intensity of headaches. This study retrospectively examined the prevalence of insomnia and headache frequency, and their effects on general psychological treatment outcomes in a sample of patients attending a university psychology outpatient clinic in metropolitan Queensland, Australia.MethodsOutcome Questionnaire 45 data were extracted for 69 adult patients who presented to the Griffith University Psychology Clinic (Mount Gravatt, QLD) in 2018, and who consented to the use of their deidentified data for research purposes.ResultsThe prevalence of frequent insomnia and headaches in the week of patients' initial session were 47.8 and 23.2%, respectively. Additionally, there was a correlation, rs = .26, p = .02 between frequency of insomnia and headaches at the initial session. Frequent insomnia (odds ratio [OR] = 4.62, p < .01), headaches (OR = 3.82, p = .055, pbootstrapped = .04), and comorbid insomnia and headaches (OR = 7.25, p = .02) were strong predictors of inadequate treatment response, adjusting for age, sex, and number of therapy sessions. Effect sizes achieved by students were large (d = 0.9), and similar to those found in studies of fully qualified therapists.ConclusionsOur study demonstrates clinicians should be aware that sleep and headache problems may complicate psychological treatment of other problems, and that presence of these factors should warrant specific targeted attention early in treatment.

The Impact of a Novel Mimicry Task for Increasing Emotion Recognition in Adults with Autism Spectrum Disorder and Alexithymia: Protocol for a Randomized Controlled Trial.

BackgroundImpaired facial emotion expression recognition (FEER) has typically been considered a correlate of autism spectrum disorder (ASD). Now, the alexithymia hypothesis is suggesting that this emotion processing problem is instead related to alexithymia, which frequently co-occurs with ASD. By combining predictive coding theories of ASD and simulation theories of emotion recognition, it is suggested that facial mimicry may improve the training of FEER in ASD and alexithymia.ObjectiveThis study aims to evaluate a novel mimicry task to improve FEER in adults with and without ASD and alexithymia. Additionally, this study will aim to determine the contributions of alexithymia and ASD to FEER ability and assess which of these 2 populations benefit from this training task.MethodsRecruitment will primarily take place through an ASD community group with emphasis put on snowball recruiting. Included will be 64 consenting adults equally divided between participants without an ASD and participants with an ASD. Participants will be screened online using the Kessler Psychological Distress Scale (K-10; cut-off score of 22), Autism Spectrum Quotient (AQ-10), and Toronto Alexithymia Scale (TAS-20) followed by a clinical interview with a provisional psychologist at the Federation University psychology clinic. The clinical interview will include assessment of ability, anxiety, and depression as well as discussion of past ASD diagnosis and confirmatory administration of the Autism Mental Status Exam (AMSE). Following the clinical interview, the participant will complete the Bermond-Vorst Alexithymia Questionnaire (BVAQ) and then undertake a baseline assessment of FEER. Consenting participants will then be assigned using a permuted blocked randomization method into either the control task condition or the mimicry task condition. A brief measure of satisfaction of the task and a debriefing session will conclude the study.ResultsThe study has Federation University Human Research Ethics Committee approval and is registered with the Australian New Zealand Clinical Trials. Participant recruitment is predicted to begin in the third quarter of 2021.ConclusionsThis study will be the first to evaluate the use of a novel facial mimicry task condition to increase FEER in adults with ASD and alexithymia. If efficacious, this task could prove useful as a cost-effective adjunct intervention that could be used at home and thus remove barriers to entry. This study will also explore the unique effectiveness of this task in people without an ASD, with an ASD, and with alexithymia.Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12619000705189p; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377455International Registered Report Identifier (IRRID)PRR1-10.2196/24543

Exploring the Role of OT in a University Psychology Clinic: A Mixed Method Design

Abstract Date Presented 03/28/20 Through interprofessional education (IPE) and collaboration, a quality-improvement program conducted in a university psychology clinic served to provide PhD psychology students with an opportunity to better understand the role of OT in a community mental-health (MH) setting. This program aimed to further examine OT’s role in a MH setting, as well as the impact of IPE and collaboration on PhD psychology students’ knowledge and understanding of OT. Primary Author and Speaker: Moira Miller Contributing Authors: Amy Mattila, Jessie Goicoechea

Embedded WAIS-IV Detection Strategies and Feigned Cognitive Impairment: An Investigation of Malingered ADHD.

Malingered attention-deficit hyperactivity disorder (ADHD) may be strongly motivated on college campuses by recreational use of ADHD medications and to obtain unwarranted academic accommodations. Rather than rely on face-valid (easily faked) ADHD checklists, the study focused on the more complex Wechsler Adult Intelligence Scale-Fourth edition (WAIS-IV; Wechsler, 2008). However, the current literature has not yet investigated well-defined detection strategies for feigned WAIS-IV presentations. Using aprioristic standards, four different detection strategies from the feigning literature were adapted to certain WAIS-IV subscales. For example, significantly below-chance performance was applied to visual puzzles. Using a between-subjects simulation design, 74 undergraduate simulators were compared with archival data on 73 outpatients diagnosed with ADHD at a university psychology clinic. Very large effect sizes (Cohen's ds from 1.66 to 1.90) differentiated between genuine and feigned ADHD. Two strategies (significantly below-chance performance and floor effect) showed strong promise if cross-validated for other feigning presentations. The study concluded with clinical considerations and future avenues for research.

A Novel Intervention for Child Peer Relationship Difficulties: The Secret Agent Society

This study evaluated the effectiveness of the Secret Agent Society (SAS) small group program in improving children’s social skills, social competence and anxiety. Participants included 27 children aged seven to 12 years (20 boys, seven girls) whose parents identified them as experiencing peer relationship difficulties or social anxiety. SAS featured a computer game and other spy-themed activities that children played during nine weekly 90 minute club meetings that were facilitated by University psychology clinic interns. The program also included weekly parent group training sessions, home missions (skills practice tasks) and weekly tip sheets that informed school staff about the skills that children were learning, and how they could support them in applying these skills in the classroom and playground. Program outcomes were evaluated using a range of parent- and child-report measures administered at pre-intervention, post-intervention and at six-week follow-up. Results suggested that SAS led to significant improvements in children’s social skills as reported by parents (Fs (2, 25) ≥ 21.91, ps < 0.0001, partial ɳ2s ≥ 0.46), children’s social competence as reported by parents (F(2, 25) = 17.12, p < 0.001, partial ɳ2 = 0.58), children’s overall anxiety as reported by parents (F(2, 25) = 8.57, p = 0.001, partial ɳ2 = 0.41), and children’s social anxiety as reported by themselves (F(2, 25) = 7.14, p = 0.004, partial ɳ2 = 0.36). All significant treatment effects were maintained at six-week follow-up. These findings suggest that the program holds promise as a community-based resilience program for children, although larger scale controlled trials of the intervention are needed.

Uma proposta de atendimento psicossocial grupal com pais e mães separados

A literatura científica aponta para diversos formatos de grupos de apoio às famílias separadas, apresentando similaridades e diferenças no que se refere ao público alvo e características das intervenções. Este artigo tem como objetivos propor uma metodologia de intervenção psicossocial grupal com pessoas em situação de separação conjugal de baixa renda que possuam filhos pequenos e analisar as conversações grupais sob o prisma da distinção entre parentalidade e conjugalidade. Utilizou-se como método a pesquisa-ação no contexto universitário e psicossocial de clínica-escola de Psicologia e dois pais e uma mãe participaram dos sete encontros grupais, onde foram discutidos os temas conjugalidade, parentalidade, comunicação, transgeracionalidade e redes sociais, entre outros. A partir da análise temática, os resultados demonstraram que o contexto psicossocial grupal contribuiu para a diferenciação entre os papéis conjugais e parentais, porém o relacionamento coparental se mostrou enfraquecido. A fim de ampliar a participação em metodologias semelhantes, sugere-se investimento em parcerias entre pesquisadores, profissionais e programas que atuem com essa população, bem como a diminuição da quantidade de encontros associada a intervenções mais voltadas à parentalidade e menos à conjugalidade.

Intentional inattention: Detecting feigned attention-deficit/hyperactivity disorder on the Personality Assessment Inventory.

Given the increasing number of college students seeking Attention-Deficit/Hyperactivity Disorder (ADHD) diagnoses as well as the potential secondary gains associated with this disorder (e.g., access to stimulant medication, academic accommodations), the detection of malingered symptom presentations in this population is a major concern. The present study examined the ability of validity indicators on the widely used Personality Assessment Inventory (PAI; Morey, 1991) to distinguish between individuals experiencing genuine ADHD symptoms and individuals instructed to present with ADHD symptomatology for secondary gain. Sixty-six participants who successfully simulated ADHD (based on elevations on the Conners' Adult ADHD Rating Scale; Conners, Erhardt, & Sparrow, 1998) were compared with a sample of undergraduate students meeting diagnostic criteria for ADHD (N = 22) and an archival sample of adults who received an ADHD diagnosis at a university psychology clinic following a comprehensive psychological evaluation (N = 41). Successful simulators obtained significantly higher scores on all relevant PAI validity indicators compared with the clinical and archival comparison samples, with the Rogers Discriminant Function demonstrating the highest predictive accuracy (AUC = .86). Traditional cut scores on the Negative Impression (NIM) validity scale used to designate probable malingering, however, were not sensitive to simulated ADHD symptoms, although they did demonstrate excellent specificity. The PAI may be informative as an indicator of potentially exaggerated or malingered symptom presentation, but alternative cut scores for symptom validity indicators may be necessary to maximize its utility in these particular types of psychological evaluations. (PsycINFO Database Record

Mindfulness-based cognitive therapy for headache pain: An evaluation of the long-term maintenance of effects

ObjectivesThis study aimed to examine the durability of gain patterns following an 8-week Mindfulness-Based Cognitive Therapy (MBCT) for headache pain program. DesignA secondary analysis of a randomized controlled trial was conducted. Participants (N=19) were individuals with headache pain who completed both the MBCT program as well as a 6-month follow-up assessment at a headache clinic or a university psychology clinic. Standardized measures of the primary outcomes (pain intensity and pain interference) and secondary outcomes (pain catastrophizing, mindfulness, activity engagement, pain willingness, and self-efficacy) were administered. Paired-samples t tests and effect sizes were examined. ResultsSignificant (uncorrected ps<.05) pre- to post-treatment gains were found for pain intensity, pain interference, pain catastrophizing, activity engagement and self-efficacy, and these gains were maintained at 6-months post-treatment. Effect sizes for the significant changes from pre- to post-treatment, and from pre-treatment to follow-up were mostly consistent across epochs (.62≤ds≤−1.40), indicating steady maintenance of effects. Improvement in mindfulness and pain willingness was non-significant immediately post-treatment and at follow-up, with small effects observed. ConclusionsThis study adds to a growing body of literature supporting the durability of MBCT for painful conditions. Results indicated a consistent pattern of maintenance of treatment-related gains across a number of key pain-related outcomes. Future research with a larger sample is needed to investigate the mechanisms underlying these continued gains in order to optimize targeted relapse-prevention.

Exploration of Client Profile and Clinical Outcome in a University Psychology Clinic

ObjectiveThe main aim of this project was to provide a client profile and to evaluate effectiveness of therapy as provided by trainees in a university‐based psychology clinic setting.MethodThe participants included face‐to‐face (n = 82) and video‐therapy (n = 20) adult clients of the University of South Australia Psychology Clinic at Magill Campus who attended the clinic between March 2011 and August 2013. A mixed design was used to evaluate treatment effectiveness. Psychological distress was measured using the Depression, Anxiety, and Stress Scales (DASS‐21) and Clinical Outcomes in Routine Evaluation (CORE‐10).ResultsScores in the CORE‐10 indicated that the clients' distress levels significantly decreased between pre‐ and post‐treatment; however, this was not dependent on therapy completion or dropout. Unemployment status was the only factor to significantly predict therapy dropout.ConclusionIn summary, results suggest that trainees gained experience with a wide range of client groups and that therapy provided by trainees was effective.

Characteristics of demand and psychological treatments in a university clinic

The objectives of this study are to describe the most common characteristics of patients receiving psychological treatment and the treatments administered. We analyzed a sample of 856 patients at the University Psychology Clinic of the Complutense University of Madrid. Five diagnostic categories accounted for 78.4% of demand: anxiety disorders (31.9%), no diagnosis (15.4%), other problems requiring clinical attention (14.2%), mood disorders (9.5%) and adaptive disorders (7.4%). A total of 17.7% presented a comorbid diagnosis and 49.3% had received treatment previously. The mean of assessment and treatment sessions was 3.5 and 12.7, respectively. The most commonly applied techniques included psychoeducation (95.1%), cognitive restructuring (74.8%), relaxation (74.4%), and control of internal dialogue (68.1%). Of the patients that had finished contact with the clinic, 68.3% were a therapeutic success. We discuss the generalization of the results and the implications for the profession and clinical practice.

Empathy from the client's perspective: A grounded theory analysis

Although empathy is one of most robust predictors of client outcome, there is little consensus about how best to conceptualize this construct. Objective: The aim of the present research was to investigate clients’ perceptions and in-session experiences of empathy. Method: Semi-structured, video-assisted interpersonal process recall interviews were used to collect data from nine clients receiving individual psychotherapy at a university psychology clinic. Results: Grounded theory analysis yielded a model consisting of three clusters: (1) relational context of empathy (i.e., personal relationship and professional relationship), (2) types of empathy (i.e., psychotherapists’ cognitive empathy, psychotherapists’ emotional empathy, and client attunement to psychotherapist), and (3) utility of empathy (i.e., process-related benefits and client-related benefits). Conclusions: These results suggest that empathy is a multi-dimensional, interactional process that affects—and is affected by—the broader relationship between client and psychotherapist.

Telepsychology in a University Psychology Clinic Setting: A Pilot Project

ObjectiveThe focus of the present study was to investigate levels of psychological distress and therapeutic alliance rated by clients attending psychological therapy sessions via video therapy or in person at a university psychology‐training clinic.MethodParticipants were 23 clients who had completed at least five therapy sessions with a provisional psychologist on placement in a university psychology clinic. Six of these attended sessions via videoconferencing in Port Augusta and 17 were local clients who attended traditional in‐person sessions. Both qualitative and quantitative methods were utilised in order to identify perceptions of and reactions to video therapy as described by participants.ResultsReported levels of psychological distress across sessions were within the clinical range and similar across both video therapy and in‐person settings, with no statistical differences between the groups. Equally high levels of therapeutic alliance were established across both settings. Participants' experiences of video therapy were further explored under five main themes identified through content analysis: Initial Reactions and Adjustments, Factors Affecting Communication, Perceived Effectiveness, Therapeutic Alliance, and Practical Factors.ConclusionsFindings suggest video therapy provided by provisional psychologists represents a feasible and acceptable means by which rural residents can access psychological treatments in the Australian context.

The development, facilitation and initial evaluation of a mindfulness group for a clinical psychology training course

This article presents an evaluation of a mindfulness group facilitated for trainee and qualified psychologists working in a university psychology clinic. The group was shown to have both personal and professional benefits for participants, but further evaluation is required.

A Case of Dissociative Fugue and General Amnesia with an 11-Year Follow-Up

Dissociative fugue refers to loss of personal identity, often with the associated loss of memories of events (general amnesia). Here we report on the psychological assessment of a 54-year-old woman with loss of identity and memories of 33 years of her life attributed to dissociative fugue, along with a follow-up 11 years later. Significant levels of personal injury and stress preceded the onset of the amnesia. A detailed neuropsychological assessment was completed at a university psychology clinic, with a follow-up assessment there about 11 years later with an intent to determine whether changes in her cognitive status were associated with better recall of her life and with her emotional state. Psychomotor slowing and low scores on measures of attention and both verbal and visual memory were present initially, along with significant psychological distress associated with the diagnosis of posttraumatic stress disorder. Although memories of her life had not returned by follow-up, distress had abated and memory test scores had improved. The passage of time and a better emotional state did not lead to recovery of lost memories. Contrary to expectations, performance on tests of executive functions was good on both occasions. Multiple stressful events are attributed as having a role in maintaining the loss of memories.

Factors associated with prolonging psychological treatment for anxiety disorders.

Anxiety disorders are one of the disorders most frequently requested for psychological attention. The purpose of this study is to identify the factors that can explain a longer duration of psychological treatment for anxiety disorders. 202 patients from the University Psychology Clinic of the Complutense University of Madrid were analyzed. Multivariate regression analysis showed that the presence of obsessive-compulsive disorder and the application of arousal control techniques followed by modeling and other specific techniques were the best predictors of treatment duration. Reducing as much as possible the number of techniques applied without reducing intervention efficacy is suggested. In some disorders that produce a greater life disorganization, it may be useful to try to organize the patient&acute;s life either as a first goal or at the same time as the intervention program, so as to increase its effectiveness and reduce the number of sessions.