Theses and Dissertations from UMD

Permanent URI for this communityhttp://hdl.handle.net/1903/2

New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM

More information is available at Theses and Dissertations at University of Maryland Libraries.

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2020 - 20222

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Author: search.filters.author.Hillman, Justin WilliamSubject: search.filters.subject.Counseling psychology

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    Getting on the Same Page: Associations of Immediacy and Client-Therapist Alliance Congruence
    (2022) Hillman, Justin William; Kivlighan, Jr., Dennis M; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    This study examined the within-dyad association of immediacy (i.e., a skill that therapists use to work with the therapeutic relationship in the here-and-now) with the strength and congruence of the working alliance across 1352 sessions of 58 adult community clients seeing 11 doctoral student therapists in individual psychodynamic-interpersonal psychotherapy. As a preliminary step, the factor structure and validity were tested for the Metacommunication in Session Questionnaire–Client Form (MSQ-C), a client-rated measure of immediacy adapted from the supervisory MSQ (Calvert, Deane, & Grenyer, 2020). After every session, clients and therapists completed the Working Alliance Inventory–Short Revised (WAI-SR; Hatcher & Gillaspy, 2006) and clients completed the MSQ-C. Factor analysis supported a two-factor structure for MSQ-C (Open Communication and Managing Disagreement/Discomfort factors). Validity of the MSQ-C was supported by predicted correlations with measures of helping skills, sessions quality, alliance, and therapist reported immediacy use, although some associations varied depending on the client or therapist rater perspective. Results of multilevel, latent variable models found that when clients reported more immediacy in a session compared to their average session, they tended to report a stronger alliance; and this effect was strongest in earlier sessions, weaker in magnitude in middle sessions, and non-significant in later sessions. Results of multilevel truth-and-bias models showed that therapist alliance ratings were temporally congruent with client alliance ratings, but client-perceived immediacy did not predict alliance congruence. Limitations and future directions are discussed.
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    Changing Attachments: The Client-Therapist Relationship and Outcome
    (2020) Hillman, Justin William; Kivlighan, Jr., Dennis M; Counseling and Personnel Services; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)
    From the perspective of attachment theory (Bowlby, 1988), this study examined if client attachment to therapist developed over the course of psychotherapy and if changes in attachment to therapist were associated with treatment outcomes. Clients (N = 112), receiving psychodynamic therapy from trainee therapists (N = 29), completed the Client Attachment to Therapist Scale (Mallinckrodt, Gantt, & Coble, 1995) and the Outcome Questionnaire-45 (Lambert et al., 1996) at baseline and every eighth session. Multilevel linear growth curve analyses showed that secure attachment to therapist increased and avoidant-fearful attachment to therapist decreased. Multilevel linear regression showed that when within-client secure attachment to therapist was higher, subsequent symptoms improved more. Client-level and therapist-level effects were explored. Results suggest that the development of a secure attachment to therapist is important for positive treatment outcomes. Implications for practice and research are discussed.