Given the ongoing dilemma for college counseling centers to meet steady increases in demand for s... more Given the ongoing dilemma for college counseling centers to meet steady increases in demand for services, this study outlines the implementation of an adapted stepped care model in a university counseling center. Our adapted model focused, as do other stepped care models, on treatment planning and lower-intensity interventions, with the addition of the intensive therapy option being provided on a weekly basis. We adopted our stepped care model across a large center and hypothesized that after implementation we would be able to serve a similar number of clients as our previous model and that treatment outcomes for these clients would improve. Descriptive data and regression analyses demonstrated support for our hypotheses, including an increased likelihood of clinically significant improvement for clients postimplementation. Implications for adapting service delivery models using practice-based evidence are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Practice-based evidence (Burlingame & Beecher, 2008) is an approach to evidence-based practice th... more Practice-based evidence (Burlingame & Beecher, 2008) is an approach to evidence-based practice that addresses treatment efficacy to remediate clinicians' inability to predict treatment response (Chapman et al., 2012; Hannan et al., 2005). The Group Questionnaire (GQ; Bormann, Burlingame, & Straub, 2011; Johnson, Burlingame, Olsen, Davies, & Gleave, 2005) is one practice-based evidence measure that supports clinical judgment to enhance psychotherapy outcomes by measuring 3 important group constructs: Positive Bond, Positive Work, and Negative Relationship. A clinical example of how one group leader used GQ data provided by group members regarding their weekly group experiences to support her interventions in a process-oriented therapy group for adults includes verbatim clinical exchanges among group members and the leader. The example also includes a GQ report with explanations of the group members' scores and numerical and graphical data. The authors detail how the leader us...
Abstract Objective: Although supervision has long been considered as a means for helping trainees... more Abstract Objective: Although supervision has long been considered as a means for helping trainees develop competencies in their clinical work, little empirical research has been conducted examining the influence of supervision on client treatment outcomes. Specifically, one might ask whether differences in supervisors can predict/explain whether clients will make a positive or negative change through psychotherapy. Method: In this naturalistic study, we used a large (6521 clients seen by 175 trainee therapists who were supervised by 23 supervisors) 5-year archival data-set of psychotherapy outcomes from a private nonprofit mental health center to test whether client treatment outcomes (as measured by the OQ-45.2) differed depending on who was providing the supervision. Hierarchical linear modeling was used with clients (Level 1) nested within therapists (Level 2) who were nested within supervisors (Level 3). Results: In the main analysis, supervisors explained less than 1% of the variance in client psychotherapy outcomes. Conclusions: Possible reasons for the lack of variability between supervisors are discussed.
With increasing demand for psychotherapy services, clinicians are carrying increasingly large cas... more With increasing demand for psychotherapy services, clinicians are carrying increasingly large caseloads (Bailey et al., 2020). As the number of new intakes exceeds the number of clinical hours available each week in some settings, psychotherapy is delivered on an attenuated schedule for returning clients (rather than the traditional weekly frequency); there is, however, little support for the efficacy of this practice. The present study explored the effect of session frequency on psychotherapy outcomes using a quasi-randomized controlled design. In a working university counseling center, we assigned therapists to either a treatment-as-usual (TAU) group (attenuated session frequency) or an experimental group (weekly session frequency). Clients were randomly assigned to a therapist in either condition. Using hierarchical linear modeling and survival analyses, we examined psychotherapy outcomes (measured by session-by-session Outcome Questionnaire 45 scores) for 1,322 clients (3,919 individual sessions). We found no differences between groups when examining the full sample, but also found limited fidelity in the experimental group. When identifying individuals who were seen weekly in at least the first three sessions after intake (sensitivity analysis), we found the following: (a) weekly therapy resulted in faster trajectories of change over time, (b) weekly therapy resulted in a greater likelihood of achieving recovery, and (c) weekly therapy resulted in a greater likelihood of achieving recovery sooner. We discuss the importance of including session frequency when considering the dose of therapy, as well as the implication that prioritizing weekly therapy may increase therapy efficacy and efficiency in routine practice. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
This article provides an overview of patience and its associated constructs by examining its role... more This article provides an overview of patience and its associated constructs by examining its role in five domains: (a) confidence and control; (b) distress tolerance; (c) relationship development, maintenance, and repair; (d) character development; and (e) spiritual maturation. It highlights initial evidence that patience contributes to increased self-regulation and impulse control, distress tolerance, self-compassion, mindfulness, empathy in relationships, perspective taking, use of cognitive reappraisals, prosocial orientation, character development, and spiritual maturation. Patience helps with coping with anxiety and depression, aids with handling uncertainty, facilitates relationship maintenance and repair, and sustains the ability to manage the ambiguities present during faith crises. It promotes persistence and long-suffering, and it facilitates humility, wisdom, forgiveness, benevolence, faith, hope, and charity. It also supports primary control efforts and activates secondary control strategies when situations are outside of a client’s control. Patience enhances the possibility of benefit finding during periods of adversity. Patience may qualify as a common factor (Wampold, 2015) operating across theoretical models and contexts, and it manifests both as a client characteristic and as a therapeutic change process. Eleven potential interventions for cultivating patience are outlined in this article.
This article provides an overview of patience and its associated constructs by examining its role... more This article provides an overview of patience and its associated constructs by examining its role in five domains: (a) confidence and control; (b) distress tolerance; (c) relationship development, maintenance, and repair; (d) character development; and (e) spiritual maturation. It highlights initial evidence that patience contributes to increased self-regulation and impulse control, distress tolerance, self-compassion, mindfulness, empathy in relationships, perspective taking, use of cognitive reappraisals, prosocial orientation, character development, and spiritual maturation. Patience helps with coping with anxiety and depression, aids with handling uncertainty, facilitates relationship maintenance and repair, and sustains the ability to manage the ambiguities present during faith crises. It promotes persistence and long-suffering, and it facilitates humility, wisdom, forgiveness, benevolence, faith, hope, and charity. It also supports primary control efforts and activates secondary control strategies when situations are outside of a client’s control. Patience enhances the possibility of benefit finding during periods of adversity. Patience may qualify as a common factor (Wampold, 2015) operating across theoretical models and contexts, and it manifests both as a client characteristic and as a therapeutic change process. Eleven potential interventions for cultivating patience are outlined in this article. Keywords: patience, self-control, emotion regulation, distress, persistence, development, equanimity, religious, self-compassion, goal, adversity
It has been stated that the supervisory relationship is as central to effective supervision as th... more It has been stated that the supervisory relationship is as central to effective supervision as the therapy relationship is to effective therapeutic outcomes. Thus, being able to understand the elements of effective supervisory relationships, monitoring those relationships, and intervening as needed would be critical in effective supervision. This roundtable presentation discussed creating, assessing, and facilitating the supervisory relationship and presented supervisory relationship data from 2002-2003. Contains a copy of the "Supervision Outcomes Survey." (Contains 17 references and 7 tables.) (GCP)
Thesis (Ph. D.)--University of Kansas, Counseling Psychology, 1994. Includes bibliographical refe... more Thesis (Ph. D.)--University of Kansas, Counseling Psychology, 1994. Includes bibliographical references (leaves 387-398).
VOLUME 31 Gratitude has recently received a significant amount of research attention in the emerg... more VOLUME 31 Gratitude has recently received a significant amount of research attention in the emerging field of positive psychology. Gratitude interventions are being empirically validated and are showing great promise in enhancing lije satisfaction, decreasing depression and anxiety, coping with adversity, facilitating relationships, building civic and moral aspirations and behaviors, and promoting physiological benefits as well. This article will tie the empirical literature to an LDS theology that has long taught and currently advocates for the cultivation ofgratitude as an essential component of a spiritually based, meaningful, and happy life. An empirical overview of the benefits of gratitude will be provided, potential gratitude interventions will be suggested, and principles for intervention effectiveness will be discussed. L ouisa Mellor Clark was the oldest living child of James and Mary Ann Mellor who crossed the plains in the Martin handcart company. Louisa was 16 at the ti...
Although hope is a valued construct in psychotherapy, it tends to be viewed as adjunct to more fo... more Although hope is a valued construct in psychotherapy, it tends to be viewed as adjunct to more focal interventions or as leverage for other valued goals. We contend that hope needs to be a targeted intervention in many cases. We will highlight issues arising in the acquisition of therapeutic hope. We acknowledge hope's dual nature as both a "gift" from God as well as an attribute that can be cultivated. Our main objectives are to define hope, confirm its essential role in well-being, recognize various hope mechanisms, introduce relevant theory, briefly highlight hope attainment issues, promote a variety of hope interventions, and list some helpful assessments and resources that can aid in nur-turing the seeds of hope and optimism. Evidence will be reviewed for the role of hope and optimism in relation to physical and mental health, life success and satisfaction, and resilience during adversity. We advocate for the central role of hope in God's plan for his children...
This paper outlines the purposes, professional obligations, and key components to consider when p... more This paper outlines the purposes, professional obligations, and key components to consider when providing effective evaluation in psychotherapy supervision. An overview of various methods for gathering supervision data for evaluation purposes is provided including self-reporting; process notes; video and audiotaping; live observation; co-therapy; and practices of reflectivity. A review is provided of research findings related to evaluation in supervision. The paper describes the creation of a Supervision Outcomes by Method Evaluation Matrix to help supervisors identify the kinds of outcomes they are trying to facilitate and the methods they may want to employ to evaluate those outcomes. A list of references to articles on evaluation in supervision and on instruments and formats for evaluation in supervision are provided. (JDM)
Given the ongoing dilemma for college counseling centers to meet steady increases in demand for s... more Given the ongoing dilemma for college counseling centers to meet steady increases in demand for services, this study outlines the implementation of an adapted stepped care model in a university counseling center. Our adapted model focused, as do other stepped care models, on treatment planning and lower-intensity interventions, with the addition of the intensive therapy option being provided on a weekly basis. We adopted our stepped care model across a large center and hypothesized that after implementation we would be able to serve a similar number of clients as our previous model and that treatment outcomes for these clients would improve. Descriptive data and regression analyses demonstrated support for our hypotheses, including an increased likelihood of clinically significant improvement for clients postimplementation. Implications for adapting service delivery models using practice-based evidence are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Practice-based evidence (Burlingame & Beecher, 2008) is an approach to evidence-based practice th... more Practice-based evidence (Burlingame & Beecher, 2008) is an approach to evidence-based practice that addresses treatment efficacy to remediate clinicians' inability to predict treatment response (Chapman et al., 2012; Hannan et al., 2005). The Group Questionnaire (GQ; Bormann, Burlingame, & Straub, 2011; Johnson, Burlingame, Olsen, Davies, & Gleave, 2005) is one practice-based evidence measure that supports clinical judgment to enhance psychotherapy outcomes by measuring 3 important group constructs: Positive Bond, Positive Work, and Negative Relationship. A clinical example of how one group leader used GQ data provided by group members regarding their weekly group experiences to support her interventions in a process-oriented therapy group for adults includes verbatim clinical exchanges among group members and the leader. The example also includes a GQ report with explanations of the group members' scores and numerical and graphical data. The authors detail how the leader us...
Abstract Objective: Although supervision has long been considered as a means for helping trainees... more Abstract Objective: Although supervision has long been considered as a means for helping trainees develop competencies in their clinical work, little empirical research has been conducted examining the influence of supervision on client treatment outcomes. Specifically, one might ask whether differences in supervisors can predict/explain whether clients will make a positive or negative change through psychotherapy. Method: In this naturalistic study, we used a large (6521 clients seen by 175 trainee therapists who were supervised by 23 supervisors) 5-year archival data-set of psychotherapy outcomes from a private nonprofit mental health center to test whether client treatment outcomes (as measured by the OQ-45.2) differed depending on who was providing the supervision. Hierarchical linear modeling was used with clients (Level 1) nested within therapists (Level 2) who were nested within supervisors (Level 3). Results: In the main analysis, supervisors explained less than 1% of the variance in client psychotherapy outcomes. Conclusions: Possible reasons for the lack of variability between supervisors are discussed.
With increasing demand for psychotherapy services, clinicians are carrying increasingly large cas... more With increasing demand for psychotherapy services, clinicians are carrying increasingly large caseloads (Bailey et al., 2020). As the number of new intakes exceeds the number of clinical hours available each week in some settings, psychotherapy is delivered on an attenuated schedule for returning clients (rather than the traditional weekly frequency); there is, however, little support for the efficacy of this practice. The present study explored the effect of session frequency on psychotherapy outcomes using a quasi-randomized controlled design. In a working university counseling center, we assigned therapists to either a treatment-as-usual (TAU) group (attenuated session frequency) or an experimental group (weekly session frequency). Clients were randomly assigned to a therapist in either condition. Using hierarchical linear modeling and survival analyses, we examined psychotherapy outcomes (measured by session-by-session Outcome Questionnaire 45 scores) for 1,322 clients (3,919 individual sessions). We found no differences between groups when examining the full sample, but also found limited fidelity in the experimental group. When identifying individuals who were seen weekly in at least the first three sessions after intake (sensitivity analysis), we found the following: (a) weekly therapy resulted in faster trajectories of change over time, (b) weekly therapy resulted in a greater likelihood of achieving recovery, and (c) weekly therapy resulted in a greater likelihood of achieving recovery sooner. We discuss the importance of including session frequency when considering the dose of therapy, as well as the implication that prioritizing weekly therapy may increase therapy efficacy and efficiency in routine practice. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
This article provides an overview of patience and its associated constructs by examining its role... more This article provides an overview of patience and its associated constructs by examining its role in five domains: (a) confidence and control; (b) distress tolerance; (c) relationship development, maintenance, and repair; (d) character development; and (e) spiritual maturation. It highlights initial evidence that patience contributes to increased self-regulation and impulse control, distress tolerance, self-compassion, mindfulness, empathy in relationships, perspective taking, use of cognitive reappraisals, prosocial orientation, character development, and spiritual maturation. Patience helps with coping with anxiety and depression, aids with handling uncertainty, facilitates relationship maintenance and repair, and sustains the ability to manage the ambiguities present during faith crises. It promotes persistence and long-suffering, and it facilitates humility, wisdom, forgiveness, benevolence, faith, hope, and charity. It also supports primary control efforts and activates secondary control strategies when situations are outside of a client’s control. Patience enhances the possibility of benefit finding during periods of adversity. Patience may qualify as a common factor (Wampold, 2015) operating across theoretical models and contexts, and it manifests both as a client characteristic and as a therapeutic change process. Eleven potential interventions for cultivating patience are outlined in this article.
This article provides an overview of patience and its associated constructs by examining its role... more This article provides an overview of patience and its associated constructs by examining its role in five domains: (a) confidence and control; (b) distress tolerance; (c) relationship development, maintenance, and repair; (d) character development; and (e) spiritual maturation. It highlights initial evidence that patience contributes to increased self-regulation and impulse control, distress tolerance, self-compassion, mindfulness, empathy in relationships, perspective taking, use of cognitive reappraisals, prosocial orientation, character development, and spiritual maturation. Patience helps with coping with anxiety and depression, aids with handling uncertainty, facilitates relationship maintenance and repair, and sustains the ability to manage the ambiguities present during faith crises. It promotes persistence and long-suffering, and it facilitates humility, wisdom, forgiveness, benevolence, faith, hope, and charity. It also supports primary control efforts and activates secondary control strategies when situations are outside of a client’s control. Patience enhances the possibility of benefit finding during periods of adversity. Patience may qualify as a common factor (Wampold, 2015) operating across theoretical models and contexts, and it manifests both as a client characteristic and as a therapeutic change process. Eleven potential interventions for cultivating patience are outlined in this article. Keywords: patience, self-control, emotion regulation, distress, persistence, development, equanimity, religious, self-compassion, goal, adversity
It has been stated that the supervisory relationship is as central to effective supervision as th... more It has been stated that the supervisory relationship is as central to effective supervision as the therapy relationship is to effective therapeutic outcomes. Thus, being able to understand the elements of effective supervisory relationships, monitoring those relationships, and intervening as needed would be critical in effective supervision. This roundtable presentation discussed creating, assessing, and facilitating the supervisory relationship and presented supervisory relationship data from 2002-2003. Contains a copy of the "Supervision Outcomes Survey." (Contains 17 references and 7 tables.) (GCP)
Thesis (Ph. D.)--University of Kansas, Counseling Psychology, 1994. Includes bibliographical refe... more Thesis (Ph. D.)--University of Kansas, Counseling Psychology, 1994. Includes bibliographical references (leaves 387-398).
VOLUME 31 Gratitude has recently received a significant amount of research attention in the emerg... more VOLUME 31 Gratitude has recently received a significant amount of research attention in the emerging field of positive psychology. Gratitude interventions are being empirically validated and are showing great promise in enhancing lije satisfaction, decreasing depression and anxiety, coping with adversity, facilitating relationships, building civic and moral aspirations and behaviors, and promoting physiological benefits as well. This article will tie the empirical literature to an LDS theology that has long taught and currently advocates for the cultivation ofgratitude as an essential component of a spiritually based, meaningful, and happy life. An empirical overview of the benefits of gratitude will be provided, potential gratitude interventions will be suggested, and principles for intervention effectiveness will be discussed. L ouisa Mellor Clark was the oldest living child of James and Mary Ann Mellor who crossed the plains in the Martin handcart company. Louisa was 16 at the ti...
Although hope is a valued construct in psychotherapy, it tends to be viewed as adjunct to more fo... more Although hope is a valued construct in psychotherapy, it tends to be viewed as adjunct to more focal interventions or as leverage for other valued goals. We contend that hope needs to be a targeted intervention in many cases. We will highlight issues arising in the acquisition of therapeutic hope. We acknowledge hope's dual nature as both a "gift" from God as well as an attribute that can be cultivated. Our main objectives are to define hope, confirm its essential role in well-being, recognize various hope mechanisms, introduce relevant theory, briefly highlight hope attainment issues, promote a variety of hope interventions, and list some helpful assessments and resources that can aid in nur-turing the seeds of hope and optimism. Evidence will be reviewed for the role of hope and optimism in relation to physical and mental health, life success and satisfaction, and resilience during adversity. We advocate for the central role of hope in God's plan for his children...
This paper outlines the purposes, professional obligations, and key components to consider when p... more This paper outlines the purposes, professional obligations, and key components to consider when providing effective evaluation in psychotherapy supervision. An overview of various methods for gathering supervision data for evaluation purposes is provided including self-reporting; process notes; video and audiotaping; live observation; co-therapy; and practices of reflectivity. A review is provided of research findings related to evaluation in supervision. The paper describes the creation of a Supervision Outcomes by Method Evaluation Matrix to help supervisors identify the kinds of outcomes they are trying to facilitate and the methods they may want to employ to evaluate those outcomes. A list of references to articles on evaluation in supervision and on instruments and formats for evaluation in supervision are provided. (JDM)
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Papers by Vaughn Worthen
long-suffering, and it facilitates humility, wisdom, forgiveness, benevolence, faith, hope, and charity. It also supports primary control efforts and activates secondary control strategies when situations are outside of a client’s control. Patience enhances the possibility of benefit finding during periods of adversity. Patience may qualify as a common factor (Wampold, 2015) operating across theoretical models and
contexts, and it manifests both as a client characteristic and as a therapeutic change process. Eleven potential interventions for cultivating patience are outlined in this article.
domains: (a) confidence and control; (b) distress tolerance; (c) relationship development, maintenance,
and repair; (d) character development; and (e) spiritual maturation. It highlights initial evidence that
patience contributes to increased self-regulation and impulse control, distress tolerance, self-compassion,
mindfulness, empathy in relationships, perspective taking, use of cognitive reappraisals, prosocial orientation,
character development, and spiritual maturation. Patience helps with coping with anxiety
and depression, aids with handling uncertainty, facilitates relationship maintenance and repair, and
sustains the ability to manage the ambiguities present during faith crises. It promotes persistence and
long-suffering, and it facilitates humility, wisdom, forgiveness, benevolence, faith, hope, and charity. It
also supports primary control efforts and activates secondary control strategies when situations are outside
of a client’s control. Patience enhances the possibility of benefit finding during periods of adversity.
Patience may qualify as a common factor (Wampold, 2015) operating across theoretical models and
contexts, and it manifests both as a client characteristic and as a therapeutic change process. Eleven
potential interventions for cultivating patience are outlined in this article.
Keywords: patience, self-control, emotion regulation, distress, persistence, development, equanimity,
religious, self-compassion, goal, adversity
long-suffering, and it facilitates humility, wisdom, forgiveness, benevolence, faith, hope, and charity. It also supports primary control efforts and activates secondary control strategies when situations are outside of a client’s control. Patience enhances the possibility of benefit finding during periods of adversity. Patience may qualify as a common factor (Wampold, 2015) operating across theoretical models and
contexts, and it manifests both as a client characteristic and as a therapeutic change process. Eleven potential interventions for cultivating patience are outlined in this article.
domains: (a) confidence and control; (b) distress tolerance; (c) relationship development, maintenance,
and repair; (d) character development; and (e) spiritual maturation. It highlights initial evidence that
patience contributes to increased self-regulation and impulse control, distress tolerance, self-compassion,
mindfulness, empathy in relationships, perspective taking, use of cognitive reappraisals, prosocial orientation,
character development, and spiritual maturation. Patience helps with coping with anxiety
and depression, aids with handling uncertainty, facilitates relationship maintenance and repair, and
sustains the ability to manage the ambiguities present during faith crises. It promotes persistence and
long-suffering, and it facilitates humility, wisdom, forgiveness, benevolence, faith, hope, and charity. It
also supports primary control efforts and activates secondary control strategies when situations are outside
of a client’s control. Patience enhances the possibility of benefit finding during periods of adversity.
Patience may qualify as a common factor (Wampold, 2015) operating across theoretical models and
contexts, and it manifests both as a client characteristic and as a therapeutic change process. Eleven
potential interventions for cultivating patience are outlined in this article.
Keywords: patience, self-control, emotion regulation, distress, persistence, development, equanimity,
religious, self-compassion, goal, adversity