Degree Name

PhD (Doctor of Philosophy)

Program

Psychology

Date of Award

5-2027

Committee Chair or Co-Chairs

Rachel Miller-Slough

Committee Members

Aubrey Dueweke, Julia Dodd, Stacey Williams

Abstract

There is a sharp increase in anxiety and depression symptoms in adolescence, and many forms of psychotherapy are shown to be effective. However, most research has examined average effects for manualized treatments that address multiple areas of functioning, which makes it difficult to determine how psychotherapy causes positive change. Process-based therapy postulates that all psychotherapies work through promoting adaptive biopsychosocial patterns of behavior (i.e., processes of change). Research has increasingly focused on the process-based therapy model, and there is a need for qualitative studies to incorporate lived experience into our understanding of change processes. The current study utilized the process-based therapy framework to create a qualitative interview with questions pertaining to each of the eight dimensions of change processes (e.g., cognitive, affective, attentional). We recruited five European American college students (Mage = 20 years, 4 females, 1 male) via a university Sona System in the Southeastern United States. To be invited for an interview, participants were required to have attended psychotherapy between the ages of 12-18, endorse that therapy was helpful (> 7 out of 10), and complete a screener that demonstrated adequate memory of therapy. Themes within each process level were generated via interpretative phenomenological analysis. Though each participant had similar presenting concerns, there was notable variation in what interventions caused positive change as well as differences in how change in one process interacted with other processes. Participants often experienced an intervention as impacting multiple change processes at once, with many quotes describing a change in accepting one’s emotions, learning new perspectives, practicing coping skills, and improving relationships. Results provide support for the need for psychotherapy to be tailored to the most pertinent change processes within a case conceptualization. Many quotes indicated that therapy was effective in addressing adolescent developmental needs, and several responses revealed important interventions that may be overlooked by current protocols. Patterns across themes provide guidance for future research and potential modifications to the process-based therapy model.

Document Type

Dissertation - unrestricted

Copyright

Copyright by the authors.

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