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Title: Aiming to Fully Understand How We Heal: Treatment and Assessment Protocol Development for Clinical Research on Performance-Specific Social Anxiety Disorder
Contributor: Stephanie E. Hall (author), Richard Bradshaw (thesis supervisor), Marvin McDonald (second reader), Bill Acton (third reader), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: The purpose of this project was to develop assessment and treatment protocols for clinical research on performance-specific Social Anxiety Disorder (SAD). The treatments used were Observed and Experiential Integration (OEI; a trauma-root-focused therapy), and Breathing, Relaxation, Autogenics, Imagery, and grouNding (BRAIN; a trauma-symptom-focused therapy). Similarities between trauma and anxiety symptoms suggest a traumatic cause of SAD. Both trauma-root-focused and trauma-symptom-focused treatments resulted in improvements in: (a) narrow-spectrum symptoms of speaker confidence and public speaking behaviour. In response to trauma-root-focused treatment: (a) broad-spectrum symptoms of general anxiety and depression improved, and (b) psychophysiological reactivity to past traumatic social experiences was reduced. Diverse types of measurements (self-report, behaviour sampling, and psychophysiological measures) will be helpful for understanding (a) broad-spectrum, (b) narrow- spectrum, and (c) psychophysiological symptoms. Results of descriptive analyses supported the existence of traumatic origins of performance-specific SAD.
Publication Year: 2017

Title: Connections and tensions among siblings in the presence of autism spectrum disorder : parental perceptions of the impact of the family system on sibling relationships
Contributor: Kristy Dykshoorn (author), Marvin McDonald (thesis supervisor), Lily Dyson (second reader), Catherine Costigan (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: The connections and tensions between siblings may impact the development and well-being that children with ASD and their typically developing (TD) siblings experience. Parenting style and parental stress are two factors that impact a caregiver's ability to effectively foster positive relationships. Finally, the interplay between sibling relationships, caregiver characteristics, sibling involvement in intervention, and success in ASD intervention is of interest. Primary caregivers (N = 108) completed an online questionnaire and a hierarchical multiple regression was conducted. Results indicated: 1) Parenting stress explains 12% of the variance found in the warmth and closeness of sibling relationships; 2) Sibling involvement and success in ASD intervention cumulatively contributes to 13.5% of the variance found in the warmth and closeness of sibling relationships; and 3) warmth and closeness uniquely explains 7% of the variance of success in ASD intervention. Limitations, practical implications, and future research direction will be discussed.
Publication Year: 2013

Title: Critical factors influencing paternal involvement : fathers’ experiences of negotiating role responsibilities
Contributor: Marvin Bravo (author), Janelle Kwee (thesis supervisor), Marvin McDonald (second reader), Trinity Western University SGS (Degree granting institution), Richard Young (external examiner), Marvin McDonald (second reader)
Discipline/Stream: Counselling Psychology
Abstract: This qualitative study uses the Enhanced Critical Incident Technique (ECIT) to explore incidents fathers report to be helpful or hindering to their parental engagement. Eight fathers were interviewed with 206 reported incidents. From the 206 incidents, 132 were identified as helpful (HE); 47 as hindering (HI); and 27 as wish list (WL) items. All incidents were assigned to one of the following categories (a) positive and negative role models, (b) Mother-Father Relationship (d) Father's Religion/Spirituality (e) Responsibility (f) Attachment (g) Personal Decision (h) Characteristics of Children (I) Reflective Parenting (j) Societal Influence (k) Father's Characteristics, and (l) Extended Family Influence. Fathers also provided 29 recommendations for effective paternal engagement. Research findings indicate major themes of responsibility, engagement, and father-mother dyad as important factors determining paternal involvement. Additionally, participants frequently referred to a confluence of factors impacting their involvement, which they navigate within a myriad of social roles.
Publication Year: 2013

Title: Death Ends a Life, Not a Relationship: Family Bereavement, Relational Grieving, and Continuing Bonds
Contributor: B. Tammy Bartel (author), Derrick W. Klaassen (thesis supervisor), Janice W. Nadeau (second reader), Lauren J. Breen (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: This study explored the complex, multifaceted, relational dimensions of grieving in the family unit. Three bereaved families, who had lost a child participated in a family conversation and individual processing interviews. The guiding research question was, “how do bereaved families grieve together and continue a relationship with their deceased child?” Data were collected using the qualitative action-project method (QA-PM). This unique methodology offered a glimpse into how these families engaged with each other in their joint grieving actions. Data analysis was informed by action theory, family systems theory, and an instrumental case study approach. Family grieving processes were identified for each family and commonalities included turning towards their grief, sharing the pain, experiencing both joy and sorrow, participating in mourning events, ongoing rituals and remembrances, recognizing different individual grieving styles, and a shared, enduring connection to their deceased child that connected them to each other. The findings from this study demonstrate the importance of recognizing the interpersonal dimensions of the grieving process, and the family as a resource in this process.
Publication Year: 2016

Title: Educators' Perspectives of Youth-Led Implementation of the FRIENDS For Life Program: A Critical Incident Study
Contributor: Nathan T Bartz (author), Marvin McDonald (thesis supervisor), Robert Lees (thesis supervisor), Annette Vogt (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: This study examined the viability of a newly piloted implementation model of the FRIENDS for Life anxiety prevention program. In Chilliwack, British Columbia, a collaborative community initiative piloted an implementation model of the FRIENDS for Life program, which involved the inclusion of high school students as chief implementers of the FRIENDS program to local elementary school populations. The purpose of the study was to answer the question of what helps and hinders the implementation of FRIENDS when high school students are the implementers. Semi-structured interviews were conducted with five educators who were asked about their experiences with the FRIENDS program, what helpful and hindering incidents they observed, and to provide a wish list for future improvements. Results suggest that a youth-led FRIENDS implementation model is a viable model of program delivery and worth consideration for future development and refinement.
Publication Year: 2018

Title: Embodiment of spirituality and sexuality : women’s lived experience of resilience to sexual shame
Contributor: Kelsey Dawn Schmidt Siemens (author), Janelle Kwee (thesis supervisor), Derrick Klaassen (second reader), Stephanie Martin (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: Due to the prevalence of sexual shame among Christian women, this study was designed to better understand the lived experiences of sexual shame resilience and embodiment. Five young, married women were selected for inclusion based on their immersion in Christian culture during adolescence and for their experiences of working through sexual shame. In order to understand the meaning of these women’s experiences, a hermeneutic phenomenological method was employed. Through participant’s narratives, four categories of themes emerged (religious messaging around sexuality, experiences of sexual shame, healing experiences, and experiences of embodied sexuality). When participants were able to work through their sexual shame, they were able to embrace and find freedom in their sexuality. This study’s findings are consistent with Brown’s (2006) Shame Resilience Theory. The clinical implications of these findings are discussed in terms of the need to provide appropriate support for women struggling with sexual shame.
Publication Year: 2015

Title: Going Through A 24-Hour Box: How Women’s Experiences of Childbirth Shape Their Embodied Sense of Self
Contributor: Neeta Sai (author), Dr. Janelle Kwee (thesis supervisor), Dr. Mihaela Launeanu (second reader), Dr. Keren Epstein-Gilboa (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: Women’s experiences of childbirth are understood primarily in terms of role change and physical or cognitive impacts. This study adopted a holistic, embodied perspective to explore how women’s childbirth experiences shape their embodied sense of self. Six women’s childbirth experiences were analysed using Gilligan’s (1982) Listening Guide method, adapted by integrating Längle’s (1993) Existential Analysis framework of the Four Fundamental Motivations. The analysis uncovered women’s voices of fulfillment and suffering as dynamic interplay suggesting that positive birth experience led to positive embodied sense of self while negative birth experience (e.g., disrupted embodiment) led to negative sense of self. These findings indicate that childbirth and motherhood can empower women to grow and be strong even in spite of possible traumatic or negative birth experience. This study has important implications for promoting a holistic understanding of the role of women’s subjective experiences of childbirth in shaping their embodied sense of self.
Publication Year: 2018

Title: Grieving in Community: Accompanying Bereaved Parents
Contributor: Marnie C Venema (author), Derrick W Klaassen (thesis supervisor), Janelle L Kwee (second reader), Richard A Young (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: This study explored relational grieving in community through examining how community members grieve with bereaved parents after the death of a child. Three bereaved parent couples and their community members were interviewed together using the qualitative action-project method (QA-PM) to examine their shared grieving actions. Data was analyzed through top-down and bottom-up processes to understand the shared intentions of their grieving actions together. The findings of this research elicited thick descriptions of relational grieving at a community level. Four main assertions of how communities grieve with bereaved parents emerged including: (a) selflessly offering emotional and practical support, (b) engaging in and honouring vulnerability, (c) holding the complexity of grieving, and (d) fostering remembrance of the deceased child together. The novel descriptions of relational grieving in community contributed to the growing area of relational bereavement research. The theoretical, empirical, and clinical implications of this study were discussed.
Publication Year: 2019

Title: Grieving Together: An Ethnography of Relational Grief in Community
Contributor: Benjamin J Bentum (author), Derrick W Klaassen (thesis supervisor), Janelle Kwee (second reader), Terry Lynn Gall (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: In this study community relational grief was researched by addressing how community members reciprocally interacted during bereavement. A focussed ethnography was used to address the research question which was, how does a religious community grieve the deaths of members together? Data analysis used the constant comparative method and was presented back to the community in a performance ethnography for confirmation and further data collection. The result was a contextually situated description of how this community grieved the deaths of community members. The four main themes were that community members: (a) shared a desire to care for the bereaved, (b) assessed relational proximity to the bereaved and the deceased to inform action according to role expectations, (c) grieved together, being impacted and impacting each other reciprocally, and (d) grieved, and interacted, according to their own unique characteristics and experiences. Implications for bereavement theory, research and practice were discussed.
Publication Year: 2017

Title: Integrating Attachment Processes in an Adopted Child with Lifespan Integration Therapy: A Hermeneutic Single Case Efficacy Design
Contributor: Carlee E Lewis (author), Janelle L Kwee (thesis supervisor), Marvin J McDonald (second reader), Joanne Crandall (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: In this study, the efficacy of Lifespan Integration therapy (LI) for addressing attachment processes with adopted children in middle childhood was investigated. A Hermeneutic Single Case Efficacy Design (Elliott, 2002, 2015) was used to gather quantitative and qualitative data from an adoptive parent-child dyad who were experiencing LI for the first time. A 12-year-old male received bi-weekly LI therapy sessions, and data was collected throughout the therapy process. The adoptive mother was used as a resource in facilitating a more secure attachment. Client change and the contribution of LI to client change were adjudicated by experts who concluded that change occurred and was due to LI. Changes in internal attachment processes and the attachment bond between the parent and child of this dyad were observed. This case provides evidence that attachment disruptions can be repaired in middle childhood and that attachment processes can be targets in interventions beyond early childhood.
Publication Year: 2017

Title: Integrating Ego Identity in an Adult Third Culture Kid with Lifespan Integration Therapy: A Reflexive Hermeneutic Single Case Efficacy Design
Contributor: Sharon M Macfarlane (author), Janelle Kwee (thesis supervisor), Marvin McDonald (second reader), Jose Domene (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: Research findings support the presence of psycho-social challenges for third culture kids (TCKs) given their characteristic lifestyle. Structured as a self-experimentation Hermeneutic Single-Case Efficacy Design (auto-HSCED), I investigated the use of Lifespan Integration (LI) therapy in addressing ego identity fragmentation as conceptualized through an Eriksonian and neo-Eriksonian model. This project sought to answer: Can LI be efficacious in addressing ego identity fragmentation in an adult TCK? Initial outcomes did not meet HSCED standards for significance, however, further investigation revealed evidence of decontextualization and reductionist therapy formulations and analysis processes. These were remediated through intersectional analysis with the use of metasynthetic principles which enabled a re-interpretation of results within a broader intersectional framework. The subsequent proposed refinement of study conclusions argued that outcomes met the threshold for significance and for demonstrating LI efficacy in producing client ego identity change. This project also provided a first-hand account of my therapeutic journey.
Publication Year: 2019

Title: Intensive family therapy with at-risk youth : a preliminary critical incident study
Contributor: Giselle Tranquilla (author), Robert Lees (thesis supervisor), Marvin McDonald (second reader), Faith Auton-Cuff (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: Multisystemic Therapy (MST) has been established as an effective treatment approach to working with at-risk youth. The Intensive Family Therapy Project followed the basic tenets of MST and adapted them to a rural community setting in British Columbia. The Project was designed to work with young offenders and their families in addressing delinquent behavior from a holistic perspective. This study used the Critical Incident Technique to examine what clients found helpful and unhelpful about the treatment program. Nine interviews were conducted involving six families. Data from the interviews was classified into seven categories, 26 subcategories. Results indicate participants found involvement in the project was more helpful than hindering, as indicated by the higher rate of positive incidents. Clients' voices identified Intensive Family Therapy as a valuable treatment approach and results indicate the potential for adapted forms of MST to be applicable, relevant and effective in working with these families.
Publication Year: 2013

Title: Intergenerational voices : exploring body image transmission in the mother-daughter dyad
Contributor: Hillary Lianna Sommers McBride (author), Janelle Kwee (thesis supervisor), Marvin McDonald (second reader), Marla Buchanan (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: Due to the prevalence of body-dissatisfaction and disordered eating among North American women, this study was designed to better understand the development of young women’s healthy body image, and how their mothers may have contributed to their embodiment. Five motherdaughter dyads were selected for inclusion based on the young adult daughter’s healthy body image. In order to best understand the participants, and empower them through the telling of their own stories, the qualitative feminist method the Listening guide was employed. Through participants’ narratives, voices were identified which spoke of the body (voices of idealized femininity, silencing, functionality, acceptance, embodiment, and resistance) and of relationship (voices of comparison, differentiation, and connection). In these voices, the mother participants spoke about their mothers, themselves and their daughters, while the daughter participants spoke about their mothers, themselves and the daughters they had or imagined they may one day have. The daughters spoke most in the voices of embodiment and resistance, demonstrating how they had come to love their bodies and resist dominant cultural narratives. Mothers were found to have taught their daughters about health and stewardship of the body. The mothers were able to do this in spite of their own body-dissatisfaction. Through relational safety and connection mothers non-judgmentally supported their daughters in non-appearance related domains, while also celebrating their daughter’s beauty.
Publication Year: 2014

Title: A journey with self-compassion : exploring self-compassion within the context of the Christian faith
Contributor: Genevieve Kalnins (author), Derrick Klaassen (thesis supervisor), Janelle Kwee (second reader), Terry L. Gall (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: Despite the spiritual roots of self-compassion, the impact of spirituality on the development of self-compassion has not been widely explored. The listening guide method and autoethnography were combined to explore the lived experience of self-compassion from a Christian faith perspective. The participant co-researchers’ narratives revealed three categories of voices. The voices of shame and criticism included oppression, internalized oppression, and judgment. These voices appeared as the participants discussed what makes self-compassion difficult. The voices of love and acceptance included connection, unity, openness, and warmth. Together, these voices were used as participants discussed their experiences of self-compassion. Finally, the voices of resistance included the voices of struggle and advocacy. These voices appeared to facilitate the development of self-compassion. This study offers a deeper understanding of the natural development of self-compassion and of how the Christian faith may facilitate or hinder self-compassion. Implications for counsellors, pastors, and future research are discussed.
Publication Year: 2015

Title: The Labyrinth of Grief: A Phenomenological Exploration of Turning Toward Loss
Contributor: Janelle K. Drisner (author), Derrick W. Klaassen (thesis supervisor), Mihaela S. Launeanu (second reader), Darcy Harris (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: This study explored the Existential Analytic grieving activity of turning toward loss. Four women, each bereaved of either a parent, spouse, child, or sibling, participated in one hour interviews. The research question was, “what is the lived experience of turning toward loss?” To understand how participants encountered and engaged with their grief, a hermeneutic phenomenological method was employed. Through lived experience descriptions, eight thematic meaning structures were revealed: (a) encounter with death, (b) surrendering to grief, (c) choosing community, (d) permitting and pursuing grief, (e) transformation of self, (f) rooting in relationship, (g) embracing life, and (h) ground of faith. From the thematic meanings emerged the metaphor of a labyrinth of grief, which symbolized the various paradoxes of grieving, signifying that turning toward loss was essentially spiritual and transformative. In describing how they turned toward their losses, the participants highlighted the inherent relational and dialogical nature of grieving.
Publication Year: 2017

Title: Lifespan Integration Efficacy: A Mixed Methods Multiple Case Study
Contributor: Monica Hu (author), Janelle Kwee (thesis supervisor), Marvin McDonald (second reader), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: Attachment theory and neurobiological research have much to say about the etiology and dynamics of psychological distress. Lifespan Integration (LI) therapy was developed by Peggy Pace (2003/2012) through years of treating adults with histories of childhood abuse and trauma. Since 2003 over one thousand clinicians have been trained in LI worldwide. Growing anecdotal reports of success call for research into LI's efficacy. A rigourous, adjudicated case study research design (Hermeneutic Single Case Efficacy Design, HSCED, Elliott, 2001, 2002) was expanded to accommodate three cases. In addition to the question of efficacy, whether and how LI protocols would be linked with the underlying theory via support in the data was also investigated. The results indicate that each of the three participants experienced significant clinical change and that there was alignment with theory supporting the claim that LI works to foster integration and other markers associated with higher functioning and mental health.
Publication Year: 2014

Title: Lifespan integration therapy with trauma-exposed children : a hermeneutic single case efficacy study
Contributor: Christian Rensch (author), Janelle Kwee (thesis supervisor), Marvin McDonald (second reader), Susan Stephen (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: Trauma in children is a devastating reality with immense psychological impact on the child. Numbers indicate that millions of children experience trauma every year. Outcome research therapy with trauma-exposed children is scarce and mostly focuses on cognitive and behavioural changes. Anecdotal evidence suggests that Lifespan Integration (LI) therapy integrates traumatic experiences into other life experiences leaving them feeling more congruent and renewed. In this research study, we investigate the efficacy of Lifespan Integration with children by means of careful examination of one participant. We applied Robert Elliott’s Hermeneutic Single Case Efficacy Research Design (2002, 2014), which uses quantitative and qualitative data to argue for and against therapy efficacy. The 12-year-old research participant received 8 sessions of LI over three months, and data was collected before, throughout, and after therapy. The extent of the client’s change over the course of therapy was investigated, as well as LI’s contribution to the change, and what parts of LI were most helpful in bringing about change. Findings indicate that the client changed substantially over the course of therapy with lasting effects at follow-up, LI was substantially responsible for this change, and the timeline as an LI specific modality helped to bring this change. Details about trauma-exposed children, the theoretical underpinnings of LI, a detailed description of the HSCED procedure, as well as further directions of LI and HSCED are discussed.
Publication Year: 2015

Title: The lived experience of men in reparative therapy
Contributor: William Stanus (author), Marvin McDonald (thesis supervisor), William Dreikorn (second reader), Derrick Klaassen (second reader), Mark Yarhouse (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: This study is a phenomenological exploration of client voice in psychotherapy. Five men were recruited from the Thomas Aquinas Psychological Clinic while in reparative therapy for issues related to unwanted Same-Sex Attraction (SSA). Open-ended interviews were conducted by telephone and then transcribed and analyzed via a phenomenological research methodology. Thematic analysis yielded 11 themes which described these men's experiences in therapy and the impact of therapy on their lives as a whole, including domains such as work, relationships, and sense of self. Reparative therapy for these men emerged as primarily about a struggle for healing of masculine identity. Benefits included being able to build better non-sexual relationships with men, becoming more open to intimate relating to a woman, and improving their sense of themselves as men. This research has shed further light on the process of reparative therapy as it is practiced at the Aquinas Clinic.
Publication Year: 2013

Title: The lived experience of moral injury in the context of intimate partner relationships: A phenomenological exploration
Contributor: Sara Kuburic (author), Mihaela Launeanu (thesis supervisor), Derrick Klaassen (second reader), Tennyson Samraj (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: Moral injury (MI) represents a unique psychological suffering instigated by one's transgression of moral values, beliefs, and expectations. MI has a serious negative impact on the psychological, existential, behavioural, and relational aspects of an individual's life. At its core, MI shakes and sometimes shatters one's sense of self, perception of humanity, and overall worldview, bringing into question fundamental values of the human existence. Thus far, research studies on MI have focused almost exclusively on investigating MI within the military context, and no study has yet investigated the lived experience of MI. The present study aimed to examine the lived experience of MI in the context of intimate partner relationships. To this end, adult participants who self-identified as having experienced moral injury due to emotional abuse and/or infidelity within their intimate partner relationships were interviewed using hermeneutic phenomenology as research method. Through the phenomenological analysis of the participants' lived experience, six core thematic meanings of MI emerged: (1) self-estrangement, (2) transgressions and discord, (3) sudden awareness, (4) lostness and sorrow, (5) will to change, and (6) the aftermath. Phenomenological writing further elaborated these thematic meanings in an effort to uncover the phenomenon of MI in the context of intimate partner relationships. The findings of this study uncovered the phenomenon of MI as a process of unraveling, becoming and transforming through suffering. The theoretical contributions and clinical implications of this study are discussed in terms of emphasizing the transformative potential of moral injury experienced in relational context. Moreover, this study revealed the importance of self and self-estrangement in the experience of MI, in addition to other key components of the phenomenon (i.e., awareness and agency).
Publication Year: 2018

Title: The lived experiences of romantic relationships following child loss
Contributor: Erin Buhr (author), Derrick Klaassen (thesis supervisor), Briana N. Goff (second reader), Paige Toller (external examiner), Trinity Western University SGS (Degree granting institution)
Discipline/Stream: Counselling Psychology
Abstract: This study examined the impact a child’s death had on bereaved parent’s relationships with their significant other utilizing phenomenology. The research question was “what was the experience of the relationship with your significant other following the loss of your child?” Semi-structured interviews were conducted with eight participants. Themes included: The relationship changed after the child’s death; Communication was important to the relationship dynamic; Grieving differences existed and impacted the relationship; Specific behaviours were identified that had the potential to facilitate or harm; Individual grief impacted the relationship; Couples’ utilized additional emotional support outside the relationship; Sex decreased. The themes were discussed within the context of the larger bereavement literature which included grieving differences, continuing bonds, and trauma models for couples. Themes were also discussed with regard for how to provide informed counselling interventions for bereaved parents, such as addressing issues that may arise because of grieving differences.
Publication Year: 2014