Jesse Owen

“Hooking Up” Among College Students: Demographic and Psychosocial Correlates

This study investigated 832 college students’ experiences with hooking up, a term that refers to a range of physically intimate behavior (e.g., passionate kissing, oral sex, and intercourse) that occurs outside of a committed relationship. Specifically, we examined how five demographic variables (sex, ethnicity, parental income, parental divorce, and religiosity) and six psychosocial factors (e.g., attachment styles, alcohol use, psychological well-being, attitudes about hooking up, and perceptions of the family environment) related to whether individuals had hooked up in the past year. Results showed that similar proportions of men and women had hooked up but students of color were less likely to hook up than Caucasian students. More alcohol use, more favorable attitudes toward hooking up, and higher parental income were associated with a higher likelihood of having hooked up at least once in the past year. Positive, ambivalent, and negative emotional reactions to the hooking up experience(s) were also examined. Women were less likely to report that hooking up was a positive emotional experience than men. Young adults who reported negative and ambivalent emotional reactions to hooking up also reported lower psychological well-being and less favorable attitudes toward hooking up as compared to students who reported a positive hooking up experience. Based on these findings, suggestions for psychoeducational programming are offered. Additionally, directions for future research are provided.

Cultural Humility: Measuring Openness to Culturally Diverse Clients

Building on recent theory stressing multicultural orientation, as well as the development of virtues and dispositions associated with multicultural values, we introduce the construct of cultural humility, defined as having an interpersonal stance that is other-oriented rather than self-focused, characterized by respect and lack of superiority toward an individuals cultural background and experience. In 4 studies, we provide evidence for the estimated reliability and construct validity of a client-rated measure of a therapists cultural humility, and we demonstrate that client perceptions of their therapists cultural humility are positively associated with developing a strong working alliance. Furthermore, client perceptions of their therapists cultural humility were positively associated with improvement in therapy, and this relationship was mediated by a strong working alliance. We consider implications for research, practice, and training.

The Alliance in Couple Therapy: Partner Influence, Early Change, and Alliance Patterns in a Naturalistic Sample

OBJECTIVE The purpose of this study was to explore the relationship between the alliance and outcome in couple therapy and examine whether the alliance predicted outcomes over and above early change. The authors also investigated partner influence and gender and sought to identify couple alliance patterns that predicted couple outcomes. METHOD The authors examined the alliances and outcomes at posttreatment and follow-up of 250 couples seeking treatment for marital distress in a naturalistic setting. The Session Rating Scale was used to measure the alliance; the Outcome Rating Scale and Locke Wallace Marital Adjustment Scale were used to measure outcomes. Couples were White, Euro-Scandinavian, and heterosexual, with a mean age of 38.5 years and average number of years together of 11.8. On a subsample (n = 118) that included couples with 4 or more sessions, the authors investigated the relationship between the alliance and outcome controlling for early change, and patterns of alliance development were delineated. RESULTS In the full sample, first-session alliances were not predictive of outcomes, but last-session alliances were predictive for both individuals and their partners. In the subsample, third-session alliances predicted outcome significantly above early change (d = 0.25) that exceeded the reliable change index. Couple alliances that started over the mean and increased were associated with significantly more couples achieving reliable or clinically significant change. Gender influences were mixed. CONCLUSIONS Given the current findings suggesting a potential alliance impact over and above symptom relief as well as the importance of ascending alliance scores, continuous assessment of the alliance appears warranted.

The Revised Commitment Inventory: Psychometrics and Use With Unmarried Couples

The Commitment Inventory measures interpersonal commitment (dedication) and constraint commitment. Since it was first published, substantial revisions have been made, but there are no published data on the psychometric properties of the new version. Furthermore, little information is available on measuring commitment for unmarried couples. This study examined the psychometric properties of the Commitment Inventory in 320 premarital or cohabiting couples (N = 640). Dyadic confirmatory factor analyses revealed that the hypothesized factor structure of six constraint subscales and one dedication subscale fit the data well for both men and women. Internal consistency coefficients were within acceptable range for most subscales. Within-couple correlations as well as correlations between subscales and with relationship quality, negative communication, and religiosity are presented. Implications for future research are discussed.

Racial/Ethnic Disparities in Therapist Effectiveness: A Conceptualization and Initial Study of Cultural Competence.

As a result of mental health disparities between White and racial/ethnic minority clients, researchers have argued that some therapists may be generally competent to provide effective services but lack cultural competence. This distinction assumes that client racial/ethnic background is a source of variability in therapist effectiveness. However, there have been no direct tests of the therapist as a source of health disparities. We provided an initial test of the distinction between general and cultural competence by examining client racial/ethnic background as a source of variability in therapist effectiveness. We analyzed cannabis use outcomes from a psychotherapy trial (N = 582) for adolescent cannabis abuse and dependence using Bayesian multilevel models for count outcomes. We first tested whether therapists differed in their effectiveness and then tested whether disparities in treatment outcomes varied across therapist caseloads. Results suggested that therapists differed in their effectiveness in general and that effectiveness varied according to client racial/ethnic background. Therapist effectiveness may depend partially on client racial/ethnic minority background, providing evidence that it is valid to distinguish between general and cultural competence.

Treatment Adherence: The Importance of Therapist Flexibility in Relation to Therapy Outcomes

OBJECTIVE The purpose of the current study was to disentangle within- and between-case variability in the adherence-outcome association. Specifically, we expected that increases or decreases in within-case adherence ratings would be positively associated with therapy outcomes. METHOD Seventy clients (74% women, 26% men; Mage = 29.8 years, SD = 11.00) received psychodynamic psychotherapy at a university-based community outpatient clinic. Adherence to core principles of a psychodynamic treatment model were coded by independent raters at the 3rd, 9th, and termination phase sessions using a psychotherapy technique scale. Therapy outcomes were assessed at both the symptom and the broadband levels of functioning. RESULTS Within-case variability in adherence ratings was significantly associated with therapy outcomes (accounting for approximately 10% of the variance in outcomes), after controlling for alliance, between-case variability, and the proportion of outcomes attributed by therapists. CONCLUSION The flexibility therapists demonstrate regarding the use of technique within a given treatment appears to be related to better outcomes across their caseload in relation to therapists who are less flexible with their interventions at the individual client level. The clinical implications of flexibility in adherence to a treatment model are discussed.

Microaggressions and Women in Short-Term Psychotherapy: Initial Evidence

The current study retrospectively examined the relationship between female clients’ perceptions of microaggressions directed toward women, working alliance, and therapeutic outcomes (N = 121). A measure, the Microaggressions Against Women Scale (MAWS), was developed specifically for this study, based on a content review of the literature, focus group, and a panel of seven female psychologists. A latent class factor analysis (returning one factor) and internal consistency estimates supported the measure. Clients’ MAWS scores were negatively correlated with working alliance and therapy outcomes, suggesting that clients’ perceptions of microaggressions can influence the process and outcome of therapy. Last, working alliance mediated the negative relationship between microaggressions and therapy outcomes. Implications for practice and further research are provided.

Initial Relationship Goal and Couple Therapy Outcomes at Post and Six-Month Follow-Up

The purpose of this study was to investigate the relationship between client initial goal for couple therapy (i.e., improve the relationship or clarify the viability of the relationship) and the outcomes (including their relationship status, i.e., separated or together) at posttreatment as well as at 6-month follow-up. Two hundred forty-nine couples (N = 498 individuals) seeking treatment for relationship distress in a naturalistic setting were treated by 20 therapists. Client initial relationship goal was attained by intake paperwork protocol, which included client initial goal for couple therapy and client perception of partner goal. Clients who reported that their goal was to improve the relationship reported better outcomes at post. Couples who reported their goal was to improve the relationship were less likely to break up at a 6-month follow-up. Of the 115 couples stating they wanted to improve the relationship, only nine (7.8%) couples were separated at 6 months. In contrast, of the 16 couples in which both partners wanted to clarify the relationship prior to therapy, nine (56%) were separated at follow-up. Therapist awareness of each individuals relationship goal prior to couple therapy could enhance outcomes, and treatment tailored according to initial goals could set the stage for positive outcomes however defined.

Benchmarking Outcomes in a Public Behavioral Health Setting: Feedback as a Quality Improvement Strategy

OBJECTIVE The purpose of this study was to evaluate the effectiveness of a large public behavioral health (PBH) agency serving only clients at or below the federal poverty level that had implemented continuous outcome feedback as a quality improvement strategy. METHOD The authors investigated the post treatment outcomes of 5,168 individuals seeking treatment for a broad range of diagnoses who completed at least 2 psychotherapy sessions. The Outcome Rating Scale (ORS; Duncan, 2011; Miller & Duncan, 2004) was used to measure outcomes. Clients had a mean age of 36.7 years and were predominantly female (60.7%) and White (67.8%), with 17.7% being Hispanic, 9.3% being African American, and 2.8% being Native American. Forty-six percent were diagnosed with depression, mood, and anxiety disorders; 18.8% were diagnosed with substance abuse disorders; and 14.4% were diagnosed with bipolar disorder and schizophrenia. A subset of clients with a primary diagnosis of a depressive disorder was compared to treatment efficacy benchmarks derived from clinical trials of major depression. Given that the PBH agency had also implemented an outcome management system, the total sample was also compared to benchmarks derived from clinical trials of continuous outcome feedback. RESULTS Treatment effect sizes of psychotherapy delivered at the PBH agency were comparable to effect size estimates of clinical trials of depression and feedback. Observed effect sizes were smaller, however, when compared to feedback benchmarks that used the ORS. CONCLUSIONS Services to the poor and disabled can be effective, and continuous outcome feedback may be a viable means both to improve outcomes and to narrow the gap between research and practice.

A Latent Class Regression Analysis of Men's Conformity to Masculine Norms and Psychological Distress.

How are specific dimensions of masculinity related to psychological distress in specific groups of men? To address this question, the authors used latent class regression to assess the optimal number of latent classes that explained differential relationships between conformity to masculine norms and psychological distress in a racially diverse sample of 223 men. The authors identified a 2-class solution. Both latent classes demonstrated very different associations between conformity to masculine norms and psychological distress. In Class 1 (labeled risk avoiders; n = 133), conformity to the masculine norm of risk-taking was negatively related to psychological distress. In Class 2 (labeled detached risk-takers; n = 90), conformity to the masculine norms of playboy, self-reliance, and risk-taking was positively related to psychological distress, whereas conformity to the masculine norm of violence was negatively related to psychological distress. A post hoc analysis revealed that younger men and Asian American men (compared with Latino and White American men) had significantly greater odds of being in Class 2 versus Class 1. The implications of these findings for future research and clinical practice are examined.