Date of Award

12-2023

Degree Name

Doctor of Philosophy

Department

Counselor Education and Counseling Psychology

First Advisor

Patrick H. Munley, Ph.D.

Second Advisor

Mary Z. Anderson, Ph.D.

Third Advisor

Rita Kenyon-Jump, Ph.D.

Fourth Advisor

Alan Lewandowski, Ph.D.

Keywords

Analogue study, military, military cultural competence, military sexual trauma, therapists, working alliance

Abstract

Victims of military sexual trauma (MST) face unique challenges as they pursue mental health treatment and supportive care. Understanding what factors impact potential treatment outcomes is critical in aiding in their recovery (Castro et al., 2015; Kroviak, 2020). Although a substantial amount of research has been conducted to evaluate prevalence and client factors associated with treating victims of MST (Teit et al., 2015; Turchik & Wilson, 2010), little is known about therapists’ factors including therapists’ expectations working with such clients. The purpose of this study was to examine the relationships between therapist type (military-affiliated versus civilian), therapist gender, client gender, multicultural competence, military cultural competence, and therapist expectations of working alliance and therapist hope for clients.

Participants were 108 licensed clinical mental health providers in which 63% identified as military-affiliated and 37% as civilian therapists. Female identified therapists represented 73% of the sample and 27% were male identified. The sample was 78.7% Caucasian/White, 7.4% African American/Black, 4.6% Biracial, 2.8% Asian, .0.90% Native Hawaiian/Other Pacific Islander, and 5.6% other race/ethnicity. Of the total participant sample, 7.4% also identified as Hispanic/Latino/or Spanish identity. Participants represented 6 different clinical mental health degree types and four different mental health provider license types.

An analogue quasi experimental design and regression analyses were used in the study comprising five independent variables including therapist participant gender, therapist type (military versus civilian), multicultural competence (MCKAS-R; Lu, 2017), military cultural competence (AMCC; Meyer et al., 2015), and MST client gender. Gender of an MST client was an independent analogue experimental variable manipulated to create two conditions of exposure through a vignette, the client being either male or female and having experienced MST. The dependent variables included therapists’ expectations as measured by the Working Alliance Inventory (Hatcher & Gillaspy, 2006) and therapist hope as measured by the Therapist Hope for Clients Scale (Bartholomew et al., 2020).

Descriptive statistics and correlations were calculated to initially investigate relationships among the variables. Two 2X2 MANOVA statistical analyses were conducted. The first MANOVA examined possible main and interaction effects associated with therapist type, client gender, and therapist expectations of working alliance and therapist hope. The second MANOVA examined possible main and interaction effects associated with therapist gender, client gender, and therapist expectations of working alliance and therapist hope with MST victims. Findings indicated that therapist type, therapist gender, client gender, and their interactions did not demonstrate statistically significant multivariate effects on working alliance and therapist hope.

Multiple regression analyses were used to investigate the extent to which multicultural competence and military cultural competence predicted working alliance and therapist hope. Regression analyses indicated that multicultural competence was not a statistically significant predictor of working alliance and therapist hope. However, military cultural competence was a statistically significant predictor of both working alliance and therapist hope. Findings, implications, limitations, and directions for future research are discussed.

Access Setting

Dissertation-Open Access

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