Master thesis / Hovedoppgave in psychology (e.g. Psykologisk institutt, UiO) or other places

Examples of previous Master's theses

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Den terapeutiske relasjonen i DBT og MBT

Garred, S., Gough, E. M. (2021). Den terapeutiske relasjonen i DBT og MBT [Unpublished master’s thesis, University of Oslo]. https://www.duo.uio.no/bitstream/handle/10852/87426/1/Hovedoppgave_Den-terapeutiske-relasjonen-i-DBT-og-MBT_Elina_Susanne.pdf

Summary

Chronic Feelings of Emptiness’ – a Useful Criterion in the Diagnosis of Borderline Personality Disorder?

Stølsnes, M. (2021). ‘Chronic Feelings of Emptiness’ – a Useful Criterion in the Diagnosis of Borderline Personality Disorder? [Unpublished master’s thesis, University of Oslo]. https://www.duo.uio.no/bitstream/handle/10852/86649/thesis.pdf

Summary

This thesis focused on the topic of chronic feelings of emptiness and its relationship to borderline personality disorder (BPD). The study used data from the Norwegian Network for Personality Disorders and included 1702 patients with various personality disorders who were diagnosed using the DSM-IV and assessed according to LEAD principles. The study found that chronic feelings of emptiness occurred almost twice as often in patients with BPD compared to those with other personality disorders, and that chronic emptiness was a more robust indicator of BPD in men than in women. Chronic emptiness was also found to be correlated with neuroticism. The study concludes that chronic feelings of emptiness may be a hallmark of BPD, but can also be observed in other personality disorders.

An article will be publised based on this master thesis.

The cultural change narrative as a core component of therapeutic change

Sundal, T., Tobiassen, A. H. (2022). The cultural change narrative as a core component of therapeutic change [Unpublished master’s thesis, University of Oslo]. https://www.duo.uio.no/bitstream/handle/10852/86649/thesis.pdf

Summary

This study aimed to investigate the similarities and differences in the change narratives provided by Mentalization-based treatment (MBT) and Dialectical behavior therapy (DBT) for patients with borderline personality disorder (BPD), and how these narratives reflect the rationale, explanations, and procedures of the treatments. A qualitative analysis of seven interviews with three informants who received MBT and four informants who received DBT was conducted using an interpretative phenomenological analysis (IPA). The results showed that the change narratives described by the informants reflected the treatment they received, with DBT informants highlighting explicit learning of a provided approach with predictable and safe therapists, and MBT informants emphasizing a long-lasting process of exploring to create procedural learning with therapists who followed their lead. The study also found that the change narratives provided by MBT and DBT reflect the different rationale, explanations, and procedures of the treatments, and suggests that further research could explore how these differences may impact therapeutic outcomes. Additionally, the results showed that the DBT informants emphasized explicit learning and the use of skills, while the MBT informants focused on an implicit process of change and the development of a mentalizing stance. The study concludes that the change narratives provided by MBT and DBT for patients with BPD reflect the specific ingredients and techniques of the treatments, and suggests that further research could explore how these differences in change narratives may impact therapeutic outcomes.

An article will be publised based on this master thesis.

Personality coaching—unlocking subjectivity with «universal» methods

Vinge, A. (2022). Personality coaching—unlocking subjectivity with «universal» methods. [Unpublished master’s thesis, University of Oslo]

Summary

This is a study that investigates the experiences of nine leaders and managers who participated in coaching using a specific method and coach. The study uses the qualitative method of Interpretative Phenomenological Analysis to analyze data collected from interviews with the participants. The results suggest that the participants' general high level of interpersonal trust facilitated the establishment of a personal bond with the coach and increased their engagement in the tasks and goals of the coaching. The participants also emphasized the importance of belief in and acceptance of the coaching method, and described how the coach's competent application of a personality framework increased their awareness of themselves, others, and their social reality. The study concludes that psychotherapy research and coaching research could learn from each other, and that integration work appears to be an ongoing process during and after coaching.

The major findings of this text are that the coaching method used in this study was successful in increasing the participants' awareness of themselves, others, and their social reality, and that the establishment of trust with the coach and belief in and acceptance of the method were important factors in the success of the coaching. The study also found that learning experiences between sessions and after the coaching facilitated the integration of the personality framework and that integration work appears to be an ongoing process during and after coaching. It is suggested that psychotherapy research and coaching research could learn from each other.

An article will be publised based on this master thesis.

Horvath, A. O. (2018, Jul). Research on the alliance: Knowledge in search of a theory. Psychother Res, 28(4), 499-516. https://doi.org/10.1080/10503307.2017.1373204

Summary

The therapeutic alliance, also known as the working alliance or helping alliance, refers to the relationship between a therapist and a client in the context of psychotherapy. The therapeutic alliance is a key aspect of the therapeutic process and is considered to be an important predictor of therapeutic outcomes. The therapeutic alliance is often described as a collaborative relationship between therapist and client, in which both parties work together to achieve the client's therapeutic goals. It includes elements such as trust, mutual understanding, and a sense of collaboration between therapist and client. It is considered a key element in the therapeutic process, as it is believed to be a predictor of therapy outcomes. There is a lack of consensus on the precise definition and operationalization of the therapeutic alliance, and this has led to the development of a wide range of measurement tools and operational definitions. There are also challenges in understanding how different variables within the broader category of therapeutic relationships fit together, overlap, or complement each other. Some efforts to address these challenges include the use of "bottom-up" approaches, such as Conversation Analysis, and the development of more sophisticated and coordinated methods of operationalization. In order to advance research on the therapeutic alliance and contribute to practice, it is important to clarify the definition of the alliance and develop more coordinated methods of operationalization.

Horvath's review begins by situating the last four and a half decades of work on the alliance within the context of the evolution of research on psychotherapy. It then discusses the challenges facing research on the alliance, including the wide range of operational definitions that results in a diffusion of the identity of the concept. The review also argues that the lack of clarity regarding how several variables within the broader category of therapeutic relationships fit together, overlap, or complement each other is potentially problematic. He discusses efforts to resolve the lack of a consensual definition and concludes by arguing that a resumption of a conversation about the relationship in the helping context in general, and the alliance in particular, should be resumed. The review highlights the importance of clarifying the definition of the alliance and developing more sophisticated and coordinated methods of operationalization in order to advance research on the alliance and contribute to practice.

The concept of the therapeutic relationship, or alliance, has been a focus of research in the fields of psychology, psychiatry, education, social work, nursing, physical therapy, and forensic sciences. However, the precise meaning of the term "alliance" is ambiguous and its role in therapy remains somewhat controversial. This review paper discusses the challenges facing research on the alliance and explores some possible ways to address these challenges in the future. One of the main challenges is the wide range of operational definitions of the alliance, which results in a diffusion of the identity of the concept. The review also discusses the lack of clarity regarding how several variables within the broader category of therapeutic relationships fit together, overlap, or complement each other. Efforts to resolve the lack of a consensual definition are reviewed, and it is argued that a resumption of a conversation about the relationship in the helping context in general, and the alliance in particular, should be resumed.

The therapeutic alliance is a key aspect of the therapeutic process and is considered to be an important predictor of therapeutic outcomes. The therapeutic alliance is often described as a collaborative relationship between therapist and client, in which both parties work together to achieve the client's therapeutic goals. It includes elements such as trust, mutual understanding, and a sense of collaboration between therapist and client. The concept has been influential in the field of psychology and has been studied by researchers in a variety of settings, including education and leadership development. There are a number of different approaches to understanding the therapeutic alliance, including psychoanalytic, behaviorist, and cognitive-behavioral perspectives. Despite some differences in the way the therapeutic alliance is conceptualized, there is a general consensus that it is a vital component of the therapeutic process and that it plays a significant role in determining the success of therapy.

The alliance is a concept that refers to the therapeutic relationship between a client and a therapist. It is considered an important factor in the effectiveness of psychotherapy, but there is a lack of consensus on its exact meaning and how it should be operationalized and measured. This lack of consensus has led to the development of a wide range of operational definitions and measurement tools, which can make it difficult to compare research findings and hinder the incremental growth of knowledge in this area. Some of the challenges facing research on the alliance include the diversity of operational definitions, the lack of clarity on how different variables within the broader category of therapeutic relationships fit together, overlap, or complement each other, and the technical challenges in measuring the alliance. To address these challenges, it is suggested that a more concise and nuanced definition of the alliance is needed, as well as more sophisticated, cohesive, and coordinated methods of operationalization. It is also recommended that researchers continue to engage in dialogue about the therapeutic relationship in general, and the alliance in particular, in order to better understand its role in psychotherapy.

The concept of the helping alliance, also known as the therapeutic alliance or working alliance, is a key factor in the effectiveness of psychotherapy. It refers to the positive, collaborative relationship between the therapist and the client that helps to facilitate the therapeutic process. The concept was first introduced by Lester Luborsky in the 1970s, but it has since been expanded upon and refined by other researchers, including Edward Bordin. There are numerous ways to measure the alliance, but the use of a large number of diverse measures has presented challenges in alliance research. Despite these challenges, research on the alliance has contributed significantly to our understanding of the importance of the therapeutic relationship in psychotherapy and has led to the development of training programs and interventions to improve the alliance and ultimately, therapy outcomes. There are currently ongoing challenges in the field, including the need to further clarify the concept of the alliance and to develop more reliable and valid measures of the alliance.

The research on the therapeutic alliance, or the relationship between a therapist and a client in therapy, has faced challenges due to the diversity of measures used to assess it. Many alliance measures provide evidence of construct validity based on statistical significance with another alliance measure or correlation with therapy outcome, but these criteria are problematic. The lack of overlap among alliance measures and the existence of so many measures suggest that they capture diverse aspects of the alliance concept. Despite these challenges, the research on the alliance has contributed to the understanding of its importance and the role of the relational side of the psychotherapy process in general. Some emerging approaches to studying the alliance, such as "bottom-up" approaches that focus on the alliance as an interactional process, offer the potential to address the challenges faced by alliance research and provide a more specific and constrained definition of the alliance concept.

The working alliance (the relationship between an athletic trainer and an athlete) in athletic training:

Quiz

1. What is the main aim of this review article?
   A) To summarize the challenges facing research on the therapeutic alliance
   B) To explore the role of the therapeutic alliance in psychotherapy
   C) To review the different operational definitions of the therapeutic alliance
   D) To discuss the impact of the therapeutic alliance on therapeutic outcomes
   
   
2. What is the therapeutic alliance referred to as in the fields of education and leadership development?
   A) Helping alliance
   B) Collaborative alliance
   C) Working alliance
   D) Therapeutic relationship
   
   
3. What is the therapeutic alliance considered to be an important predictor of in the therapeutic process?
   A) Trust
   B) Mutual understanding
   C) Collaboration
   D) Therapeutic outcomes
   
   
4. Which of the following is NOT one of the approaches to understanding the therapeutic alliance?
   A) Psychoanalytic
   B) Cognitive-behavioral
   C) Humanistic
   D) Behaviorist
   
   
5. What is the main challenge facing research on the therapeutic alliance?
   A) Lack of consensus on the meaning of the alliance
   B) Limited research on the alliance in specific populations
   C) Lack of funding for alliance research
   D) Limited availability of measurement tools
   
   
6. How does the lack of consensus on the definition of the alliance impact research in this area?
   A) It makes it difficult to compare research findings
   B) It hinders the development of new measurement tools
   C) It limits the ability to generalize findings to different populations
   D) All of the above
   
   
7. What are some of the ways researchers have tried to address the lack of consensus on the definition of the alliance?
   A) By developing new measurement tools
   B) By engaging in a conversation about the relationship in the helping context
   C) By focusing on the therapeutic process as a whole
   D) All of the above
   
   
8. What is the therapeutic alliance also known as?
   A) Helping alliance
   B) Working alliance
   C) Collaborative alliance
   D) Therapeutic bond
   
   
9. Which of the following is NOT a challenge facing research on the therapeutic alliance?
   A) Wide range of operational definitions
   B) Lack of clarity regarding how different variables within the broader category of therapeutic relationships fit together
   C) Lack of consensus on the meaning of the alliance
   D) Limited research on the alliance in specific populations
   
   
10. What is the therapeutic alliance generally described as?
    A) A collaborative relationship between therapist and client
    B) A power dynamic between therapist and client
    C) A one-sided relationship in which the therapist holds all the power
    D) A relationship based on confrontation and conflict
    
    
11. What is a common method used to operationalize the therapeutic alliance in research?
    A) Self-report measures
    B) Observational measures
    C) Both self-report and observational measures
    D) Interviews with clients and therapists

Correct answers

Ten Things to Remember About Common Factor Theory

Laska, K. M., & Wampold, B. E. (2014, Dec). Ten Things to Remember About Common Factor Theory. Psychotherapy, 51(4), 519-524. https://doi.org/10.1037/a0038245

Summary

Common factor theory suggests that the common factors present in all forms of psychotherapy, such as the therapeutic relationship and expectation of improvement, are more important for therapeutic change than specific techniques or interventions. Common factor models are not a closed system and there is no such thing as a "common factor" treatment. Rather, the goal of common factor models is to identify the factors that make psychotherapy effective. Common factors have been shown to be more important for therapeutic change than specific techniques or interventions, and the training and expertise of the therapist is more important for therapeutic outcomes than the specific treatment approach they use. Contextual factors, such as the client's cultural background and the therapeutic setting, are also important in the therapeutic process. Common factor theory also suggests that the mechanisms of change in empirically supported treatments (ESTs) are not well specified and there is little empirical evidence to support the claim that specific mechanisms are necessary for therapeutic change.

According to common factor theory, the common factors present in all forms of psychotherapy, such as the therapeutic relationship and expectation of improvement, are more important for therapeutic change than specific techniques or interventions. This does not imply that the same treatment should be applied to all patients, as the treatment should be adapted to the characteristics of the individual patient. The use of random controlled trials (RCTs) as the primary method of evaluating the effectiveness of treatments has limitations and may not always be the best path to knowledge. It is important to consider other forms of evidence, such as clinical expertise and client preferences, in addition to RCTs. The training and expertise of the therapist is more important for therapeutic outcomes than the specific treatment approach they use. Cultural adaptation of treatments and the use of feedback to improve the quality of services may also be important in the therapeutic process. Finally, common factor theory highlights the importance of contextual factors, such as the client's cultural background and the therapeutic setting, in the therapeutic process.

Quiz

1. What is the main focus of common factor theory?
   a) The specific techniques or interventions used in psychotherapy
   b) The common factors present in all forms of psychotherapy
   c) The mechanisms of change in empirically supported treatments (ESTs)
   d) The cost of training necessary to disseminate particular treatments
   
   
2. What has research shown about the importance of specific techniques or interventions in therapeutic change? a) They are more important than common factors
   b) They are equally important as common factors
   c) They have little impact on therapeutic change
   d) They are the primary driver of therapeutic change
   
   
3. Which of the following is NOT a common factor identified by common factor theory?
   a) The therapeutic relationship
   b) Expectation of improvement
   c) Specific techniques or interventions
   d) The training and expertise of the therapist
   
   
4. What is the goal of common factor models?
   a) To identify the factors that make psychotherapy effective
   b) To compare specific treatments to "common factor" treatments
   c) To provide a closed set of factors for all forms of psychotherapy
   d) To demonstrate the superiority of empirically supported treatments (ESTs)
   
   
5. What is the relationship between cultural adaptation of treatments and therapeutic outcomes?
   a) Cultural adaptation of treatments has no impact on therapeutic outcomes
   b) Cultural adaptation of treatments is associated with worse therapeutic outcomes
   c) Cultural adaptation of treatments is associated with better therapeutic outcomes
   d) There is not enough evidence to determine the relationship between cultural adaptation and therapeutic outcomes
   
   
6. How do common factor models view the role of the therapist in the therapeutic process?
   a) As the primary driver of therapeutic change
   b) As having a limited impact on therapeutic change
   c) As not relevant to therapeutic change
   d) As the sole determinant of therapeutic success or failure
   
   
7. What is the relationship between the training and expertise of the therapist and therapeutic outcomes?
   a) The training and expertise of the therapist is not related to therapeutic outcomes
   b) The training and expertise of the therapist is more important for therapeutic outcomes than the specific treatment approach they use
   c) The training and expertise of the therapist is less important for therapeutic outcomes than the specific treatment approach they use
   d) The training and expertise of the therapist is equally important as the specific treatment approach they use
   
   
8. What is the relationship between feedback and the quality of services in psychotherapy?
   a) Feedback has no impact on the quality of services
   b) Feedback is associated with worse quality of services
   c) Feedback is associated with improved quality of services
   d) There is not enough evidence to determine the relationship between feedback and quality of services
   
   
9. What is the importance of contextual factors in the therapeutic process according to common factor theory? a) They are not important in the therapeutic process
   b) They are equally important as specific techniques or interventions
   c) They are less important than specific techniques or interventions
   d) They are a key aspect of the therapeutic process
   
   
10. What is the role of random controlled trials (RCTs) in the evaluation of the effectiveness of treatments according to common factor theory?
    a) RCTs are the only valid method of evaluating the effectiveness of treatments
    b) RCTs should receive the highest prioritization among all forms of evidence
    c) RCTs have limitations and may not always be the best path to knowledge
    d) RCTs are not considered at all in the evaluation of the effectiveness of treatments according to common factor theory

 Correct answers

1. b) The common factors present in all forms of psychotherapy
2. c) They have little impact on therapeutic change
3. c) Specific techniques or interventions
4. a) To identify the factors that make psychotherapy effective
5. c) Cultural adaptation of treatments is associated with better therapeutic outcomes
6. a) As the primary driver of therapeutic change
7. b) The training and expertise of the therapist is more important for therapeutic outcomes than the specific treatment approach they use
8. c) Feedback is associated with improved quality of services
9. d) They are a key aspect of the therapeutic process
10. c) RCTs have limitations and may not always be the best path to knowledge

Healing in a Social Context

Wampold, B. E. (2021). Healing in a Social Context: The Importance of Clinician and Patient Relationship. Frontiers in Pain Research, 2, 21. https://doi.org/10.3389/fpain.2021.684768

Summary

The concept of social healing refers to the idea that the healing process can be influenced by social interactions and relationships. Social healing may be present in eusocial species, and particularly well-developed in humans. This article suggests that the role of the relationship between a healthcare provider and a patient in the healing process, is social healing. The text argues that this relationship, along with other contextual factors, can have a significant impact on the patient's health outcomes, beyond the specific treatment or medication being administered. This is supported by research on placebos, which have been shown to have a significant effect on subjective outcomes and physiology despite not containing any active ingredients. The text also discusses the role of the relationship in somatic medicine and psychotherapy, and suggests that the relationship may be a key factor in the effectiveness of these treatments. Wampold also discusses potential mechanisms by which the relationship may be therapeutic, including social support, protection, and assistance, and the importance of the relationship in regulating the patient's physiology and emotions. Finally, the text discusses the implications of this research for healthcare and the treatment of pain.

The paper discusses the concept of natural, specific, and contextual effects in the course of a disorder and how the relationship between the patient and clinician can be considered a contextual effect. It also discusses evidence for the importance of the relationship in healing, including research on placebos, somatic medicine, and psychotherapy. The paper concludes by discussing the mechanisms through which the relationship may be therapeutic and the implications for healthcare and the treatment of pain.

In summary, the relationship between a patient and a clinician plays a significant role in the healing process. The importance of the relationship has been demonstrated through research on placebos, somatic medicine, and psychotherapy. The relationship can influence health outcomes through several mechanisms, including the interaction between specific ingredients and aspects of the relationship, providing social support and protection, and creating a sense of safety and trust. It is important for clinicians to recognize the importance of the relationship and to prioritize building a strong and positive relationship with their patients.

The article states that loneliness is a greater risk factor for mortality than other factors such as obesity, smoking, lack of exercise, and excessive drinking. It is well-established that socially isolated individuals lack the social connections necessary to thrive and survive, particularly when under threat. The article also mentions that perceived loneliness, or the feeling of not being supported by those in one's social network during difficult times, is particularly predictive of mortality. The article suggests that a caring and understanding clinician can provide needed social support for patients who are socially isolated and may improve health outcomes by combating loneliness.

According to the article, there is evidence that a good relationship with a clinician can improve patient adherence to the specific ingredients of a treatment, such as taking prescribed medication as directed. Meta-analytic evidence suggests that physician communication is positively correlated with patient adherence, and there is almost a 20% greater risk of non-adherence if the physician communicates poorly. However, the article also mentions that there is some evidence that makes interpretation of medical adherence studies ambiguous, as patients who adhere to placebos have been found to have lower morbidity and mortality in some large clinical trials. The article also discusses the idea that the alliance between the patient and therapist in psychotherapy may be therapeutic by itself or may be necessary for the difficult work of therapy, and that perceived loneliness may be an important factor in patient health outcomes and can be addressed through the therapeutic relationship.

Wampold writes:

"One possible mechanism for the therapeutic value of relationship, which was alluded to earlier, is that the specific ingredients and aspects of the relationship interact. The most obvious way that this may happen in medicine is that a good relationship with the clinician augments patient adherence to the specific ingredients of the treatment. That is, if a patient has a good relationship with the practitioner, then the patient will follow the prescribed course of treatment, say, by taking the medication as prescribed. There is meta-analytic evidence that physician communication is positively correlated with patient adherence; there is almost a 20 percent greater risk of non-adherence if the physician communicates poorly.

However, there is some evidence that makes interpretation of medical adherence studies ambiguous. Not surprisingly, patients have better outcomes if they adhere to effective drug therapies. A meta-analysis of adherence to effective drug therapy and mortality found that the odds of mortality were lower when patients used their medications as directed, not surprisingly, but interestingly odds of mortality were also lower when patients adhered to a placebo as well, suggesting the benefits of adherence might involve a contextual effect as well as a specific effect. Indeed, there several large clinical trials that show that adherence to placebos reduces morbidity and mortality."

In summary, this article suggests that a good relationship between patients and clinicians can improve adherence to treatment, which may in turn lead to better health outcomes. However, the evidence for this relationship is not strong and more research is needed to fully understand the extent of its impact. The article also highlights the importance of social support in healing, particularly for individuals who may be socially isolated or have low levels of perceived loneliness. Loneliness has been found to be a significant predictor of mortality, indicating the importance of addressing social connections in healthcare.

Quiz

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