Joel Simons

Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)


Graduate Department of Clinical Psychology


The quality of the relationship established between client and clinician during psychotherapy has been found to be a robust, common, and curative factor regardless of clinician theoretical orientation. The positive impact of therapeutic relationships remains distinct from technique and accounts for the greatest amount of therapeutic change that is within clinicians’ control. The growth of effective mindfulness-based treatments has led some to postulate that mindfulness may improve clinicians’ ability to establish positive therapeutic relationships. If that is true, then mindfulness practice may be particularly relevant to early clinical training when students are learning basic relational skills. This study examined the effects mindfulness training had on first year doctoral students’ ability to establish positive therapeutic relationships with volunteer pseudotherapy undergraduate students. An experiment was conducted comparing an experimental group which received mindfulness training to an active control group which watched training videos. Ability to establish therapeutic relationships with pseudoclients was measured comparing multiple pre- and post-treatment measures. As predicted, students practicing mindfulness achieved greater levels of self-rated mindfulness. However, contrary to prediction, students practicing mindfulness had less positive therapeutic outcomes, similar “therapeutic alliance,” and similar “therapeutic presence,” as rated by their pseudoclients. Also contrary to prediction, students receiving mindfulness training rated their own therapeutic presence similarly to controls; supervisor ratings of clinical competency also did not differ between groups. As predicted, students practicing mindfulness perceived their training as more beneficial to their clinical competency than their non-mindfulness counterparts, particularly in the domains of self-care and self-reflection. Therefore, mindfulness training may be particularly relevant to developing clinicians’ subjective impression of growth in self-care and reflective practices, although these impressions were not found to translate into more positive client perceptions of the therapy experience.