Date of Award


Document Type


Degree Name

Doctor of Psychology (PsyD)


Graduate Department of Clinical Psychology

First Advisor

Kenneth Logan, PsyD

Second Advisor

Aundrea Paxton, PsyD

Third Advisor

Marie-Christine Goodworth, PhD


With the development of the Adverse Childhood Experiences (ACE) questionnaire, Felitti et al. (1998) established that childhood trauma has a wide-ranging impact on adult health. Subsequent studies have identified a myriad of relationships between childhood adversity and negative physical, psychological, social, vocational, educational, and developmental outcomes in adulthood (Centers for Disease Control and Prevention, 2020; Hughes et al., 2017; Kalmakis & Chandler, 2015). New research has uncovered higher rates of ACEs among those in helping professions (Butler et al., 2018; Harris, 2019; Thomas, 2016), but it is unclear how these experiences impact their work as helpers. This study investigated the treatment outcomes of clients in simulation therapy at a university-based site in the Pacific Northwest. The researcher hypotheses therapists would have higher rates of ACEs, that therapists with higher ACEs and high resilience would have better treatment outcomes and therapeutic alliances, and that therapists who had attended personal therapy would have higher resilience and better treatment outcomes. Results indicated therapists experience significantly higher rates of childhood emotional abuse and household mental illness and significantly lower rates of physical and sexual abuse. No significant relationship was found between therapist ACE scores, resilience, personal therapy attendance, and treatment outcomes. A small negative relationship between the quality of the therapeutic alliance and therapist resilience was found. Additionally, there was a small positive relationship between therapeutic relationships and treatment outcomes. Finally, no relationship was found between therapist personal therapy and level of resilience and better treatment outcomes. The implications of these findings are discussed.

Included in

Psychology Commons