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A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Clinical Psychology, University of Regina. x, 186 p. Child welfare workers report a high prevalence of mental health concerns, such as posttraumatic stress and depressive symptoms, after directly or indirectly experiencing workplace traumatic events (Regehr et al., 2000, 2004). Factors within an organization, such as supportive administrators, supervisors, and coworkers (Boyas et al., 2012; Dagan et al., 2016) can impact reported mental health symptoms. Institutional betrayal research, as an extension of betrayal trauma theory, suggests that institutions play a role in impacting the development and severity of mental health symptoms in individuals who are dependent on them. Institutional betrayal, the actions or inactions of an institution when responding to a traumatic event, has been used to explain how organizational factors impact mental health symptoms in different settings (Smith et al., 2016; Smith & Freyd, 2013). To date, there has been no specific measurement of institutional betrayal linking child welfare organizations to the mental health and professional well-being of child welfare workers, after a workplace traumatic event occurs. The purpose of the current study was to explore this relationship in Canadian child welfare workers. Using a mixed-method approach was used, 70 child welfare workers in Saskatchewan and Alberta completed surveys about workplace traumatic events, mental health and professional well-being, and institutional betrayal and support. Thirteen child welfare workers in frontline and supervisory positions participated in semi-structured interviews to gather further information about mental health and professional well-being after workplace traumatic events. The survey data showed how institutional support was significantly related to professional well-being, such that workers who reported higher levels of institutional support also reported higher levels of professional well-being. ii Experiences of workplace traumatic events were significantly related to institutional betrayal, such that workers who reported direct exposure to workplace traumatic events also reported higher levels of institutional betrayal. Additionally, child welfare workers reported experiences of traumatic events at a prevalence similar to first responder professions (Regehr, Chau, et al., 2002; Regehr, Goldberg, et al., 2002; Van Ameringen et al., 2008). Using thematic analysis, three major themes were identified in the interview data: traumatic and stressful workplace experiences, mental health and professional well-being, and organizational responses. The experiences child welfare workers reported through survey and interview data fit within an institutional betrayal lens. Workers reported feeling distrustful and/or let down by their organizations after workplace traumatic events occurred, which was identified as impacting their mental health and professional wellness. Implications and workplace considerations are discussed, such as organizations increasing worker awareness of mental health and professional well-being supports and providing long-term and ongoing supports. The current research is the first to show that the workplace traumatic events and mental health and professional well-being of child welfare workers can be understood through the theoretical orientation of institutional betrayal. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Social Work, University of Regina. viii, 139 p. The purpose of this study was to expand the current understanding of father parental stress through an interpretive phenomenological analysis of fathers of children with Autism Spectrum Disorder’s lived experience. Parents of children with Autism Spectrum Disorder have been found to experience higher levels of stress than both parents of typically developing children and all other special needs children that have been researched to date. The experience of parental stress for parents of children with Autism Spectrum Disorder has primarily looked at the experience of mothers, with limited studies exploring the experiences of fathers. The current study interviewed six fathers who have a child between the ages of six and 12 with Autism Spectrum Disorder. Through analyses of the interviews, five superordinate themes were identified: (1) Covid-19 Pandemic, (2) Isolation, (3) Self-Efficacy, (4) Stressors, and (5) Coping. Participants highlighted the breakdown of their limited supports during the global pandemic, and the sense of loss, isolation, and frustration this created. Participants also identified negative perceptions of their self-efficacy, tied to vague perceptions of success as a father. They experienced isolation, due to stigma and ignorance of their child’s needs and feeling that there is a lack of dedicated supports for fathers. Participants discussed high levels of stress due to the chronic nature of their child’s needs and fear of what their future holds as fathers. Lastly, participants discussed limited options for coping due to guilt when trying to utilize strategies and supports, as well as negative perceptions of masculinity that created barriers and stigma to accessing supports. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Clinical Psychology, University of Regina. ix, 235 p. Childhood anxiety is the most prevalent mental health concern facing Canadian children but often goes untreated. Parent-administered, Internet-delivered cognitive behaviour therapy (ICBT) has been suggested as an approach to improve treatment access. For this approach to be effective, however, it is important to ensure that parents will use and remain engaged with the treatment intervention. ICBT researchers frequently include measures of engagement in efficacy studies, but the measures tend to be uni-dimensional and inconsistent across studies. Perski, Blandford, West, and Michie (2017) developed a conceptual model of engagement, designed to address limitations in the literature by capturing two broad dimensions of engagement: objective (i.e., intervention usage) and subjective (i.e., attention and interest). The aim of the present study was to use the Perski model to examine engagement within parent-administered ICBT. Ninety-one parents of children with anxiety participated in the nine-week, therapist-guided, parent-administered ICBT program, Anxiety treatment for Children through online Education (ACE). Measures of population characteristics (e.g., demographics; child and parent mental health; parent beliefs) and intervention features (e.g., credibility; satisfaction; working alliance) were administered throughout treatment. Measures of objective engagement (i.e., number of logins per week; number of messages sent by participant to their coach) and subjective engagement (i.e., the Digital Behaviour Change Interventions Engagement Scale) were collected at post-treatment. Forty-seven parents completed the entire intervention, while 44 dropped out. Analyses revealed that 20.3% of parents who dropped out did so during the first lesson, while the remaining parents dropped out at varied timepoints. There were no differences in population characteristics between families who ii dropped out early in the program and those who dropped out later. Higher pre-treatment child anxiety symptoms, lower pre-treatment parent mental health symptoms, and higher levels of parent education were associated with a greater likelihood of program completion. Primary analyses focused on engagement among parents who completed the entire intervention. Findings suggested that more negative parent beliefs about child anxiety predicted higher objective engagement but were also associated with higher child anxiety scores across treatment. Higher credibility and content satisfaction were associated with higher subjective engagement. The working alliance was the only factor associated with both objective and subjective engagement (i.e., a stronger working alliance predicted higher engagement). Importantly, child anxiety symptoms significantly improved from pre- to post-treatment. Neither objective nor subjective engagement was associated with treatment outcome, although this was likely due to methodological issues with the measurement of engagement. Findings have important implications for the development of parent-administered ICBT, highlighting a need to examine the working alliance, parent beliefs about anxiety, and content satisfaction as potential avenues for enhancing engagement and outcome. Findings also have implications for the systematic investigation of engagement in low-intensity interventions; most notably, findings underscore the importance of including multi-dimensional measures of engagement. Ultimately, the present study serves as a valuable step forward in understanding and maximizing engagement in low-intensity interventions, which can lead to the refinement of more accessible treatment options for children struggling with anxiety. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Science in Experimental and Applied Psychology, University of Regina. ix, 106 p. This study empirically tested predictions from a new evolutionary model of risky decision-making, the relative state model (RSM), using Texas holdem poker scenarios. The RSM suggests that risk taking is a product of one of two interacting pathways—need (desperation) and ability (affordance). According the RSM, decisions are made based on an assessment of one’s relative state, attributable to the interaction of embodied and situational factors within the environment of competition. Embodied factors are inherent physical or psychological capabilities of the decision-maker; situational factors determine how those capabilities compare relative to others in an environment. In the present study, I tested predictions of the RSM in a hypothetical winner-take-all poker tournament scenario. In this decision environment, card strength and number of chips represent embodied and situational factors respectively. Relative state was operationalized in a 2x2 (high/low) embodied by situational factor design with each of the four conditions designed to test predictions made by the RSM. Participants made choices between calling an all-in bet (risky) or folding (non-risky). Of n = 629 participants recruited, n = 297 passed a general poker knowledge screening quiz and were the focus of the primary analysis. Evidence for both ability and need-based risk taking was found. However, the experiment did not offer evidence for an interaction between need and ability as predicted by the RSM. Limitations of the experimental design and peculiarities of the sample suggest further enquiry is necessary. This study provides the first direct intentional experimental evidence for ability-based risk-taking, and suggests directions for future research. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Clinical Psychology, University of Regina. X, * p. Approximately one in five Canadian couples experience infertility, defined as being unable to achieve pregnancy despite 12 or more months of attempts to conceive. Experiencing infertility has been disproportionately associated with an array of psychological difficulties in women, however, there has been little research examining which coping strategies and behaviours may be helpful during these high-distress times of a woman’s cycle. Fifty-eight women were recruited for a study, via social media, examining the daily coping strategies and fertility monitoring methods (e.g., use of ovulation predictor tests), in relation to daily infertility distress among women with infertility. Over the course of one menstrual cycle, daily coping strategies, use of fertility monitoring methods, quality of life, and mood was assessed in the morning and evening of every second day. A number of adaptive and maladaptive coping strategies were identified: adaptive strategies included focusing one’s energy on activities unrelated to conceiving, such as focusing on other life goals, trying to stay optimistic, and actively planning next steps following an unsuccessful cycle. In contrast, avoidance of infertility reminders and seeking emotional support from others were associated with worse psychological outcomes. The use of fertility monitoring techniques was associated with greater anxiety. In terms of the influence of pregnancy test taking, a negative test was associated with an increase in depressive symptoms but also a decrease in anxiety symptoms compared to days where no test is taken. These findings highlight a number of potential areas for clinical targets for future infertility specific interventions. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Clinical Psychology, University of Regina. viii, 97 p. More than 6% of Canadian children experience anxiety at a severity which warrants a diagnosis. Cognitive Behavioural Therapy (CBT) is an effective treatment for childhood anxiety but it can be difficult for parents to access due to factors such as cost and geographical obstacles. Parents have successfully and effectively implemented CBT to their children in the past, and we wanted to know if parents were interested in fusing parent-administered CBT with the Internet to overcome accessibility issues. The objective of this study was to investigate parents’ interest in assuming the role of laytherapist in online therapy and the factors associated with this interest, using the Theory of Planned Behaviour (TPB). Among 164 parents, nearly 75% said they were interested in participating. Statistically significant and positive associations were found between interest and parent variables (i.e., parent confidence, stress, Internet proficiency), demographic variables (i.e., parent education level), and TPB variables (i.e., attitudes, subjective norms, perceived behavioural control (PBC)). Regression analyses showed that parent and demographic variables accounted for 12.5% of the variance in parent interest. In the final model, two components of the TPB—attitudes and PBC—and one parent variable—parent confidence—were predictive, accounting for an extra 32% of variance in parent interest. These findings indicate that many families would adopt this therapy, which is a timely discovery given the current global pandemic. Recommendations to boost parent interest include a) inducing positive attitudes toward ICBT, b) assuring parents that many barriers are removed due to nature of ICBT, and c) increasing parent confidence in assuming role of ‘lay-therapist.’ Future directions and limitations are discussed. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Clinical Psychology, University of Regina. vii, 147 p. Cognitive behaviour therapy (CBT) has been identified as an effective form of treatment for childhood anxiety disorders, but many families are unable to access it. One possible way of increasing access to treatment is by providing online CBT training to parents so that they can implement CBT with their children at home. Exposure therapy is a particularly beneficial component of CBT but poses unique challenges in the development of a parent-administered, Internet-delivered CBT (ICBT) program, as research suggests that parents may be hesitant to implement exposure techniques with their children. Few studies have investigated ways to address such challenges. The aim of the present study was to develop and test the usability of a parent-administered, online exposure therapy module. The exposure therapy module was created in conjunction with six other modules, which together comprised a larger, parent-administered, ICBT program. The program, titled The Child Anxiety Course for Parents, was based on the University of Manitoba’s self-help, parent-administered Coaching for Confidence program, but was modified to reflect a therapist-guided mode of delivery. An iterative approach was used to test four domains of the module’s usability: acceptability, clarity, user-friendliness, and feasibility. During the first testing iteration, 10 therapists reviewed the exposure therapy module and provided verbal feedback during focus groups. Their feedback was analyzed using a thematic analysis approach and was incorporated into further development of the module. The primary suggestions that emerged from therapist feedback were to: include more detailed information for parents; provide parents with more encouragement; and incorporate references to information contained in other modules of the program (e.g., cognitive restructuring). Therapists also expressed satisfaction with the proposed mode of therapist guidance (i.e., a weekly check-in e-mail message from a therapist), although some suggested increasing the contact to twice per week. During the second testing iteration, five parents of children with anxiety reviewed the module, provided verbal feedback during individual sessions, and completed usability questionnaires. Descriptive analyses were used to assess usability ratings while thematic analysis was once again employed to analyze verbal feedback. Parent feedback was generally favourable, as parents relayed high levels of satisfaction with module content and with the prospect of a weekly check-in with a therapist. The primary suggestion for module improvement was to include more examples showcasing the implementation of exposure therapy. Based on parent feedback, the exposure therapy module was finalized. Changes to the module from therapist and parent feedback resulted in an acceptable, clear, user-friendly, and feasible exposure therapy module ready to be implemented and its efficacy evaluated in further studies. Findings are expected to inform future research into parent-administered exposure therapy for childhood anxiety disorders. Furthermore, The Child Anxiety Course for Parents, which is expected to eventually serve as a treatment option for families in Saskatchewan, is one of the only known therapist-guided, parent-administered programs delivered entirely via the Internet. By contributing to the development of such a program, the present study may ultimately assist in increasing children’s access to mental health services, thereby reducing anxiety among Saskatchewan children. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Clinical Psychology, University of Regina. viii, 130 p. This study examined child and parental factors associated with fatigue in parents of children with Autism Spectrum Disorders (ASDs) by using the Middle-Range Theory of Unpleasant Symptoms (TOUS) model. The research was designed to 1) extend our understanding of fatigue in parents of children with a diagnosis of ASDs by investigating fatigue in both mothers and fathers, and 2) identify and examine the associations between psychological, physiological, parental situational, and child-based situational factors. Mothers (N = 78) and fathers (N = 34) of children with ASDs aged 2-12 years were recruited from across Canada. Participants completed a confidential questionnaire battery regarding their fatigue level, parenting self-efficacy, parenting satisfaction, sleep quality, depressive and anxiety symptoms, social support, marital satisfaction, level of physical activity, caregiving burdens, their child’s sleep quality, and their child’s behavioural problems. Fathers reported lower levels of fatigue than mothers. Fatigue was associated with psychological, physiological, and situational factors, including child-based situational factors, although child-based situational factors were predictive of fatigue in mothers but not fathers. Fatigue was negatively correlated with parenting self-efficacy and parenting satisfaction in both mothers and fathers. This study improves our understanding of a variety of factors that impact parental fatigue, allowing clinicians to better support parents and provide avenues for the development of interventions to help reduce parental fatigue. It also contributes to the existing literature by exploring how maternal and paternal experiences of children with ASDs differ and how parental fatigue is related to ASDs. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy in Clinical Psychology, University of Regina. ix, 225 p. The main objective of this study was to investigate the concurrent role of multiple antecedents of social competence in a group of children with Autism Spectrum Disorder (ASD). Existing models of social competence were adapted to include three domains of executive function (EF: Cognitive, Behavioural, and Emotional Regulation), and two domains of Social Emotional Learning (SEL: Nonverbal Awareness, Social Understanding). The EF domains were related to sustained attention, working memory, planning, behavioural inhibition, and affective decision making; SEL domains included social comprehension, and identification and interpretation of social cues. Social competence was defined in terms of social skills and adaptive social functioning. The relationships amongst the EF and SEL domains, and social competence were examined in a sample of 49 boys with ASD and 48 neurotypical boys, aged 8 to 13 years. Results showed that the ASD group performed significantly below the control group on most SEL and EF domains. Children with ASD were also rated significantly lower on social competence measures and parental ratings of EF. Importantly, the EF domain of Cognitive Regulation predicted social competence in boys with ASD whereas the SEL domain of Social Understanding predicted social competence in neurotypical boys. These findings contribute significantly to our understanding of social competence and quality of life in boys with ASD. The observation that Cognitive Regulation predicts social competence in boys with ASD has important clinical implications for specifically targeting EF in both assessment and treatment. A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy *, University of Regina. *, * p. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements For the Degree of Doctor of Philosophy in Clinical Psychology University of Regina. xi, 207 p. Parental self-efficacy (PSE) is a cognitive construct that can be defined broadly as an individual’s appraisal of his or her competence in the parental role. Researchers interested in child developmental outcomes have highlighted the important role that PSE plays in psychosocial child adjustment. Despite its importance, the PSE construct has been understudied in men. Given the enduring gendered nature of parenting, it seems likely that fathers’ PSE may differ from mothers’ PSE in important ways. This study was the first to develop and validate a self-report scale that assesses the PSE of fathers with preschool aged children. The research was conducted in a series of three phases. In Phase 1 of the research, fathers were interviewed and invited to discuss their perceptions of their roles and responsibilities within their families. Using thematic content analysis methodology, 11 themes were identified: parenting in context, teaching, financial responsibility, general responsibility, domestic upkeep and maintenance, accessibility, discipline and self control, safety and protection, play, nurturing, and instrumental care and routines. Critical feedback from subject matter experts was sought concerning the parenting domains and parenting tasks identified. A pool of potential PSE scale items was then drafted. In Phase 2 of the research, a convenience sample of 224 Canadian fathers completed the draft items. The psychometric properties of the new Fathering Self- Efficacy Scale (FSES) were investigated. The scale was reduced to 22-items which loaded onto three distinct factors. The factors represented positive engagement, direct care and financial responsibility. In Phase 3 of the research, a new sample of 247 Canadian fathers was recruited to complete the PSE items and the associations between their responses on the new scale and other existing scales were examined. In addition, 66 spousal reports of fathering self-efficacy were also sought. The three-factor structure of the FSES replicated in Phase 3 and was found to be a superior fit to the data when compared to alternate 2-factor and 1-factor models. Statistically significant, positive associations were found between the FSES, other measures of self-efficacy and a measure of father involvement. Statistically significant negative associations were found between the FSES and measures of parenting stress and depressive symptoms. There were no statistically significant differences between spousal reports of fathering selfefficacy and fathers’ own self-report. Paternal self-efficacy was predicted by family income, general self-efficacy, domain general PSE, parenting stress and parent responsibility. Overall, the results offer initial evidence of the reliability and the construct validity of the FSES. The emergence of this new scale will be important to fathering research and can provide an important contribution to the ongoing development of therapeutic family interventions. A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy *, University of Regina. *, * p. Student yes

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Psychology, University of Regina. xii, 103 p. Infant sleep problems have been found to be related to child, parent, and family difficulties in both the short and long term. Behavioural interventions have been shown to be important for reducing and preventing these associated problems. As the primary caregivers of infants, parents are key figures in providing information about their children to clinicians and researchers. They also determine whether and when to seek treatment for infant sleep problems, and how interventions are implemented. However, little is known about how parents perceive infant sleep problems, a factor that is important in parental decisions for seeking infant sleep interventions. Thus, it is vital to gain further insight into parents’ understanding of infant sleep problems. Guided by the transactional model of infant sleep developed by Sadeh, Tikotzky, and Scher (2010), this study explores the relationship between child age, mothers’ perception of infant sleep problems for their own children, mothers’ sleep-based attribution, and mothers’ assessment of infant sleep problems for children in a scenario. Results from a sample of 878 mothers of children 6 to 23 months of age showed that child age, mothers’ perception of a sleep problem for their own children, and sleep-based attributions were significant predictors of mothers’ assessment of infant sleep problem for scenario children. With regard to child age, mothers were more likely to give more responsibility for sleep behaviours to and to assess an infant sleep problem for older infants than younger infants. When mothers thought their own children had a sleep problem, this seemed to be related to their global perceptions of infant sleep behaviours, as they were also more likely to identify an infant sleep problem for a scenario child. Lastly, mothers attributed greater child responsibility (higher child-centered locus, controllability, and intentionality) and parent-centered locus for good sleep and less so for negative sleep. The implications of these findings and future directions are discussed. Student yes

A substantial group of adolescents demonstrate behavioural patterns consistent with the DSM-IV-TR diagnosis of borderline personality disorder (BPD). In light of the paucity of empirically validated interventions for adolescents with BPD, there is a fundamental need to develop and assess novel treatments for this underserved population. Following the research evidence for the effectiveness of standard Dialectical Behavior Therapy (DBT) for adult outpatients as well as the growing evidence for the usefulness of modified DBT programs adapted for adolescents, the primary purpose of this study was to investigate the effect of a 12-week outpatient DBT skills group that included family members and that was provided as an adjunct to non-DBT individual therapy (i.e., Treatment As Usual) for multidiagnostic suicidal adolescent outpatients. This study also offered an opportunity to examine how DBT skills group intervention might be provided in a "real-world" community-based system of care. A natural consequence of conducting this type of research is having less rigorous control over facets of the investigation. In this study,process challenges impacted the research design, and, ultimately, the opportunity to reach valid conclusions about the effects of the DBT intervention on the basis of a pre-post research design and analysis. Preliminary results suggest that a DBT skills group intervention may be a useful intervention for adolescents but additional studies are required to validate the effectiveness of DBT with this population. Implications for treatment development, service delivery, and future research directions are discussed in light of the findings. A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy *, University of Regina, ix, 136 l. Student yes