A positive psychological approach to trauma involves acknowledging the distress that often results from traumatic experiences, while also focusing on trauma as an opportunity for posttraumatic growth. Organismic valuing theory posits that the social environment may serve as a facilitator of posttraumatic growth to the extent that it supports the survivor's basic psychological needs for autonomy, competence, and relatedness. Of these needs, autonomy has been the most debated, particularly by cross-cultural researchers noting that autonomy is equivalent to independence and therefore not a universal need. Although there is increasing literature on the importance of autonomy across cultures and its use as a common factor across various forms of psychotherapy, there are to date no evidence-based studies examining autonomy support in the context of psychotherapy for trauma-related issues within a multicultural context. The purpose of this study was to qualitatively explore use of autonomy supportive factors by trainee therapists working with culturally diverse clients who had experienced trauma. A sample of 5 participants (3 collectivistic and 2 individualistic) across 2 community counseling centers were selected, and a trauma discussion within a videotaped psychotherapy session was analyzed for each. Directed content analysis using a coding system created for this study and derived from various theories was employed to analyze therapist responses to clients' trauma discussions. Results indicated that the therapists provided autonomy supportive responses for less than half of these discussions, with the majority of the responses characterized as empathic reflections of factual content. Also, our results indicated that autonomy supportive responses generally were provided more often to the collectivistic clients, and appeared to be mostly congruent with the cultural background of the client. Given the findings in our study, increased education and training in providing culturally sensitive, evidence-based therapy for trauma-related issues appears to be indicated for therapists in graduate programs, such as through specific courses focusing on the intersection between trauma and culture. In addition, a treatment manual incorporating the autonomy supportive codes from this study could be developed for therapists early on in training to provide guidelines for implementing autonomy support in trauma-related therapy with culturally diverse clients.

Library of Congress Subject Headings

Dissertations (PsyD) -- Psychology; Autonomy (Psychology); Psychic trauma -- Treatment; Psychoanalysis and culture

Date of Award


School Affiliation

Graduate School of Education and Psychology



Degree Type


Degree Name


Faculty Advisor

Hall, Susan;