First Advisor

Pendleton-Helm, Heather

First Committee Member

Fulling-Smith, Jennifer A.

Second Committee Member

Weingartner, Angela

Third Committee Member

Moore, Melanie

Degree Name

Doctor of Philosophy

Document Type


Date Created



College of Education and Behavioral Sciences, Applied Psychology and Counselor Education, APCE Student Work


Death anxiety has been an unremitting agent of the human experience. The psychological dilemma posed by the awareness and forecasting of death can increase anxiety, thus affecting well-being through the compulsive desire or will to persist (Becker, 1973; Yalom, 1980). Such psychological armor can manifest in conscious and unconscious behaviors, thoughts, and emotions to which persons utilize psychological, social, and cultural defenses to manage anxiety (Becker, 1973; Solomon et al., 2015). Across all levels of counseling, there has been a deficiency in awareness and discussion of death-related fears within the therapeutic process (Lacocque & Loeb, 1988). Therefore, due to the enduring and immutable conflict of prospective non-being, death anxiety has been directly operational during psychotherapeutic sessions for all in the counseling room. As an enhancement to counseling training, an exploration into death anxiety and its encumbered defenses, both inside and outside the counseling room, has proposed significant influences on counselors’-in-training (CITs’) understanding of themselves and their respective influence on client experiences (Routledge & Juhl, 2010). This study was designed to explore the hypothesized relationship of the effects of death anxiety on CITs’ overall efficacy in treating clients presenting with substance use disorders by answering the question, to what extent does death anxiety and substance use bias explain graduate students’ perceptions of self-efficacy, and which, if any, of these variables contributes distinctively to the explanation after controlling for age, gender, and the combined effect of years of work experience in human services status and gender? Furthermore, the study explored the secondary and tertiary questions: do years of work experience in human services impact students’ perception of self-efficacy when working with substance use disorder populations, and to what extent do CITs’ gender and death anxiety explain their perceptions or biases toward a substance use population? Data from 94 participants were analyzed using hierarchical regression, considering demographic variables. Contrary to expectations, death anxiety (p > .05) and substance use bias (p > .05) did not significantly predict self-efficacy, leading to the rejection of the initial hypotheses. However, work experience in human services emerged as a statistically significant predictor of self-efficacy (p = .007), affirming its expected importance. Gender and death anxiety were not significant predictors of bias towards substance use populations (p > .05 for both), which led to the dismissal of the third set of hypotheses. These results suggest that practical experience was a key factor in developing self-efficacy for counselors-in-training (CIT), while death anxiety and substance use bias have had limited influence. The findings informed clinical practice and suggested future research directions, particularly in investigating other potential influences on counselor self-efficacy.

Abstract Format



195 pages

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Copyright is held by the author.