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A FOLLOW=UP SWDY OF CHILDREN'S
BEHAVIOR CHANGES A3 RELATED TO

THEER PARENTS‘ PARTICKPATEQN
EN GROUP THERAPY

Thesis {or “30 Deanne a); M. A.
MERE-Gm STATE UMVERSETY

Lois Quick ‘WiEliams
19-64

THESIS

 

LIBRARY

Michigan State
University

 

A FOLLOW-UP STUDY OF CHILDREN'S BEHAVIOR CHANGES
AS RELATED TO THEIR PARENTS' PARTICIPATION
IN GROUP THERAPY
BY
Lois Quick Williams
Abstract of a Master's Thesis
Completed Summer Term, 1964

This study employs a new approach to the problem of reliability
of the criterion measure of outcome of therapy. To assess the pro-
gress of 22 children of parents who had participated in a group therapy
program aimed at improvement of disturbed parent-child relation-
ships, 43 parents were interviewed in their homes and 42 of whom
completed the Positive Attitude (PA) Index either immediately before
or immediately after being interviewed.

The parent's verbatim replies concerning his or her child's im-
provement provided the major criterion of change. Each parent was
interviewed separately by the author and the parent's independent
evaluations of the child were rated by two judges with background in
the assessment of inter-familial relationships and trained in the rating
procedure. Their independent ratings of interview items produced

inter—rater reliabilities from . 58 to . 92 with a median of . 72.

Lois Quick Williams

To discover the differential effects and predictive value of certain
variables on the criterion of child's improvement, ratings of intake
interviews of 21 of the 22 families were made. Two judges experienced
in assessment of clinic-referred families independently rated the inter-
views according to scales constructed on the three dimensions, ”Mode
of Child—Parent Interaction, " "Parents' Marital Relationship, ” and
"Parents' Control Practices. ” It seemed advisable to obtain the ratings
of a third qualified judge because inter-rater reliability on the ”Control
Practices" scale were low and because of lack of agreement on which
cases were lacking in information thus reducing the N's of the com-
parisons. Reliabilities for the three pairs of judges were: .81, . 24,

. 86;. 56, . 59, . 92; .81, . 58, . 79.

A third approach to the evaluation of outcome of therapy, the PA
Index, provided change scores. The 28 parents for whom scores were
available from pre-therapy testing did not show significant gain from
pre-therapy to follow-up. The follow-up scores of all 42 parents
correlated . 36 with an overall estimate of child's improvement.

Those items from the PA Index which showed significant response
changes from pre—therapy to post-therapy, pre-therapy to follow-up,
and post-therapy to follow-up were listed and their content and direc-
tion of shift examined.

Three subscales from the PA Index having relevance to the three

dimensions upon which the intake interviews were scaled provided a

Lois Quick Williams

separate set of scores. "Feelings About Child'l correlated . 46 with an
overall estimate of child's improvement, . 65 when couples' scores
were combined; "Feelings About Spouse" correlated .63 with child's
improvement, . 65 when couples' scores were combined. Each of the
above were significant beyond the .05 level. "Strictness and Control"
correlated -. 32 with individual and -. 37 with couples' estimates of
child's improvement, neither coefficient being significantly larger than
zero.

The ratings of the intake interviews were compared to five dif-
ferent aspects of the child's adjustment. The three scales used in
rating all showed that they were associated to the areas of child's ad-
justment, but not uniformly so. The highest degree of association
found was between "Child's Feelings About Himself" and "Control
Practices" (.61, significant at the .01 level).

The general conclusions of the study are: (1) substantial improve-
ment in children's adjustment was felt to have taken place by the
majority of parents; (2) three dimensions pertaining to love-hostility,
autonomy-control, and marital relationship proved to be associated
to the degree of reported change in the child; (3) the finding that
reports of a parent's own relationship to the child were largely un-
associated to the three dimensions whereas reports of a spouse's

relationship to the child were significantly associated, points up the

Lois Quick Williams
importance of obtaining independent reports from both parents in

assessment of parent-child relationships.

Approved:

[\_L/ L 61,/'1
#iCommittee Chairman

7

Date: / O /lA/'fioj;/ ”Wild/-

Thesis Committee:
John R. Hurley, Chairman
Alfred G. Dietze
Bertram P. Karon

A FOLLOW—UP STUDY OF CHILDREN'S BEHAVIOR
CHANGES AS RELATED TO THEIR PARENTS'

PARTICIPATION IN GROUP THERAPY

BY

Lois Quick Williams

A THESIS
Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

MASTER OF ARTS

Department of Psychology

1964

W'I-
’, «I

ACKNOWLEDGMENTS

The author wishes to express her gratitude and sincere appre-
ciation for the great amount of time and assistance generously given
by her committee chairman, Dr. John R. Hurley.

The valuable criticisms of Dr. Bertram Karon and Dr. Alfred
Dietze in preparation of the final draft are also deeply appreciated.

For the invaluable contribution by the five judges, Nicholas
Borrelli, Clyde Crego, Rosamond Mitchell, Gerald Casey and
Shirley Hurley, the author is also indebted).

The cooperation of Dr. Lucy Rau, Director of the Clinic, and
Mrs. Mary Cross, Secretary, who typed and duplicated the question-

naire, is most gratefully acknowledged.

INTRODUCTION

Beginning in 1959, a series of groups of from four to five parent-
couples met weekly in the Psychology Clinic of Michigan State Univer-
sity for periods of fifteen weeks duration. Four years after the first
group met, all participating parents still residing in the immediate
area and nearby towns were contacted and became the subjects of this
study, an effort to determine the outcome of their group experience.

The children of these parents had originally been referred to the
clinic because of difficulties mainly connected with school adjustment.
The greater part of the follow-up interview was accordingly focused
on the child and his progress in the one to four years intervening be-
tween the last group meeting attended by the parents and the follow-up
interview. In addition, it was hOped that something could be learned
of the changes in the parent's own relationships.

Follow-up studies of children who have been seen by clinicians but
who have not received treatment are rare; systematically carried out
studies of progress of children who have been referred to clinics but
whose parents alone have been the subjects of therapy have apparently
not been made up to now.

In part this is due to the problem of obtaining a check on the relia-
bility of the reports of persons who have known the child over a period

of years and are in a position to make comparative judgements of the

Child's deveIOpment. Because both mother and father were involved in
the group therapy procedure, interviewing both was a feasible approach,
and by making each of the pair of interviews separately, independent
estimates of the change in the child were obtained.

Other sources of information about the subjects were available.
From clinic files were obtained the intake interviews which had been
written by trained or in-training psychologists after seeing one or both
parents, usually both parents at the same time. For the purposes of
this study, it was necessary to choose from these interviews a small
number of variables upon which the cases could be rated reliably. This
procedure provided a way to compare the original order of the subjects
on dimensions of family relationships with their order on the criterion
of child's improvement.

Selection of dimensions was simplified by reference to the results
of recent factor analytic studies. Two major reference dimensions for
parental behavior, love—hostility and autonomy-control, have emerged
from several studies (Becker, 1962). As the material which the parents
chose to bring out at intake emphasized symptoms and concerns, the
words of the parents to describe their children's reactions to them
seemed to be the best indicator of love or hostility in the relationship.
The scale constructed was called "Mode of Child's Interaction with
Parents. "

The complex area of disciplinary practices was spottily described

at intake, as was use of punishment, but it was felt that the scale

constructed with principle reference to punishment and control and
called "Control Practices" would permit judges to rate all but a few of
the cases.

A third variable had particular relevance to the sample at hand,
many of whom at time of intake described a conflictual marital relation-
ship, in some cases so severe that it overshadowed their concern about
the child's behavior. It had been suggested by Farber that satisfaction
with the performance of a child is partly a function of the quality of the
husband-wife interaction system. Specifically, he has shown that the
role model established by the spouse would be one which the parent in
the "high-integration" marriage finds congenial, and this parent would
then accept his Opposite sex child in a similar role. But marital frus-
tration and hostility may be projected to the child with whom the parent
has become identified in the "low-integration" marriage (Farber, 1963).
The third scale constructed for the evaluation of the intake interviews
is the "Marital Relationship" scale.

A third source of information with which to evaluate the outcome of
therapy was provided by the Positive Attitude Index (Appendix A). This
index was specifically designed to measure changes in parental attitude
toward more desirable mental health practices. Its 50 items may be
described as self-report items falling in the general classifications of
attitudes toward self and spouse as parents, attitudes toward own child-
ren, attitudes toward therapy, and beliefs about the rearing and educa-

tion of children. Items were keyed in the direction consonant with

positive parental attitude as independently rated by a panel of well
qualified judges for whom "positive attitude" was defined as, "A more
open and accepting psychological orientation toward either one's self
or others; a heightened sense of responsibility in interpersonal rela-
tionships; an increased adaptability and/or personal resourcefulness"
(Maizlish and Hurley, 1963).

The PA Index provided three separate approaches to evaluation of
interview responses. Another group of parents who had participated
in group therapy, some of whom were included in the present sample,
had been found to make a significant shift toward more positive attitude
when tested at the beginning and at the end of group meetings. (Maizlish
and Hurley, 1963). Would the present sample show a significant gain
when their scores at follow—up were compared with their pre- and post-
therapy scores? Second, what particular items would prove to be
sensitive to change, either gain or loss? Third, from item subscales
along dimensions similar to those constructed for the purpose of rating
the intake interviews, could the criterion of child's improvement be pre-
dicted?

From the above sources of information-—follow-up interviews,
Positive Attitude Index scores, and intake interviews--data will be
examined to test the following:

1. Expected gain in means of scores on the Positive Attitude

Index from pre—therapy to follow-up for the 28 subjects
who were tested on both occasions;
2. An hypothesized positive relationship between the scores on

the PA Index at time of follow-up and an overall index of
estimated child's improvement;

3. Expected relationships between judges' ratings of intake
interviews and the estimated child's improvement in each of
five areas of adjustment. As higher ratings on the scales
represent greater tendency toward extremes of conflict, hos-
tility and punitiveness, comparison are. expected to yield
negative relationships.

4. Expected positive relationships between overall estimated
child's improvement and pre-therapy scores of 28 sub-
jects on three subscales, items from the PA Index selected
on the basis of similarity to the three dimensions upon which
the intake interviews are to be rated.

All tests for significance of relationship, Chi-square tests of equal
distribution of cases, and t tests for differences between means are
two-tailed tests. Measures of association are Pearson product-moment
r's unless specifically designated otherwise.

In the ensuing analysis, the assumption that any amount of the
child's improvement is expressly due to the group therapy is not made.
Multiple causesu-the effects of growth on symptomatic behavior (for
which unfortunately no norms exist), for example--may have contributed.
Although there is no way to determine to what extent the therapy had
determined the outcome, the child's improvement remains the best
criterion, one which can be used to compare the results with those of
subsequent studies of this nature.

There is no evading the fact that parents' perceptions of their child-
ren are not the equivalent of observations by persons trained in objec-
tivity. The hOpes and expectations of the parents, their projections of
feelings about themselves and their spouses on their children, their

identifications with the children, are some of the elements which enter

into parental perceptions. But to a large degree it is the faulty

perceptions which were the aim of therapeutic intervention. To the
extent these were altered, the parent could begin to perceive the efforts
of the child toward growth and thus aid him. The progress of the child
and the change in parents' attitude, it must be assumed, will be con-

comitant.

METHOD

Obtaining the Cooperation of the Sample Families. All the families

 

for whom current addresses could be found received letters requesting
their COOperation in research appraising the outcome of the parent-
group program. The author then telephoned each family and arranged
an appointment for the interviews in their homes. All 22 families who
still resided in an area within a 40-mile radius Of the MSU campus con-
sented to participate. Because of the immediate unavailability of some
parents, the entire interviewing period took over two months.

The Interview Questionnaire. (Appendix B.) The interview, taking

 

approximately 30 minutes to complete, was arranged as follows: ques-
tions regarding the age, occupation, religion of the respondent; any
psychological treatment of the child and the parent before and after the
group therapy; a preliminary question (Item B1) of general nature; a 5-
item checklist (B3) presented to the parent for his rating of Much Worse,
Some Worse, No Change, Some Better, Much Better, the 5areas of the
child's adjustment; and finally the interview prOper, a series of Open
questions concerning the child's present functioning, inquiries into the
parent's reaction to the group experience and his Opinion of the amount
of change observed in his or her relationship to the child, the spouse's
relationship to the child, and his or her relationship to the spouse.
Subjects' verbatim responses were taken down by the author on the

questionnaire forms. Later, typescripts were prepared and then cut

and reassembled so that all responses to a single item appeared together,
numbered according to subject, to be rated by the judges. Eleven items
were selected for rating on the basis of relevance to the major criterion,
their clarity, variability and length.

The responses to the majority of the items were not very variable
and were rated on 3 or 4-point scales. Other items required scales of
5, 6 or 7 points. All scales were along the dimension of change, but
scale points had to be defined in terms of the type of responses evoked
by a particular item (see Table 7).page 20)

Rating the Follow-up Interview. The two judges who rated the inter-

 

view items were selected for their background of experience with parents
and children. Both were graduate students assisting in the MSU Psy-
chology Clinic. Neither had had contact with the families of the study.

A training session was held with the author and the two judges
present to familiarize them with the rating procedure. They rated the
introductory item (Item Bl) independently, achieving an inter-rater
reliability coefficient of . 74. After discussion of their most discrepant
ratings, their reliability rating became . 89 for this item. All subse-
quent ratings, however, were done independently by the two judges.
(Reliabilities are reported in Table 7.).

The Intake Interview Scales. Because of differences in conditions

 

in which the intake interviews were conducted, the interviews were not
uniformly representative of both parents. Study of the interviews led

to the conclusion that only one rating per couple could be made. For

purposes of analysis, the individual ratings on the criterion measure were
combined into a single score for husband and wife to correspond to the
ratings on the intake scales. There was a total of 21 interviews (one
family was not represented as no intake interview existed for that
family).

Construction of the three scales was done with the following prin-
ciples in mind:

1. To find categories which were as discrete as possible as
scale points;

2. To arrange the categories in order of apparently increasing
hostility, conflict, and punitiveness;

3. To use the descriptive terms most often employed by the
parents rather than the terms used by the interviewer to
interpret his impressions of the parents.

(For scales used, See Appendix C)

It was hoped that by definition of each scale category inter-rater
agreement would be maximized and impressions of the parents would
be minimally influenced by interview material not specifically per-
taining to the scales.

Because of the lack of information in some of the interviews for a
particular rating dimension, the judges were instructed to use an "X"

whenever they thought a case presented insufficient information.

Rating the Intake Interviews. Two judges were selected for their

 

experience with families and family casework. Both were graduate
students and assistants in the MSU Clinic. A training session was held

in which three intake interviews not part of the sample but selected for

10

their similarity to sample cases from various dimensional extremes
were independently rated by both judges. Discussion of the discrepant
ratings helped to solve problems of how the interview material should
be interpreted. All their ratings of actual sample cases were inde-
pendent.

As inter-rater reliability for this pair of judges was poor for the
Control Practices scale (. 24), and because of the number of subjects
for whom the judges felt ratings could not be made reduced the N's for
the Marital Relationship scale, a third judge was trained in a manner
identical to the first two. This judge was qualified by her experience
with an out-patient family service clinic and was also a graduate student.
In the majority of cases where the first two judges had used the Option
of making no rating, they were not in agreement in their use of this
Option. By using a third judge, it was possible, where one of the three
judges had declined to make a rating, to use the average of the ratings
of the other two judges.

Table 1. Product-Moment Correlations of Inter-Rater Reliability on
Ratings of Intake Interviews.

 

Intake Inte rview Sc ale 8

 

Mode of Child's Parents' Parents'
Interaction with Marital Control
Judge Pair Parents Relationship Practices
(N's in Brackets)’
A vs. B .81 (18) . 79 (15) . 58 (20)
B vs. C . 56 (18) . 92 (17) . 59(19)

(3 vs. A .81 (19) .86 (16) .24 (19)

 

11

The Positive Attitude Index. (See Appendix B.) The 50 items can be

 

rated Strongly Agree, Mildly Agree, In Doubt, Mildly Disagree or
Strongly Disagree, each rating scored from 1 to 5 respectively. Nine-
teen of the items were keyed for scoring in the reverse direction. The
items are classified into three groups according to the consistency of
the panel of raters previously described, and are called High, Moderate,
and Low consensus classes. The comparisons of pre-therapy, post—
therapy, and follow-up scores are based on the High and Moderate con-
sensus items alone. Correlation of follow-up scores of all subjects with
child's improvement estimates are also based on High and Moderate con-
sensus items. This procedure is in accord with prior research with this
index (Maizlish and Hurley, 1963). Analyses of individual items were
carried out on the entire sample of items, however.

PA Index Subscales. By combining items with apparent unidimen-

 

sionality from the PA Index, three subscales were constructed on
variables which were roughly parallel to the three variables used to
rate the intake interviews. They are, "Parent's Feelings About Child"
(3 items), "Parent's Feelings About Spouse" (3 items), and "Strict-
ness and Control" (4 items).

Characteristics of the Sample. Of the 43 parents interviewed, over

 

half were from 36 to 43 years of age. Twenty-four percent were younger,
to 30 years, and 24 percent were older, to 72 years. Occupations of
the blue-collar class were held by 28 percent of the fathers; 50 percent

were in sales, held clerical or managerial positions, or owned their

12

Own firms; 22 percent ranked in the professional category. All, with
the exception of one or two families, appeared to be of low-middle or
middle class status. Seventy-seven percent were Protestants, the other
23 percent being Catholic, mixed Protestant—Catholic, and one of no
preference. One family lived on a farm; three families lived in towns
in rural areas and the remaining 82 percent had homes in the city of
Lansing, Michigan and its suburbs.

The educational level of the parents varied widely. Nineteen per-
cent of the sample had less than a high school education, 35 percent
held high school diplomas, 14 percent had had some college, 12 per-
cent were college graduates, 10 percent had training beyond college
and 10 percent held advanced degrees.

All subjects were questioned about all contacts with "professional
persons" subsequent to the group meetings. A few of the parents had
received psychological counseling after their participation in the group,
but this was limited to four of the parents. Two of the mothers under-
went brief periods of hospitalization for acute depression, another
apprently barely avoiding such an attack, but none of the three indicated
that they had had psychotherapy. Other help with problems of a psycho-
logical nature seemed to be limited to pastoral counseling, utilized by
two participants.

The majority of the children of the parents who participated in the
group program had been referred to the MSU Psychology Clinic for

problems connected with school-~indifference to schoolwork, refusal

13

to do schoolwork, reading difficulty not attributable to lack of ability,
restless or aggressive behavior in school, refusal to talk in school,

and over-fearful of failure in school. Two children under six years were
referred because of anticipated difficulty in school for reasons of poor
peer relationships and undecipherable speech.

Nightmares and restless sleep were symptoms shared by eight of
the children, nocturnal enuresis by five, thumbsucking and nailbiting by
four. One boy had shown indications of a personality disturbance and
acting-out behavior.

Although many of the children had been seen by professionals for
diagnosis, none were considered to have disturbances necessitating
hospitalization. Six received treatment in the MSU Psychology Clinic.
The difference between the total judges' ratings of parents' estimates
of improvement (items B2 through B6) for this group and the overall
improvement estimates for the untreated group of children is too slight
to indicate a need for singling out the group of treated children for
special analyses.

Table 2. Comparison of Means and Standard Deviations of Judges'

Ratings of Parents' Estimate of Child's Improvement for
Treated and Untreated Children.

 

_N_ Mean S. D.

In-

.13.

 

 

Treated Children 6 64. 66 15. 85
. 29 n. s.
Untreated Children 15 60. 20 18. 53

 

l4

Inasmuch as the interviewing at follow-up was done in conjunction
with administration of the PA Index, every subject, save one who de-
clined to take the test, either completed it immediately before being
interviewed or immediately after. The possibility that the test may
have influenced the results of the interview was examined with these
results:

Table 3. Difference between Means of Total Judges' Ratings of

Parents' Reports of Child's Improvement Made Before
and After Completion of Positive Attitude Index.

 

 

 

Mean Total of D N
Parent's SD —
Estimates
Subjects Interviewed
Before Seeing PA Index 29. 42
1. 36 19
Subjects Interviewed
After Seeing PA Index 31. 79

 

As it was known that the correlation between husbands' and wives'
estimates was . 66, it was apprOpriate to use the test for correlated
measures as a test sensitive to test the proposition that the PA Index
may have influenced the reports of the parents. There is no basis to
conclude that it did influence reports.

Another check on data was made necessary by the repeated testing
of some individuals. Of the 42 subjects tested on the PA Index at

follow-up, 28 had been previously tested.

15

Table 4. Difference Between Means of Positive Attitude Index Score of
Subjects Tested Once and Subjects Tested More than Once.

 

 

 

Mean
PA Score N S. D. t P
Subjects tested once 135. 79 14 10. 61
.59 n. 3.
Subjects tested twice 142.10 28 ll. 60

 

f

Although the difference according to previous testing was not signi-
ficant, the possibility that it had had some effect should not be discarded
inasmuch as the groups are small and variability large (Walker and

Lev, 1953).

RESULTS

The Interview Questionniare. The frequencies in each interval

 

of the five-point checkratings (item B3 of the questionnaire) made

by the parents indicate that in each of the five areas of the child's
adjustment, the parents felt that there had been improvement. When
the number of parents reporting improvement was compared to number
reporting no improvement or change for the worse, using the Chi-square
statistic (with Yates' correction), three of the five areas show improve-
ment to be the report in significantly more than half the cases. Only
three children of the entire sample of 22 were rated as some worse or
much worse in any category, and only one of the three was agreed upon
as some or much worse by his particular parents. Actual frequencies
of parental reports are given in Table 5.

The judges' pooled ratings of the parents' estimates of child's im-
provement, which are explained in detail further on, were broken down
into percentages in Table 6. The frequencies of Table 6 were not tested
for differences because the three degrees of improvement are the
author's arbitrary dividing points based on the distribution of the judges'
ratings. In other words, the judges' ratings were not based directly
on a scale of the three degrees of improvement which appear in the
table.

The results of the two approaches are somewhat discrepant. It is

believed that lack of a "Never a Problem" category in the checklist is

16

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Table 6. Judges' Ratings of Improvement in Children in Five Areas of

Adjustment as Reported by Parents.

 

Percentage of Parents Reporting Improvement

 

Little or Some Much Never a
Area of No Improve— Improve- Improve— Problem
Adjustment ment ment ment
School 35% (15) 25% (11) 33% (14) 7% (3)
Other Children 16% (7) 30% (13) 12% (5) 42% (18)
Other Parent 14% (6) 33% (14) 28% (12) 25% (11)
Parent Interviewed 19% (8) 30% (13) 23% (10) 28% (12)
Child's Feelings
About Himself* 33% (14) 16% (7) 28% (12) _.._

 

$2370 of (10) parents unsure

partly reSponsible for the discrepancies.

Inspection of individual cases

shows, for example, that the three ratings of "Never a Problem" in the

school adjustment area of Table 6 were checked as No Change by one of

the three parents and Some Better and Much Better by the other two. An-

other source of discrepancy might be a tendency, when giving verbal

reports about school performance, to compare the child to classmates

rather than to an accurate perception of the child as he was at time of

intake.

The agreement between Spouses was greater for the verbal esti-

mates of child's improvement (. 66) than for the checklist ratings (. 36),

when the ratings for the five areas are totaled.

This finding would argue

for greater confidence in the validity of the judges' ratings of the parents'

verbal e stimates .

\’

\_,«

19

Table 7 gives all questionnaire items rated and the scales used in
rating them, the inter-rater reliabilities, median scale values and
median scale ratings as determined by judges. The range of reliability
coefficients is . 58 to . 92. The median reliability of the items used as
the criterion of child's improvement in the analyses to follow is . 78;
this is probably an underestimate inasmuch as the ratings used were
the pooled ratings of the two judges.

All items show median scale ratings higher than median scale values
except the items concerning school adjustment, the child's feelings
about himself, the change in the relationship between the parent inter-
viewed and spouse, and the question regarding ways in which the group
therapy program was felt to have fallen short.

Although school problems appear to have been of persistent concern
to the parents, symptomatic behavior in general appeared to be much
abated. When questioned about newly arising symptoms, the parents
as a group reported very few.

The items concerning the parent's own relationship with his child
and spouse were not as productive of information as had been hOped.
Responses were often superficial or evasive. Evidently the questions
asked were either not subtle enough or the parent was not prepared
to answer questions referring to personal relationships.

Although the majority of the items On the questionnaire were
phrased to avoid answers of "yes" and "no", a few invited this kind of

response and were not included in the items to be rated by judges. All

20

 

 

Table 7. Rating Scales for the Eleven Questionnaire Items with Inter-
Rater Reliability, Range and Median Value, and Median
Scale Rating for Each.
Rater Range Median Median
Agree- of Scale Scale
ment Scale Value Rating
B1 In what ways do you think that
your participation in the group
was helpful to your child? , 89 o..7 3, 5o 4. 90
0 Has observed no change in
child
1 Feels doubtful; no specific
change reported
2 Feels his attendance relieved
child's anxiety
3 Temporary change for better
reported
4 Discovered that other parents
have similar problems
5 Appears more accepting or
less anxious regarding child;
change in attitude toward
original difficulty
6 Gained understanding and in-
sight regarding the effect of
parental actions (in general
or specific to own problems)
B2a In general, how is (child) getting
along in school? . 82 0-3 1. 50 1. 04
0 No improvement; parent ex-
presses concern and does not
describe any change
1 Some improvement
2 Much improvement
3 School never a problem
B2b How is (child) now getting along with
other children? . 92 0-3 1. 50 l. 93

0 Parent indicates some difficulty
exists and does not report any
improvement

1 Parent reports some improve-
ment, perhaps referring to an
existing difficulty

21

Table 7 (Continued)

 

Rater Range Median Median
Agree- of Scale Scale
ment Scale Value Rating

 

2 Parent reports much improve-
ment. Difficulty not stressed

3 Parents state this never a
problem or appears unconcerned
with it

B2c How are things going between
(child) and his/her father/

mother? (Scale for B2d) . 67 0-5 2. 50 3. 44

B2d How are things going between
(child) and yourself at present? . 77 0-5 2. 50 3. 33

0 Emphasis on the conflict or
difficulty of the relationship;
distance between parent and
child seems probable. NO
reference to improvement

1 Ambivalent relationship; parent
reports alternating good and
bad feelings or interactions
with child

2 Parent reports a Specific dif-
ficulty which does not seem to
have damaged the relationship
or have created the element of
conflict as in 0 above.
”Average"

3 Improvement of the relation—
ship reported, but parent also
reports some difficulty

4 Improvement of the relationship;
no difficulty reported

5 "Fine", "very well"

B2e What are his/her feelings about
himself/herself--how does he/
she feel toward himself/herself
now? .79 0—3 1.50 1.11

22

Table 7 (Continued)

 

 

 

Rater Range Median
Agree- of Scale
ment Scale Value

Median
Scale
Rating

 

B5

Parent seems noncommittal

or defensive, or may be de-
rogatory toward child. May
feel the child conceals his
feelings, is indifferent, and
parent can't discern child's
feelings

Unclear if there is any improve—
ment; indication that the child
has negative feelings toward
himself

A little improvement; positive
and negative indications mixed
Clearly some improvement in
child's ability to understand
and control his feelings, or a
generally favorable picture of
the child with instances of suc-
cessful coping.

Which of the original symptoms

and difficulties (listed by inter-

viewer) have changed or disap-

peared, and which are still

present? .67 0-3 1.50

0

l

2

3

Little or no appreciable im-
provement indicated in any

of the child's symptoms

Most significant symptom un-
changed; one or more symp-
toms improved

Some improvement with regard
to most significant symptom;
others improved and/or unim-
proved

Clearly much improvement, es-
pecially in regard to most
significant symptom

2.02

23

T able 7 (Continued)

 

 

 

Rater Range Median Median

 

Agree- of Scale Scale
ment Scale Value Rating
B6 What recent problems or symp-
toms, if any, have arisen with
(child)? .68 0-3 1.50 2.50

0 More than one new symptom
is described

1 A new symptom which has
serious implications

2 A new symptom which is not of
a serious nature or is not
present to a serious degree

3 No new symptom

C4 In what ways did your Spouse's

participation in the parent group

influence his/her way of relating

to other members of the family?

(Revised after tenth interview to:

How did your spouse's part in the

parent group change his/her re—

lationship to (child)? How did the

meetings change his/her relation—

ship to others in the family?) . 75 0-3 1. 50 l. 67

0 Can't be rated; statement un-
clear or no statement

1 Parent reports no change;
statement unfavorable in tone

2 Statement favorable in tone but
unspecific, pat, or qualified
in some way

3 Parent feels Spouse has become
aware of problem, spouse has
tried a new approach to the
problem, or parent gives an
example of improvement in the
relationship

C5a In what ways would you say that your own
participation in the parent group in—
fluenced your relationships with (child)?
Revised after tenth interview to: How
did your part in the group discussions
change your relationship with (child)? . 58 0—3 1. 50 l. 89

24

Table 7 (Continued)

 

 

 

Rater Range Median Median
Agree- of Scale Scale
ment Scale Value Rating
0 Vague, contradictory or quali-
fied statement
1 No improvement, or parent
implies no improvement
necessary
2 Parent tries to be more patient,
become more relaxed with the
child, more understanding, etc.
3 Parent gives example of actual
insight into own actions or
child's needs
C5b (Part Of above question) And with
your Spouse? . 84 0-3 1. 50 l. 08
0 Parent focuses his reply on the
Spouse-child relationship; un-
clear or no reSponse
1 Parent implies or reports no
change
2 Relationship may have been
helped
3 Clear improvement indicated
C7 What ways did the group sessions
fall short of effectively helping
with your family's problem, and
what specific problems were not
helped? .62 0-3 1.50 1.14

0 Statement implies criticism of
makeup of the group, the sub-
ject matter discussed, number
of sessions, lack of interest,
etc. Parent evades question,
criticizes a Spouse, other mem-
bers of the group, or the group
leader.

1 Parent seems reluctant to make
a definite statement . Statement
gives no indication Of help or in—
sight gained.

25

Table 7 (Concluded)

 

 

Rater Range Median Median
Agree- of Scale Scale
ment Scale Value. Rating

2 Mixed comment, with some
indication that the parent
was helped or others were
helped. Parent feels insight
into Own problem was gained,
but is somehow dissatisfied

3 Parent gained insight or was
helped. Other favorable com-
ment implying no criticism of
group program.

 

pertained to the parents' reaction to the experience of group therapy.
Item C9, "Have you ever recommended this group program to parents
with problems similar to yours?" was given a "yes" by 22 or slightly
more than half of the 43 subjects. Those who answered "no" often
mentioned that they had not had the Opportunity. Item C12, "How would
you feel about participating in a more lengthy program of this kind in
the future?" received 25 positive assents and four qualified by remarks
such as "Should the occasion arise, " constituting 67 percent of the
sample.

To another item not rated by judges, "How did you feel about the
number of meetings?" 59 percent felt it was adequate or about right,
30 percent would have liked more, and the balance of responses, 11 per-

cent, indicated an underlying critical attitude.

26

The Positive Attitude Index. Contrary to expectation, the gain in

 

scores of the group which had been tested on the PA Index at pre-therapy
(and part of which had been tested also at post-therapy) did not hold to

a significant degree.

Table 8. Changes in Means of PA Index Scores from Pre-therapy to

Post-therapy and Follow-up for High and Moderate Con-
sensus Items.

 

 

 

t, High t, Moderate
Consensus Consensus
3(- N S. D. Items Items
Post-therapy 146. 65 23 8. 29
2. 57* 3. 37**
Pre-therapy 140. 32 28 11. 55
. 89 . 99
Follow-up 142.14 28 ll. 60
*P< . 05;
**P< . 01

The total of high and moderate consensus items for the group of 28
subjects was higher at follow-up than at pre-therapy but not significantly
so when the _t_ test for correlated measures was employed.

The following three tables show the high, moderate and low con-
sensus items on which significant gain or loss of points occurred. The

t test for correlated measures was used for these comparisons.

The PA Subscales. The three scales extracted from the PA Index

 

on the basis of their congruence with the three variables upon which the
intake interviews were rated were compared with an overall index of

children's improvement, the combined ratings of the parents' responses

27

Table 9a. Significant Pre-therapy to Post-therapy Response Shifts on
PA Index Items. Items Which Showed Significant Re3ponse
Shifts When Pre-therapy and Follow-up Scores are Com-

pared Indicated by Symbol.

 

Net

Response
Item Content Change

Persons
Making
Change

In

 

Sharing family difficulties with a
group of parents seeking under-

standing can be helpful. (R) 9

In relation to the children I am

likely to act on impulse rather

than to take time to consider

things calmly. (gm) 13

The child should know that his
teachers always do everything for
his benefit. (gm) 22

Even well-trained children need not
be polite at all times. (R) 17

Thinking back about my own child-
hood experiences could help me to
be a better parent. (R) (gm) ll

Sharing one's problems with a
group of parents seeking understand-
ing could offer a lot of comfort. (R) 11

I have been an inadequate parent
almost since the children were
born. (1m) -10

My spouse makes constructive
efforts to be a good and under—
standing parent. (R) 7

Strictness with children almost
always brings good results. 19

If the mother is even partly em-
ployed she does harm to her
children 10

In general, relatives cause trouble

between parents and children. (gm) 9

10

11

l6

14

13

12

14

13

11

l 3 J;- s'v 'J;
. I“ v" 'I"

4! J5 s"

‘ r O s" \" sh
.

' r 5 «'1 \')
4.\ a“
O

. 01>:=

45“”*
O

: 5 1 : s‘r s'o
1“ a"
.

089*
. P I

\‘I \‘I \l’
o o.\ t'§ r.‘

. 89:}:

. 82>!<

28

Table 9a (Concluded)

 

 

 

 

Net Persons
ReSponse Making
Item Content Change Change t
Relief, at times, may be obtained
through the right Opportunity to
express one's troubles and doubts.
(R) 12 9 2.41**
Parents should not talk about any
of their disagreements in front of
the children. (gm) 17 16 l, 95*

 

gm: gain maintained at follow-up (i. e. , Pre-therapy to Follow—up
gain remains significant as shown in Table 9c)

1m: loss maintained at follow-up

 

 

 

R: Item for which scoring was reversed
*** P ( . 01
** P < . 05
>l‘P < . 10
Table 9b. Significant Post-therapy to Follow-up ReSponse Shifts on
PA Items.
Net Persons
Response Making
Change Change _t_
Sharing family difficulties with a
group of parents seeking under-
standing can be helpful. (R) —6 5 2. 31*4<
In relation to the children my Spouse
is likely to act on impulse rather
than to take time to consider things
calmly. 9 10 1. 82*
Sharing one's problems with a group
of parents seeking understanding
could Offer a lot of comfort. (R) -8 10 4. 18**=!<
I am reluctant to help our children
with sex education. -11 7 2. 21
Strictness with children almost
always brings good results. -14 15 2. 52**
Relief may, at times, be Obtained
through the right Opportunity to
express one's troubles and doubts
(R) -6 9 1. 81

\I’

\J

29

Table 9c. Significant Pre-therapy to Follow-up Response Shifts on PA

Index Items .

 

 

Net Persons

Response Making

Change Change
In relation to the children I am
likely to act on impulse rather than
to take time to consider things
calmly. 20 14 85* 1 ’1
My spouse is reluctant to help our
children with sex education. -16 10 . 16*>1 i
The child should know that his
teachers always do everything for
his benefit. 18 13 22** 1~
Thinking back about my own child-
hood experiences could help me tO
be a better parent. (R) 13 11 . 84*
Because of my civic interests, com-
munity affairs should come before
my family responsibilities -5 4 02*
When visiting, my spouse often
enjoys having our children come
with us. (R) 9 8 . 74*
I have been an inadequate parent
almost since the children were born -10 7 17**
Children need to be left with baby
sitters in order to become inde-
pendent Of their parents. (R) 10 14 78*
In general, relatives cause trouble
between parents and children. 12 15 81*
Parents should not talk about any
Of their disagreements in front Of
their children 17 15 . 85*

 

***P< .01
**P< .05
*P<.10

30

responses to Items B2a through B6, the items concerning the five areas
of adjustment and the two concerning symptoms. The scale content and

the correlations obtained are as follows:

Table 10. Correlations of Pre-therapy Scores on PA Subscales and
Totals of Ratings of their Estimates Of Child's Improvement.

 

Individual Couples '

Scores Combined
Scores
Content of PA Subscales (N228) (N212)

 

I. Feelings about Child
I enjoy our children. (R)
Most of the problems with my children
are similar to those that other parents
have with their children. (R) . 46* . 65*
My spouse enjoys our children. (R)

II. Feelings about Spouse
My spouse's faults make it very difficult
to deal adequately with the children. . 63** . 65*
My spouse is considered a good parent
by those who know our family. (R)
My spouse has been an inadequate parent
almost since the children were born.

HI. Strictness and Control

We should understand our children and
the limits of their abilities rather than
insist that they do what we think is
good for them. (R) -. 32 -. 37

Even well trained children need not
necessarily be polite at all times. (R)

Strictness with children almost always
brings good results.

Leniency with children almost always
brings good results

 

R: Item for which scoring was reversed.
**P< . 01
*P< . 05

31

The correlations between both "Feelings about Child" and'T‘eelings
about Spouse" scales and the overall estimate of child's improvement
are consistent with the expectation that high scorers would report more
improvement. However, the negative correlations between the estimate
of child's improvement and the "Strictness and Control" scale is in a
direction contrary to expectation, although not to a significant degree.

Further analysis of the Strictness and Control subscale shows that
none of the parents agreed with the leniency item and at the same time
disagreed with the strictness item. However, six parents disagreed
with the leniency item and agreed with the strictness item. Three per-
sons agreed with both items (all were mothers with histories of depres-
sive episodes), and thirteen parents disagreed with both items in accord
with the concept Of Positive Attitude.

It should be noted that the first three items of the Strictness and
Control subscale are high consensus items whereas the leniency item
was a low consensus item, in terms of degree of agreement of the panel

of judges rating the items for consistency with the positive attitude concept.

The Ratings of the Intake Interviews. It is apparent from Table 11 that

 

although 13 of 15 relationships are in the direction predicted, 5 of the
15 are too low to permit the conclusion of existance of a relationship
even when correction for the attenuating effect of low inter-rater relia-
bilities is taken into consideration. The scales are not uniformly pre—

dictive of parents' estimates of child's improvement. There is a puzzling

32

discrepancy between the parents' estimates of improvement in their own

and their Spouse's relationship to the child.

Table 11. Product-Moment Correlations between Ratings of Couples'
Estimates of Child's Improvement at Follow—up and Ratings
of Intake Interviews on Three Variables.

 

Intake Interview Rating Variables

 

I. II. III.
Mode of Parents' Parent's
Parent—Child Marital Control
Child's Improvement: Interaction Relationship Practices
Area of Adjustment (N=20) (N=17) (N=19)
Child's School Adjustment -. 23 -. 09 -. 09
Child's Relationship to
Other Children -. 16 -. 47 +. 04
Child's Relationship to
Other Parent -. 52* -. 49* -. 47>!
Child's Relationship to
Parent Interviewed —. 33 + . 08 -. 08
Child's Feelings About
Himself -.30 -.46 -.61**

 

**P< .01
*P<.05

In general, no one scale seemed more predictive than the other two.

The child's relationship to the spouse and the child's feelings about him-

self were the areas most sensitive to the ratings of the parents accord-

ing to the descriptions of them at time of intake.

DISCUSSION

The Outcome of the Follow—up Interviews. Satisfactory evidence of

 

improvemeht in five areas of the children's adjustment and reduction in
number or severity of symptomatic behavior was shown. Moreover, in
relating the child's improvement to the effect of the group therapy, a
majority of the parents indicated in their response to Item Bl that their
children had been helped by their participation in the parent group
meetings.

The summary of the judges' pooled ratings of parental estimates of
child's improvement indicates that the problem of school adjustment may
be a persistant one, with up to a third of the sample reporting little or
no improvement.

The verbal reports of the parents seem to have proved to be more
reliable and consistent than the checkratings they made over the five
areas of adjustment.

However, the PA Index subscale, "Feelings About Spouse", seemed
to be more sensitive to husband-wife interaction than the interview
question asked. Except in cases of severe marital discord, respondents
did not appear to believe that their relationships to their spouses were
pertinent to child's improvement.

It is believed that a shorter interview and increased attempts to get

detailed responses to questions could result in improvement in the

33

34

inter-rater reliabilities of the items rated. Questionnaire items seeking
information about the quality of the husband-wife interaction should be
related to the child in some way.

Response Shifts on the PA Index. The content of the items for which

 

significant response shifts were found can help explain why the gain as
of post—therapy was not maintained.

The return to endorsement of the item "Strictness with children
almost always brings good results" played a part. The two items, "I
am reluctant to help our children with sex education" and "My spouse
is reluctant to help our children with sex education" indicate an area of
new concern to the parents; many of the children of the sample had
passed into puberty since the time when the parents had attended the
group meetings. Three items referring tO psychological methods such
as "Sharing family difficulties with a group of parents seeking under-
standing can be helpful" showed a net loss between post-therapy and
follow-up; the total net loss for the three items was not as great as for
the total net loss of the strictness and sex items mentioned above and
may be attributed to the minority of subjects who reported little benefit.

Perhaps the heterogeneous nature of the test items, the sensitivity
Of some items to changes in age of the respondents' children, and the
differing situations in which testing took place help to explain the insigni-
ficant gain over pre-therapy scores at follow-up.

Examination Of the PA Subscales and Their Association to Child's

 

Improvement. Although the subscales describing attitudes toward spouse

 

35

and child Show a surprising degree of correlation to child's improve-
ment, the "Strictness and Control" subscale, although its item con-
tent suggests that an uncompromising, authoritarian quality is
revealed in low scores, the scores did not predict child's improve-
ment.

The findings in regard to the specific items dealing with strict-
ness and leniency suggest the presence of conflict in the parents con-
cerning the two concepts. This conflict would perhaps be more
susceptible to resolution and modification than the feelings toward
child and spouse as revealed by the other two scales. The complexi-
ties of the uncharted area of disciplinary concepts demand a great
deal of patient research before much can be done to directly alleviate

the conflict, however.

The Intake Interview Ratings and Correlations with the Five Areas

 

Of Children's Adjustment. The discrepancy in size Of correlations

 

between parents' estimates of their own and their spouses' relation-
ships to the child (see Table 11, Page 32) suggests several explanations.
From one angle, it might appear that parents whose relationships
tended toward the extremes of hostility, conflict and punitiveness repre-
sented by the three scales, were more critical of the spouse than they

were of themselves. From another angle, it might be said that

36

parents tending toward the Opposite extremes felt greater satisfaction
with the improvement between spouse and child than they felt with their
own ability to create family harmony.

Corroborating the latter interpretation is the response to the PA
Index item, "I have been an inadequate parent almost since the children
were born, " which, as reported in Table 9b and Table 9c was agreed
with at post-therapy and at follow-up to a significantly larger degree
than at pre-therapy.

Inspection of the data suggests that the parents reporting least im-
provement in their children may have reacted to the question of their
own relationship to the child with responses intended to hide difficulty,
whereas the parents who reported more improvement in the child
tended to give responses expressing manifest guilt. In their appraisals
of the spouse-child relationship, they may tend to be more objective.

In making the evaluation of the child's feelings toward himself,
some parents were unable to report observations of evidence of the
child's feelings (for example, "I don't know. It's very seldom that you
get information like that from a teenager, " "I really don't know, "

"He doesn't have any feelings, " "He doesn't Show his feelings, " "Joe
doesn't talk too much about himself, his problems. He seems satisfied
with what he's doing, " "As far as I can tell, he's happy the way he is. ")
It is interesting to speculate that the difficulty these parents had in

evaluating this aspect of the child's adjustment may account for the

37
high negative correlation with the control practices scale in which a
high rating was given for parents who were discrepant in impulsivity,
harshness, or frequency of use of punishment. The inability to put
themselves in the child's place, a conscious identification process, seems
to accompany administration of punishment in harsh, impulsive and/or
discrepant ways.

The data of Table 11 may Offer some confirmation of Farber's con-
tention that satisfaction with the performance of Opposite-sex children
is a function of satisfaction with the role-model of the spouse. At least
the data of this study suggest that the quality of the spouse-child inter-
action is more a function of the marital relationship than the self-child
interaction.

Unless this discrepancy is the result of the invarying order Of the
questions in the interviews, a possibility which should be tested experi-
mentally, it suggests a necessary requirement for other interviews
attempting to assess child-parent interactions: some control over the

effect of the respondent's point of view on his reports.

SUMMARY

The aim Of the study was to assess outcome of group therapy with
parents of children referred to the MSU Clinic from one to four years
prior to the beginning of the study. Twenty—two couples were contacted
by mail. Forty-three individual parents were later interviewed in their
homes by the author.

The parent's verbatim replies concerning his or her child's improve-
ment provided the major criterion of change. Each parent was inter-
viewed separately by the author and the parent's independent evaluations
of the child were rated by two judges with background in the assessment
of inter-familial relationships and trained in the rating procedure. Their
independent ratings of twelve interview items produced inter-rater relia—
bilities from . 58 to . 92 with a median Of . 72.

To discover the differential effects and predictive value of certain
variables on the criterion of child's improvement, ratings of intake inter-
views of 21 of the 22 families were made. Two judges experienced in
assessment of clinic-referred families independently rated the inter-
views according to scales constructed on the three dimensions, "Mode
of Child-Parent Interaction, " "Parents' Marital Relationship, " and
"Parents' Control Practices. " It seemed advisable to Obtain the ratings
of a third qualified judge because inter-rater reliabilities on the "Con-

trol Practices" scale were low and because of lack of agreement on

38

39
which cases were lacking information, thus reducing the N's of the
comparisons. Reliabilities for the three pairs of judges were: . 81,
.24, .86; . 56, . 59, .92; .81, . 58, .79.

A third approach to the evaluation Of the outcome of therapy, the
PA Index, provided change scores. The 28 parents for whom scores
were available from pre-therapy testing did not show significant gain
from pre-therapy to follow-up. The follow-up PA scores of all 42
parents correlated . 36 with an overall estimate of child's improvement.
Those items from the PA Index which showed significant response
changes from pre-therapy to post-therapy, pre-therapy to follow-up
and post-therapy to follow-up were listed and their content and direc-
tion of shift examined.

Three subscales from the PA Index having relevance to the three
dimensions upon which the intake interviews were scaled provided a
separate set of scores. "Feelings about Child" correlated ' .46 with
an overall estimate of child's improvement, and . 65 when couples'
scores were combined. "Feelings about Spouse" correlated . 63 with
child's improvement, . 65 when couples' scores were combined. Each
of the above was significant beyond the . 05 level. "Strictness and Con-
trol" correlated -. 32 with individual and —. 37 with couples' estimates
of child's improvement, neither coefficient being significantly larger
than zero.

The ratings of the intake interviews were compared to five different

aspects of the child's adjustment. The three scales used in rating all

40

showed that they were associated to the areas of child's adjustment, but
not uniformly so. The highest degree of association found was between
"Child's Feelings About Himself" and "Control Practices" (. 61, signi-

ficant at the . 01 level).

The general conclusions of the study are that (l) substantial im-
provement in children's adjustment was felt to have taken place by the
majority of parents, (2) three dimensions pertaining to love-hostility,
autonomy-control, and marital relationship proved to be associated
to the degree of reported change in the child, (3) the finding that reports
of a parent's own relationship to the child were largely unassociated
to the three dimensions whereas reports of a spouse's relationship
to the child were significantly associated, points up the importance
of obtaining independent reports from both parents in assessment of

parent- child relationships .

REFERENCES

Becker, Wesley C. DeveIOpmental Psychology. In Annu. Rev. Psychol.,
Palo Alto, Calif: Annual Reviews, Inc., 1962.

 

Farber, Bernard. Marital integration as a factor in parent—child
relations. Child Develpm. , 1962, 33, 1-14.

 

Maizlish, I. Leon and Hurley, J. R. Attitude changes Of husband and
wives in time-limited group psychotherapy. Psychiat. Quart.
Suppl. , Part 2, 1963.

 

 

Walker, Helen M. and Lev, Joseph. Statistical Inference. New York:
Holt, Rinehart and Winston, 1953.

 

APPENDICES

APPENDIX A

The statements in this questionnaire are rated differently by many
people. The answers are in this sense neither "right" nor "wrong. "
Please read these statements and rate each of them as follows:

Strongly Agree Strongly Disagree
Mildly Agree Mildly Disagree
In Doubt

Do not hesitate to rate each statement exactly the way you feel at this
time. Make a ./ in the Space you consider apprOpriate for each item.
If anything is not clear, feel free tO ask questions at any time.

Strongly Mildly In Mildly Strongly
Agree Agree Doubt Disagree Disagree

1. We can improve as par-
ents by listening to others
as they give convincing
examples of good rela-
tionships with their child-
ren.

2. If a child behaves well at
home he still may have
good reasons for behav-
ing poorly in school. ___._ __ _ __ _—

3. When visiting, I often en-
joy having our children

with us. _.._— __ ___._ _.____ __

4. My own faults make it
very difficult to deal
adequately with the
children. _ __ _.._._._ __ _—

5. Parents should never
disagree with the school
principal and teachers. _.__ __ _____ __ ...___

10.

ll.

12.

13.

. Sharing family difficulties

with a group of parents seek-
ing understanding can be
helpful.

. It is all right for the children

to need me less and less as
they grow up.

. I make constructive efforts to

be a good and understanding
parent.

If the mother cares for the
children in the right way it
is unimportant for the father
to participate frequently.

I believe that I can profit
from information and acquire
know-how about being a good
and understanding parent.

In relation to the children I
am likely to act on impulse
rather than to take time to
consider things calmly.

It is better if children do not
play with the neighbors'
children.

Undesirable behavior in par-
ents may be reflected by the
Child so that the child in turn
engages in undesirable be—
havior.

14. I enjoy our children.

15. Whether in giving children

a good time you succeed in
making them happy indivi-
duals, will also depend on
how you feel about them.

Strongly
Agree

Mildly In
Ag re e Doubt

Mildly Strongly
Disagree Disagree

16.

l7.

18.

19.

20.

21.

22.

23.

24.

25.

Strongly Mildly
Agree Agree

1 am considered a good par-
ent by those who know our
family.

In relation to the children

my spouse is likely to act on

impulse rather than to take

time to consider things

calmly. __ _—

My spouse is reluctant to
help our children with sex
education. __ _—

If whippings don't help,

bribes should be used to

gain cooperation from

children. —— ——--

My spouse's faults make it
very difficult to deal ade-
quately with the children. __ _.._._._

Most of the problems with

my children are similar to

those that other parents have

with their children. —-—-—-— _—

I think that husband and wife
should never disagree on how
to discipline their children. ——-——— _—

We should understand ,Our

children and the limits Of

their abilities rather than

insist that they do what we

think is good for them. —— ——

The child should know that
his teachers always do every-
thing for his benefit. _.._._ _.._.—

Even well trained children
need not necessarily be
polite at all times. __ _.._—

In
Doubt

Mildly Strongly
Disagree Disagree

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

Strongly Mildly In
Agree Agree Doubt

I believe that much progress
will be made in our family. _.___ ___._ _—

Thinking back about my own
childhood experiences could
help me to be a better par-

ent. __ __ _.._—

I am often burdened with
guilt feelings about my be-
havior toward the children. ___ __ _.._—

Only a stubborn child will

continue with bad habits such

as nail biting and frequent

crying spells. —— —— —--——

Because of my civic inter-
ests, community affairs
should come before my

family responsibilities. _.._— ._._ _—

When visiting, my spouse
Often enjoys having our
children with us. ———-——— ----— _—

Sharing one's problems with

a group Of parents seeking

understanding could offer a

lot of comfort. —— ~— _—

Showing your child affection
would not tend to make him
a "softy. " _.._._._ __ __

My Spouse enjoys our child-

ren. ——-—-- —--—— -———

I have been an inadequate
parent almost since the
children were born. _.___ .____ _..__

Mildly Strongly
Disagree Disagree

36.

37.

38.

39.

40.

41.

42.

43.

44.

45.

Strongly
Agree

I am reluctant to help our
children with sex education __

Children need to be left

with baby sitters in order

to become independent of

their parents. _.—

I believe that my spouse

can profit from information

and acquire know-how about

being a good and understand-

ing parent. ——

My Spouse makes construc-
tive efforts to be a good
and understanding parent. __

My spouse is considered a
good parent by those who
know our family. _..__

Strictness with children al-
most always brings good
results. _—

If the mother is even partly
employed she almost al—

ways does harm to her

children. _—

My spouse has been an in-
adequate parent almost
since the children were
born.

In general, relatives cause
trouble between parents and
children. —-———

It is not enough to teach chil-
dren what is right, how you
teach them is also important.

 

Mildly
Agree

In
Doubt

Mildly Strongly
Disagree Disagree

46.

47.

48.

49.

50.

I often feel helpless and
overwhelmed in dealing
with the children.

Leniency with children al-
most always brings good
results.

Relief may, at times, be
obtained through the right
Opportunity to express one's
troubles and doubts.

My spouse often feels help-
less and overwhelmed in
dealing with the children.

Parents should not talk
about any of their disagree—

ments in front of their
children.

Strongly Mildly In Mildly Strongly

Agree

Agree Doubt Disagree Disagree

Al
A2
A3
A4
A5

A6

A7

A8

A9

A10

A11

B1

B2a

B2b

APPENDIX B

M. S. U. PARENT-GROUP FOLLOW-UP STUDY

Respondent Child

 

 

Place interviewed Date

 

 

P.A. Scale given before ( ) after ( )interview.

Father's occupation

 

Respondent's education: through grad ( ); years college ( )

Respondent's age: 20-27 ( ); 28-35 ( ); 36-43 ( ); 45-50 ( );
50- ( ).

Children in family: How many boys ( ) Ages:

 

How many girls ( ) Ages:

 

Child's age ( ); LQ. ( ); degree of pathology

 

Religious preference

 

Were there professional persons consulted concerning the problem
that later brought you into the parent group? (Give dates, duration,
and nature. )

Briefly describe any professional contacts following participation
in the parent group:

In what ways do you think that your participation in the group was
helpful to your child?

In general, how is (child) getting along in school?

How is (child) now getting along with other children?

B2c

B2d

B2e

B3

B3a

B3b

B3c

B3d

B3e

B4

B5

How are things going between (child) and his/her father/mother?

How are things going between (child) and yourself at present?

What are his/her feelings about himself/herself—-how does he/she
feel toward himself/herself now?

PLEASE MAKE A RATING OF AMOUNT AND KIND OF CHANGE
YOU HAVE NOTICED IN YOUR CHILD, SINCE THE GROUP
MEETINGS. PLACE A '/ IN THE APPROPRIATE COLUMN.

Much Some No Some Much
Worse Worse Change Better Better

Child's relationship with
other children

Child's school adjust-

ment _._._ __ ._._._ __ _—

Relationship with other
parent __ __ _.._— __ .__

Relationship with you

Feelings toward himself

Original symptoms and difficulties (enter before interview):

 

 

 

 

Which of these difficulties have changed or disappeared, and which
are still present?

 

 

 

 

B6 What recent problems or symptoms, if any, have arisen with (child)?

Cla As the group meetings progressed, would you say that you became
more personally involved or less personally involved?

Clb What effect did this have on your spouse?

C2 How did you feel about the number of meetings ?

C3a How much did you and your spouse talk over the things brought up
by the group, later in private?

C3b In what ways did you feel that these personal family discussions
were upsetting?

C4 In what ways did your spouse's participation in the parent group
influence his/her way of relating to other members of your
family? (Specific illus.)

C5a In what ways would you say that your own participation in the parent
group influenced your relationships with (child)?

C5b And with your Spouse ?

C6 What were the consequences of your group experience with regard
to other family members, other children, grandparents, other
relatives or acquaintances?

C7

C8

C9a

C9b

C10

C11

C12

C13

In what ways did the group sessions fall short of effectively helping
with your family's problem, and what specific problems were not
helped?

Do you have any suggestions about how the group program might
have been more effective?

Have you ever recommended this group program to parents with
problems similar to yours?

Have you ever recommended any other kinds of help to a parent?

Did you get any new ideas about handling children from the group
discussions? What were they?

Did you have other professional help with these problems? How
would you compare the results with those from the parent group?

How would you feel about participating in a more lengthy program
of this kind in the future?

Would you check which of the words below best describes your
overall reaction to participating in the parent group:

( ) Angry ( ) Interested

( ) Disgusted ( ) Stimulated

( ) Bothered ( ) Satisfied

( ) Disappointed ( ) Enthusiastic
(

) Puzzled.

\

o“ I!\

21‘ ’(\

APPENDIX C

RATING SCALES FOR INTAKE INTERVIEWS

Mode of Child's Interaction with Parents

0

Demanding; "spoiled" or "babied" by themselves, resulting
in attitudes or habits they regard as immature.

UnCOOperative, indifferent, or stubborn; the child is not
especially concerned with failure in school, if such exists.

The child is believed tO fear a parent or rejection by a
parent; he or she may cry Often and fears failure, in
school or elsewhere.

Negativistic, rebellious, or resentful toward parents or a
parent. The child may often act out or say he hates a
parent.

Parent's Control Practices

No particular methods of punishment, withdrawal of love,
restrictions, etc. are described by the parents.

The parents are not sure how to discipline. They use
various methods of punishment which they feel are ineffec-
tive means of controlling or gaining cooperation of the
child.

The parents use various methods of punishment which they
feel are effective. They tend to stress obedience and
avoid leniency.

The two parents describe their discrepant attitudes toward
or use of punishment, or are discrepant in impulsivity,
harshness, or frequency of use of punishment.

Parents' Marital Relationship

0 - Both parents apparently share responsibility in making

decisions about family matters. There is no indication

Appendix

C (Continued)

that either parent feels the presence of conflict with the
other, or feels dissatisfaction in regard to the Spouse.

The relationship appears to be free of conflict, one

parent seeming to dominate the other or assuming reSponsi-
bility for decisions concerning family, apparently with the
consent of the more passive spouse.

Some conflict is described by the parents, apparently
centered on their differing conceptions of the parental

roles or child-rearing methods. The parents may describe
Opposite family backgrounds. There is no evidence of dis-
satisfaction of one parent with the other.

Unresolved feelings of resentment or dissatisfaction seem
to indicate sources Of conflict between the parents, but the
parents frequently avoid discussion or recognition of an
issue rather than argue.

The parents describe Open arguments in the home, tension
and bickering, and may seek to place blame on each other.

There is little or no indication of feelings of warmth or
esteem of one parent for the other. Arguments are fre-
quent and Open. A parent may describe efforts to escape
from the relationship temporarily.

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