*— , - Q"" n <' ‘- . .. . .. -40%WL_;“4’|_~"".,‘:Yksul‘)”\n D ._ . o . o .‘qu’o . - ..‘ r , c. ... ... . .. . . , ._ ‘ _ . ‘ -, 6'3 ' v \'| -.. . . -o ... .. . . . . . ‘ o ‘ .. . A. . . ’ ' _' “ "‘ ‘_ " -> -. c 'u'O-o . . ... PERCEPTIONS or WHAT WAS HELPFUL AND mass or BEHAVwR wnnm ~ . GROWTH GROUPS. Thesis for the Degree of M... A. _ - MECHiGAN STATEUNWERSETYV ’ . SHARAI M. FREEMAN 1976 5- ‘ um" “Hi- §j|\\\\\\\\\\ \l . " an» L HMS & SUNS' Beox amnm mg LIBRARY Bl NOE RS summ- _T. mum; ‘__ —‘ ——— b an; ABSTRACT PERCEPTIONS OF WHAT WAS HELPFUL AND RATINGS OF BEHAVIOR WITHIN GROWTH GROUPS BY Sharai M. Freedman This is a study of the stability overtime of what is perceived as helpful within small, interpersonally- oriented groups and how such perceptions link with inter- personal behaviors. Because it is the only available instrument designed to comprehensively survey perceptions of what kinds of experiences are helpful in such groups, Yalom's (1970) set of 60 items representing twelve "curative factors" in group psychotherapy was used to collect perceptions of "what was helpful." Data about interpersonal behaviors was collected using Hurley's (1976a) sets of semantic differential scales which yield summary measures called the Acceptance versus Rejection of others (ARO) and self-Acceptance versus Rejection (SAR). Hurley (1976b Note 1) has reviewed much evidence which appears to support the view that ARO and SAR represent the two prin— cipal dimensions of interpersonal behavior. If these dimensions are so powerful and ubiquitous, they seem likely Sharai M. Freedman to be related to individual's perceptions of what is helpful to their constructive uses of interactions within small groups. Thus, another goal of the present study was to identify linkages between individuals' perceptions of what is helpful and ratings of their behaviors on ARO and/or SAR by coparticipants in small growth groups. Yalom's (1970) 60 items were administered to 27 participants in four ten-week interpersonal learning groups at pre-group, after 24-hours of group experience, and after 50-hours of group experience. Within each group the mem— bers also rated each other's behavior on ARO and SAR after three, 24, and 50 hours of group participation. The individual items representing Yalom's twelve purported "curative factors" were found quite stable in average helpfulness rankings over time, for nine of the eleven items (out of 60) ranked as most helpful at each time period (pre-group, at 24-hours, and at SO-hours) retained this status on each occasion. Similarly, there was little variation over these times in the mean helpful- ness rankings of Yalom's twelve "curative factors," with his Interpersonal Learning Input, Interpersonal Learning Output, and Catharsis item quintets ranking as the most helpful. However, most item quintets showed inadequate internal consistency, making the meaning of this stability uncertain. Nevertheless, items representing Yalom's Interpersonal Learning Output and Catharsis categories Sharai M. Freedman gained significantly in mean "helpfulness" from pre-group to SO-hours. Many statistically significant correlations were found between the group members' ratings of coparticipants on the SAR and ARO measures with individual's rankings of the helpfulness of individual items. There were clear patterns among these correlations, as the helpfulness rankings of Yalom's quintet of Family Re-enactment items generated 25 positive versus one negative correlation with subscales from the SAR and/or ARO measures, while the quintet of Guidance items generated sixteen negative and zero positive correlations with the same behavior ratings scales. A cluster analysis of intercorrelations among twelve individual items, which jointly provided 73 percent of all significant correlations between behavior rating subscales and Yalom's sixty items, revealed a polarity between the items representing Yalom's Family Re-enactment and Guidance categories. Fortunately, these two categories were composed of item quintets which possessed substantial internal consistency. The preponderance of positive correlations between the Family Re-enactment category and high ratings on SAR and ARO was surprising given that the usual focus of such groups tends to be on "here and now" problems and inter- actions. It is postulated that persons rated relatively high on SAR and/or ARO may be more accessible to genetic Sharai M. Freedman insights (linking their group experiences to prior familial patterns) than those who are rated lower on these inter- personal dimensions. Also, opportunities for genetic insight may not be readily available outside of such group experience. On the other hand, group members rated lower by coparticipants on SAR and ARO ranked items dealing with guidance and advice from other group members as especially helpful. In summary, individual perceptions of what is helpful proved highly stable and appeared to be only mildly influenced by increasing degrees of group experience. These perceptions proved abundantly and meaningfully linked with interpersonal behaviors within the group on the ARC and/or SAR measures. The latter findings suggest that more comprehensive analyses of the needs of individual group members may well relate to both their developmental status in a Maslowian sense as well as to their actual behaviors within personal growth and psychotherapeutic groups. Related research possibilities were discussed. PERCEPTIONS OF WHAT WAS HELPFUL AND RATINGS OF BEHAVIOR WITHIN GROWTH GROUPS BY Sharai M. Freedman A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS Department of Psychology 1976 ACKNOWLEDGMENTS I would like to thank Dr. John R. Hurley first and foremost for his helpful assistance through all phases of this project. His consistent encouragement and constructive suggestions made the completion of this thesis a reality. I would also like to thank Mr. Bill Brown. His lucid and patient explanations on the finer points of using the computer were indispensible. ii TABLE OF CONTENTS LIST OF TABLES . . . . . . . . . . . . . . . LIST OF FIGURES . . . . . . . . . . . . . . INTRODUCTION . . . . . . . . . . . . . . . . STATEMENT OF THE PROBLEM . . . . . . . . . . METHOD . . . . . . . . . . . . . . . . . . . sample 0 O O O O O I O 0 O O O O O O O 0 Measures . . . . . . . . . . . . . . . . PROCEDURE 0 O O O O O O O O O O O O O O O 0 RESULTS 0 O O O O O O O O O O O O O O O O O Pooling the Data from the Three Groups . Yalom's Twelve "Curative Factors" . . . Individual Items . . . . . . . . . . . . Linkages Between Item Rankings and Behavior Ratings . . . . . . . . . . . DISCUSSION 0 O I O C O O O O O O O O O O C O Shifts in Helpfulness Rankings Over Time Individual Differences in Perceptions of What is Helpfu1 O O O O O O O I O O 0 Recommendations . . . . . . . . . . . . APPENDIX A. CURATIVE FACTOR CATEGORIES AND ITEMS B. PRODUCT-MOMENT CORRELATIONS AMONG YALOM'S 60 ITEMS AT 50-HOURS . . . C. MATRIX OF INTERCORRELATIONS AT SO-HOURS AMONG TWELVE ITEMS WHICH HAD THREE OR MORE STATISTICALLY SIGNIFICANT CORRE- LATIONS WITH RATINGS OF BEHAVIOR IN GROUPS 0 O O I O O O O O O O O O 0 iii Page vi 11 13 13 14 16 19 19 19 22 25 37 37 41 46 50 52 Page REFERENCE NOTE I I O O O O O O O O O O O O O I O O O O 5 3 LIST OF REFERENCES 0 O C O O O O C C O O C O O O O O O 54 iv LIST OF TABLES Table Page 1. Mean Rank Assigned to Yalom's Categories at Three Times, Alpha Coefficients, and Retest of Changes . . . . . . . . . . . . 20 2. Comparison of Results of Oblique Multiple Group Factor Analysis of SO-Hour Item Ratings (Study A) with the Results of the 1975 Rohrbaugh and Bartels Study (Study B) . . . . . . . . . . . . . . . . . . 23 3. Eleven Items Ranked Most Helpful at Each Time PeriOd O O O O O O O O O O O O O O O O O 26 4. Significant Correlations Between Individ— ual's Helpfulness Ranking of Item and SAR/ARC Rating by Group . . . . . . . . . . . 29 5. All Correlations Between Helpfulness Rankings of Individual Items and Rated Behaviors in Groups on Specific Sub- scales Which Attained Statistical Significance . . . . . . . . . . . . . . . . . 32 LIST OF FIGURES Figure Page 1. Group Behavior Ratings . . . . . . . . . . . . . 18 2. Typal bonds supplemented by all additional statistically significant bonds among all individual items which generated at least three reliable correlations between item helpfulness rankings and behavior ratings . . . . . . . . . . . . . . . . . . . 35 vi INTRODUCTION A pervasive and controversial problem in the field of clinical psychology is the search for curative factors which underly successful psychotherapy. To delineate these factors some researchers have focused on characteristics or behavioral aspects of the therapist. Recent findings suggest that there is little consensus about which therapist variables are related to outcome. A review of outcome literature by Luborsky, Chandler, Auerbach, and Cohen (1971) indicated that therapist empathy and experience were the only two therapist variables reliably related to outcome. Studies by Truax (1966) and Truax and Mitchell (1971) found the variables of warmth and genuineness to be sig- nificantly related to outcome. In opposition to the above findings, Garfield and Bergin (1971) did not find empathy, warmth, or genuineness to be related to patient outcome; neither did a subsequent comprehensive study of these three variables by Mitchell (1974). These results led Mitchell (1974) to conclude that twenty years of research has failed to identify any therapist variables which consistently relate to positive patient outcome and which could also be ascribed to a heterogeneous group of therapists. The “|.ll’| search for client variables had also proved to be unpro- ductive according to Lerner and Fiske (1973). Thus, there seems to be no general consensus that either therapist or client variables are consistently and significantly related to successful therapeutic outcome. Several studies indi- cate that the therapeutic process may generate a set of variables which are interactional in nature, i.e., with both the therapist and client as contributors (van der Veen, 1965; Moos & Clemes, 1967). An extension of these latter two studies by Moos (1970) scored patients and therapists separately on three variables: total activity, feeling words, and reinforcements. Patient problem expression and therapist accurate empathy were also rated for each interview. The results indicated that the largest proportions of the variance were accounted for by Patient x Therapist x Session interactions. That is, patient and therapist behaviors were determined by the therapist, the patient, and their particular interaction with one another. If this interactional idea is applied to the investigation of curative factors in group psychotherapy, the problem becomes more complex. Not only do the clients interact with the therapist, but also with each other. This multidirectional interaction has far reaching conse- quences in terms of the therapeutic process and-also in terms of the search for curative factors in group psychotherapy. Moreno (1975) states that "the locus of the therapeutic influence is in the group rather than the therapist." In other words, the members of the group mediate the therapeutic process (Yalom, 1970). The multi- plicity of interactions occurring in group psychotherapy is seen to produce "a curative environment" (Mullan, 1962) which has a "more potent energy than any of the individ- ual's comprising it" (Gillis, 1962). There has been some preliminary support for the idea that the group as a whole can be the locus of change. Liberman (1970) studied the effect of the group leader's systematic reinforcement of cohesive statements. In the experimental group he found that: . . . the patients directed their actions increas- ingly toward other group members and away from the therapist . . . they attributed more of the satis- faction they experienced to other group members rather than the therapist (p < .005, sign test). These results suggest that the most significant component in terms of producing change is not the amount of cohesion directed from the therapist toward individual group members, but the amount of cohesion manifest among the group members. Truax (1966) measured therapist warmth, genuine- ness, and empathy using three different measures: inter- action measures which focused on therapist-patient, patient- therapist, and therapist-group interactions; time-sample measures which focused on group interactions; and patient perception measures. The time sampling of group interaction was found to be the best predictor of personality change. Thus, as in Liberman's (1970) study, the therapeutic con— ditions characteristic of the group were the most potent and predictable factors relating to successful outcome. Having substantiated the importance of patient- patient interaction, a further investigation leads to the specification of particular variables which operate in group therapy. A comprehensive overview of approximately 300 articles concerning the dynamics of group therapy was made by Corsini and Rosenberg (1955). The articles were examined for specific statements of dynamics in psycho- therapy. After all identical statements were combined, 166 different mechanisms remained. The researchers then clustered statements that represented the same concept. The result was the following 10 category classification of group therapy dynamics: (1) Acceptance - respect for and sympathy with the individual; belongingness, a warm comfortable feeling in the group. (2) Altruism - the desire to help others. (3) Universalization - realization that one is not unique, that there are others with problems identical or similar to one's own. (4) Intellectualization - learning, acquiring knowledge in the group. (5) Reality Testing - in the group real, important things occur; the group is not an artificial environment. (6) Transference - strong emotional attachment to the therapist, to separate members of the group or to the group as a whole. (7) Interaction - interaction engaged in by a thera- peutic group. (8) Spectator Therapy - individuals gain from observing themselves and others. (9) Ventilation - the release of feelings. (10) Miscellaneous. More recently Yalom (1970) categorized a set of curative factors. His search for these factors focused on the interactions that occur in group psychotherapy, using patient's self-reports, therapist's evaluations, and research correlating in-therapy variables with therapeutic outcome. He observed that each foci poses problems. Patient's evaluations are subjective, therapist's evalu- ations are biased towards certain theories, and all sources are subject to group-specific interactions. The research approach has the major problem of outcome measurement. Given that therapist evaluations by patients and thera- pists are the only readily accessible sources of data about group psychotherapy, a combination of these was con- sidered by Yalom (1970) to supply the best current evidence for identifying the pertinent curative factors. From such sources Yalom specified 10 curative factors which overlap substantially with those earlier derived by Corsini and Rosenberg (as shown in parentheses): (1) Imparting of Information (Intellectualization). (2) Instillation of Hope. (3) Universality (Universalization). (4) Altruism (Altruism). (5) The Corrective Recapitulation of the Primary Family Group (Reality Testing) (6) Development of Socializing Techniques. (7) Imitative Behavior (Spectator Therapy, Trans- ference) (8) Interpersonal Learning (Reality Testing, Trans— ference, Interaction). (9) Group Cohesiveness (Transference, Interaction, Acceptance) (10) Catharsis (Ventilation). The validity of the categories chosen by thera- pists may be questioned. Do patients report similar cate- gories when asked to define what has helped them in group psychotherapy? Berzon, Pious, and Farson (1963) investi- gated this point by asking patients to complete a question- naire concerning the event in therapy which helped them most personally. Nine response categories emerged from the agreement of three judges. These categories are presented in descending order of frequency as follows: (1) Increased awareness of emotional dynamics. (2) Recognizing similarity to others. (3) Feeling positive regard, acceptance and sympathy for others. (4) Seeing self as seen by others. (5) Expressing self congruently, articulately or assertively in group. (6) Witnessing honesty, courage, openness or expres— sions of emotionality by others. (7) Feeling warmth and closeness generally in the group. (8) Ventilating emotions. A comparison of these patient-derived categories with Yalom's (1970) categories shows much agreement across the two sources. In discussion of these curative factors, Yalom (1970) points out several of their characteristics. For example, the factors are seen as interdependent and over- lapping. Second, they are viewed as having different com- parative values for individual patients. This latter point was investigated by Yalom, Tinklenberg, and Gilula (1970). The 20 patients selected for this study had terminated after averaging about 16 months of therapy. They were described by the authors as "well-educated, middle socioeconomic class outpatients with neurotic or characterologic problems." The subjects had been chosen as successful patients by four different criteria and were asked to Q-sort 60 items according to how helpful each item had been in their own group psychotherapy. The items were written to represent 12 curative factor categories-- a slight modification and expansion of Yalom's previously listed 10 categories. The results of the Q—sort ranking of these items for "helpfulness" during group psycho- therapy and some elaboration of the general nature of the items constituting each is as follows: (1) Interpersonal Learning "Input - learning about oneself by receiving feedback from group members. (2) Catharsis - expressing negative and/or positive feelings in the group. (3) Group Cohesiveness - feeling like a member of a group. (4) Insight - learning about the causes and origins of one's problems. (5) Interpersonal Learning "Output" — learning how to interact with others. (6) Existential Factors - the existential awareness of man in the framework of existence. (7) Universality - learning that one's problems are not unique. (8) Instillation of Hope - realizing that the group has the capacity to help members with their prob- lems. (9) Altruism - helping othersf (10) Family Re-enactment - the group as a family proto- type. (11) Guidance - receiving suggestions from group members. (12) Identification - imitation of behavior manifest by the group leader or other group members. A third point Yalom (1970) makes concerning these factors is that they underlie every type of therapy group. Support for this comes from a study comparing the rank- ordering of growth groups and Yalom's (1970) group therapy patients. Sherry and Hurley (1976) administered Yalom's Q-sort items at the end of a 20-hour growth group consti- tuted of undergraduates at Michigan State University (MSU). Results from a comparison of the mean rank assigned to the 12 categories indicated that the members ranked these categories for "helpfulness" during their group experience quite similarly to the ranks assigned by Yalom's (1970) successful group psychotherapy participants (rho = .76, d: = 10, p < .01). The "helpfulness" rankings assigned to individual items by both groups were also very similar (rho = .78, d£_= 58, p < .001). An expected result from the Yalom, Tinklenberg and Gilula study was the wide divergence found between the 10 rank-orderings of curative factors by different "success- ful" former group members. Because individual patients have different needs, they are likely to be helped by different kinds of experiences within their group. Yalom et a1. (1970) investigated several variables to try and discover what mediated an individual's choice of order. Age, sex, length of time in therapy, original reason for seeking therapy, and degree of improvement failed to correlate significantly with individual differences in curative factor preference. STATEMENT OF THE PROBLEM This study is a further investigation of Yalom's curative factors. First, the changes incurred by being a group member over time will be explored. Tuckerman (1965), Gendlin & Beeble (1968), and Rogers (1967) have indicated that groups move through different phases. Thus, it would be expected that different clusters of factors become important at different points in therapy. Yalom (1970) suggested that curative factors such as Instillation of Hope, Guidance, and Universality may be important in an early stage of the group experience while factors dealing with a higher degree of confrontation, such as Catharsis, may not emerge until later. Taking these stages into account by administering the Q-sort at the beginning, at the middle, and at the end of the group would show shifts in preference of certain item categories. Thus, the first hypothesis states: I. The groups' mean rank-ordering of "curative" factor categories will shift when initial, middle, and final rankings are compared. This hypothesis makes the assumption that the five items representing each category are internally consistent. A standardized alpha coefficient will be obtained for each 11 12 category at each time period to determine whether this assumption is accurate. Individual differences in the rank-ordering of Yalom's curative factors will also be investigated. Differences in ranking of items for "helpfulness" will also be compared to participants behavior in the group. Ratings on two salient interpersonal dimensions which have been described by Hurley (1976b, Note 1) and labeled self-acceptance versus rejection (SAR) and acceptance versus rejection of others (ARO) will be investigated. An instrument routinely used in small undergraduate groups to measure these two dimensions, called the Group Behavior Ratings (GBR), will be used in this study. Evidence that GBR scores on these dimensions possess construct validity (Cronbach & Meehl, 1955) has previously been presented (Hurley, 1976a). If there are important individual dif- ferences in the perception of the helpfulness of Yalom's 60 items, it seems likely that these differences should be manifested in linkages with how fellow group members rate the individual on these major interpersonal dimen- sions. This leads to the following hypothesis: II. The group's mean rank ordering of "curative" factor items for "helpfulness" will correlate with their SAR/ARC ratings as given by other group members. That is, group members with high SAR and/or ARO ratings will choose different items when Q-sorting for helpfulness than group members with low SAR and/or ARO ratings. METHOD 'Sample The participants in this study were 27 upper- classmen who signed up for a 1976 Winter term course entitled Experiential Interpersonal Learning Groups (Psych 400H) at MSU. The course description informed the students that the focus of the course was on increasing awareness and sensitivity to interpersonal operations. It stated that the groups would be used to learn about how others experience, perceive, and respond to the participant and to learn how to get more fully in touch with how one pro- cesses reaction, thoughts, and feelings toward others. It was made clear that students who were seeking formal psychotherapy should seek help at the MSU Counseling Center. The average age of the participants was 21 years and many of them were members of the Honors College. Students were assigned to one of three groups which had 7, 8, and 9 members respectively. An attempt was made to distribute students equally and to separate facilitators and members who had known each other previously. Two groups had one facilitator or leader each while the third had two facilitators. The group leaders were selected by 13 14 the course instructor, largely due to their prior success- ful participation in these groups and for their interest in learning leader skills. Measures Yalom's 60 "curative" items were administered with the standard Q-sort instructions to obtain each participants rank-ordering of helpfulness for each item. All 60 items and their appropriate categories are shown in Appendix A. A new version of Hurley's (1976b) Group Behavior Ratings (GBR) was used to obtain personality data on individual participants. Rankings were obtained on the subscales of the two prepotent interpersonal dimensions of SAR and ARO. In a bipolar semantic differential format, group participants are asked to rank all group members on four SAR subscales: Shows feelings-Hides feelings, Expressive-Guarded, Active-Passive, and Independent- Dependent. Similarly, they are asked to rank all group members on four subscales of ARO: Warm-Cool, Helps others- Harms others, Involved-Detached, and Accepts others- Rejects others. One GBR scale, Liked-Disliked, was excluded from all data analyses because it did not directly contribute to either the SAR or ARO measures. Its role in the instrument was to ”drain off" excessive emotional reactions to fellow group members so that the other ratings might be less influenced by affect and represent 15 more cognitive appraisals. To this end it was positioned first among the nine rating scales. As yet there has been no study of how effectively the Liked-Disliked ratings serve their intended function. PROCEDURE In two groups the subjects met for two 90-minute sessions per week, while the third group met for one three~ hour session weekly. All groups met for a total of 10 weeks. Two weekend marathon sessions of 12 uninterrupted hours each were held at about the third and seventh week- ends of the 10-week term. All participants including the group leaders, were administered Yalom's 60 curative factors three times: at the first class meeting, at the half—way mark, and at the last class meeting. On each occasion the subjects were given the following set of written instructions: Sort this set of 60 items into the seven groups listed below, according to how helpful you expect (or have found) the content of each item to be in your experience within your experiential group this‘ term. The items were developed for use in psycho- therapeutic groups so translate terms like "thera- pist" into group facilitator(s) or leaders. Sort the items into the following seven groups: A. Most helpful to me (2 items only) B. Extremely helpful to me (6 items only) C. Very helpful (12 items only) D. Helpful (20 items) E. Barely helpful (12 items) F. Less helpful (6 items) G. Least helpful to me (2 items only) Finally, record the numbers (1-60) of the items which you placed in each grouping (A through G) on the enclosed card and sign your name. Thank you. 16 17 The 60 items were typed in random order on one sheet so that each category was represented once every twelve items. These reordered items were given to the participants who were asked to tear each item off the sheet and place each in one of the seven categories as described by the instructions. Participants were then asked to list the number of the items they chose for each category on an index card and to recount them to make sure all 60 items were accounted for. All subjects including group leaders were admin- istered Hurley's (1978) SAR/ARO instrument after the first group meeting, during the fourth week of the term (about 24 hours of group experience) and in the week before the final group meeting (about 50 hours of group experience). The GBR is depicted in Figure l, and includes the standard instructions used. The ratings each person gave themselves and each other group member, plus all ratings which they received from others were scored and plotted on a grid representing ARO on the "X” axis and SAR on the "Y" axis. 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IO- asunsnonoa oswnsnouoo _ cswnsnsuoa _ asunsnohoa . asunsnwkma _ oswnnmekom _ asunamGNoa _ cannsnoNoo ouunsanmo .u osunsanom m a.» ouwnsanma a osmnaanoox a.» asunanona a.“ oHanneNom m u_Ho«~nsnoNsms.a osnnsmosoma o.mo«~naanouH_o oLannonmo < uo—Nnamwsoma_u oansanumo a_§~onuiouuumnuuo mo cowmmouma.“ accenuom HON o .— N n a n o N o a a . ocuuaoucumou anon Hons: 953 o a N n a n o N o a . 39.323 .003 9530.38 05 oawnnnwsom figsfififlm.§fi oswnanohoa . .8: owns an: Puoi8n co ‘1' Macao 50m: @0950 Java: 0 5" «Monica gown. Add No «can: pawn 520209555 mmDOMU 2H MOH>§ NO gun—km RESULTS Pooling the Data from the Three Groups To investigate whether the data from the three small groups could be pooled, a One-way Analysis of Vari- ance (Nunnally, 1967) was run between the groups on SAR, ARO, and their eight bipolar subscales. No significant between-groups differences were found for these variables at any of the three time periods. In terms of significant differences between the groups on the ranking of Q-sort items for helpfulness, only six items over the three time periods were found. Since nine such differences (60 items x 3 times) at the .05 level might be attributed to chance and no pattern was apparent in them, all data were pooled. Yalom's Twelve "Curative Factors" Each of the seven response categories for helpful- ness were assigned a number from one, for "most helpful," to seven, for "least helpful." Weighted means were com— puted for each category. These means and the rank order of the categories for each time of testing and related alpha coefficients are found in Table l. A One—way Analysis of Variance was used to compare category means at each time period to assess whether the means shifted 19 20 .Nooo. v.m.. .moo. v.m. mm.H om. NH m.mN 6N. NH o.mN mo. NH m.mN cowumofluflucmuH Nm. mN. NH 6.6N mo. NH v.vN om. NH m.mN mocmoNso ow. NN. 0H «.mN mo. 0H o.mN mm. oa m.NN ucmsuomcmumm NNHemm NN. Nm. m N.NN Ne. w o.NN «m. m N.NN NuNNmmum>Ncs NN. mv. m N.NN mm. m m.NN mm. m o.NN mmom mo :oNumNNNumcH No.N AN. 6 N.mH Nm. 6 m.mN mN. N N.oN mmmcm>flmwnoo msouo om.N HN. N o.NN mm. N m.HN Na. 0 m.mN muouomm Hmflucwumflxm mm. mm. m o.mH NN. m N.NH an. m N.mH amfisuuam «.vo.oa NN. m m.mN mo. m m.oa es. s m.NH mfimumsumo N¢.N mm. v N.NN om. v m.NN mm. m «.6H unmfimaH .mN.m NN. a N.vN mN. a v.¢N om. N o.mN unmuso mcficumoq HmcomummuoucH om. ow. N e.sN qN. N N.¢N mm. H o.vN usmcH mcficummq Hmcomuwmuouca .M mamas scum .mnu Manse xcmm m mana scum )MI: musom om musom em QwOHOIon mowcmnu mo ammuLM was .mucowofimmmou unmad .mmfiaa mouse um mowuoomumo m.fibamw on cocmwmmfi xsmm sum: H manna. 21 significantly. The means of two categories, Catharsis and Interpersonal Learning Output, showed significant decreases in mean scores over time (p < .0001 and p < .0005 respec- tively). Since Hypothesis I was based on the assumption that the quintets of items representing each category were internally consistent, standardized alpha coefficients (Nunnally, 1967) were calculated to determine this assump- tion's reasonableness. Also given in Table 1, these standardized alpha's are generally low, reaching .60 or above for only five categories at both pre-group and 24 hours and for only six categories at 50 hours. Only the Family Re-enactment and Identification categories obtained alpha's of .60 or above at all three time periods. Altruism, Group Cohesiveness, Guidance, and Family Re- enactment tended to increase their alpha's over time, while Universality, Interpersonal Learning Input, Interpersonal Learning Output, Catharsis, Insight, and Instillation of Hope tended to decrease over time. Inspection of these alpha's shows that the group participants did not view Yalom's (1970) item quintets, representing his 12 cate- gories, as homogeneous. This general lack of stability and internal consistency among the quintets is consistent with an independent study by Rohrbaugh and Bartels (1975). They made a multivariant analysis of Yalom's Q-sort using 22 participants (E = 72) from diverse psychotherapy groups, and found 14 separate clusters, as shown on Table 2. An oblique multiple groups factor analysis (Nunnally, 1967) was used to identify how individuals in the present sample grouped their items at the 50-hour Q- sort. These results, also given in Table 2, show that 16 categories were formed. The integrity of four of Yalom's categories was wholly or largely maintained (Existential factors, Guidance, Altruism, and Family Re-enactment), while three others were only marginally maintained (Universality, Group Cohesiveness, and Identification). However, Yalom's five other categories were not well repre- sented by his item quintets. Interestingly, neither of the two categories (Catharsis and Interpersonal Learning Output) which shifted significantly over time in mean helpfulness rankings showed much internal consistency, either in terms of their alpha coefficients (Table l) or by homogeneous structures (Table 2). Individual Items Since categories generally proved neither inde- pendent from one another nor to possess adequate internal consistency, changes in mean ranking over time was investigated for selected individual items. It was planned to select only the 12 "most helpful," or the tap 20 percent, of the items for this purpose, but several items tied for twelfth place at each time period so only the top 11 items 23 am. no. em. me. mm. em. nu- Nm. am. mm. om. NN. mm. mN. om. am. am. HN. ma a .ma .NH .mH Amfimnmsumoc mm a .6m .Nm Rasmuso .oqn .mumuch «N .NN .NN .HN .A.mwsoo msouov 0H .N .0 me a .vv .Nv .Nv Ammomc mm .Nm + A.um>flqav ma .NH mun cmuoN owlmm Ausmuso .mqq .muouch mN .AusmcH .oaq .mumucnc ma a ma Aunmnmch we .Ammomc mm .Nm .x.umgumoc «N .Hm “coaumoflmaucmunc om .A.mo£oo msouwv OH a N .m .A.suua¢v m Ausde .mcq .mumuch vN w NN .Aunmuso .mcq .muouch ON a NH .A.:Huadv N. Aunmfimsnc om + Aucmsuomcmumm NHNsmmv me a .vv .Nv. Asuflammum>flcoc ma a .NH .HN Ausmuso .maq .mumuch HN + Namflsnuadv v .m .H I.NHNumcH muons Hm + Amocmoflswc oNISN Amuouomm Nanucoumflxmc om suns mm m Ncsum 4 Ncsum manna ucmnoflmumoo A.MNmmmaoss mfimufl mv m hounm a Nuzum mofluommumo paw memuH usmnuwumnoo m.eonw .Am N953 wosum maouumm can nmsmnunom mNmH onu mo muadmom on» auw3 A4 Nosumv mmcflumm smuH “somuom mo mHmNHmnd uouomm msouo mamfluaaz wsvwano mo muHSmmm no nomwummfioo N magma 24 III oo.H N Ausmuso mcwcumoq anaemummnouaHv mm me. oo.H mm a Nm mHmumnumoc NM NV. nu- AcoHumHHHumcH «moms mm a «m .Hm N NN. om. we a Na Auanmch Ne w HusmcH .mcH .mumuch mH H.HHHumcH omomc mm .HNHHsmmc me .H.umnumoc I). am. N mm .x.um>H:ac vH .H.mmnoo msouoc m H.cmch Nm .H.umaumoc em. HN. mH w NH mm .x.um>Hcac NH .A.mmnoo msouoc m mm. 0N. ov a .mm .mm .mm AuoHumonHuaoan mm a mm Ammom mo cowumaawumch vm + .A.uomcmlmm .Emmv om. Nm. NV 8 me He .H.HHuamoHc ov .Auanmch mv a we m Nwsum a Nwsum A.mHmmMHocs msmuH me m Nasum a Nosum unmam ucofloammooo mmwnomoumo paw msmuH ucmsuflumsoo m.Eonw Aposswucoov N wands 25 were used. The results, given in Table 3, show notable stability over time in these "most helpfur' items. Nine of the 11 items rated most helpful at pre-group retained their status after both 24 and 50 group-hours. This implies that preconceptions concerning item helpfulness prior to any group experience were consistent with the perception of what seemed helpful after 24 and 50 hours in the group. Yalom's 12 categories were unevenly represented by these 33 citations of very "helpful" items in Table 3. Thus, there were 10 citations of Interpersonal Learning Output items (three each at pre-group and 50 hours; flour at 24 hours), nine citations of Interpersonal Learning Input items (three at each time), eight citations of Catharsis items (three each at pre-group and at 24-hours and two at 50-hours), five citations of Insight items (two each at pre-group and 50 hours, one at 24-hours), and Existential factors received one pre-group citation. Seven of Yalom's twelve categories were never represented by these very "helpful" items. Linkages Between Item Rankings and Behavior Ratings There was considerable temporal stability in individual group members' ratings on SAR and ARO, as all of the pertinent correlations were statistically signifi- cant at or beyond the .01 level. Thus, pre-group SAR scores correlated .67 with SAR at 24-hours and .76 with 26 Table 3 Eleven Items Ranked Most Helpful at Each Time Period Pre-Group 24 Hours 50 Hours The group's teaching me about the type of impression I make on others (#16) Improving my skills in getting along with people (#21) Discovering and accept- ing previously unknown and unacceptablg parts of myself (#48) Learning how I gome across to others (#17) Learning how to egpress my feelings (#34) Learning that I must take ultimate responsibility for the way I live my life no matter how much guidance and support I get from others (#60) Learning why I think and feel the way I do (i.e., learning some of the causes and sourges of my problems) (#47) Learning about the way I related to the other group members (#23)a Other members honestly telling me what they think of me (#18)C 10 3.04 27 Table 3 (continued) Pre-Group 24 Hours 50 Hours The group' 3 giving me an opportunity to learn to approach others (#24)a 10 3.04 9 3.00 Being able to say what was bothering me instegd of holding it in (#35) 10 3.04 10 3.11 Expressing negative and/ or positive feelings toward another member (#32)b 10 3.11 Feeling more trustful of groups and of other people (#22)a 2 2.41 aInterpersonal Learning Output b . CatharSis CInterpersonal Learning Input dInsight eExistential factors 28 50-hour SAR. Pre-group ARO scores correlated .81 with 24-hour ARO and .70 with 50-hour ARO. The correlations between 24 and 50-hour scores were: SAR = .81 and ARO = .83. The correlations of SAR with ARO were generally much higher than expected: pre-group = .64, 24-hours = .79, 50- hours = .84. Thus, at 50-hours about 70 percent of the variance in SAR and ARO scores was common to both. This suggests that these measures were much less independent than those provided by earlier GBR versions (Hurley, 1976a). Implying either technical problems with these measures or a surprisingly strong bond between SAR and ARO, this sub- stantial SAR-ARC overlap makes it pointless to attempt to differentiate between their linkages with item "helpfulness" rankings. Table 4 depicts all statistically significant (p'< .05 two-tailed) correlations between the helpfulness ratings assigned each item by individuals and how that individual was rated on SAR and ARO behaviors within the group. The positive correlations given in Table 4's upper portion show that persons rated high on SAR and/or ARO by peers tended to rank items concerned with Family Re- enactment (41-45) and Interpersonal Learning Input (16 and 18) as especially helpful. Conversely, the negative corre- lations of Table 4's lower portion show that persons rated low on SAR and/or ARO tended to rank Guidance items #26 and #27 as very helpful. 29 Table 4 Significant Correlations Between Individual's Helpfulness Ranking of Item and SAR/ARO Rating by Group Pre—Group, 24 Hours 50 Hours SAR ARO SAR ARO SAR ARO Items The group's teaching me about the type of impres- sion that I make on others (#16)b .41 Other members honestly telling me what tgey think of me (#18) .38 Trying to be like some- one in the group who was better adjusted than I (#36) .39 Being in the group was, in a sense, like reliving and understanding my life in the family in which I grew up (#41)a .44 Being in the group some- how helped me to under- stand old hang-ups that I had in the past with my parents, brothers, sisters, and other impor- tant people (#42)a .47 .45 Being in the group was, in a sense, like being in a family, only this time a more accepting and understanding family (#43) .48 Being in the group some- how helped me to under- stand how I grew up in my family (#44)a .46 .41 30 Table 4 (continued) Item Pre-Group 24 Hours SAR ARO SAR ARO 50 Hours SAR ARO The group was something like my family--some members or the facili- tator(s) being like my parents and others being like my relatives. Through the group experi- ence I understand my past relationships with my parents and relatives (brothers, sisters, etc.) (#45)a Learning that others have some of the same "bad” thoughts and feelings I do (#13) The facilitator(s) sug- gesting or advising some; thing for me to do (#27) Group members suggesting or advising something for me to do (#26) Getting things off my chest (#31) Seeing that other group members improved encouraged me (#54) .44 -.39 -.48 -.64 .49 .43 .43 -040 -.51 aFamily Re-enactment item. bInterpersonal Learning Input item. C O 0 Guidance item. 31 Pursuing the linkages between behavior ratings within each group and rankings of item helpfulness further, correlations were determined between ratings on each of the eight SAR and ARO subscales and Yalom's 60 items at all time periods. All statistically significant linkages are depicted in Table 5. Three categories of items having exclusively positive correlations with the behavior ratings are listed in this table's left-hand section, except for item 43's -.40 correlations with Independent—Dependent. Five categories (Interpersonal Learning Input through Interpersonal Learning Output) containing items having mixed positive and negative correlations with behavior ratings are given in Table 5's central section. Three categories having exclusively negative correlations with these behavior ratings are shown in Table 5's extreme right. These data further differentiate between Yalom's Family Re-enactment and Interpersonal Learning Input (except for item 20) categories, whose items consistently correlated positively with SAR and/or ARO and their subscales, versus his Guidance category whose items consistently correlated inversely with the same behavior ratings. The total number of negative correlations clearly exceeded the number of positive correlations for categories Guidance (0+, 16‘), Instillation of Hope (0+, 5'), and Universality item 13 (0+, 5‘). In sharp contrast, the inverse pattern held for the Family Re-enactment category 32 0". «MI NVI nVIHnI mm. A nvl an on 6N on Guadvano 35 a _H 33 158 3853 ON «a on Hanna acacuuoq N“ «v on «Q Nv av av an NC ov «a av vv 0!! an m1 an on «V M! nv we h. «m on an on No 3 unoHaau. me vv Mv NV av unusaunealoa N35.“ in on nuinao nuuoficl 0: cm.n(sxvuanxflz. on vN ON on vN an on QN on On «N am .8633 o I) 00>HO>SH guests-533* .u> nuonuo name: vHou .u> and: O x 4 «56598 c u> uc-ocuauvnu Izzwinm .u> O>duu< novuaso 0') o>aunounxu .238.— 81! o u> 85:8,... :86 z 4 a .Aumou ooawuulo3u .mo. v.mv OOGMOHMNGmHm Hwoaumflumum oocwmuud nownz moamomnsm oamwoomm co mmaouo ca muow>mnom voumm can maouH amsvw>wocH mo mmcwxsdm mmocHsmmHom soozuom mcoaumHouuou Hdfl m HYTHMB 33 (25+, l-). Thus, helpfulness rankings of items from the Guidance, Universality, and Instillation of HOpe categories link with low ratings on SAR and/or ARO subscales, while the latter link oppositely with helpfulness rankings of ell Family Re-enactment items and with several items from the Existential Factors, Insight, and Interpersonal Learning Input categories. Only for two of the 60 items did bgth_positive and negative correlations between helpfulness rankings and behavior ratings reach statistical significance. Thus, Family Re-enactment item 43 had three significant positive correlations with ABC subscales at 50-hours, plus a similar significant pre-group link with total ARO, but correlated -.40 with SAR's Independent-Dependent subscale at 50-hours. Catharsis item 33 correlated —.44 with ARO's Helps others - Harms others subscale at 50-hours, but .38 with ARO's Accepts others - Rejects others subscale at the same time. These minor inconsistencies, especially for item 33, seem most reasonably attributable to chance. Of the 77 statistically significant linkages between helpfulness rankings of individual items with behavior ratings depicted in Table 5, thirteen were for single items and four additional items accounted for two correlations each. The remaining twelve items accounted for 56 corre- lations: nine by item #27, eight by #45, six by #42, five each by #13 and #44, four each by items #26 and #43, and 34 three each by items #16, #22, #30, #41, and #54. Since these twelve items determined 73 percent (56 of 77) of all statistically significant linkages with behavior, an exami- nation of the structure of their intercorrelations should be revealing. The matrix of intercorrelations among these dozen items at 50-hours (given in Appendix C) was analyzed by McQuitty's (1957) elementary linkage analysis. The source matrix for all correlations at 50-hours is given in Appendix B). McQuitty's technique identifies the items which intercorrelate more highly than they correlate with any other item as the nucleus of a type. Each addi— tional typal member must correlate more highly with at least one other typal member than it correlated with any nonmember of that type. The outcome of typal analysis is depicted in Figure 2, supplemented by all additional bonds between items which were statistically significant at the .10 level (two-tailed test). This more relaxed criterion of statistical significance was used here to permit the fuller mapping of inter-item linkages. In Figure 2, nuclear pairs are double-bonded while other typal members are depicted by single heavy bonds, solid for positive correlations, but broken for negative corre- lations. The two resulting typal structures are supple~ mented by lighter bonds showing all additional correlations which attained the .10 level. Also, all linkages point Oil ~29 1. (I \ /7”‘§""‘"” 33 I I / \ ~ \ ‘3 \ / t \ ‘ I! If 7‘ \ z /’ ‘43” \ ‘\ / ’I \ \\ I “ / / \ ’I Figure 2. Typal bonds (heavy links) supplemented by'all additional statistically significant (p < .10, two-tailed test) bonds (lighter links) among all individual (2 items which generated at least three reliable correlations < .05, two-tailed test) between item helpfulness rankings and behavior ratings (see Table 5). 36 toward that item which contributed more to the total covariance among this set of twelve items. Inspection of Figure 2 reveals two typal structures interlinked by four exclusively negative cross-typal bonds, suggesting a single general cluster with identifiable positive and negative poles. The positive pole, of which Family Re-enactment item #44 is central, includes all other items from that category plus Interpersonal Learning Input item #16 and three quite peripheral items (#13, #22, and #54). The negative pole is marked by three Guidance items, the most central of which is item #27. Two of these Guidance items correlate inversely with the core positive item (#44), while the core negative item (#27) correlated inversely with three different Family Re-enactment items. Thus, a somewhat loose but clear polarity generally obtains between the subsets of Family Re-enactment versus Guidance items which correlated so oppositely with ratings of behavior within the groups. DISCUSSION Shifts in Helpfulness Rankings Over Time Yalom's 12 "curative factors" generally lack ade- quate internal consistency as shown by their rather low alpha coefficients and dispersal in the cluster analyses, in varying degrees, of the items representing all cate- gories but two (Guidance and Existential Factors). Thus, the statistically significant shifts over time of the Catharsis and Interpersonal Learning Output categories appear more attributable to a few specific items within each quintet, than to reflect meaningful general changes. When the focus was shifted to individual items by attending to the 11 items ranked as most helpful at each of the three time periods, much stability was demonstrated by the fact that nine of these items selected at pre-group retained high helpfulness rankings at both the 24- and 50- hour marks. Notable contributors to the total of 13 dif- ferent items ranked among these "11 most helpful" were all five items from Yalom's Interpersonal Learning Output quintet, three of his five "Catharsis" items, and two items each from his Interpersonal Learning Input and Insight categories. Because so many of these items were ranked 37 Ill-IIIIIIIIIIIIIIII 38 highly in helpfulness before the group experience actually began, it appears that the group members brought strong preconceptions about the nature of "helpful" experiences to the group and these were very resistant to change. It may be that these pre-group beliefs were valid, at least in the sense that group experiences failed to disconfirm them. However, the ability to retain old beliefs and opinions in the face of strong contradicting evidence is too well—known to accept this stability of the individual's preconceptions as persuasive evidence that the content of these items was genuinely helpful. Nevertheless, the content of these items ranked as exceptionally helpful, given in Table 3, clearly tells us what group members strongly believe to be helpful. While the present data provide only weak evidence of meaningful shifts from the beginning to the 50-hour point it is interesting to note the content of the two items (of the 11 most helpful) which most increased their mean helpfulness rankings over this interval. These items were "Learning about the way I related to the other group members" (#23, Interpersonal Learning Output, ranked eighth at pre-group but fourth at 24-hours and third at 50-hours) and "Being able to say what was bothering me instead of holding it in" (#35, Catharsis ranked 10th at pre-group and 24—hours but fifth at SO-hours). These items incre- ments in mean helpfulness may indicate that sufficient 39 trust was generated in the groups to permit members to interact meaningfully, as reflected in their increasing desire to learn about their interpersonal relationships (#23) and ability to express bothersome feelings (#35). A One-way Analysis of Variance was made on each item over the three time periods, to investigate whether any item significantly shifted in mean rankings of helpful- ness over time. A total of 10 items changed significantly. Four of these had significant decreases in helpfulness rankings (shown by an increase in mean) from the pre-group to the 50-hour period: #6 "Belonging to and being accepted by the group" (p < .01, Group Cohesiveness); #14 "Learning that others had parents and backgrounds as unhappy or mixed up as mine" (pl< .01, Universality); #25 "Working out my difficulties with one particular member of the group (p,< .001 Interpersonal Learning Output); and #31 ”Getting things off my chest" (p_< .01, Catharsis). The general content of these items pertains to feeling accepted by the group and actively interacting with it. Two items registered significant overall increases in helpfulness rankings (shown by a decrease in mean) from pre-group to 50-hours: #48 "Discovering previously unknown or unacceptable parts of myself" (p < .05, Insight) and #60 "Learning that I must take ultimate responsibility for the way I live no matter how much guidance or support I get from others" (2 < .05, Existential factors). 40 Four other items shifted significantly but incon- sistently in helpfulness over these intervals. Items #12 ("Seeing that I was just as well off as others") and #35 ("Being able to say what was bothering me instead of hold— ing it in”) increased in helpfulness from pre-group to 24-hours but then decreased in helpfulness ranking at 50-hours. Item #47 ("Learning why I think and feel the way I do") declined whereas item #22 ("Feeling more trustful of group and other people") decreased in helpfulness rank- ing (shown by an increase in mean) from pre-group to the 24-hour mark, but both approached their pre—group means at the 50-hour mark. The fluctuations of these latter two items (47 and 22) appear mainly attributable to chance. In summary, the predicted shift in preference for particular categories, which was based on the supposition that groups move through phases, is not strongly supported by these data. The stability with which individuals ranked the 11 most helpful items at each time period, and the lack of a clear conceptual pattern in the content of the items that did have significant increases or decreases in mean helpfulness rankings gives no strong support for this idea. Whether the group actually moved through different phases appears questionable. It is also possible that obtaining individual's perceptions of item helpfulness over time does not tap these phases. I II I III)- I I II I 41 Individual Differences in Perceptions of What is Helpful Much support for the hypothesis of meaningful individual differences in the perceptions of what is helpful was evidenced by the many statistically significant corre- lations between how the individual was rated by fellow group members on the SAR and ARO measures with the person's helpfulness rankings of Yalom's items. There appear to be clear patterns among these correlations: Persons rated below others on SAR and ARO by their fellow group members tended to rank as especially helpful items from Yalom's Guidance, Instillation of Hope, Universality, and Inter— personal Learning Output categories. Except for the last category, these were all among the most clearly defined and internally consistent of Yalom's categories. Persons who fellow group members tended to rate high on SAR and ARO scales tended to rank as especially helpful items representing Yalom's Family Re-enactment category. This category was also one of the most internally consistent and clearly defined. Scrutiny of the content of items chosen as helpful by group members rated higher than others on SAR and/or ARO suggests that these individual's place importance on gaining insight and understanding about the past (Family Re-enactment). It is interesting to note the preponderance of correlations (Tables 4 and 5) of items in the Family Re-enactment category with SAR and ARO scales. This was 42 surprising in that the kinds of experiential groups studied tend to de-emphasize genetic insight, i.e., the usual focus is on "here and now" current problems and group interactions. Perhaps genetic insight was especially sought after by group members with high rankings on SAR and/or ARO because their level of self-acceptance and acceptance of others allows for openness to self-knowledge. These items might also have been chosen because genetic insight was unique to the group experience and something which was not readily available in experiences outside the group. On the other hand, the content of items ranked as helpful by group members rated low on SAR and/or ARO sug- gests that these individuals tend to seek more guidance from other members and facilitators, place importance on learning to be more trustful of others, and learning that their problems are not unique. Perhaps persons who received low ratings on SAR and/or ARO are at a stage of needing help and support from others (Guidance). As Yalom (1970) states, it is to be expected that various curative factors will differentially benefit individual's according to personal needs. A theoretical basis for this idea is offered by Maslow's (1970) hierarchy of basic needs. Some individuals may have predominant needs of the variety which Maslow calls "Safety Needs." These needs (i.e., security, stability, dependency, and 43 protection) appear to have a conceptual link with Yalom's Guidance items, whereas Universality may be linked with Maslow's higher order "Belongingness and Love Needs." Persons rated highly on SAR and/or ARO appear more likely to have access to feelings of Universality and Guidance from others. Their hierarchial need level may be beyond the "Safety Needs" and may extend to the "Self- Esteem Needs." These latter include the desire for self- respect, for confidence, freedom, and independence. Group members with high ratings on SAR and/or ARO also tended to rank as more helpful items from the Family Re-enactment category. Exploration is considered by Maslow (1968) to be a "higher" need than the "Safety needs." Knowing one- self, although a cause for fear for persons whose self- esteem is shaky, is sought after by more secure and "self- actualized" individuals. Thus, the knowledge of an indi- vidual's level of need satisfaction in the Maslowian hierarchy may be an important link to understanding the specific types of curative factors that will enhance psychological growth. Argyris (1968) also supports the idea that indi- viduals at different levels of self-acceptance and self- awareness may be more accessible to different types of factors. He discusses inherent differences in the learning process represented by "psychotherapy" versus "the acqui- sition of competence." Argyris concludes that individuals 44 with little self-acceptance would benefit most from the kind of learning manifest in therapy, whereas the acqui- sition of competence requires individuals who are more self—accepting at the outset. In conclusion, the present results suggest that the level of self-acceptance and/or the acceptance versus rejection of others are importantly linked with an indi- vidual's perception of curative factors. Recommendations Any inferences drawn from these data must take into account the limitations of the study which include the sample size (N = 27), the homogeneity of its' members (upperclassmen and honors students), and the nature of the group experience (a lO-week personal growth group). Since treatment conditions, psychotherapists, facilitators, and clients are not generally so homogeneous (Kiesler, 1966), further investigation of the relationship between curative factors and SAR/ARO should include larger and more hetero- geneous samples of different types of groups led by leaders with different orientations. There are also strategic limitations to the present study. The goal of research of this kind is ultimately to identify which factors help which individuals. Focus can then be placed on ongoing therapy and therapist—training programs so that individuals can be exposed to the kind of factors they benefit from the most. But identifying 45 which factors an individual chooses as helpful does not allow for the assumption that these factors are in fact beneficial to their psychotherapeutic progress. This problem represents the common dichotomy in research between process and outcome. As Kiesler (1971) states, the iden- tification of powerful treatment methods presupposes relating the elements of the psychotherapeutic process to its outcome. A research design that would link process and outcome in this case must discover whether individual's self-designated curative factors are actually occurring in the group and whether they affect his outcome. This could be accomplished by a diagnosis-process-outcome method (Philip, 1973). First, an evaluation is made of the presenting problem, then systematic observations of behav- ior are made in the group. A uniform coding method would record interventions and outcome data for all group members. The development of a uniform observational data language for group process and individual client outcome would facilitate identifying those factors which are curative for each individual client. A research approach of this kind would give impetus to the delineation and development of effective treatment methods. APPENDICES APPENDIX A CURATIVE FACTOR CATEGORIES AND ITEMS .mcwaoom =momn amass man on oEooHo3= m we m>mm mamoom “mayo Eoum ucoummmwp >Ho> no: E.H awn» mcacnmmq .mcHE mm as omxHE Ho unmanns mm monsoum Ixomn one mucmnmm pm: mumnuo was» mcanuwmq .00 H mmcflamow cam managers =omn= dawn on» no wfiom o>mn muonuo umsu mcacumoq .muosuo mm mmo Haws mm umsn mm3 H was» msflmmm :.umon deem on» :w Ham mu.m3 "Ewanoum mo mm>u he sufl3 oco aaco may uo: E.H madcumoq .ma .va .MH .NH .HH .HHmumN .mm .ONch sonN scum omumumoxm. .mE Umummoom 0cm pooumnopcd 0:3 mamowm mo msoum m on mnfiwcoamm .HmmCOH 0c mcoam mcflaoom .msoum mnu Na Umumooom mcfimn Haflum one maomma usonm mmnfinu mafimmmuumnam mafiamo>mm .oamoom Honuo nuwz uomucoo mmoao ooscHusou .msoum n ma woumooom mcflon one on mafimconm .mm>HH “Hosp CH usmuuomsfl mcflon new muonuo @cfimaom .muosuo on mammwe mo uumm msfl>flu .mnonuo ochHm: «0 mcHxaHsu new mammNE mcfluuomuom .ocfle mo omens mpmwc .mumnuo mcwuusm .uowmmouluaom whoa ma so>flm was muonuo 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.mHmoom quuHOQEH umsuo Ho .mumumHm .mHmCuoun .muCoumm >8 Cqu ummm ms» CH cm: H umru mm: ImCMC pHo UCmumnmpCC ou w8 pomHoC 30Co80m msoum onu CH mCHmm .mC 3oum H noHss :H NHHamH we» CH meH >8 mCHpCmum lumUCC UCM @CH>HHoH oxHH .mmCom m CH .mmz mCoum mCu CH mCHmm .mw .vv .mv .N¢ .Hv uCGECUMCmmm >HH86m .m .Houmm Mme>8 Cuouumm pHCoo H msoum 0:» CH mCooEOm mCHoCHm .umHmmHmCu >8 oxHH mCH>mswn UCm wCHHH8UC .Hwn808 maoum HmCHOCm Ho wH>um ecu no m8mHHmCCm8 mCHumopd .mEMm on» ow on we nmmHma uH 80mm UHHown UCm mmeH HwCuo wxmu CCC mmCHCu mCHmmMHHMAEm Hmo>mu pHCoo muonuo umnu mCHomm .H Can» Uwumsnpm Coupon mm3 0C3 msoum on» CH mComEOm oxHH on on mCH>nB .ov .mm .mm .Nm .om coHumoHHHucmeH .m 49 .mumCuo 808w pom H uuommsm pCm oUCmpHCm C058 30: nouum8 0C oHHH >8 o>HH H >m3 oCu How >UHHHQHmCommoH muCEHUHC oxmu umCE H uwnu mCHCHmmH .mmHuHHmH>Hnu CH ms quCmo mmoH mCHmn UCC >HumoC0C oHO8 wHHH >8 mCH>HH mCCu pCm .Cumop UCM oHHH >8 Ho moCmmH UHmmn may mCHomm .oCon omHH oomw HHHum umC8 H .mHmomm nonuo ou umm H omoHo 3o: Houum8 0C umnu mCHNHCmoomm .Cpmop 808w UCm CHmm m.oHHH mo o80m 808m mmmomo 0C mH when» >Hou88 IHUHC was» OCHNHCmooom .uanCC 0C8 HHCHCC mmEHu um mH mHHH umzu mCHNHCvooom .08 Comm unsooCo 0CH8 oxHH m8mHnoum CUHS muonuo pmemC can macho mCu umau mCH30CM .m8 comm IHCooCm ©o>oum8H muon8m8 msoum nonuo umnu oCHoom .oCH8 ou HMHHEHm m8mHnonm po>H0m Um: muwCuo umsu mCmem .oCHE ou HMHH8Hm mEoHnoum 00>Hom pm: mumnuo mCHsoCM .o8 on mCHHHmmCH mmz Coupon mCHuumm muonpo mCHomm .00 .mm .mm .5m .mm .mm .vm .mm .Nm .Hm .A8m H mm 8C H >C3 oHHH >Humw >8 CH mCOmmmH mum ouoCuv uCo8m0H0>op pCm pooanHCo >8 ou woumHoH mH >muou o>maon 6C8 Hmmm H 30: umnu mCHCnmmH .AomHH >8 CH mpoHme umHHumm ou mConn 30C080m umnu muCHHooH CUH3V >HHmoHumHHmeCC mCOHumsuHm no mHmoom 080m on women H umnu mCHCHmmH .HHmm>8 Ho muumm oHnmumoOUMCC no C30CxCC >HmCoH>oum OCHumooom 6C0 mCHuo>oomHa .Am8oHnonm >8 Ho moouCOm pCm momsmo wCu mo «80m mCHCHmoH ..m.Hv 06 H >m3 on» mem pCm xCHCu H >C3 mCHCHme .ummm >8 CH onomm nonuo CuH3 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