THE EFFECTS OF OPEN AND CLOSED INQUIRY MODES
USED BY COUNSELORS AND PHYSICIANS IN AN INITIAL
INTERVIEW ON INTERVIEWEE PERCEPTIONS AND SELF- '

DISCLOSURE

Dissertation for the Degree of Ph. D.
MICHIGAN STATE UNIVERSITY
DOLORE ROCKERS, OSF.
1976

LIBRARY

Michigan Scam

INI\\II\\IIIIII\I8I§III§I\

3 1293 01067

 

_..—-

This is to certify that the
thesis entitled
THE EFFECTS OF OPEN AND CLOSED INQUIRY MODES
USED BY COUNSELORS AND PHYSICIANS IN AN INITIAL INTERVIEW
ON INTERVIEWEE PERCEPTIONS AND SELF-DISCLOSURE

presented by

Dolore Rockers, O.S.F.

has been accepted towards fulfillment
of the requirements for

Ph. D. degree in _C_ans£.ling

 

NED/MM

\
Major proffi

Date Au net 27

0-7639

 

 

PLACE IN RETURN BOX
to remove this checkout from your record.
TO AVOID FINES return on or before date due.

 

mg 32 5 2

DATE DUE

DATE DUE

 

Inf-

n- .‘\ c

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1/96 alumnus-p.14

ABSTRACT

THE EFFECTS OF OPEN AND CLOSED INQUIRY MODES
USED BY COUNSELORS AND PHYSICIANS IN AN INITIAL INTERVIEW
ON INTERVIEWEE PERCEPTIONS AND SELF-DISCLOSURE

By
Dolore Rockers, O.S.F.

Health care is an area of concern for every person. This care .
includes treatment of body and mind and, therefore, both.physicians and
counselors can be considered health care providers. Because of parallel
factors in training and practice across the disciplines of counseling
and medicine, there is a need for collaborative research and an exchange
of knowledge regarding productive teaching programs and effective inter-
viewing techniques. There have been no reported studies which.examine
the effects of specific interview styles as they are used by different
health professionals. The question of whether or not the occupational
status of the interviewer affects interviewee perceptions and self-
disClosure has not been investigated directly. The sex of the inter—
Viewer and the sex of the interviewee have been reported to have dif—
ferential effects on interview outcomes but the research available is

not conclusive.

The purpose of this research.was to look at the effects of an
open or closed inquiry style, as they are used by a.male or a female
counselor or physician in an initial, infbrmation-gathering interview,

on the interviewee's perceptions and self-disclosure. The basic research

 

 

—
“——
.——-—-

_—
—_

 

—«—_
_-—

OUESI
fessi
close
as a
fessi

or ti

eithe

tepti

or mi
the I

and f

Dolore Rockers, O.S.F.

questions addressed were: 1) Does the inquiry style of the health pro-
fessional in an initial interview affect either the amount of data dis-
closed by the patient or the patient's perceptions of the professional
as a caring person? 2) Does the occupational status of the health pro-
fessional influence either the amount of data disclosed by the patient
or the patient's perceptions of the professional as a caring person?

3) Does the sex of the health professional, or of the patient, affect
either the amount of data disclosed by the patient or the patient's per-
ception of the professional as a caring person?

The independent variables were: 1) Inquiry Mode (open, closed
or mixed); 2) Occupational Status (counselor or physician); 3) Sex of
the Interviewer (male and female); and 4) Sex of the Interviewee (male
and female). Two instruments measured the interviewee's perceptions of

the interviewer as a caring person: the Counselinngvaluation Inventory

 

which is a twenty-one item rating form with three subscales to measure
interviewer comfort, counseling climate and interviewee satisfaction;

and the Barrett-Lennard Relationship_1nventory which has items covering

 

the concepts of empathy, congruence, level of regard and unconditional-
ity of regard. The interviewee's self-disclosure in the interview was

measured by the Interviewee Productivity Measure which.was a frequency

 

count of the factual and attitudinal data the interviewee presented
during the audio-taped interview. Trained tape reviewers made the count
while listening to the playback of the interview.

Four Research Associates, two female and two male, were trained

to present the following treatment conditions: 1) an Open Inquiry Mbde

Dolore Rockers , 0. S.F .

in which at least 80% of the inquiries were asked in a manner which
allowed the interviewee wide latitude in response; 2) a Closed Inquiry
Mode with at least 80% of the inquiries phrased so that they could be
answered with a simple "yes," "no" or short factual answer; and 3) a
Mixed Inquiry Mode with at least 40% open inquiries and 40% closed in-
quiries. The latter was considered the control condition. The Associates
simulated the roles of physician and cormselor on alternate days and
presented the treatments in a randomly determined manner.

Seventy-two female and seventy-two male volunteer subjects
were randomly assigned to the three treatment conditions that were
spread across a four week period of time. The twenty minute audio-taped
interview was an initial history-taking interview similar to an intake
interview in any health clinic. I

Hypotheses were tested for the main and interaction effects of
the four independent variables. The dependent measures were the two in-
ventories of the interviewee' s perceptions of the interviewer and the
one measure of the quantity of data gathered from the interviewee. Multi-
variate and univariate analyses of variance were performed using the
Firm computer program and with the probability of a Type I error set at
the .05 alpha level. The Inquiry Mode used in the initial interview, the
Occupational Status of the interviewer and the Sex of the Interviewee
were the hypotheses that had non-significant nultivariate and univariate
F's. These three variables had. no differential effects on either the
amount of data disclosed by the interviewee or on the interviewee's per-

ceptions of the professional as a caring person.

Dolore Rockers, O.S.F.

The hypothesis which tested for differences between.male and
female interviewers showed that the females received significantly
higher ratings than the males. The Barrett-Lennard Relationship Inven-
tory was the dependent measure on which the female interviewers were
rated as having significantly more unconditional positive regard, a
higher level of regard and more empathic understanding than the male
interviewers. Additional analysis showed that between-male and between-
female interviewer differences were also significant on the subscales
of the Barrett-Lennard. Explanations considered included the pos-
sibility that these two female interviewers were quite different from
the two male interviewers in their interpersonal approach to the inter-
viewees or that the cultural stereotype of the female as the more
nurturant and empathic person was influencing the interviewee'S‘percep-

tion. Further research was suggested to test these hypotheses.

THE EFFECTS OF OPEN AND CLOSED INQJIRY DIODES
USED BY COUNSELORS AND PHYSICIANS IN AN INITIAL INTERVIEW
ON INTERVIEWEE PERCEPTIONS AND SELF-DISCLOSURE

By

Dolore Rockers, O.S.F.

A.DISSERTATION

Submitted to
Michigan State University
in.partia1 fulfillment of the requirements
for the degree of

DOCTOR.OF PHILOSOPHY

Department of counseling, Personnel Services
and Educational Psychology

1976

ACKNOWLEDCMENTS

Many persons advised, encouraged and assisted me in the comple-
tion of this research. I would like to thank the following individuals
in particular.

James R. Engelkes, committee Chairman, who contributed time and
helpful suggestions during the execution of this research.

John M. Schneider, comnittee member, colleague and friend, who
provided insight about the research, challenged my creative thinking
and supported my professional efforts during the last three years.

Richard G. Johnson, corrmittee member, who assisted me in devel-
oping the research design and made helpful criticisms about the analysis.

Betty L. Giuliani, committee member, who prompted me to take a
look at some of the theoretical questions underlying research methodology.

Judy Breitmeyer, Holly Holdman, Marty McKay, and Tony Straseski
who worked as Research Associates with enthusiasm and professionalism.

William Heater, Chairman of Social Sciences at Lansing Column-
ity College, the professors and the students of the Social Science De-
partment who were willing to promote this research by their cooperation.

Amy Sevenski, Debbie and Beth Hoatlin, and Kelly Lynch who gave
up several Saturday and Sunday afternoons to act as receptionists.

The Rockers family who have loved, consoled and applauded me in
my efforts for many years. They helped me to keep the essential reali-
ties of life in the proper perspective.

The members of the Personnel Board of the Franciscans of
Rochester, Minnesota, who were always interested in my progress and
generous with their emotional support.

Kenneth Pierre, David Vandergoot, Marjorie Habenicht, Meigan
Fogarty, J. Margaret Pirkl and many other friends and colleagues who
lived through the ups and downs of graduate study with me. They cared
for and encouraged me with generosity.

ii

TABLE OF CONTENTS

 

 

 

 

 

 

 

Chapter Page
I. IDENTIFICATION OF THE RESEARCH PROBLEM ..................... 1
Introduction ................................................ l
Rationale

The Dyad ................................................. 2
The Initial Interview .................................... 4
Inquiry.M0des ............................................ 5
Occupational Status ...................................... 7
Sex Differences .......................................... 9
Expectations, Satisfaction and Self-Disclosure ........... 9

The Problem
Purpose ................................................. 11
Research Questions ...................................... 12
Overview ................................................... 13
II. REVIEW OF THE LITERATURE .................................. l4
Inquiry Styles in the Interview ............................ 14
Occupational Status Effects in the Interview ............... 20
Sex Differences in the IntervieW' ........................... 22
Client Satisfaction and Disclosure in the Interview ........ 24
‘ Audio Recording Effects in the Interview' ................... 27
SUmmaEy .................................................... 28
III. DESCRIPTION OF METHODOLOGY AND DESIGN ...................... 31
Selection and Training_of Research Associates .............. 31

 

Selection of Subjects

 

Population ............................................. 33
Sample... ............................................... 33
Generalizability of Sample .............................. 34

iii

Chapter Page
III. continued

DependentIMeasures

 

 

 

 

 

 

 

The Counseling Evaluation Inventory ..................... 35
The Barrett-Lennard Relationship Inventory .............. 37
The Interviewee Productivity Measure .................... 39
Treatment Procedures
Phase I - Pre-Treatment ................................. 40
Phase II - Treatment .................................... 40
Phase III - Post-Treatment .............................. 44
Design ..................................................... 44
Hypotheses ................................................. 46
Statistics Used ............................................ 47
Summary .................................................... 48
IV. PRESENTATION OF RESULTS 50
Preliminary Data ........................................... 51
Tests of Hypotheses
Hypothesis One - Inquiry Mede Main Effect ............... 55
Hypothesis Two - Occupational Status Main Effect ........ 58
Hypothesis Three - Interviewer Sex Main Effect .......... 60
Hypothesis Four - Subject Sex Main Effect ............... 65
Summary .................................................... 67
V. SUlvMARY AND DISCUSSION 71
Summary ..................................................... 71
Discussion of Results ....................................... 72
Inquiry Mbdes in the Interview ........... ' ................ 72
Occupational Status Effects in the Interview ............ .74
Sex Role Differences in the Interview .................... 75

iv

Chapter Page

V. continued

 

 

Limitations ................................................. 77
Recommendations for Further Research ........................ 79
LIST OF REFERENCES ............................................... 81
APPENDICES
Appendix
A. Letters Recruiting Research Associates ...................... 87
B. Training Program.for Research Associates .................... 90
C. Sample of Open and Closed Inquiries ......................... 93
D. Letter Recruiting Subjects .................................. 95
E. Demographic Questionnaire

Summary Tables of Demographic Characteristics ............... 97

F. Interviewee Productivity Measure
Training Program.for Tape Reviewers

Reliability Calculations ................................... 104
G. Appointment Reminder for Subjects .......................... 109
H. Subject's Introduction to Interview Situation

Consent to be Taped Form ................................... 110
I. Interviewer's Prompt Card .................................. 112
J. Additional Univariate Tables ............................... 113

Table Page
3.1 Sequence of Inquiry Modes for Each Interviewer ............ 43
3.2 Sumnary of Design Characteristics ......................... 45
4.1 Scoring Ranges for the Dependent Measures ................. 51
4.2 Sumnary of Means and Standard Deviations for the

Miltivariate Analysis of Variance of Three

Dependent Measures ................................ 52, 53, 54
4.3 Mlltivariate Analysis of Variance

between OPEN, CLOSED and MIXED INQUIRY MODES .............. 56
4.4 The Pooled Means for the INQUIRY NDDE Main Effect ......... 57
4.5 Miltivariate Analysis of Variance

between COUNSELOR STATUS and PHYSICIAN STATUS ............. 58
4.6 The Pooled Means for the OCCUPATIONAL STATUS Main Effect. .59
4.7 Miltivariate Analysis of Variance

between MALE INTERVIEWERS and FEMALE INTERVIEWERS ......... 60
4.8 The Pooled Means for the INTERVIEWER SEX Main Effect ...... 61
4.9 Univariate Analysis of Variance of the

Dependent Measures for INTERVIEWER SEX Main Effect ........ 62
4.10 Miltivariate Analysis of Variance Within Female

and Within Male Interviewers .............................. 63
4.11 The Pooled Means for the Within Male

, and Within Female Interviewer Effects ..................... 64

4.12 Multivariate Analysis of Variance

between MALE SUBJECTS and FEMALE SUBJECTS ................ 65
4.13 The Pooled Means for SUBJECTS SEX Main Effect ............. 66

LIST OF TABLES

4.14 Summary of the Miltivariate Analysis of Variance for

the Total Scores of the BLRI, the CEI and the 1m ..... '. .. .68

vi

Table . Page

4.15 Summary of the Moltivariate Analysis of variance for the
Three Subscales of the Counseling Evaluation Inventory....69

4.16 Sumnary of the Multivariate Analysis of Variance for the
Four Subscales of Barrett-Lennard Relationship Inventory..70

E.l NUmber of Subjects by Years of Age ........................ 99
E.2 Nomber of Subjects by Years of Education Completed ........ 99
E.3 Marital Status of Subjetcs ............................... 100
E.4 Income Level of Subjects or Their Source of Support ...... 100
E.5 Heme Town of Subjects .................................... 101
E.6 Race of Subjects ......................................... 101
E.7 NUmber of Subjects by Occupation ......................... 102
E.8 NUmber of Subjects Who Saw a Physician over the Last

Three Years and Their Attitude Toward the Physician ...... 103

 

E.9 Number of Subjects Who Saw a Counselor over the Last
Three Years and Their Attutude Toward the Counselor ...... 103

 

J.1 Univariate Analysis of Variance of the
Dependent Measures for INQJIRY MODE Main Effect .......... 113

J.2 Univariate Analysis of Variance of the ’
Dependentheasures for OCCUPATIONAL STATUS Effect ........ 114

J.3 univariate Analysis of variance of the Dependent
IMeasures for the withianale and within.Female Effect....115

J.4 univariate Analysis of variance of the
Dependentheasures for the SUBJECT SEX Main Effect ....... 116

vii

 

CHAPTER I

IDENTIFICATION OF THE RESEARCH PROBLEM

Introduction

 

This study is an investigation of a patient's disclosure of
personal information and the patient's perceptions of the interviewer
in an initial interview conducted by a health professional using one of
three inquiry styles. Because of parallel factors in interview training
and practice across the disciplines of counseling and medicine, there is
a need for collaborative research and an exchange of knowledge regarding
productive teaching programs and effective interviewing methods I
GMatarazzo, 1971). This research is designed to further this exchange.

Initial patient interviews, whether conducted by counselors or
physicians, have several common elements. Each is a dyadic interaction
which is both asymmetrical and reciprocal. Asymmetrically, the inter-
viewer has the higher status as defined by the occupational role and the
service being offered to the requesting second party. Initially, the
interviewer controls the manner, direction and content of the informa-
tion-gathering first session. Sex differences and the individual frames
of reference of each party are also asymmetrical factors.

ReCiprocity within the dyad is evidenced in the interplay of

verbal and non-verbal cues from one person which prompt the other's

2

response. Efficient use of time, empathic listening and response to in-
formation shared, ethical treatment as a human being with full rights
and responsibilities, and effectiveness in attaining the ultimate goals
of the encounter are the ideal mutual expectations Of interviewer and
interviewee. The outcome of such an asymmetrical yet reciprocal inter-
view between adults affects all subsequent interactions. It is here that
the first match between expectation and satisfaction is made.

Training programs in counseling and medicine teach that informa-
tion is most effectively and efficiently gathered during the course of
the interview if specific inquiry methods are used (Benjamin, 1969; I
Enelow G Swisher, 1972). These methods are judged adequate if they lead
to accurate labeling of the interviewee's concerns and if they aid in
developing an effective intervention plan. The interviewee's satisfac-
tion and self-disclosure are alos measures of the effectiveness of the

encounter (Truax 8 Carkhuff, 1967).

Rationale

The Dyad

An interest in the communication patterns between two or more
persons provided the basis for the core of Harry Stack Sullivan's theory
(1953) on the psychiatry of interpersonal relationships. One of his pos-
tulates pertinent to this study is that each person in any two person
interaction is involved as a portion of the interpersonal field, rather
than as a separate entity, in the total processes of that special field.

Each dyadic encounter creates a unique field which is finite

and yet fluid. The patterns reflecting expectations and needs of both

parties emerge only when this interpersonal field is created. Individ-
ual personal histories, social roles, the limited set of learned behav-
ioral responses that each person brings, the purpose of the interaction,
the content covered in the interview, and the expectations of both.par-
ties help to define the specific nature of the interpersonal field.
Enelow and wexler (1966) label this continuing interplay between a phy-
sician and patient a "transactional process" and they indicate that it
is influenced by the interpersonal histories and social roles of both
the physician and patient. Kell and Mueller (1966) call the constant
stimulation and consequent response between a counselor and client the
"reciprocal impact . "

Szasz and Hollender (1956) and Magraw (1966) elaborate on the
nature of the physician-patient relationship and present three models
to describe it. These models are styles of interacting which could
occur in a variety of clinical or social settings. The model 0f.§E£in

ity:passiviry presents the stance that one person in the dyad is active

 

and the other is inactive or acted upon. The health professional does

something to the patient. In the model of guidance-cooperation the pro-

 

fessional tells the patient what to do and the patient obeys. The most
powerful in the relationship does the leading and the other cooperates.

The mutual participation model promotes the postulate of equality in

 

power, need and activity. The health professional helps the patient to
help himself. The authors hasten to point out that any one of the models
may be entirely appropriate under certain circumstances.
In this research the model used is similar to the guidance-co-
operation model in that the interviewer directs the information flow

and the interviewee is instructed to respond to the inquiries. Since

this kind of relationship is like the beginning of a nonrcrisis encoun-
ter, the initial history-taking interview is selected as an analogous
situation for this study.

"Problems in human contact between physician and patient often
arise if, in the course of treatment, changes require an alteration in
the patterns of the...re1ationship (Szasz and HOIlender, 1956)." When
the interpersonal field changes the professional must be able to recog-
nize the nuances and adapt interpersonal behavior appropriately. In the
interview this might mean a change in inquiry style, termination of the
present encounter, or referral to another professional. The interview,
as defined in this research, does not allow for such adaptive responses
because the outcome of interest is the effect of specific inquiry
styles on a patient's perceptions and self-disclosure. Maintaining one
inquiry style throughout the interview and varying the style across in-

terviews is the procedure used to test for differential effects.

The Initial Interview

 

The health professional has three basic goals for the first in-
terview (Sullivan, 1949; Sheppe G Stevenson, 1963; Enelow & wexler,
1966; Tyler, 1969): 1) to establish a positive relationship with the
patient; 2) to determine the specific and immediate concerns of the
patient at the time of the interview and to begin remedial treatment if
that. seems indicated; and 3) to elicit the pertinent personal his-
tory which will help to clarify the patient's frame of reference and
provide clues for acceptable or threatening intervention programs. The
patient, also, expects some specific intervention and a relationship
‘with a professional who demonstrates an interest in this individuallas;

a person and not just a list of symptoms (Snyder G ware, 1974).

Daily (1960) suggested that a "life history" provides the
framework for the ordering of all the other data collected about a pa-
tient. A content validity analysis of eighty video-taped interviews of
Family Practice physicians indicated that inquiry into a patient's per—
sonal hiStory is a significant part of the diagnostic workup (Cassata
23.21) 1974). The Sytematic Counselor Training Program at Michigan State
university (Winborn 23.212 1971) encourages collection and review of
pertinent client data as a beginning step in the counseling process.
For those who question the efficiency of a life history-taking proce-
dure, Enelow and wexler (1966) stated that they have demonstrated re-
peatedly that an informative personal history can be obtained in an
initial interview of under thirty minutes.

The initial interview may be the only contact between the pro-
fessional and patient or it may be the beginning of an extended rela-
tionship. First impressions are formed by both.parties as each tests
the skills and personal qualities of the other. An assumption made in
this research is that the first impression may be a significant causal
factor in: l) the patient's willingness to be self-disclosing; 2) the
nature of the information provided by the patient (Bird, 1955; Engel 8
iMorgan, 1973); 3) the patient's return for further assistance; or
4) the manner in which the patient complies with the proposed interven-
tion plan (Davis, 1968). The question then becomes; "What interactional

variables influence this first impression?"

InquiryiMOdes

 

In an information-gathering interview such as the initial ses-

sion between a health professional and patient, a question and answer

format is generally used. The inquiry style of interest in this research
can be represented by a continuum that has a relatively general question
at one end and a very specific question at the other extreme. The dicho-
tomous end points have been called "exploratory - non-exploratory" by
Kagan (1972), "open - closed" by Benjamin (1969), "ambiguous - specific"
by Siegman and Pope (1972), and "reflective - leading" by Ashby 23.21.
(1951). These researchers have theorized that the extreme ends of the
continuum affect the quality and quantity of the data obtained in the
interview in a different manner. The open mode of inquiry is said to
create a warm, positive atmosphere and is an encouragement to the inter-
viewee to respond with a wide variety of content. The opposite kind of
inquiry may inhibit the interviewee, limit the response to a specific
answer, and may be detrimental to establishing good rapport (Benjamin,
1969).

Enelow and Swisher (1972) proposed that the open style of ques-
tioning should be used first in an interview to set the patient at ease.
Then the interviewer should proceed to a more specific and closed style
to get the detailed information that is needed for further diagnosis
and program planning. There are those professionals who would say that
an open style can be used throughout the interview without diminishing
pertinent information flow. Others (Enelow G wexler, 1966), acknowledg-
ing the constraints of time, insist that direct questions are the most
efficient and do not interfer with effectiveness. Of course, judgments I
about the adequacy of the data in terms of quality and quantity are
relatively subjective decisions made by the professional as the diagno-
sis and intervention plans begin to crystalize.

In speaking about the medical interview, MacKinnon and Michels

(1971) pointed out that as long as the patient sees the physician as a
potential source of help, the patient will volunteer, "more or less
freely," as much information as seems pertinent to helping the profes-
sional deal with the concern. There are two questions which follow from
this. Does the quality or quantity of data given by the interviewee de-
pend upon the manner of inquiry? Does the quality or quantity of data
depend on the kind of data which is pertinent to either the interviewer
or the interviewee? In this research the pertinent data, from the inter-
viewer point of view, is a constant in the interviewer role. The manner

of inquiry is varied.

chupational Status

 

The health professional, by virtue of specialized training, ex-
perience, and cultural stereotypes is assigned a certain social and pro-
fessional status which has recognizable patterns of behavior and speci-
fic functions in society. The sum total of the cultural patterns asso-
ciated with a particular status is called a role (Hellander, 1967).

Ivey and Robin (1966) identified three basic elements of a role. It is:
1) a set of norms which arise from general social agreement; 2) a spe-
cific position or location in.a social structure in relation to others;
and 3) expectations for behavior that have been assigned by significant
others and describe what the individual taking a position actually does.

The general norms which have been defined for the physician
GMagraw, 1966) can be applied to other health professionals. There is
an acceptance of the responsibility for caring for another person who
is seeking help, a commitment to act in the patient's interest and not
for the professional's own personal gain, and a sense of obligation to

remain emotionally neutral, objective and non-judgmental with.the

 

patie
ideal:
UN h
their
tarin
Malpr

1971)

depen
Consi
has 1
total
ihNes

Patie

patient. These three elements of the health professional's role are

idealized postulates of behavior which are monitored by professional
and legal statutes. Though physicians or counselors may think that

their professional behavior is according to these idealized norms of
caring, the patient may perceive the relationship quite differently.
Malpractice suits are one manifestation of this variance (Dornette,

1971) .

The specific position or status within the social structure
depends on the occupational specialty of the health professional being
considered. Each position in the hierarchy of the health professions
has its own set of expectations about behavior based on ill-defined cul-
tural generalizations and each person's past experiences. This research
investigates whether or not these differences have any effect on the ,
patient's perceptions of the interviewer or amount of self-disclosure.

Adler (1972), a sociologist, pointed out that "it is in the in-
terview that the professional's role is established." Health profes-
sionals have been recruited mainly from the upper and middle classes.
Therefore, part of their role behavior is a function of their cultural
background. Reactions of patients to the professional have also been
shown to follow class attitudinal patterns (Simnons, 1958). Higher sta-
tus patients are less passive in the interview and offer much more of
the requested information spontaneously. The lower class patient may
defer to the professional and, yet, may demonstrate a hesitancy to fol-
low interviewer leads.

Occupational status, as defined in this study, is manipulated
to induce a mind set in the patient to eXpect behavior patterns associ-

ated with the status of physician or counselor.

Sex Differences

 

Sex is considered to be a significant attribute of a social
role and there are fairly fixed social expectations about sexual behavi-
or (Hollander, 1967). Guttman (1974) reports that "in the counseling
profession(s) women have been valued primarily for their nurturant and
supportive functions." The male, conversely, is valued for his scienti-
fic expertise and an aggressive approach to problem-solving. If these
views are the prevailing cultural stereotypes they are, then, likely to
affect a patient's perceptions of and response to the interaction with
a health professional. Of course, there may be real behavioral varia-
tions between male and female health professionals in their approach to
patients because of their own socialization processes. One of the main
purposes cu? this research is to see if the sex of the interviewer or
of the interviewee is a differentiating factor in the initial interview

GDCQJJ’IEET .

Expectations, Satisfaction and Self-Disclosure

 

Expectations regarding the quality of care are a reflection of
the patient's personal needs, status, sex, age, professional expertise,
past experiences, and a variety of values and attidues regarding health
care. An extensive study of the health expectations of persons in sev-
eral counties of southern Illinois has shown that attitudes toward gar;
igg_(defined as the humanness of the physician) and guring_(the quality
of medical treatment and the competency of the health professional)
"appear to reflect the same underlying attitudinal dimensions (ware 8
Snyder, 1975)."

If the patient expects to be "cared for" and "cured" because of

interaction with the health professional, then one measure of the

10

satisfaction for such care and cure might be the patient's perceptions
of the professional as a caring person.

The more that the client perceives the therapist as real or

genuine, as empathic, as having an unconditional regard for

him, the more the client will move away from a static, fixed,

unfeeling, impersonal type of functioning, and the more he

will move toward a way of functioning marked by a fluid,

changing, acceptant experiencing of differentiated personal

feelings. The consequence of this is alteration in personality
and behavior in the direction of psychic health and maturity
and more realistic relationships to self, others, and the

environment (Rogers, 1961. p.66).

This perception of the professional as a caring person is vital
to the physician-patient relationship as well as to that of the counsel-
or and client. Bernstein and Dana (1970) have listed three ways that
patients demonstrate dissatisfaction with the relationhsip with the
health professional: 1) by non-payment of bills; 2) by non-compliance,
conscious or unconscious, with treatment regimes; and 3) by filing mal-
practice suits. Dornette (1971), physician and lawyer, said that even
though the physician has committed a negligent act that has injured the
patient, "the physician who maintains sound rapport with that patient
still may escape liability."

Willingness to cooperate in the comprehensive disclosure of
personal-social information during the initial interview, measured by
the quantity and quality of data, is another indication that the inter-
viewee is satisfied with the relationhsip (Jourard, 1971).

In summary, the variables of (l) inquiry style in an initial
interview, (2) occupational status of the professional conducting the
interview, (3) the sex of interviewer and interviewee, and (4) the in-
terviewee's satisfaction with the relationship are the interacting ele-

ments which this research aims to test for differential effects. Inter-

viewee satisfaction is defined operationally to include two separate

11

dimensions: 1) the interviewee's perceptions of the interviewer as a
caring professional, and 2) the amount of personal information the in-

terviewee is willing to disclose during the interview.

The Problem

 

Health care is an area of concern for every person. This care
includes treatment of body and mind and, therefore, both physicians and
counselors can be considered health-care providers. Since both.medicine
and counseling train persons to interview patients for various purposes,
each could benefit from the findings that the other profession has veri-
fied through years of developing and evaluating training programs and
techniques. But before transfering learning paradigms from one disci-
pline to another, the effects in each setting should be examined. Do the
inquiry styles used by counselors have the same effect when used by
physicians? At present there are no such.cross-discipline studies. Are
male and female interviewers perceived to have the same relationship
qualities by male and female interviewees? There is no definitive re-

search which can answer this question.

Purpose
The purpose of this research is to test the effects of open,

closed, and mixed inquiry modes, as they are used by male and female
counselors and physicians in an initial, information-gathering inter-
view. The inquiry modes are defined as follows:

1) The OPEN INQUIRY interview has leads which solicit opinions,

feelings, facts...anything the interviewee would like to say.

12

2) The CLOSED INQUIRY interview has interviewer leads asked in
a manner where "yes," "no," or a short, factual answer seems

the most appropriate.

3) The MIXED INQUIRY interview has a combination of open and

closed interviewer leads.

Two instruments measure the interviewee's perceptions of the

interviewer as a caring person: The Counseling Evaluation Inventory

 

(Linden, Shertzer 5 Stone, 1965) is a twenty-one item rating form with
three subscales to measure interviewer comfort, counseling climate and

‘interviewee satisfaction. The Barrett-Lennard Relationship Inventory

 

Barrett-Lennard, 1962) , modified, has items covering the concepts of
empathy, congruence, level of regard and unconditionality of regard.
The interviewee‘s self—disclosure in the interview is measured by the

Interviewee Productivity Measure. This is a frequency count of the

 

factual and attitudinal data the interviewee presents during the audio-
taped interview. Trained tape reviewers make the count while listening

to the tapes.

Research Questions

 

There are three general questions to be addressed by this

research:

1) Does the inquiry style of a health professional in an initial
interview affect either the amount of data disclosed by the
patient or the patient's perceptions of the professional as

a caring person?

2) Does the occupational status of the health professional in-

fluence either the amount of data disclosed by the patient

13

or the patient's perceptions of the professional as a caring
person?

3) Does the sex of the health professional, or of the patient,
affect either the amount of data disclosed by the patient
or the patient's perception of the professional as a caring

person?

Overview

In this study the effects of four independent variables on the
patient's perceptions and disclosure in an initial interview with a
health professional are investigated. The independent variables are:

1) Inquiry Mode (open, closed or mixed); 2) Occupational Status
(counselor or physician); 3) Sex of the Interviewer (male and female);
and 4) Sex of the Interviewee (male and female). Subjects were asked to
disclose personal-social and medical information in a twenty minute
initial interview conducted by the health professional.

Chapter 11 contains a review of pertinent experimental litera-
ture related to the independent variables. In Chapter III, the experi-
mental design, procedures, dependent measures and hypotheses are
described. The analysis of the data is presented and interpreted for
each hypothesis in Chapter IV. A discussion of results, implications for
further research.and a summary of the entire study can be found in

Chapter V}

CHAPTER II

REVIEW OF THE LITERATURE

The dyadic interview has been the subject of numerous research
efforts which have been reviewed extensively elsewhere GMatarazzo, 1965;
Bergin 6 Garfield, 1971). In this chapter those experimental studies
which.pertain specifically to the variables being tested in this re-
search are presented. The review is arranged under the following head—
ings: 1) Inquiry Styles in the Interview; 2) Occupational Status.
Effects in the Interview; 3) Sex Difference Effects in the Interview;
4) Client Satisfaction and Disclosure as Interview Outcomes; and

5) Audio-Recording Effects in the Interview.

Inquiry Styles in the Interview

 

Studies of inquiry style have been done using both naturalistic
and experimental interviews, actual face-to-face interactions and paper-
pencil interviews, recordings, transcripts of recordings and case notes
done from memory after the interview was completed. Results reported are
contradictory and replications are seldom presented in the literature.
The outcomes of each of the experiments reviewed here provide evidence
of the need for controlled laboratory testing which.can be tested fur-
ther in the natural setting.

Snyder (1945) analyzed therapist leads using some of the first
14

15

audio-recordings made of actual Rogerian therapy sessions. He identi-
fied 31.6 percent of the therapist leads as reflection and clarifica-
tion of feelings, 27.6 'percent as simple statements of acceptance of
the interviewee, and only 5.7 percent as direct questions asked of

the client. In 1964, Hopke determined that the most common verbal
behaviors utilized by experienced school counselors were probing or
interrogation (50 percent), interpretive leads (22 percent), support-
ive statements (13ijpercent), understanding (11. percent), and evalu-
ative remarks (3 pmncent). No indication was given as to the theoret-
ical orientation of the school counselors.

Whatever may be the interviewer's style, the consequences of
the leads used bear investigation. Also using the recorded interviews
of Rogerian therapists, Bergman (1951) found that reflection of feel-
ing leads were followed by continued self-exploration on the part of
the client. Structuring leads were succeeded by abandonment of self -
exploration. Therapist leads requesting clarification of infbrmation
also resulted in a decrease in self-exploration. An intensive analysis
of psychotherapy procedures used by four therapists who recorded
sessions with two patients each over a period of eight months was done
by Lennard and Bernstein (1960). They showed that therapists compen-
sate fer high patient verbal output by reducing their own output and
vice versa. This phenomenon, called the informational reciprocity
model, means that when the patient is being highly productive in the
amount of infbrmation being given, the therapist tends to use more
ambiguous leads which allow the patient to respond with a number of
alternative responses. When the patient is not being productive in

the amount of information being volunteered, the therapists tend to

16

increase their own input by using more highly specific remarks which
require specific responses from the clients. Siegman and Pope (1962)
replicated the Lennard and Bernstein study using twelve initial psychi-
atric interviews. They did find a positive correlation between the ther-
apist's ambiquity level in leads and subsequent patient productivity in
responses. There was no support for the hypothesis that high interviewee
productivity is followed by more ambiguous leads from the therapist. “
The question of whether or not twelve initial interviews can be compared
to a series of therapy sessions over time might be answered in part by
one of Lennard and Berstein's findings which postulated that the amount
of therapeutic talk is relatively stable from interview to interview.

The reciprocal interaction effect mentioned above has been cap-
italized on as a research strategy for the study of dyadic interaction
effects in experimental settings. Jones and Thibaut (1958) suggested
that reducing the interaction to an."asymmetrical contingency" allows
the standardization of the role behavior of one party while permitting
the other's behavior to vary freely. The studies cited below attempted
to control the interviewer role and then look at the consequences for
the interviewee.

A series of four integrated studies by Ashby, Ford, Guerney
and Guerney (1957) was one of the first attempts to specify therapist
behavior prior to client contact. Two "families" of verbal responses

were first identified. The reflective therapy family had leads such as

 

"restatement of content, reflection of feeling, nondirective leads, and

nondirective structuring responses." The leading therapy family empha-

 

sized "directive leads, interpretations, directive structuring, approv-

al, suggestions, advice, information-giving, and persuasion." Ten

17

therapists were trained to a criterion level of using approximately
two-thirds responses in the appropriate family for any one interview.
Six of the ten could demonstrate the criterion consistently with a total
of twenty-four clients seen over a period of several weeks. Differences
between the client's pretherapy characteristics, the client's verbal
behavior in the interview, the relationship between the therapist and
client, and the changes which occurred in the client were investigated
for each therapy family. No clear differences were found. There was
some support for the hypothesis that predicted that the client's pre-
therapy characteristics would influence how they reacted to each type
of therapy. Also, the individual therapists seemed to elicit differen-
tial effects from the clients independent of the type of therapy they
offered.

Baker (1960) used the same procedural format as Ashby E£.§l.
(1957) to look at the effects of a leading and a reflective therapy on
a client's "indiscriminate perceptions and on resistance to analyzing
problems." The only significant finding suggested that a leading therapy
might be more successful than a reflective therapy in helping the client
reduce "personal overgeneralizations." That is, the leading therapy
which used more direct questions elicited more direct answers that were
free of global personal descriptions.

Counseling researchers Pallone and Grande (1965) refined the
"family" of counselor leads to four, reflection, interrrogation, inter-
pretation and confrontation, and analyzed their effects on client
communication and the client's perception of interview rapport. Four
counselors were trained to reach a treatment criterion.where at least

70 percent of the interviewer leads occured in the appropriate mode.

18

Interviewers were assigned to present the treatment to actual clients.
Highschool clients, whose area of concern for counseling was pre-
determined to be a vocational, educational, social or personal problem,
participated in the audio-taped initial interviews. Following the
interview the clients completed the Anderson and Anderson Rapport Rat-
ing Scale (1962). The audio-tapes were rated by independently trained
judges to count the number of problem relevant statements the clients
made and to check on the maintenance of the treatment conditions by
the interviewers. The conclusions indicated that the inquiry style of
the counselor does differentially affect the kinds of things the client
talks about in the interview. 1) Interpretive leads fbstered.more
discussion of educational and vocational problems. 2) Reflective
leads were effective in eliciting talk about personal problems. 3)
Social problems were talked about no matter what the inquiry style,
although the interrogative style appeared to be the least effective.
Neither the types of interviewer lead nor the problem discussed seemed
to have significant effect on perceived rapport according to the
clients.

.All of the above research investigated therapeutic interactions
in a natural clinic setting. Siegman and Pope (1972) did a series of
experiments which set up the initial interview in the laboratory with
a.major objective of simply obtaining infbrmation from the interviewee.
They were interested in two sets of variables which influence the flow
of infbrmation between persons; communication variables and relation-
ship variables. TWo communication variables of interest were the
differences between ambiguous interviewer leads (general probes which

allow the client to respond with a number of alternative responses)

19

and specific interviewer leads (questions which demand a short yes, no-
or factual answer). Using a highly controlled interview situation
with fOur interviewer leads of an ambiguous nature and four that were
specific, they were able to demonstrate that ambiguous interviewer
remarks, in contrast to specific ones, were associated with more
productive interviewee responses. Productivity was measured by count-
ing the number of words per response. The authors feund that numbers
of words per response correlated highly (.96) with the number of clause
units per response and was an easier measure to make. Whether the
interview was started with a specific or with an ambiguous inquiry did
not affect the amount of interviewee productivity according to Siegman
and Pope. The latter finding is in contrast to that of Hawes (1974)
who said that order effect is significant for greater information
sharing. Siegman and P0pe also reported one study in which they demon-
strated that interviewer warmth (defined by the manner in which ques-
tions were asked and the mind set given to interviewees prior to the
encounter) did increase the verbal output of the interviewee.

Several researchers have tried to sort out the causes for
differences in client productivity and in the quality of the relation-
ship in the dyadic encounter. Natural settings do not allow for
control of situational and relationship variables, and experimental
settings have questionable application to real life interactions. There
is no evidence from either avenue of investigation that is conclusive
about the specific effects of certain interviewer leads on client verbal
behavior or rapport. The effects of interrogative leads have been
reported only by Siegman and Pope and they used a short eight inquiry

protocol which is quite dissimilar to a longer clinical interview.

20

The question still remains. What is the effect of an open or closed in-

quiry style on a client's verbal behavior and perception of rapport?

Occupational Status Effects in the Interview

 

Studies on status effects in the interview have usually defined
status as a difference in expertise between.members of the same profes-
sion. One report does describe a paper-pencil simulation with confiden-
tiality of data as one of the manipulated variables. Edelman and Snead
(1972) hypothesized that mental health professionals (a psychiatrist,

a psychologist, and a social worker) differ from personnel managers

in the extent of the confidential information they avowedly elicit

from interviewees. A tape-recorded message described the interaction

of the interview and the client then completed a questionnarie that
asked how much he or she would be willing to self-disclose in this
situation. There were no differences between the three mental health
workers, but clients were significantly hesitant to disclose confiden-
tial information to the personnel manager. The experiment may have been
confounded by the kinds of information the interviewer was inquiring
about in the interview. For example, female clients were reluctant to
disclose personal sexual information to the personnel manager. Mental
health workers seemed to have the right to certain personal infbrmation
about clients because of the nature of their roles on the job.

Several counseling studies have manipulated the "expert-ness"
of the counselor and examined the effects on client compliance with
treatment, perceptions of the counselor, and the amount of client

self-disclosure in the interview. Dell (1973) reported that the level

21

of expertise was not differentially effective in enducing subject com-
pliance with a treatment plan that would help them overcome procrastin-
ation. Guttman and Haase (1972) found that non-experts were perceived
as more helpful to college students discussing vocational plans; clients
from the expert group remembered more information at a later time; and
there were no differences between groups on ratings of counseling cli-
mate, counselor comfort or client satisfation using the Counseling
Evaluation Inventory (Linden, Shertzer 6 Stone, 1965). Brooks (1974)
looked at the effects of disclosing to a high or low status (expert)
counselor. The status was manipulated by introductory statements given
to the client and by the accoutrements of the interview setting. She
found that status dimensions did not have a direct effect on the amount
of self-disclosure. Interaction effects did show that high status males
got more disclosure from males and females. The status of the female
seemed to have no effect.

Differences between levels of expertise of medical students and
staff physicians on attitudinal and behavioral aspects of the physician-
patient relationship were studied by Davis (1968) as a part of a larger
study on patient compliance. Attitudinal data was obtained from a mail-
ed questionnaire. Tape recordings of actual patient interviews provided
the behavioral data for analysis. The purpose for this part of the
study was to characterize some physician role attributes that are spe-
cific to the relationship with the patient; to determine if physicians
and students express the same attitudes and exhibit behavior that is
consistent with these attitudes; and to trace the effects of these at-
titudes on the physician's own satisfaction and on the patient's adher-

ence to medical advice. Attitudinally, staff physicians and students

22

differed on the amount of concern necessary for the doctor—patient in-
teraction. Behaviorally they treated patients with the same difficulty
in interpersonal communication. They asked for information and the
patient gave it. The patient received little feedback in terms of ex-
planation, diagnosis, or evaluation. Thirty-eight percent of both stu-
dents' and physicians' patients failed to follow their doctor's advice.
Davis contended that with less rapport there was greater likelihood that
the patient would be non-compliant. Both students and staff physicians
demonstrated the need for additional training in interactional skills.
.All of the studies mentioned are rather tangential to the ques-
tion of whether or not a particular occupational status has any effect
on the data the patient is willing to disclose or the manner in which
the professional is perceived. Status effects that have not been studied
include the questions of whether certain kinds of information might be
disclosed more willingly to one kind of professional than another;
whether disclosure and compliance with recommended treatment plans may
be related to perceived status differences either within the same pro-
fession or across professions; whether social stereotypes exist concern-
ing the qualities of the counselor or the physician. This research will
look at the amount of self-disclosure and perceived differences in the
professionals' interpersonal qualities because of occupational status

differences manipulated in the simulated interview.

Sex Differences in the Interview

 

Surprisingly few reported experimental studies have investigated

systematically sex difference effects in the interview. What has

23

been done showsiiisparate results. Fuller (1963) assigned thirty-two
college clients to four male and four female counselors to discuss vo-
cational-educational problems in an initial interview. The intent was
to look for differences in the expressions of feelings. The interviews
were not taped so the analysis was done using data taken from.case
notes. Female clients generally expressed more feelings than males
according to these notes. In fact, more feelings were expressed in all
pairs with a female, either counselor or client, than were expressed in
all male dyads. No difference in the amount of feeling expressed was
due directly to the main effect of counselor sex. These results are
questionable because of the potential inaccuracy, completeness and in-
dividual biases within each counselor's case notes.

Brooks (1974), using forty male and forty female undergraduates,
assigned these clients to male or female counselors for an initial
counseling interview. She hypothesized that females would be more self-
disclosing than males. This was not supported. Pairs with females,
either as counselor or client, showed greater self-disclosure than all
male pairs and thus, partially substantiated Fuller's (1963) findings.

Thirty-seven black students participating in a special college
program were interviewed initially by both male and female counselors
in an investigation of the consequences of compatibility of race and
sex (Grantham, 1973). Client satisfaction and depth of self-exploration
were measured from taped interviews using Carkhuff's depth of self-ex-
ploration scale (1969). Generally, female counselors elicited more per-
sonally relevant material than their male counterparts.

IMcIlvaine (1972) looked at the differences between the way

coached and non-coached clients evaluated the effectiveness of the

 

defer.

(113111
Physic
ferenc
to be
0f tre
More f

ential

the Se:
result:
Ceptior

Q’dalitj

El'idehce
Of life,

24

counseling interaction. Counselor sex and the sex of the client were
independent variables in the design. There were no significant main
effects because of either manipulation. One interaction effect did show
that uncoached female clients were "extremely lenient" in their ratings
of the male counselors as compared to the rating patterns of other cli-
ent groups. The author indicated that this might be a spurious effect,
or, it might be an indication of an aculturated behavior of female
deference to males.

In a paper-pencil investigation of the sex effects between the
quality of care given to male and female patients by male and female
physicians, Singleton (1975) reported no statistically significant dif-
ferences but she noted trend distinctions. Male physicians seemed not
to be influenced by the gender of their patients in terms of the kind
of treatment they would give; female physicians treated male patients
more favorably; and both male and female medical students gave prefer-
ential treatment to patients of their own sex.

Not any of the above studies show definite conclusions regarding
the sex effect in the interview. Only the amount of self-disclosure that
results from various sex combinations has been addressed directly. Per-
ceptions about male and female professionals and the interpersonal

qualities they exhibit in the interview need to be tested.

Client Satisfaction and Disclosure in the Interview

 

Contentment with the relationship with a health professional is
evidenced by the patient changing some significant function or attitude

of life, returning for a second appointment, complying with.a.prescribed

25

treatment plan, paying the bill, trusting and liking the interviewer,
and disclosing personal data to the interviewer. Indices of operation-
ally defined measures of patient satisfaction include post-interview
ratings of such factors as interviewer's comfort and the interview cli-
mate (Linden, Shertzer 8 Stone, 1965), empathic understanding, congru-
ence and level of positive regard (Barrett-Lennard, 1962); third party
ratings of the quality and quantity of information disclosed by the in-
terviewee in response to specific interviewer leads (Hawes, 1974); self-
reports of the amount of data disclosed (Jourard, 1971); measures of
patient compliance to proposed treatment interventions (Davis, 1968).

Gladstein (1969), looking at client expectation, the counseling
experience itself and consequent satisfaction found that client expec-
tations were very diverse. Mbst of the time expectations were met. Even
those who received only some help were as satisfied as those who had all
expectations fulfilled. Fisher (1971) found that the same phenomenon was
operating in an out-patient clinic where patients had to wait long peri-
ods of time to see the physician and at some discomfort to themselves.
IMost of the patients viewed the overall care as favorable and rated the
clinic high on "interest in patients."

Jourard (1971) conducted the primary research on the concept of
self-disclosure. Some of his findings are of interest in this research:
female disclose more than males; females receive more disclosure than
males; there are large individual differences in self-disclosure scores
indicating that people differ widely in their willingness and readiness
to be known.

.All of Jourard's data is based on self-report information and

its application to dyadic interaction situations is open to question.

26

Truax and Carkhuff (1964, 1965) looked at self-disclosure in the inter-
personal interaction and found that the level of empathy, respect and
genuineness offered by the counselor is directly related to the depth
of self-exploration and constructive personality change evidenced by
the client. Shapiro, Krauss and Truax (1969) used a modified Barrett-
Lennard Relationship Inventory with undergraduates in psychology, men
applying for jobs as policemen, and patients in a day psychiatric hos-
pital. Subjects were asked to rate four of their closest friends on how
much was disclosed to them and how much disclosure was received from
them. Subjects reported engaging in more verbal than non-verbal self-
disclosure and more disclosure with positive than negative affective
tone. One of the conclusions was that similar interpersonal variables
between persons are effective in leading to more open and full relation-
ships in and out of therapy.

Heller (1972) stated that the context in which self-disclosure
occurs seems to be an important determinant of its appearance. "Within
the context of a private interview conducted in the name of science, a
college student readily accedessand needs no further prompting than.de-
tailed instructions concerning what is expected of him." So, too, may
be the case with any volunteer subject in any research project.

Using a controlled interview, Brooks (1974) looked at the inter-
action effects of sex and status on self-disclosure and found that fe-
males were not more self-disclosing than males, contrary to the findings
of Jourard (1971).

There are three aspects of self-disclosure which need to be
Ineasured according to Cozby (1973); the amount or breadth of the dis-

Closure, the intimacy or depth of the disclosure, and the length of

27

time taken in disclosing. Mbst measurements look only at one or the
other of these factors. The interviewee's perceptions and self-disclo-

sure have some precedent for use as measures of patient satisfaction.

Audio-Recording Effects in the Interview

 

When recording instruments are a part of the interview the pos-
sible effects on the interaction and outcomes becomes an area of concern.
Roberts and Renzaglia (1965) investigated the differences between the
presence and absence of recording instruments in the interview; There
were three experimental conditions: taperecorder present and very visi-
ble, only the microphone visible, and the entire machine hidden. Out-
comes showed that the clients made more favorable self-references when,
they knew they were being recorded and more unfavorable when they
thought they were not being recorded. Tanney and Gelso (1972) also found
that client's self-reports were affected by the recording. Non-recorded
clients reported that the interview was more stimulating.

Early research by Covner (1942) and Lamb and Mahl (1956) showed
that a sizeable portion of counselors and trainees, as well as psychia—
trists and residents, believed that recording affected their own behav-
ior and that of their clients. This was a subjective finding and may not
reflect actual interview behavior. Harper and Hudson (1952) indicated
that if clients really are affected by recordings it is hard to detect
unless tape reviewers are specificlly trained to such an awareness.
Covner (1942) compared the accuracy and completeness of written reports
to the actual audio-tape data. He found a 70 percent accuracy but only

a 30 percent completeness in the data on the written case notes.

28

Recent research reviewed by Gelso (1974) identified three vari-
ables which moderate the effects of recording in the interview: 1) the
problem of concern--clients discuss personal problems with less inhibi-
tion than educational or vocational concerns; 2) personality patterns-
Tanney and Gelso (1972) found that highly controlled, self-denying per-
sons with strong inferiority feelings are most inhibited in an inter-
view; and 3) sex of the interviewee-—female clients erpegr_to be more
inhibited according to Van Atta (1971). Other conclusions that Gelso
drew from his survey of the literature are that a client's consent to be
interviewed does not dissipate the effect of being recorded, and the
effects of recording do not seem to lessen upon repeated exposure to
being recorded. The latter conclusion was made from research that com-
pared only two consecutive sessions.

The effects of being recorded in an interview are inconclusive.
But, there are reported differences of various sorts for both interviewe
er and interviewee. The implications for the use of audio-recording
equipment in an.interview are that the outcomes will, most likely, be

affected and should be analyzed with an awareness of potential effects.

SEER

Studies of specific inquiry styles began with the analysis of
the interviewer's verbal behavior as heard on recordings of actual ther-
jpy and counseling interviews (Snyder, 1945; Hepke, 1964). Interviewer
leads were categorized and the client's responses were analyzed. The
:next step was to look at the effects of interviewer leads on patient be-

ihavior in the real setting and identify the patterns in the lead-response

intera
1962).
role b
ing at
1960;

View u
manipu.
tion at
with it
istic j

leads I

disc ipl
Vestiga
PTCfess
fects 0
Davis,

entes,

sionall
task Te

29

interactions (Bergman, 1951; Lennard G Bernstein, 1960; Siegman 8 Pope,
1962). These patterns were experimentally tested by standardizing the
role behaviors of the interviewer in the therapy interaction and look-
ing at the consequences for the interviewer (Ashby et al, 1957; Baker,
1960; Pallone G Grande, 1965). The initial,information-gathering inter-
view using interrogative leads was studied in a series of laboratory
nanipulations by Siegman and Pope (1972). They investigated communica—
tion and relationship variables using a standardized interviewer role
with four specific and four ambiguous interviewer leads. Mbre natural-
istic initial interviews which compare the effects of such interrogative
leads have not been reported.

Occupational status effects on interview outcomes using across-
discipline professionals as interviewers have, generally, not been in-
vestigated (Edelman 6 Snead, 1972). Level of expertise within the same
profession has been studied and the outcomes show some differential ef-
fects on the interview (Dell, 1973; Guttman 8 Haase, 1972; Brooks, 1974;
Davis, 1968). If within the same profession there are reported differ-
ences, then, across professions which each have culturally and profes-
sionally established norms and role behaviors but, sometimes, similar
task responsibilities (i.e. history-taking) there will be differences
which warrant investigation.

Research into the effects of the sex of the interviewer or of
the interviewee on interview outcomes showed interaction effects such
as; pairs with females as either counselor or client seemed to disclose
:more (Fuller, 1963; Brook, 1974), female counselors, generally, elicited
:more personally relevant material than male counselors (Grantham, 1973),

female clients were more lenient in their ratings of male counselors

30

(McIlvaine, 1972), and female physicians treated male patients more
favorably (Singleton, 1975). Though all of these studies indicate some
differences because of sex, not any of them were able to show a main
effect of significance. The client's perceptions of the male and female
as a warm and caring professional have not been reported.

Satisfaction with the professional relationship has been.mea-
sured with four basic indices: attitude measures (Gladstein, 1969;
Fisher, 1971; ware 8 Snyder, 1975); compliance with treatment programs
(Davis, 1968); ratings of interviewer performance (Linden, Shertzer 6
Stone, 1965; Barrett-Lennard, 1962; Shapiro, Krauss G Truax, 1969); and
the amount of client self-disclosure (Jourard, 1971; Truax G Carkhuff,
1964, 1965; Hawes, 1974; Brooks, 1974). When used in combination, these
measures seem to validly illuminate some aspects of client satisfaction
with the professional-client interaction.

The use of audio-recording equipment during an interview did
have an effect on the client and the professional, at least in their
stated attitudes. The measurable effect on the actual interaction was
difficult to determine.

.All of the variables considered in this review (inquiry style,
occupational status, sex effects in the interview) need further inves-
tigation. In this research the interrogative, initial interview will be
conducted by male and female health professionals, counselor and physi-
cian, with male and female clients. Two satisfaction indices (ratings
of interviewer performance and client self-disclosure) will be used. The
interviews will be recorded so that accurate and complete data will be
available even though this recording might prompt the client to alter

the data.

Open, cli
male com
terview.
tion: thf

Wthea

E
TERI com
fessional
tiOn Conn
fOUI‘th YE
{Appendix
dues as ‘I
able fOr 1
imbursed
Rehabilita

Thrk as in

CHAPTER III

DESCRIPTION OF METHODOLOGY AND DESIGN

The primary purpose of this research was to test the effects of
open, closed, and mixed inquiry modes as they were used by male and fe-
male counselors and physicians in an initial, information-gathering in-
terview. The dependent measures were two dimensions of patient satisfac-
tion: the patient's perceptions of the interviewer as a caring person,

and the amount of self-disclosure by the patient in the interview.

Selection and Training of Research Associates

Research Associates, who would be trained to deliver the treat-
ment conditions, were recruited from two populations of new health pro-
fessionals at Michigan State University; 27 master's level Rehabilita-
tion Counselors in their last quarter of clinical internship, and 30
fourth year medical students in the last term of clinical experience
(Appendix A). Each group had specific training in interviewing proce-
dures as a part of their academic programs. They were asked to be avail-
able for ten hours on each of three consecutive weekends and would be re-
imbursed at the rate of three dollars per hour. Two male and two female
Rehabilitation Counselors and no medical students were contracted to
work as interviewers. Consequently, the decision was made to simulate
the occupational roles using title changes, planned differences in

31

32

attire (suit or white lab coat) and instructions to the interviewee
about the professional who would be conducting the interview.

Preliminary to the training, each Associate was asked to con-
duct a twenty minute interview with a volunteer interviewee so that
a baseline measure of the interviewer's natural inquiry style could be
obtained. The directions for this interview were similar to those
used during the actual treatment phase. This provided an opportunity
to pilot test procedures and instruments.

Training sessions were scheduled two days prior to each treat-
ment presentation. The general procedure was; 1) to discuss the con-
cepts being trained, 2) to practice identifying specific inquiries
using printed transcriptscfi?actual interviews, 3) to listen to an
audio-tape demonstrating an inquiry style and discuss, 4) to practice
the inquiry mode in an interview(s) until the trainer or assistant
determined that the criterion level was met (see Appendix B for Train-
ing Procedures). All interviewers were able to reach criterion in a
maximum of three practice interview attempts per treatment mode.
Training aimed to have each interviewer demonstrate the minimum.cri-
terion level of at least 80 percent open inquiries for the Open Treat-
:ment MOde, at least 80 percent closed inquiries for the Closed Treat-
rnent Mode, and a combination of at least 40 percent Open inquiries
and 40 percent closed inquiries for the Mixed Treatment Mbde (see
Appendix C for sample Open and Closed Inquiries). The total number
of inquiries used during the twenty minute interview varied depending
on the flow of the individual interview. Periodic checks during the
course of each treatment indicated that the criterion levels were

inaintained by each interviewer.

Pogilatic
1

class mai
area. A i
marital c
represen‘

a health

Sallie

I
Variety (
Science T
the T686;
Participg
did no, 5
able to 1
C811 couj

JeCts Cor

I
of 17 to
92 PeTCen
Seven per
Dated, a1
Tears of I

training.

33

Selection of Subjects

 

Population

 

The population of interest in this study was the average middle-
class male and female adult of a moderately large (150,000) metropolitan
area. A wide range of social, educational, occupational, economic and
marital characteristics was preferred. It was assumed that this would
represent a typical group who would regularly employ the services of

a health professional.

Sample

The local Community College seemed the best source for such a
variety of persons. With the permission of the chairman of the Social
Science Department and the cooperation of several professors who allowed
the researcher to visit their classes, 212 subjects initially agreed to
participate (Appendix D). Approximately one third of those recruited
did not show up for their interview appointments. Enough of these were
able to be rescheduled so that the count of at least three subjects per
cell could be maintained. Seventy-two male and seventy-two female sub-
jects comprised the final sample.

Demographic characteristics for the sample showed an age range
of 17 to 60 years with.most persons in the mid-twenties. The majority,
92 percent, were Caucasian and 8 percent were Black or Mexican. Twenty-
seven percent of the subjects were married, 10 percent divorced or sep-
arated, and 63 percent were single. The range in education was three
'years of highschool to graduate training or several years of vocational

training. Occupations varied from the unskilled to the professional.

34

Income levels included subjects who lived with.parents and those who
gross over 25,000 per year. Half of the subjects had no previous contact
with a counselor. One third had never seen a physician on a one-to-one
interview basis. All demographic characteristics of the sample are
detailed in Appendix E.

All of the volunteer subjects expressed a desire to have feed-
back on the experimental outcomes. This was a cooperative group of per-
sons who were willing to give up one hour of a weekend to visit a
strange campus to take part in the research of a person they did not
know. About one third of the subjects were given a small portion of

course credit for participating.

Generalizability of the Sample

 

This sample of persons had minimal contact with a physician over
the last three years and even less contact with a counselor. They may,
therefore, be typical of the general population of persons who never go
to see such.health.professionals unless there is a crisis in their pri-
'vate lives. The results of this study might be generalized to any group
of persons with similar demographic characteristics. HOwever, the exper—
imental conditions were such that this kind of one time contact with a
ihealth.professional may never happen outside of a laboratory. Though,
in.some clinics, one professional collects the intake personal history
and then transfers the patient to another professional for further tests

and treatment.

35

DependentiMeasures

 

Three instruments were used to gather the dependent data: the

Counseling Evaluation Inventory, the Barrett-Lennard Relationship Inven-

 

 

tory, and the Interviewee Productivitereasure. The two inventories were

 

completed by the interviewee immediately following the interview with
the counselor or physician. The productivity measure was taken by

trained tape reviewers who listened to audio-tapes of each interview.

The Counseling Evaluation Inventory

 

Linden, Shertzer and Stone (1965) developed the Counseling
Evaluation Inventory (CEI) as a refinement and modification of the fifty
item Interview Rating Scale of Anderson and Anderson (1962). Several
hundred highschool students rated their master's level counselor train-
ees on the GET following the termination of a counseling relationship.
This initial data was factor analyzed and three factors with a total of
twenty-one significant items emerged. The Counseling Climate subscale
‘with nine items, the Counselor Comfort subscale with five items, and the
Client Satisfaction subscale with seven items make up the shortened
version of the CEI.

Each of the items was rated by the client on a five point Likert
scale. The authors used a weighted factor scoring formula to obtain sub-
scale and total scale scores. Gabbert (1965) further investigated this
scoring system and suggested that scores based on the factor method typ-
ically assume a curvilinear form and may measure strength of attitude
toward a counseling situation rather than direction of attitude. The

ILikert formula appears to measure direction of attitude according

36

to Gabbert. Strength of attitude was the more important consideration
in this research so the factor scoring system of weighted values was
used.

Test-retest reliability checks were done on both the prelimin-
ary sixty-eight item form and the twenty-one item short form at both
fourteen day and one hundred day intervals. The median reliability
coefficient reported for all of the subscale scores and for the total
score was .72. Discriminative validity significant at or beyond the
.05 level was demonstrated using the counselor trainee -praticum grades
as a provisional criterion. Haase and Miller (1968) indicated that item
content and client comments suggested a high degree of face validity.

The Counseling Evaluation Inventory has been used as a depen-
dent measure with highschool and college level clients. Haase and
Miller (1968) showed that in the college setting a more general inter-
pretation was appropriate rather than strict adherence to the factored
subscale meanings. McIlvaine (1972) reported a difference between
the manner in which coached or non-coached clients rate counselors on
the CEI. Coached clients tend to rate counselors more nearly like the
training supervisors rate them than non-coached clients do. When used
'to demonstrate differences between recorded and non-recorded counseling
:sessions (Tanney 8 Gelso, 1972) the scores on the CEI were not discrimr
:inating.

For this research the clients were non-coached, college level

Persons who were interviewed in a recorded session. All of the factor

scores and the total score were analyzed.

37

The Barrett-Lennard Relationship Inventory

 

Barrett-Lennard (1962) built the Relationship Inventory (BLRI)
around Rogers' formulations (1957) regarding the ”necessary and suffie
cient conditions" for the therapy process; unconditional positive re-
gard, empathic understanding, and the congruence or genuineness of the
therapist. The client's experience of the therapist's response was con-
sidered to be the primary locus of therapeutic influence in the rela-
tionship according to Barrett-Lennard. Thus, his inventory is a series
of statements on which the therapist is rated by the client. Five speci-
fic concepts provide the content focus for the original 92 item instru-

ment: 1) Empathic understanding is defined as "the extent to which

 

one person is conscious of the immediate awareness of another;"

2) Level of regard refers to "the affective aspect of one person's re-

 

sponse to another," 3) Unconditionality of regard is "specifically con-

 

cerned with how little or how much variability there is in one person's

affective response to another;" 4) Congruence is the degree of inte-

 

gration or absence of inconsistencies between a person's "total experi-

ence, conscious awareness and over-communication;" 5) Willingness to

 

be known is the factor which shows the degree "to which one person is
willing to be known as a person, by another, according to the other's
desire for this." The sixteen items of the latter scale were not used
fer this research study because the interviewer was trained to use only
inquiry leads during the interaction with the patient, therefore, there
was no self-disclosure on the part of the interviewer.

The questionnaire format used on the BLRI instructs the rater
to indicate whether an item is correct or incorrect according to the

individual's perception and, then, assign a weight to the feeling.

38

There are three degress of "yes" identified as +1, +2, +3 and three
degrees of "no" weighted as -l, -2, -3. Items are grouped so that every
fifth item represents another concept. A specific scoring technique
yields "a possible scoring range of -3n to +3n, where n is the number
of items used for the particular variable."

Five expert judges classified each of the Inventory items as
either positive or negative indicators of the concept in question. Also,
several drafts of the items and discussion and written comments from
experts familiar with the Rogerian theory validated the accuracy of
the content. Other types of validity were not directly reported. The
internal consistency of the five scales of the Inventory was assessed
using the Spearman-Brown formula for split-half reliability. The co-
efficients were reported to range from .82 to .93 for the client form
of the instrument. A separate test-retest reliability check was done with
thirty-six students who were asked to rate a long-term relationship out-
side of a therapy setting. The test-retest correlation data was; level
of regard .84, empathic understanding .89, congruence - .86, and
unconditionality of regard .90. Intercorrelations between subscales
suggested that each scale measured an independent variable. uncondition-
ality of regard seemed to be the most independent measure of the five.
'The congruence and empathic understanding measures, "though theoreti-
cally and operationally separate and distinct, are, in this instance,
empirically indistinguishable." Other factor studies by Mills and
Zytowski (1967) and walker and Little (1969) disputed Barrett-Lennard's
claim that each.subscale is an independent measure. Mills and Zytowski
‘reported a general component which accounts for two-thirds of the total

'variance in their analysis. walker and Little obtained only three

39

factors which they interpreted as "nonevaluative acceptance, psycholo-
gical insight, and likeability."

For this research each of the subscales was analyzed as if it
was an independent measure. The Willingness to be Known scale was not

used .

Interviewee Productivity Measure

 

The Interviewee Productivity Measure (IPM) , a measure of the
amount of personal data a patient discloses during the interview, was
designed specifically for this research. Cozby (1973) suggested that
breadth or amount of data was one of the three basic parameters of self-
disclosure.

The four interviewers were trained to use a specific inquiry
mode to ask about twelve aspects of the patient's life. Each of the
twenty minute interviews was audio-taped. Three masters level counselor
trainees, naive to the research, were then trained to review the tapes
and tally the discriminate bits of information that had been volunteered
by the interviewees. An "information bit" was defined as a noun phrase
which gave new information to the interviewer (See Appendix F for the
Training Program for Tape Reviewers, the IPM Form, and the Reliability
calculations). Inter-reviewer reliability was calculated using an anal-

ysis of variance formula suggested by Ebels (1951). The reliability

range was '. 69 to .92. The calculations were made during the training
sessions and three tines during the actual review of the experimental
tapes. Each reviewer had approximately fifty audio-tapes assigned in a
randon fashion.

The Interviewee Productivity Measure dealt only with the quanti-

ty of information provided by the interviewee and not with the quality

40

of information or appropriateness of the response. Affective and factual
data were tallied together. Only the total IPM score was analyzed.

The tape reviewers were also trained to recognize and tally the
interviewer inquiry as either open or closed. This was done as a check

on the maintenance of the criterion in each of the treatment procedures.

Treatment Procedures

 

The procedures, including pre- and post-treatment activities,

are presented in chronological order.

Phase I - Pre-Treatment

 

During this period the four Research Associates were hired and
trained to deliver the experimental treatments. The specific interview
procedures were pilot tested. Research subjects were recruited and ran-
domly assigned to a treatment condition. One week prior to the scheduled
interview each subject was phoned to confirm the appointment time. An

appointment reminder and a campus map were then mailed (Appendix G).

Phase II - Treatment

 

On the day of the interview the subject was met at the entrance
of the building and directed to the clinic area. A second receptionist
checked the name and handed the subject a description of the interview
situation and a release form which authorized the audio-taping of the
interview and the use of the tape for research purposes (Appendix H).

Each sheet had the interviewee's assigned code number at the top. This

 

 

 

 

 

corresp

terview

in a C01
to crea‘
sisted <
faced an
Hdipaed
plant 01
inten'ie
On the d
gin When
Depend'm
the offi

the inte

tiOHnair

viewee t
the inte
Viewer p
appropri
the inte;
resmnsil

a chance

41

corresponded to the coded audio-tape and the instrwnent packet the in-

terviewee would complete after the interview.

The setting. Since interviews were conducted on the weekend

 

in a counseling center that was otherwise unoccupied, it was possible
to create a setting similar to a general clinic. The clinic space con-
sisted of a large reception room and several small offices. Those which
faced an outer corridor were used as the interviewing offices. Each was
equipped with a desk,two straight-back chairs, a lounge chair and a
plant or two. The positioning of all furniture was standardized and the
interviewee was always seated so the one-way window was to the back.
On the desk each interviewer had a tape-recorder which was ready to be-
gin when the receptionist knocked on the door bringing a new patient.
Depending on the occupational role which was being simulated, a sign on
the office door named the interviewer (i.e. Tony S...,IM.A., Counselor;
or Tony 8..., MgD., Physician).

Six inner offices were used as individual testing rooms where
the interviewee completed the CEI, the BLRI and the demographic ques-

tionnaire following the interview.

The interview. At the right tine the receptionist took the inter-

 

viewee to the office, knocked on the door and introduced the subject to
the interviewer. Since the tape-recorder was already running, the inter-
‘viewer proceded to structure the situation (repeating the name with the
.appropriate title, occupation, place of work, the general purpose of
the interview, a statement about time limits, confidentiality and the
responsibilities of each participant of the dyad, and giving the subject

a chance to ask any initial questions). After this short introduction,

42

the interviewer, using the prescribed inquiry protocol, began seeking
information about the interviewee's personal-social and medical history
(Appendix 1). Each interviewer followed an individual pace in.proceeding
through the content areas. The important directive was that the twenty
minute interview should cover the content areas in the listed order and
should use the assigned inquiry mode for that interview.

During the course of the interview the researcher monitored the
non-verbal behaviors of the interviewers through the one-way windows of
each office. This was done so that differences between interviewers
could be kept at a minimum (See Appendix B for the behaviors that were
standardized across interviewers).

When the audio cassettes (twenty minutes in length) clicked off
the interviewer was instructed to terminate the interview, give the in:
terviewee the instrument packet, and send the subject back to the gener-
al reception area. The interviewee was then shown to a private testing
room and instructed, by the receptionist and by a cautionary note, to
complete the instruments "a§_if_your relationship with this counselor
or physician is going to continue across time. Be as honest as possible.

The interviewer will not see your individual response." The latter

 

statement was added in an attempt to counter any guilt feelings a sub-

ject might have for rating a particular interviewer toward the negative

end of the scale.

Occupation simulation. Status was simulated using changes

 

(If attire and different titles. The counselor wore professional business
clothes and the physician wore a white lab coat. Title distinctions were
introduced: 1) on the interview description sheet given to the subject

prior to meeting the professional; 2) on the interview office door;

their
change

ital r

The f0
merits .
tervie

Table

Using
the ,.

tebirie

43

3) by the receptionist as she introduced the patient; and 4) by the
interviewer who repeated the name with title, job and place of work at
the beginning of the interview. As counselors, the interviewers used
their real life personal descriptors. As physicians, the family name was
changed, the title "Doctor" was added, and the job became that of a med-

ical resident with the Michigan State University Medical School.

me. Interviews were scheduled over four consecutive weekends.
The fourth Saturday and Sunday were used to reschedule missed appoint-
ments. The particular sequence of inquiry modes followed by any one in-
terviewer was determined randomly to counteract possible order effects.

Table 3.1 shows the treatment sequence for each interviewer.

Table 3 . 1

Sequence of Inquiry Modes for Each Interviewer

 

 

 

 

Interviewer
WEEK
#1 (male) #2 (male) #3 (female) #4 (female)
1 OPEN MIXED OPEN CLOSED
2 CLOSED OPEN CLOSED MIXED
3 MIXED CLOSED MIXED OPEN
4 VARIED VARIED VARIED VARIED

 

 

Each interview itself was twenty minutes in length and timed by
using tape cassettes of twenty minutes per side. The interviewer began
the tape as the receptionist knocked on the door and terminated the in—

terview after the cassette clicked off.

situati

minutes

any one

plannet

Phase 1

Hate St

attordi

0f the

44

The amount of time that each subject spent in the treatment
situation varied from 60 to 90 minutes for the interview and 30 to 45
minutes for completion of the pest-interview instruments.

As many as eight twenty minute interviews were scheduled for
any one interviewer per day. Ample time between subject contacts was

planned to assure that interviewers Would not be fatigued.

Phase III - Post-Treatment

 

Following the conclusion of the series of interviews three grad-
uate students in counseling were trained to review each audio-tape
according to the Interviewee Productivity Measure.

After analysis the outcomes of this research were mailed to all

of the persons who participated.

Desigp

A post-test only control group model was the design for this
3 x 2 x 2 x 2 x 2 study with a total of 48 cells and three subjects per
cell (Table 3.2). Subjects, 72 male and 72 female, were randomly
assigned to a treatment mode to be interviewed by one of four inter-
viewers, two male and two female, over the course of four weeks. The
same four interviewers presented all of the treatment conditions accord-
ing to a predetermined random order. The Mixed Inquiry Mode was estab-
lished as the control treatment. This was based on an examination of
sample interviews taken from a pool of existing interviews conducted by
medical students, practicum counseling students and practicing health

professionals. This analysis showed that in interViews with patients,

5
4

whozmw>wouefi snow and ow women we...Ha

 

 

 

 

 

 

 

 

 

 

 

. . . u 4. Ta
Baum . u . . . . u . . . . u . . . . u . . . . u . . . . u . .

. _ _ . . .
. — . . . .

. . u . . . . u . . . . u . . . . u . . . . n . . . . u . . mg
_ . . . _ .
. . _ . . .

. . u . . . . u . . . . u . . . . u . . . . u . . . . u . Sam
_ . _ . . _
_ m . . _ .

wmmm . u . . . . u . . l . . u . . . . u . . . . u . . . . n . .

_ . _ _ . . .
. . m . . . .

. . m . . . . m . . a . . m . . . . m . . . . m . . . . m . . ma<2mm
. . . _ _ .

. . u . . . . u . . . . u . . . . u . . . . n . . . . u . mam
. . . _ . .
.1. L Li h .i i

«a new me Le as new Na new «a new me He as new Na Ha ea mam me at as new we Ha_ maomemem
. . l . _ . _

mamaow" mama mamamm” mama mamammM mama mamammm mama onEomm mama meEomm wane
. . . _ . .
. . . _ a . .
0 V J 0 V a .T V «P

moqmmzsou z<Honwmm l moammZDou z<Honwmm mOAMmzaoo z<HUHmwmm
_ I
owe: zufiavcH emxaz m wee: huwovcH eomoao H oeoz hufisvaH ammo

 

mZOHHHDZOU Hzm29<mmH

 

 

 

mowumflpouomumsu :mwmoa mo enmeesm

N.m oHDMB

46

the professionals used approximately half open and half closed inquiries.
Differences between subjects wre identified by analyzing three

dependent measures: the Counseling Evaluation Inventory, the Barrett-

Lennard Relationship Inventory, and the Interviewee Productivity

Measure.

Hypotheses

 

The basic research questions of this study were broadly stated
in Chapter I. Below is a more specific presentation of each experimen-

tal hypothesis.

Hypothesis One. There are no differences in the subjects' mean
scores on the Counseling Evaluation Inventory. the Barrett-
Lennard Relationship Inventory, or the Interviewee Productivity
Measure across the three treatments--the OPEN INQUIRY MODE, the
CLOSED INQUIRY MODE, or the MIXED INQUIRY MODE.

 

Alternate Hypothesis One. The subjects' mean scores on the
Barrett-Lennard will be higher for the Open Inquiry Mode than
for either the Closed Inquiry Mode or the Mixed Inquiry Mode.

 

Hypothesis Two. There are no differences in the subjects' mean
scores on the Counseling Evaluation Inventory, the Barrett-
Lennard Relationship Inventory, or the Interviewee Productivity
Measure across the two occupational categories-~COUNSELOR or
PHYSICIAN.

 

Hypothesis Three. There are no differences in the subjects'
mean scores on the Counseling Evaluation Inventory, the Barrett-
Lennard Relationship Inventory, or the Interviewee Productivity
iMeasure given either a MALE or a FEMALE INTERVIEWER.

 

Hypothesis Four. There are no differences between MALE SUBJECTS
or FEMALE SUBJECTS on the mean scores of the Counseling Evalua-
tion Inventory, the Barrett-Lennard Relationship Inventory, or
the Interviewee Productivity Measure.

 

pation
rariat
Relati
statis
I for be
variat
is lih
possibi
ficant
I Severaj
likely

null h)

multire
homoget
diStrn
Equal r
the1t ti
the 355

for ‘11 \

47

Statistics Used

 

This study has four independent variables (inquiry mode, occu-
pational status, interviewer sex, interviewee sex) and three dependent
variables (the Counseling Evaluation Inventory, the BarretteLennard
Relationship Inventory, and the Interviewee Productivity Measure). The
statistic of choice was the multivariate F, a ratio of the mean squares
for between groups to the mean squares for the within groups. The Mllti-
variate Analysis of variance procedure (MANOVA) was chosen because it
is likely to be more powerful than a univariate analysis since it is
possible to obtain significant multivariate differences without signi-
ficant univariate effects. The MANOVA analyzes relationships among
several dependent measures simultaneously. In addition, MANOVA is less
likely than ANOVA to occasion Type I error, or false rejection of the
null hypothesis (Hummel G Sligo, 1971).

The assumptions of MANOVA are: 1) the dependent variables are
multivariate normally distributed, 2) the dependent variables have
homogeneous variances, and 3) the errors of measurement are normally
distributed across the treatment population (Cooley G Lohnes, 1971).
Equal numbers of observations in each design cell were maintained so
that the test of hypotheses would be robust to possible violations of
the assumptions. There were no indications that the assumptions required
for MANOVA were not met.

The data was analyzed using the Univariate and.Multivariate
Analysis of variance, Covariance and Regression computer program of
Finn (1968) modified and adapted for use on the CDC 6500 by Scheifley
and Schmidt (1973). Tests of hypotheses done using the Finn are univar-

iate and step-down (using assigned weights) multiple correlation

 

 

analysi
bles an

and deg:

compute

ije I
non-dir
has det

each de}
for eac]
hithout
Set of E
iables I
I“5 of 1
“as .03
wbscah

'05/4 01

48

analysis to determine the relationship between the independent varia-
bles and the individual dependent measures. The order of independent

and dependent variables was determined by the researcher prior to the
computer run.

The MANOVA outcomes were evaluated with the probability of a
Type I error for hypothesis testing set at .05 (p .05). MANOVA is a
non-directional test, therefore, directionality of significant effects
was determined by using a post hoc examination of significant variable
mean scores.

Univariate analyses of variance were calculated separately for
each dependent measure by the Finn program. By using a controlled alpha
for each set of univariate analysis, these F's could be investigated
'without increasing the risk of a Type I error. The alpha level for each
set of analysis was determined by dividing the .05 by the number of var-
iables being tested in each set. Thus, when examining the univariate
F's of the CEI, the BLRI and the IPM tested together, the alpha level
was .05/3 or .017. When considering the univariate F's for the four
subscales of the BLRI, the alpha level for the test of significance was
.05/4 or .0125.

MED:

Seventy-two female and seventy-two male Community College stu-
cients were randomly assigned to the forty-eight cells of the experimen-
‘tal.conditions involving four independent variables (inquiry style,
‘the occupational status of the interviewer, the sex of the interviewer

and the sex of the interviewee).

to do an
physiciai
(Open, c1

I
e was as
Inventor}
Viewee se
tape revi

h‘

analyzed 1

49

Two female and two male master's level counselors were trained
to do an information-gathering interview as either a counselor or a
physician. Each interview was done using one of three inquiry modes
(open, closed, or mixed).

After the twenty minute tape recorded interview, the interview-
ee was asked to rate the interaction on the Barrett-Lennard Relationship
Inventory and the Counseling Evaluation Inventory. The amount of inter-
viewee self-disclosure was determined from the tapes by three trained
tape reviewers usitg the Interviewee Productivity Measure.

With three dependent measures for each subject, the data was

analyzed using the Multivariate Analysis of Variance.

variate
sented 1
closed,
Cilmselo

View».

CHAPTER IV
PRESENTATION OF RESULTS

The analyses of four main effects hypotheses, using the multi-
variate analysis of variance program developed by Finn (1967), are pre-
sented in this chapter. These hypotheses test the effects of open,
closed, and mixed inquiry modes as they are used by male and female
counselors and physicians in an initial, information-gathering inter-
view.

The first section in this chapter introduces the means, stan-
dard deviations and the results of the interaction tests. Section two
reports the multivariate statistics for each of the main effects hypoth-
eses. The following combinations of means scores were each tested;

1) the total scale means of the three measures--the CEI, BLRI, and IPM,
2) the three subscale means of the CEI--Client Satisfaction, Interview
Climate, and Counselor Comfort, and 3) the four subscales of the BLRI--
Unconditionality of Regard, Level of Regard, Empathic Understanding,
and Congruence.

Tables of pooled means are given for each hypothesis tested so
that directional trends can be seen. When univariate F's are significant
they also are tabled near the hypothesis test data. Additional Univariate
tables can be found in Appendix J. The chapter ends with a summary state-

ment regarding the outcomes of each hypothesis test.

50

51

PreliminaryrData

 

Table 4.1 identifies the scoring range for each of the depen-
dent measures and their subscales. It also lists the range of mean
scores for this group of research subjects. Cell mean scores and stan-
dard deviations for the three treatment groups are shown in Table 4.2.

Each moan and standard deviation was calculated for a cell size of

three subjects.

Table 4.1

Scoring Ranges for the Dependent Measures

 

 

Dependent Standardized Mean
Measures Score Ranges+ Scores Range

 

Barrett-Lennard

Relationship

Inventory (TOTAL) -207 to +207 18.67 to 167.00
Unconditional Regard - 54 to + 54 -5.33 to 41.00
Level of Regard - 54 to + 54 12.00 to 45.00
Empathic Understanding - 48 to + 48 2.33 to 35.33
Congruence - 51 to + 51 9.67 to 45.67

Counseling

Evaluation

Inventory (TOTAL) 0 to 44 21.00 to 41.00
Client Satisfaction 0 to 14 4.67 to 11.00
Counseling Climate 0 to 18 10.67 to 18.00
Counselor Comfort 0 to 12 3.67 to 12.00

Interviewee

Productivity

.Measure 0 to ---- 204.00 to 380.33

 

+determined by the authors of the instruments

52

3823.1. m do 022/, :8 _

 

.6» 83338 f coCE>oc Ewe—Sum.

e5... 5.62 58+

 

 

 

 

 

 

 

 

 

 

 

 

II . W .I in. . . u
m m . m
ms.u oo.av~n mm.ooH no.ha~ mm.vo ao.a~m m eu.m~ oo.em~ Hm.me nm.~vm H ~m.a~ no.vm~ Ho.om so.m- m mo.~m no.oe~
oo.nH oo.eo~u cm.mMfi nn.~m~ um.aa nn.~m~ ” oo.~m nm.oo~ mo.mm mm.~h~ “ Hm.HH~ mm.vom H~.nv nn.mv~ H om.un mm.oon
m m m m l
n u n n .
Hm.n so.» m oo.m mm.m um.m he.» m Hm.m no.” mo.~ oo.o~ m Hm.e no.“ ao.m so.m m mm.u mm.o
mo.~ oo.m " ov.m oo.o~ an.m so.m " mu.m mm.o na.o so.o “ ma.m No.5 vo.¢ no.a H so.m oo.m
84 8.: ” mmé 3.3 3.4 8.3 H mm; 3.: 24 8.3 n $4 3.3 8.». 2.2 n 34 2.3
nm.~ so.oa " Hm.~ nn.m~ mo.~ oo.n~ " oc.H oo.- oo.~ oo.mH " ~m.~ so.mu ah.n he.~H n Hm.m mm.e~
34 nmg " mo.~ 86 8.». 3.0 “ mo.~ 8.0 8.~ SK “ SA 8;. cod 36 u 84 cod
~m.~ nm.m " om.v .oo.a ea.” nm.m “ oo.n oo.s ms.v so.a " Hm.~ mn.h oo.e oo.m " o~.v No.5
oo.~ oo.mn " oo.o oo.¢m No.m mm.m~ " H~.A oo.m~ ma.v so.mm " an.a nn.om ma.oa no.o~ “ oo.m so.v~
mm.« oo.HN " va.m mm.vm Hm.h oo.a~ " mm.m nn.m~ No.~H mn.o~ " mn.m so.wN No.H~ mn.a~ " BA.NH oo.om
No.» nm.a~ m H~.vu oo.a~ e~.m mo.a~ m o«.n oo.m~ No.v mm.~m m mm.a oo.Hm Nv.N~ no.~u " HN.A oo.wH
am.oH oo.o~ " Hm.o ao.- om.e~ oo.- " v~.uH oo.oH oa.~u oo.m~ " mm.om mm.m~ NA.mH oo.a~ “ Nm.nH ao.mu
-.n nm.v~ " mm. nm.o~ om.a~ he.v_ " mn.~ oo.m~ on.HH oo.m~ " um.e so.o~ m~.a ao.a “ ma.m mm.~
m~.m oc.a~ " ~o.m nm.- so.o~ no.0u m mm.mu oo.e ~e.- so.uu " om.m Ac.ma mm.m~ nm.- N eo.m~ no.»
mo.~ oc.mm n ma.¢ mm.om om.e oo.m~ " as.w mm.am ao.a mn.om " o~.e mm.mm «o.m Ac.h~ " me.o mn.HN
c~.mH oc.m~ m om.o oo.~m mu.m~ 50.0N m m~.o oo._~ LH.o mm.m~ " om.aH no.mm oo.a~ co.Nm " mm.nN oo.m~
an.uu no.a~ " m~.m no.m~ Na.m~ oo.m u mm.a mm.eu AA.A so.su " N4.~H so.o~ mm.- nn.v " co.” oo.m-
mc.H~ mn.o~ m ma.¢~ oo.m~ mo.m~ oo.m m Hm.mH so.vu hm.ofi mm.m “ mu.eu so.» mo.s~ nm.- N om.- nn.w
o~.mm no.mh " mm.HN no.~N~ ou.~v mm.aa " Ho.au so.mo m~.Hm mm.~oH " mm.- no.0HH om.ov mm.¢m " mHHHN “Oman
o~.mm so.ma ” om.Hm oc.eoH 1 Am.oo mm.ma ” ~m.mv so.mm L m~.Hv mm.mo ” Hm.- mm.aw . No.sa 50.nm a ON so so mm
on .x m cm .u mm .x m cm .x cm x m mm M nm .N m cm .x
a. w m. N. m a. a. n m. N. m H.
meagmu mu<z m4<zmu mu<z
83958 5:. 3 93;
m8: >885 280

333:
n 3232695
2 oozofltoucu

988:8 83238
3958 ED. 3958
:ofiuumwmfimm 2826

34.85 boucosfi
cos. E3 96
wfi. Homcsou

Zu- zu. zu. zu.

mucoEmcou
W5 Pangaea: 2qu95

Emwom mo #33
Bums. 353358:

SEE tongues
mongoose.
unaccua-uuowuam

zu. :u. 2m zu- zu.

 

mafia-Egan

 

 

 

 

«.333: «52893 82... mo 352:; we $9352 833333.. a...» wow 430M338

N4. @32.

33.58 anathema: .«o .CmESm

 

 

5&3

 

 

 

 

 

 

 

m . . . m m 0.500002
00.00 00.000 0 00.00 00.000 00 00 00 000" 00.00 00.000 00.0 00.000 0 00.00 00.000 00.00 00.000 0 00.00 00.000 0 000>00000000
00.00 00.000 0 00 00 00.000 00.00 00.000" 00.00 00.000 00.00 00.000 " 00.000 00.000 00.00 00.000 0 00.00 00.000 00 odza0>00000
00. 00.00 m 00. 00.00 00.0 00.0 m 00.0 00.0 00.0 00.0 m 00.0 00.0 00.0 00.0 m 00. 00.0 0 0000500 000000000
00.0 00.0 0 00.0 00.0 00.0 00.0 0 00.0 00.0 00.0 00.0 n 00.0 00.0 00.0 00.0 n 00.0 00.0 2
00. 00.00 m 00.0 00.00 00.0 00.00 m 00.0 00.00 00.0 00.00 m 00.0 00.00 00.0 00 00 m 00.0 00.00 0 0000000 0000000000
00.0 00.00 0 00. 00.00 00.0 00.00 H 00.0 00.00 00.0 00.00 0 00.0 00.00 00. 00.00 H 00.0 00.00 00 . .
00.0 00.00 m 00.0 00.0 00.0 00.0 m 00.0 00.0 00.0 00.0 m 00.0 00.0 00.0 00.0 m 00.0 00.0 a 000000000000 000000
00.0 00.0 n 00.0 00.0 00.0 00.0 0 00.0 00.0 00.0 00.0 0 00.0 00.0 00. 00.0 0 00. 00.0 00 .
00.0 00.00 m 00.0 00 00 00.0 00.00 m 00.0 00.00 00.0 00.00 m 00.0 00.00 00.0 00.00 m 00.0 00.00 a 00<0O00 000000>00
00.00 00.00 0 00.0 00.00 00.00 00.00 H 00 00 00 00 00 00 00.00 0 00.00 00.00 00.0 00.00 H 00.0 00.00 00 00000000>0

" u u " m5. 30058
00.0 00.00 m 00.00 00.00 00.00 00.00 m 00.0 00.00 00.0 00.00 m 00.0 00.00 00.00 00.00 m 00.0 00.00 a 0000000=00
00.00 00.00 0 00.0 00.00 00.0 00.00 H 00.00 00.00 00.00 00.00 H 00.00 00.00 00.0 00.00 H 00.0 00.00 2
00.00 00.00 H 00.0 00 00 00.00 00.00 m 00.00 00.0 00.0 00.00 m 00.0 00.00 00.0 00.00 H 00.0 00.0 a 0000000000000 00000050
00.00 00.00 0 00.0 00.00 00.00 00 00 0 00.0 00.00 00.0 00.00 0 00.00 00.0 00.0 00.00 0 00.00 00.00 2 .
00.0 00.00 0 00.0 00.00 00.00 00.00 m 00 00 00 00 00.00 00.00 m 00.0 00.00 00.00 00.00 0 00.0 00.00 0 000000 00 00000
00.00 00.00 H 00.0 00.00 00.0 00 00 0 00.00 00.00 00.00 00.00 H 00.00 00.00 00.0 00.00 H 00.00 00.00 2
00.0 00.00 0 00.0 00.00 00.00 00 00 m 00.00 00.0- 00.0 00.00 m 00.00 00.00 00.0 00.00 H 00.0 00.0- 0 000000 0000000000000
00.0 00.00 H 00.0 00.00 00.00 00.00 H 00.0 00.00 00.00 00.00 0 00.00 00.0 00.0 00.0 H 00.0 00.00 2
00.00 00.000 0 00.00 00.000 00.00 00.000m 00.00 00.00 00 00 00 000 0 00.00 00.000 00 00 00.000 0 00.00 00.00 0 0000000 0000=e>00
00.00 00.00 0 00.00 00.00 00.00 00.00 0 00.00 00.00 00.00 00.00 H 00.00 00.00 00.0 00.000 0 00.0 00.00 2 000000000000
00 m u 00 0:0 000 m u 00 m 00 00 u 00 0:0 8 m u 000 00 0000560000080

0. m 0. 0. m 00 .. m . 0. m 0. 00U00
0 0 0. 0 0. .i0 -000 0000000: 020020000
00.05.0000 00.22 00.7.0.0: 00.2:
.0300 E08 :2 00 0.005

 

 

0000: 0000820 000080

 

 

 

 

 

000000000 0.0 00000

 

.54

 

 

 

 

 

 

 

 

 

 

 

00.00 00.000m 00.00 00.000 00.000 00.000m 00.00 00.000 00.0 00.000m 00.00 00.000 00.00 00.000 W 00.00 00.000 0 000>0wmnmmwd
o~.vm 3.30.." 3.3 8.va 20.2: $.Nmmu $6: mm.m0.~ 3.0.0 3.02" 8.00.0 oo.~a~ 8.: 0.0.0.2 " 3.? 0.0.00: 2 ouxgtoucw

0 0 n n .
00.0 00.0 n 00.0 00.0 00.0 00.0 n 00.0 00.0 00.0 00.0 n 00.0 00.0 00.0 00.0 n 00.0 00.00 0 00 00:00.
00.0 00.00 m 00.0 00.0 00.0 00.00 m 00.0 00.0 00.0 00.0 0 00.0 00.0 00.0 00.0 m 00.0 00.0 2 00ousou 0 0
00. 00.00 0 00.0 00.00 00.0 00.00 m 00.0 00.00 00.0 00.00 0 00.0 00.00 00.0 00.00 m 00.0 00.00 0 0:0 00:00
00. 00.00 m 00.0 00.00 00.0 00.00 0 00.0 00.00 00.0 00.00 0 00.0 00.00 00.0 00.00 0 00.0 00.00 00 0000000 .0 o
00.0 00.0 m 00.0 00.0 00.0 00.00 m 00.0 00.0 00.0 00.0 0 00.0 00.0 00.0 00.0 m 00.0 00.0 0 000060 000 000000
00.0 00.0 0 00.0 00.0 00.0 00.0 n 00.0 00.0 00.0 00.0 m 00.0 00.0 00.0 00.0 0 00.0 00.0 2 . 0 . aw .
00.00 00.00 m 00.0 00.00 00.00 00.00 m 00.0 00.00 00.0 00.00 m 00.00 00.00 00.0 00.00 m 00.0 00.00 a 00<0000 00o0:o>=0
0n0 0000“ 0900 0000 2:0 0000" 090 0000 00: 0000 "0100 0000 0N0 0000 n 090 0000 2 causeea

" n u 0 000000000800
00.00 00.00 m 00.00 00.00 00.00 00.00 m 00.0 00.00 00.00 00.0 m 00.00 00.00 00.00 00.00 m 00.0 00.00 0 0000000000
00.0 00.00 0 00.00 0.00 00.0 00.00 0 00.00 00.00 00.0 00.00 0 00.0 00.00 00 00 00.00 0 00.0 00.00 2
00.0 00.00 m 00.0 00.00 00.00 00.00 H 00.0 00.00 00.0 00.00 m 00.0 00.00 00.00 00.00 m 00.00 00.00 0 000 00000 a u 0000a
00.00 00.00 0 00.0 00.00 00.0 00 00 0 00.0 00.00 00.0 00.00 H 00.0 00.00 00.00 00.00 0 00.0 00.00 2 .00 0: 0:
00.0 00.00 H 00.0 00.00 00.0 00.00 H 00.0 00.00 00.00 00.00 H 00.0 00.00 00.00 00.00 0 00.0 00.00 0 000000 00 0o>o0
00.00 00.00 0 00.0 00.00 00.0 00.00 0 00.0 00.00 00.00 00.00 0 00.0 00.00 00.0 00.00 H 00.0 00.00 2
00.0 00.0 0 00.0 00 00 00.0 00.0 0 00.0 00.0 00.0 00.00 m 00.0 00.00 00.0 00.00 H 00.0 00.0 a 0 000000
00.00 00.00 0 00.00 00.0 00.0 00 00 0 00.0 00.00 00.00 00.0 H 00.00 00 00 00 00 00 0- 0 00.0 00 00 z. 00 an: 0 . . .0couca
00.00 00.00 0 00 00 00.00 00.00 00.00 0 00.00 00.00 00.00 00.00 m 00.0 00.000 00.00 00.000 0 00.00 00.00 a 0o00 0000000:
00.00 00.000" 00.00 00.000 00.00 00.00 0 00.00 00.00 00.00 00.00 0 00.00 00.00 00.00 00.00 H 00.00 00.00 x 00< 00000000000“
00 0 _ 00 00 00 00 0 00 00 00 0 0 00 06 a 0 m 00 00 000.080-300.000

m 0. 0. 0 0. 0. u 00 0. " mpumn

0 m . i0 -000 000000000020020000

m0<zmu 000: 000020. 004: .
00000058 .0000 U0 0.00.5
000000000020 00002

 

 

 

 

 

000000000 0.0 o0000

 

 

55

No hypotheses were generated in relation to the interaction
effects between the variables of this study. An analysis of possible in-
teraction effects was computed, however, because of the importance of
interpreting and limiting the generalizability of the main effects..A11
two-way, three-way, four-way and five-way interactions (3 possible forty—
one interactions for each main effects hypothesis test) did not reach
significance. The multivariate F's for these interaction effects are

reported in Tables 4.14, 4.15 and 4.16.

Tests of Hypotheses

 

Hypothesis One - Inquiry Mode Main Effect

 

There are no differences in the subjects' mean scores on the
Counseling Evaluation Inventory, the Barrett-Lennard Relation-
ship Inventory, or the Interviewee Productivity Measure across
the three treatments--the OPEN INQUIRY MODE, the CLOSED INQUIRY

MODE or the MIXED INQUIRY'MODE.

For the main effect of Inquiry Mode the Miltivariate F's did not
reach significance at the .05 alpha level (Table 4.3). Investigation of
the table of pooled means (Table 4.4) shows that the Closed Inquiry Mode
had higher means on all indices, though there are no significant differ-
ences. The univariate F's did not reach significance (Appendix J).

The alternate hypothesis that subjects' mean scores on the
Barrett-Lennard Relationship Inventory would be higher in the Open In-
quiry Mode than in either the Closed Inquiry Mode or the Mixed Inquiry
1Wode was rejected.

The null hypothesis for the Inquiry Mode main effect was not.

rejected.

56

Table 4.3

Multivariate Analysis of variance
between OPEN, CLOSED and MIXED INQUIRY MODES

 

 

Dependent df Mu1tivariate
Measures F p

 

Barrett-Lennard
Counseling Evaluation
Interviewee Productivity 6, 188 .6923 .6561

Subscales of the CEI
Client Satisfaction
Counseling Climate
Counselor Comfort 6, 188 .2742 .9486

 

Subscales of the BLRI
Unconditional Regard
Level of Regard
Empathic Understanding
Congruence 8, 186 .5903 .7852

 

 

57

Table 4.4
The Pooled Means for the INQUIRY MODE Main Effect

 

 

 

 

Dependent Inquirthodes
Measures OPEN CLOSED MIXED
(n=48) (n=48) (n=48)
Barrett-Lennard
Relationship
Inventory (TOTAL) 81.44 88.54 85.31
Unconditional Regard 13.56 15.35 12.48
Level of Regard 29.75 30.94 31.56
Empathic Understanding 16.40 18.73 17.35
Congruence 23.04 24.98 24.58
Counseling
Evaluation
Inventory (TOTAL) 28.79 29.96 29.67
Client Satisfaction 6.92 7.29 6.90
Counseling Climate 14.06 14.37 14.40
Counselor Comfort 7.81 8.29 8.40
Interviewee
Productivity

Measure 268.12 291.90 287.33

 

S8

Hypothesis Two - Occupational Status Main Effect
There are no differences in the subjects' mean scores on the
Counseling Evaluation Inventory, the Barrett-Lennard Relation-
ship Inventory or the Interviewee Productivity Measure across
the two occupational categories—~COUNSELOR or PHYSICIAN.
For the Occupational Status main effects the multivariate F's
did not reach significance for any of the scale combinations (Table 4.5).
The table of pooled means (Table 4.6) indicates that the Counselor
Status was rated higher on all indices except the Productivity Measure.

The univariate F's did not reach significance (Appendix J).

The null hypothesis for Occupational Status was not rejected.

 

Table 4.5

Multivariate Analysis of variance
between COUNSELOR STATUS and PHYSICIAN STATUS

 

 

Dependent df M111: ivar iate
IMeasures F p

 

Barrett-Lennard
Counseling Evaluation
Interviewee Productivity 3, 94 .8969 .4459

Subscales of the CEI
Client Satisfaction
Counseling Climate
Counselor Comfort 3, 94 1.1893 .3182

 

Subscales of the BLRI
Unconditional Regard
Level of Regard
Empathic Understanding
Congruence 4, 93 2.1260 .0838

 

59

Table 4.6
The Pooled Means for the OCCUPATIONAL STATUS Main Effect

 

 

 

agggfignt COUNSELOR PHYSICIAN
(n=72) (n=72)

Barrett-Lennard

Relationship

Inventory (TOTAL) 89.33 80.86
Unconditional Regard 16.15 ' 11.44
Level of Regard 30.90 30.60
Empathic Understanding 18.72 16.25
Congruence 25.25 23.15

Counseling

Evaluation

Inventory (TOTAL) 30.00 28.90
Client Satisfaction 7.07 7.00
Counseling Climate 14.69 13.81
Counselor Comfort 8.24 8.06

Interviewee

Productivity

Measure 277.18 288.14

 

6O

Hypothesis Three - Interviewer Sex Main Effect

 

There are no differences in the subjects' mean scores on the

Counseling Evaluation Inventory, the Barrett-Lennard Relation-

ship Inventory, or the Interviewee Productivity Measure given

either a MALE or a FEMALE INTERVIEWER.

For the Interviewer Sex main effect the multivariate F for the
total scores of the three dependent measures exceeded significance at

the .0285 alpha level; the multivariate F for the four subscales of

the BLRI also exceeded significance at the .0287 alpha level
(Table 4.7).

Table 4.7

Miltivariate Analysis of Variance
between MALE INTERVIEWERS and FEMALE INTERVIEWERS

 

 

Dependent df Multivariate .
Measures F p

 

Barrett-Lennard
Counseling Evaluation
Interviewee Productivity 3, 94 3.1537 .0285*

Subscales of the CEI
Client Satisfaction
Counseling Climate ~
Counselor Comfort 3, 94 .2888 .8334

 

Subscales of the BLRI
Unconditional Regard
Level of Regard
Empathic Understanding
Congruence 4, 93 2.8377 .0287*

 

 

*p less than .05

61

A.post hoc investigation of the pooled means for each of the
dependent measures and their subscales shows that the Female Interview-

ers were rated higher consistently on each of the measures (Table 4.8).

Table 4.8

The Pooled Means for the INTERVIEWER SEX Main Effect

 

 

Dependent ‘MALE FEMALE
Measures INTERVIEWER INTERVIEWER
(n=72) (n=72)

 

Barrett-Lennard

Relationship

Inventory (TOTAL) 76.03 94.17*
Unconditional Regard 10 . 71 16. 89*
Level of Regard 28.75 32.75*
Empathic Understanding 15.06 19.93*
Congruence 28.12 29.28

Counseling

Evaluation

Inventory (TOTAL) 28.90 30.04
Client Satisfaction 6.84 7.25
Counseling Climate 14.07 14.47
Counselor Comfort 8.01 8.32

Interviewee

Productivity

iMeasure 277.32 287.58

 

*p less than .05

‘62
Some of the univariate tests for this hypothesis were signifi-
cant below the controlled alpha levels. A p less than .017 was set
for the analyses which compared three variables (i.e., .05/3), and a

p less than .013 was set for the analysis of the comparisons of four

variables (i.e., .05/4).

Table 4.9

Univariate Analysis of Variance
of the Dependent Measures for INTERVIEWER SEX Main Effect

 

 

 

 

 

Iaependent Mean df Univar iate p
easures Square F
Barrett-Lennard 11844.6944 l, 96 7.4668 .0075a
Counseling Evaluation 46.6944 1, 96 .6783 .4123
Interviewee Productivity 3792.5069 l, 96 .8543 .3577
Subscales of the CEI
Client Satisfaction 6.6736 1, 96 .7415 .3914
Counseling Climate 5.8403 1, 96 .5969 .4417
Counselor Comfort 3.3611 1, 96 .2550 .6148
Subscales of the BLRI
Unconditional Regard 1375.1736 1, 96 9.2225 .0031b
Level of Regard 576.0000 1, 96 4.8782 .0296
Empathic Understanding 855.5625 1, 96 7.7436 .0065b
Congruence 473.0625 1, 96 3.2771 .0734

 

3p less than .017

bp less than .013

l
mastic;

iii the)

the .0:

Cow
Una
Lew

C011:

Consider;
on the Be
diffmnC

the male

5:1

63

Differences between the two interviewers of each sex were also
investigated using the multivariate test. The F for the four subscales
of the Barrett-Lennard Relationship Inventory exceeded significance at

the .0254 alpha level (Table 4.10).

Table 4.10

MUltivariate Analysis of variance
within Female Interviewers and within Male Interviewers

 

 

Dependent d f Miltivar iate
Measures F p

 

Barrett-Lennard
Counseling Evaluation
Interviewee Productivity 3, 94 .3829 .7656

Subscales of the CEI
Client Satisfaction
Counseling Climate
Counselor Comfort 3, 94 .2941 .8296

Subscales of the BLRI
Unconditional Regard
Level of Regard
Empathic Understanding
Congruence 4, 93 2.9186 .0254*

 

 

*p less than .05

The pooled means for each of the individual interviewers shows
considerable differences within both the male and female interviewers
on the Barrett-Lennard (Table 4.11). Despite the within interviewer
differences the female interviewers consistently were rated higher than
the male interviewers on all of the indices.

The null hypothesis for Interviewer Sex main effect was rejected.

64

Table 4.11

The Pooled Means for within Male and within Female Interviewer Effects

 

 

Dependent iMALE FEMALE
Measures INTERVIEWER INTERVIEWER
#1 #2 #3 #4
(n=36) (n=36) (n=36) (n=36)

 

Barrett-Lennard

Relationship

Inventory (TOTAL) 65.36 86.69* 97.72 90.61
Unconditional Regard 8.28 13.14* 15.75 18.03
Level of Regard 26.22 31.28* 35.64* 29.86

Empathic Understanding 11.75 18.36* 19.72 20.14

Congruence 31.42* 24.81 25.89 32.67*

Counseling

Evaluation

Inventory (TOTAL) 27.20 30.61 30.81 29.28
Client Satisfaction 6.25 7.39 7.44 7.06
Counseling Climate 13.28 14.86 14.86 14.03
Counselor Comfort 7.67 8.36 8.50 8.14

Interviewee

Productivity

.Measure 280.11 274.61 286.22 288.94

 

*p less than .05

65
Hypothesis Four - Subject Sex Main Effect

There are no differences between the MALE SUBJECTS or the

FEMALE SUBJECTS on the mean scores of the Counseling Evaluation

Inventory, The Barrett-Lennard Relationship Inventory, or the

Interviewee Productivity Measure.

For the Subject Sex main effects test the multivariate F's did
not reach significance at the .05 alpha level (Table 4.12). The table
of pooled means (Table 4.13) indicates that the females subjects had
higher mean scores on all of the indices except the Productivity mea-

sure. The univariate F's did not reach significance (Appendix J).

The null hypothesis for the Subject Sex main effect was not rejected.

 

Table 4.12

Nhltivariate Analysis of variance
between MALE SUBJECTS and FEMALE SUBJECTS

 

 

Dependent df Mbltivariate p
Measures F p

 

Barrett-Lennard
Counseling Evaluation
Interviewee Productivity 3, 94 1.1411 .3367

Subscales of the CEI
Client Satisfaction
Counseling Climate
Counselor Comfort 3, 94 1.5277 .2125

Subscales of the BLRI

Unconditional Regard

Level of Regard

Empathic Understanding

Congruence 4, 93 1.3639 .2526

 

 

66

Table 4.13
The Pooled Means for SUBJECT SEX Main Effect

 

 

Dependent FEMALE ‘MALE
Measures SUBJECTS SUBJECTS
(n=72) (n=72)

 

Barrett-Lennard

Relationship

Inventory (TOTAL) 90.47 79.72
Unconditional Regard 15.36 12.24
Level of Regard 31.81 29.69
Empathic Understanding 19.08 15.90
Congruence 26.32 22.08

Counseling

Evaluation

Inventory (TOTAL) 30.31 28.64
Client Satisfaction 7.18 6.89
Counseling Climate 14.79 13.75
Counselor Comfort 8.33 8.00

Interviewee

Productivity

Measure 277.99 286.92

 

67

§EEE§EX.

Hypotheses were tested for the main and interaction effects of
four variables: 1) the Inquiry Mbde used in an initial interview;
2) the Occupational Status of the interviewer; 3) the Sex of the Inter-
viewer; and 4) the Sex of the Interviewee. The dependent measures were
two inventories of the interviewee's perceptions of the interviewer
(the Counseling Evaluation Inventory and the Barrett-Lennard Relation-
ship Inventory) and one measure of the quantity of data gathered from
the interviewee. Mlltivariate and univariate analyses of variance were
performed with the probability of a Type I error set at the .05 alpha
level. Tables 4.14, 4.15 and 4.16 summarize the outcomes of these tests.

Of the four experimental hypotheses tested in this research,
three had non-significant multivariate F's. The hypothesis which tested
Ieffects between male and female interviewers showed significant differ-
ences existed between the sexes (in the direction of the females) and,
also, within the two interviewers of the same sex. The Barrett-Lennard
Relationship Inventory was the dependent measure on which the female
interviewers were rated as having more unconditional regard and more
empathic understanding than the male interviewers.

A discussion of the results of the analysis of the data is pre-

sented in Chapter V.

Summary of the Mbltivariate Analyses of variance
for the Total Scores of the BLRI, the CEI, and the IBM

68

Table 4.14

 

 

Sources of

Mbltivariate

 

Variation df F p
INQUIRY MODE 6, 188 .6923 .6561
OCCUPATIONAL STATUS 3, 94 .8969 .4459
INTERVIEWER SEX 3, 94 3.1537 .0285*
REPLICATION‘within

INTERVIEWER SEX 3, 94 .3829 .7656
SUBJECT SEX 3, 94 1.1411 .3367
Z—WAY INTERACTIONS 42, 279.61 1.0321 .4236
3-WAY INTERACTIONS 48, 280.37 .8880 .6832
4-WAY INTERACTIONS 27, 275.17 .6994 .8671
S-WAY INTERACTIONS v6, 188 .5975 .7322

 

*p less than .05

The order for the step-down.analysis of variance was BLRI, CEI

and THU.

69

Table 4.15

Summary of the Multivariate Analysis of variance
for the Three Subscales of the Counseling Evaluation Inventory

 

 

 

Sources of df Multivariate p‘
ariation F

INQUIRY’MODE 6, 188 .2742 .9486
OCCUPATIONAL STATUS 3, 94 1.1893 .3182
INTERVIEWER SEX 3, 94 .2888 .8334
REPLICATION within

INTERVIEWER SEX 3, 94 .2941 .8296
SUBJECT SEX 3, 94 1.5277 .2125
Z-WAY INTERACTIONS 42, 279.61 1.0168 .4488
3-WAY INTERACTIONS 48, 280.37 .8981 .6654
4-WAY INTERACTIONS 27, 275.17 .8699 .6554
S-WAY INTERACTIONS 6, 188 1.5227 .1728

 

The order for the step-down multivariate analysis of the three
subscales of the CEI was Client Satisfaction, Counseling Climate and

Counselor Comfort.

70

Table 4.16

Summary of the Multivariate Analysis of variance
for the Four Subscales of the Barrett-Lennard Relationship Inventory

 

 

 

Sources of df' Mu1tivariate

variation F p
INQUIRY MODE 8, 186 .5903 .7852
OCCUPATIONAL STATUS 4, 93 2.1260 .0838
INTERVIEWER SEX 4, 93 2.8377 .0287*
REPLICATION‘within

INTERVIEWER SEX 4, 93 2.9186 .0254*
SUBJECT SEX 4, 93 1.3639 .2526

Z-WAY INTERACTIONS 56, 363.92 .2253 .1415
3-WAY INTERACTIONS 64, 366.36 .0142 .4529
4-WAY INTERACTIONS 36, 350.25 .1516 .2588
S-WAY INTERACTIONS 8, 186 .5593 .8103

 

*p less than .05

The order for the step-down multivariate analysis of variance

Regard, Empathic understanding and Congruence.

of the four subscales of the BLRI was Unconditional Regard, Level of

CHAPTER V

SUMMARY AND DISCUSSION

§EEE§EX

The purpose of this study was to look at the effects of an open
or closed inquiry style, used by a counselor or a physician.in an ini-
tial interview, on the interviewee's perceptions and self-disclosure.
Four Rehabilitation Counselors, two female and two male, were trained
to interview using a specified inquiry style. They were to obtain per-
sonal-social and medical information such as might be asked of a patient
during an intake interview at a psychological or medical clinic. Seventy-
two female and seventy-two male interviewees were randomly assigned to
three treatment conditions and were interviewed in a twenty minute
audio-taped session. Following the interview the subjects completed two
inventories, the Counseling Evaluation Inventory and the Barrett-Lennard
Relationship Inventory, to indicate their perceptions of the interviewer.
The amount of self-disclosure by the interviewee was measured by three
trained tape-reviewers using the Interviewee Productivity Measure.

‘HypotheseS'were tested for the main and interaction effects of
four variables: 1) the Inquiry Mede as used in.an initial interview,

2) the Occupational Status of the interviewer, 3) the Sex of the Inter-

viewer, and 4) the Sex of the Interviewee. Three of these four

71

 

72

hypotheses had multivariate F's which did not reach significance at the
.05 alpha level. The hypothesis which tested differences between male
female interviewers showed significant differences between the sexes

and, also, within each of the sets of interviewers of the same sex.

The Barrett-Lennard Relationship Inventory was the dependent measure

on which the female interviewers were rated as having significantly high-
er. unconditional regard and empathic understanding than the male

interviewers.

 

Discussion of Results

 

Inquiry Modes in the Interview

 

There were no differences which approached significance for the
treatment effects of an initial interview conducted with open inquiries,
closed inquiries or a mixture of open and closed inquiries- An examina-
tion of the table of pooled means (Table 4.4) showed that the Closed
Inquiry Mode consistently had higher means on all of the measures than
did the Open Inquiry Mede..Ashby §t_al_(1957), Baker (1960) and Pallone
and Grande (1965) reported a similar lack of results when they examined
the differential effects of inquiry style. All of these experiments
used a criterion level of 70 to 80 interviewer leads in the experimental
category for any one treatment. It may be that this criterion was too
low and that when, for example, an open lead was used with.a.closed
lead they contaminated each other and the singular effect was dissipated.

Siegman and Pope (1972) do report differences in client produc-
tivity given an ambiguous or specific interviewer lead, but their exper-

imental manipulation was much.more rigorous and short (timeewise) than

73

this more naturalistic interview. Perhaps the time element averages out
the effects of different inquiry styles.

Medical educators (Enelow G Swisher, 1971) have promoted the
use of open inquiries to establish rapport with patients. The subjects
of this experiment seemed to perceive similar levels of empathy, regard,
warmth and congruence whether the interviewer used open or closed leads.
Tihere was some indication that the Closed Inquiry Mode produced more
"information bits." In the Open Inquiry Mode the mean mimber of infor-
Ination bits collected in twenty minutes was 268.12 and in the Closed
Ivlode it was 291.90. It is interesting to note that this occurred in
spite of the fact that the total average of closed leads used by the
interviewers was approximately twice as many as the number of open leads

used in any one interview.

An investigation of the type of lead each interviewer began the
interview with indicated a variation and yet the total output from the
interviews was not significantly different. This calls into question
Hawes (1974) claim that the beginning lead determines the amount of in-
formation obtained. It tends to‘support the findings of Siegman and Pope
(1972) . In actual clinical practice the issue might be when to use which
type of lead. As Enelow and Swisher (1971) suggested, the interviewer
should use the open lead when inquiring into new areas and the closed
or direct question when attempting to get detailed information within
a c:01‘1tent area. The data from this research could be reviewed with the
purpose of identifying the kind of information that was obtained by

each type of interviewer lead.

. K~___a_.‘,

occ
poc
a1
thl
uni
jus
and}
than
one
4165':
ings <
Perha;

strong

74

Occupational Status Effects in the Interview

There were no statistically significant differences between the
occupational status dimensions of physician and counselor. The table of
pooled means (Table 4.6) showed that the counselor was rated higher on
all but the Interviewee ProductiVity Measure. A multivariate analysis of
three of the Barrett—Lennard subscales (those which had the highest ”T.
Ltnivariate F's) did reach the .05 alpha level. This analysis was done

just as a trial. The Congruence subscale was the one left out of the

 

analysis because this scale seemed to have considerably lower scores
than the other subscales and it was, also, the scale that subjects indi-
cated was hard to interpret. Since the lack of independence has been
questioned (Mills 8 Zytowski, 1967; Walker 6 Little, 1969) these find-
ings cannot be claimed to be significant. But they do indicate that,
perhaps with a larger sample, the occupational status effect might be
stronger.

All four of the interviewers were trained counselors by profes-
sion and assumed the physician role for the sake of this research. On
the positive side, this controlled for personality differences and
aclatclemic training effect differences between physicians and counselors.
On the negative side, if there are subtle mannerisms and attitudes which
affect the physician's approach to a patient in a way dissimilar to
that of a counselor, these effects were washed out by the experimental
sjmlllattion. Rehabilitation Counselors were used for this study because
the rehabilitation professional is familiar with medical vocabulary and
has Worked with physically disabled persons as a part of the job.

The training in empathy skills that these four interviewers had

may ac:CCJunt for the higher ratings on the interpersonal dimensions.

Each
at t}
theii
terns
views

physj

at qL
treat

culti

Physi

haVe

seems
Playj
lege
the a
khat

they

75

Each of them was working in a conmmity mental health counseling center
at the time of their participation and it can be assumed that much of
their client contact time dealt with the client's personal-social con-
cerns. This was what they were inquiring about in the research inter-
views also. This may be quite different from the daily tasks of the
physician.

The fidelity of the simulation for the occupational status was
at quite a low level (i.e. dissimilar to reality). The intent was to
create a mind set in the subjects which would, in turn, surface their
culturally and socially determined stereotypes of physician and counsel-
or - Since the majority of the subjects had very little contact with
physicians and even less with counselors, this initial mind set may not
have been very strong.

Even though the experiment covered four weeks of time there
seemed to be no commmication between subjects about the dual role-
playing by the interviewers. Subjects were from several community col-
lege classes and seemed not to know each other. They did not question
the authenticity of either professional role. Several subjects asked
what clinics the counselors and physicians were working in because

they wanted further contact.

Mole Differences in the Interview

On all of the measures, the female interviewers received signi-
ficant 1y higher ratings than the males. Additional analysis showed that
the b€3‘ttween-male and between-female differences were of considerable
propot‘tion, but the two females were rated higher on every measure.

One of the first explanations to consider is that the two female

 

9M

1e

thy

ti:
the

ark

76

interviewers, indeed, were quite dissimilar to the two males in their
data gathering skills and in their interpersonal approach to clients.
Age, current place of employment, a master's level training program,
similar evaluations from clinical supervisors about interpersonal
skills, and past job experiences did seem to indicate a good match. A
personal interview with the researcher and a baseline screening inter-
view did not show any obvious differences amoung the four.

The cultural stereotype of the female as the more nurturant per-
son (Guttman, 1973) could have accounted for some of the differences,
especially on the Barrett-Lennard measures of empathy and unconditional-
ity of regard. Leary (1957) postulated that the nature of the affective
exchange is a function of the personality patterns of the participants
in an interaction and one may "draw out" certain responses from the
other person. So, if the subjects were expecting the female interviewer
to be nurturant and empathic, maybe this is what they evoked from her.

Sex role differences between the ratings of male and female sub-
jects did not reach significant alpha levels. They both perceived the
interviewers relatively the same and both sexes disclosed approximately
the same amount of information. If the interview tapes had been analyzed
for the quality of the data volunteered, affective and cognitive, the
outcomes might show that females disclosed more affective information
as Fuller (1963) suggested. The Interviewee Productivity Measure iden-
tified just the quantity of information given. With further training
the tél-pe-reviewers could be taught to discriminate between affective
and Cognitive bits of information.

The question of whether or not persons unfamiliar with the var-

iables being measured can evaluate them accurately (NtIlvaine, 1972)

77

might have been an issue if the interviewee ratings were being compared
to those of supervisors or of the interviewers, but they were not. The
important issue for this research was the strength of the perceptions
and not the accuracy of them. Interviewees were also told that the
interviewers were not going to see their individual ratings. This was
done to encourage honesty, especially in giving negative ratings. Be-
cause this was a one time meeting there was no chance for future atti-
tudinal retaliation by either party.

An interesting side effect of this research project was that it
seemed to be the first chance for many of the subjects to have a contact
of this nature with either a counselor or a physician. Several indicated
that they thought this would help them when they eventually do begin a
relationship with such a professional. Well over half of the subjects
took the time to write comments on their experience with the research
interview. These remarks were both positive and negative, but, in both
cases, subjects were "glad to have been a part of the research project."

This attitude of helpfulness may have affected the level of self-dis-

closure especially.
Limitations

There were several research design and instrumentation issues
that limited this research. The Research Associates, all of one profes-
51011 13111: simulating another, may have missed the subtle role differences
that exist in reality. Using some physicians and some counselors as in-
terviewers to carry out the same research would eliminate the effects of

the 10“? fidelity simulation. To see if the mind set of the interviewee

78

was the crucial factor in differentiating counselor and physician on
the three subscales of the BLRI, the interviews could be done using all
‘ physicians and having them simulate counselors.

The number of subjects in each cell of the design was only
three. More subjects per cell would have increased the power of the de-

sign by lowering the within cell variance and might have produced more

definitive results.

 

The simulated interview situation may be completely atypical of
the kind of initial interview these persons would experience if they ' I .:
visited the offices of a counselor or a physician. Subjects knew they
were part of an experiment and that this would be their only contact
with this professional. Whether these factors caused more or less self-
disclosure in the interview, or more positive than negative ratings on
the inventories, remains open to question.

The Cmmseling Evaluation Inventory and the Barrett-Lennard

Relationship Inventory were designed, initially, for use with long-term
Client-counselor relationships. Though they have been used in several
initial interview studies, there is still a question about the appro-
Priateness of such use. Another question is whether or not the same
variables are of as nuch interest and concern in the physician-patient
relationship as in the counselor-client relationship.

Scores on the Congruence scale of the Barrett-Lennard were lower
in eVery hypothesis tested than any of the other subscale scores. In
reflec ting on the actual interview situation, this was the scale that
caused the subjects the most concern in interpretation. Since this is
the SCale that attempts to measure interviewer genuineness, it might be

the one that is most affected by a sinulated situation in which the

79

dyad members know that the situation is not "genuine."

The Interviewee Productivity Measure seemed to be too global
to discriminate between self-disclosure under the treatment variables.
Perhaps training the tape-reviewers to differentiate between affective
and cognitive self-disclosure would produce the more powerful measure.
Looking at frequency tallies for each discreet content area rather than

using the total summed frequency would also produce a more refined

measure.
An initial intent of this research was to be able to make re-

commendations regarding interview training programs of physicians and
counselors. Inquiry techniques and the amount of data gathered by them
will, most likely, always be a part of the concern of those training
interviewers. This study indicated that the interpersonal dimensions
my be the most significant aspect of such training. Perhaps, female

professionals already have the interpersonal skills, or are perceived

as having more than the male professional. This does not mean that the
fernale professional can use the skills any more appropriately, but :

rather, that such professional qualities as empathic understanding and

regard have been culturally ascribed or personally socialized.

Recommendations for Further Research

The major finding of this research, that females were perceived
to have more of the "necessary and sufficient conditions" of a good in-
terviewer than males, certainly needs to be examined again under other
Circn-du‘flstances. Attitude measures concerned with sex stereotypes admin-

istered as part of the treatment would be helpful for identifying the

80

mind set of the sample being tested.

The occupational status issues need further investigation,
especially in situations where various professionals perform similar
tasks. This study could be redone using all physicians as interviewers
to see if the results are similar. Or, this study could be planned using
some physicians and some counselors. In the latter case, the question
of personality differences and aculturated mannerisms of the profession
muld have to be addressed.

The setting for the interview is another area with research
potential. Does it matter whether the office looks like a physician's
office or a counselor's office?

The subjects for this research had no expectations about the
professional, long-term nature of the relationship they were begirming.
Would a real setting, with long term contacts between the professional
and the interviewee affect the perceptions of the interviewee or the
Willingness to be self-disclosing? These comparisons need to be made?

Ultimately, the purpose of any research on the interview inter-
act ion is to discover those variables which will maximize the effects
0f the dyadic exchange to the benefit of both of the parties involved.
In Order to realistically do this, the research situation must be as
Close to the actual interviewer-interviewee relationship as possible.
Or, if a laboratory model is investigated first, the finding should

then be tested with field research.

 

LIST OF REFERENCES

LIST OF REFERENCES

Adler, L. M. The social context of the clinical interview. In A. J.
Enelow and S. N. Swisher (Bds.) , Interviewing and patient care.

New York: Oxford University Press, 1972.

Anderson, R. P., G Anderson, C. V. Development of an instrument for
measuring rapport. Personnel and Guidance Journal, 1962, 4_1_,

18-24.

Ashby, J. D., Ford, D. H., Guerney, B. G., G Guerney, L. F. Effects on
clients of a reflective and a leading type of psychotherapy.

Psychological Monographs, 1957, ‘_7_l_ (Whole No. 453), 1-32.

The differential effects of two psychotherapeutic approaches

Baker, E.
Journal 9f Counseling Psychology, 1960,

on client perceptions.
1, 46-50.

Dimensions of therapist response as causal

Barrett-Lennard, G.T.
Psychological Monographs, 1962 ,

factors in therapeutic change.
_7_6, (Whole No. 562), 1-43.

Benjamin, A. The helLing interview. Boston: Houghton Mifflin Company,
1969.

Bergman, D. V. Counseling method and client responses. Journal g
Consulting Psychology, 1951, _l_5_, 216-224.

Bemstein, L., 6 Dana, R. H. Interviewing and the health professions.
New York: Appleton-Century-Crofts, 1970.

Bird, B. Talking with patients. Philadelphia: J. B. Lippencott Com-
pany, 1955.

Br<>oks, L. Interactive effects of sex and status on self-disclosure.
Journal o_f_ Counseling Psychology, 1974, _2_l_, 469-474.

Cal‘klnff, R. .R. Helping and human relations. Chicago: Holt, Rinehart
and Winston, 1969.

CaSsata, D. M., Conroe, R. M., & Clements, P. W. A program for enhanc-
ing medical interviewing using videotape feedback in the family
practice residency. Paper presented to the International
Comlmmications Association. New Orleans, 1974.

81

 

82

Cooley, W. W., 8 Lohnes, P. R. Multivariate data analysis. New York:
Wiley 6 Sons, Incorporatédj 1964.

Covner, B. J. Studies in the phonographic recording of verbal material:
I. The use of phonographic recordings in counseling practice
and research. Journal of Consulting Psychology, 1942, 9,
105-113.

Covner, B. J. Studies in the phonographic recording of verbal naterial:
III. The completeness and accuracy of counseling interview
reports. Journal o_f_ General Psychology, 1943, _3_0_, 181-203.

Cozby, P. C. Self-disclosure: a literature review. Psycholgical
Bulletin, 1973, _7_9, 73-91.

Dailey, C. A. The life history as a criterion of assessment. Journal
_of Counseling Psychology, 1960, 1, 20-23.

 

Davis, M. S. Attitudinal and behavioral aspects of the doctor-patient
relationship as expressed and exhibited by medical students and
their mentors. Journal of Medical Education, 1968, 5,337-343.

Dell, D. M. Counselor power base, influence attempt,_and behavior
. change in counseling. Journal 9f Counseling Psmholgy, 1973,
23, 399-405.

Dornette, W. H. L. This thing called "malpractice." Clinical
Anesthesia, 1971, _9_, 26-45.

Ebels, R. L. Estimation of reliability ratings. Psychometrika, 1951,
Q, 407-424.

Edelman, R. 1., a Snead, R. Self-disclosure in a simulated psychiatric
interview. Journal gf Consulting and Clinical Psychology, 1972,
_3_§, 354-358.—"— ‘

Enelow, A. J ., G Swisher, S. N. Interviewing and patient care.
New York: Oxford University Press, 1972.

Enelow, A. J. , a Wexler, M. Psychiatgy _ig the gactice g medicine.
New York: Oxford University Press, 1966.

 

Engel, G. L. "The best and the brightest," the missing dimension in
medical education. The Pharos, 1973, 129-133.

Engel, G. L., 8 Morgan, W. L. Interviewing the patient. Philadelphia:
W. B. Saunders Company, 1973.

Fis11er, A. W. Patient's evaluation of outpatient medical care. Journal
fiMedical Education, 1971, 46, 238-244.

 

Fuller, F. F. Influence of sex of counselor and of client on client's
expression of feeling. Journal _o_f Counseling Psychology, 1963,
10, 34-39.

 

83

Gabbert, K. H. An investigation of variables thought to be influencing
client attitudes toward the counseling experience. Unpublished
master's thesis Colorado State University, 1965.

Gabbert, K. H., Ivey, A. E., G Miller, C. D. Counselor assignment and
client attitude. Journal 3f Counseling Psychology, 1967, 14,
131-136.

 

Gelso, C. J. The effects of recording on counselors and clients.
Counselor Education and Supervision, 1974, 14_, 5-12.

 

Gladstein, G. A. Client expectation, counseling experience and satis-
faction. Journal gt: Counseling Psychology, 1969, l_6_, 476-481.

 

Grantham, R. J. Effects of counselor sex, race and language style on
black students in initial interviews. Journal _o_f_ Counseling
Psghology, 1973, Q, 553-559.

Guttman, M. A. J. (Ed.) Women and ACES: perspective and issues.
Commission for Women, Association of Counselor Education and
Supervision, Washington, D.C., 1974.

 

Guttman, M. A. J ., G Haase, R. F. Effect of experimentally induced sets
of high and low "expertness" during brief vocational counseling.
Counselor Education and Supervision, 1972, 171-178.

 

I—Iaase, R. F., 5 Miller, C. D. Comparison of factor analytic studies
of the counseling evaluation inventory. Journal 91 Counseling
Psychology, 1968, l_S, 363-367.

Flawes, E. M. Effects of question order on the interview process.
Presented at the Interpersonal and Small Groups Competitive
Papers Program. Speech Comrmmication Association, Chicago, 1974.

Heller, A. Laboratory interview research as an analogue to treatment.
In A. E. Bergin and S. L. Garfield (Eds.), Handbook gfipsycho-
therapy and behavior change. New York: Wiley 8 Sons, Incorpor-
ated, 1971.

 

H01 lander, E. P. Principles and methods 91 social psychology. New York:
Oxford University Press, 1967.

 

 

Mel, T. J ., G Sligo, J. R. Empirical comparisons of univariate and
multivariate analysis of variance procedures. Psychological
Bulletin, 1971, Z_6_, 49-57.

Ivey, A. E., 8 Robin, S. 8. Role theory, role conflict and counseling:
a conceptual framework. Journal o_f; Counseligg Psychology, 1966,
13_, 29-37.

JoIles, E. E., G Thibaut, J. W. Interaction goals as basis of inference
in interpersonal perception. In R. T. Tagiuri and L. Petrullo
(Eds.) , Person, percgption and interpersonal behavior. Stanford:
Stanford University Press, 1958.

 

84

Jourard, S. M. Self-disclosure: 99 experimental analysis g 2% trans-
parent self. New York: Wiley 6 Sons, Incorporated, 1971.

 

Kagan, N. Influencing human interaction. Video-tape and film series
manual. East Lansing: Educational mblication Services,
Michigan State University, 1972.

Kell, W. L., E. Mieller, W. J. Impact and chagge: 9 study gcounseling
relationships. New York: Appleton-Century-Crofts, 1966.

 

 

lamb, R., E. Mahl, G. F. Manifest reaction of patients and interviewers
to the use of sound recording in the psychiatric interview.
American Journal 91 Psychiatry, 1956, l_12_, 731-737.

 

 

Leary, T. Interpersonal diagnosis 9§_personality. New York: Ronald
Press, 1957.

 

 

Lennard, H., G Bernstein, A. The anatomy 9_f_ psychotherapy. New York:
Columbia University Press, 1960.

 

 

Linden, J. D., Stone, S. C., G Shertzer, B. Development and evaluation
for rating counseling. Personnel and Guidance Journal, 1965,
94, 267-276.

 

MacKinnon, H. , 8 Michels, S. The psychiatric interview E clinical
practice. Philadelphia: W. B. Saunders, 1971.

 

Magraw, R. M. Ferment _‘19 medicine. Philadelphia: W. B. Saunders, 1966.

Matarazzo, R. G. Research on the teaching and learning of psychothera-
peutic skills. In A. E. Bergin and S. L. Garfield (Eds.),
Handbook 91: psychotherapy and behavior change: 9n_ experimental
analysis. New York: Wiley 8 Sons, Incorporated, 1971.

 

McIlvaine, J. F . Coached clients as raters of counseling effectiveness.
Counselor Education and Supervision, 1972, 12_, 123-128.

 

Mills, D. H., 8 Zytowski, D. G. Helping relationship: a structured an-
alysis. Journal o_f_ Counseling Psychology, 1967, 11, 193-197.

 

Pallone, N. J ., 8 Grande, P. P. Counselor verbal mode, problem relevant
canmmication, and client rapport. Journal 91 Counseling
Psychology, 1965, 12_, 359-365.

 

 

Roberts, R. R., Jr., 6 Renzaglia, G. A. The influence of tape recording
on counseling. Journal 91: Counseling Psychology, 1965, 12_, 10-16.

Rogers, C. R. 99 becoming 9 person. Boston: Houghton Mifflin, 1961.

Rogers, C. R. The necessary and sufficient conditions of therapedtic
personality change. Journal 9f Consultim Psychology, 1957, 21,
95-103.

85

Scheifley, V. M., E. Schmidt, W. H. Jeremy D. Finn's nultivariate-uni-
variate and multivariate analysis of variance, covariance and
regression, Modified and adapted for use on the CDC 6500.
Occasional paper number 22, Office of Research Consultation.
Michigan State University, October, 1973, 1-23.

Shapiro, J. C., Krauss, H. H., G Truax, C. B. Therapeutic conditions
and disclosure beyond the therapeutic encounter. Journal 9f
Counseling Psychology, 1969, l_6_, 290-294.

Sheppe, W. M., Jr., G Stevenson, I. Techniques of interviewing. In

H. I. Lief, V. F. Lief and N. R. Lief (Eds.), The psychological
basis 9f medical practice. New York: Hoeber, 1963.

 

Siegman, A. W., 6 Pope, B. Studies _i_n_ dyadic conmunication. New York:
1972.

Simmons, 0. Implications of social class for public health. In E. G.

Jaco (Ed.), Patients, physicians and illness. Glencoe, Illinois:
The Free Press, 1958.

Singleton, D. 8. Sex as a determinant of responses to patient manage-

ment problems by physicians and medical students. Unpublished
doctoral dissertation, Michigan State University, 1975.

Snyder, W. U. An investigation of the nature of nondirective psycho-
therapy. Journal 91 General Psychotherapy, 1945, _3_3, 193-232.

Snyder, M. K., 8 Ware, J. E. A study of twenty-two hypothesized dimen-
sion of patient attitudes regarding medical care. Technical
report number MHC 74-10. Carbondale, Illinois, Southern
Illinois School of Medicine, 1974.

Sullivan, H. S. The interpersonal theory 9f_ psychiatry. H. S. Perry
and M. L. Gawel (Eds.). New York: W. W. Norton 8. Company, 1953.

 

Szasz, T. S., G Hollender. H. A contribution to the philosophy of med-
icine. Archives g Internal Medicine, 1956, 9_7_, 585.

 

Tanney, M. F., 8 Gelso, C. J. Effect of recording on clients. Journal
o_f_ Counseling Psychology, 1972, 19, 349-350.

Truax, C. B., 6 Carkluff, R. R. Client and therapist transparency in
the psychotherapeutic encounter. Journal 9i Counseling_
Psychology, 1965, 11, 3-9.

Truax, C. B., 6 Carkhuff, R. R. Significant developments in psychother-
apy research. In L. E. Abt and B. F. Reiss (Eds), Progress _19
clinical psycholcgy. New York: Grune 5: Stratton, 1964.

 

86

Truax, C. B., G Carkhuff, R. R. Toward effective counseling and psycho-
therapy: training and practice. Chicago: Aldine Publishing
Company, 1967.

 

 

 

Tyler, L. E. 199_workl9£_the counselor. New York: Appleton-Century-
Crofts, 1969.

van.Atta, R. E. Excitatory and inhibitory effects of various methods
of observation.in counseling. Journal 9§_Counseling Psychology,
1969, 19, 433-439.

walker, B. S., 8 Little, D. F. Factor analysis of the Barrett-Lennard
Relationship Inventory. Journal 9f_Counseling Psychology, 1969,
19, 516-521.

 

ware, J. E., 6 Snyder, M. K. Dimensions of patient attitudes regarding
doctors and medical care services. .Medical Care, 1975, 11,
669-682.

 

Winborn, B. B., Hinds, W. C., 6 Stewart, N. R. Instructional objectives
for the professional preparation of counselors. Counselor
Education and Supervision, 1971, 19, 133-137.

 

 

 

APPENDICES

 

APPENDIX A
LETTERS RECRUITING RESEARCH ASSOCIATES

APPENDIX A

LETTERS RECRUITING RESEARCH ASSOCIATES

Dear

Your name was given to me by Dr. James Engelkes when I asked for a list
of persons in the Lansing area who had demonstrated a competence in in-
terviewing skills. Since you are nearing the end of you internship ex-

perience, you, undoubtedly, have had much practice in interacting with
clients.

I am.a doctoral student in Counseling and, at present, I am planning a
dissertation research project which compares the effects of certain in-
terviewing skills of physicians and counselors. During the past three
years I have been training MSU medical students in the skills of inter-
viewing. I am.interested in empirically testing some of the differences
between the medical interview and the counseling interview.

would you be interested in being a Research Associate? Ten to fifteen
hours of your time would be required--evening(s) and/or weekend(s) in
late January. I will monetarily reimburse you and you will enrich your
professional competence as a result of this experience.

Please return the attached form as soon as possible. Then I will be in
contact with you by phone to give you more details of the experiment.

Thank you. I appreciate your willingness to be of help.

Dolore Rockers
Doctoral Candidate, MSU

I am interested in being a Research Associate for this experiment.
I would like more information before I commit myself to the project.

I am not interested in participating in this experiment.

Name Phone Number

 

87

88

125 Kenberry Drive, #9
East Lansing, Michigan 48823
February 2, 1976 '

Dear

Thank you for responding to my request for a Research Associate in the
Health Professional Interview Research Project. As with most plans of
this magnitude, things never er smoothly; so, the execution of this
experiment has been delayed in time. Since your plans may also have
changed, I would like to outline the tasks of the Research Associate
as they are at this stage and then, on the weekend, I will call you to
see if you are still interested in participating.

Tasks of the Research Associate:

1. Preliminary Interview: In the experiment the reactions of the
person being interviewed are of primary interest. However,
it is necessary to have some initial idea of the particular
interviewing style of the professional who is conducting the
interview.

a. Come to Room 250, Erickson Hall, Campus, during the
week of Februagy 9-15, for a fifteen minute screening
interview.

 

 

1) Clients will be provided.

2) The contents of the interview will cover the
client's personal-social history.

3) The interview will be audio-taped.

b. Following the interview you will fill out an Interview
Evaluation Form. 80 will the client. This is to check
your perceptions of the interview and allows for a
pre-test of the instruments.

c. This will be about an hour of time and the rammeration
will be $5.

2. Tape Coding: These tapes will then be coded anonymously to
determine your interviewing style. Approximately eight inter-
viewers with varying styles will be asked to participate in
the actual research experiment (at three dollars per hour).

 

3. Research Interviews: There will be sane flexibility depend-
ing on persons' schedules.

 

a. Attend a three hour training seminar on 999 weekday
evening for the weeks of February 16-20. 23-27 and
March 1-5.

 

 

89

b. Conduct approximately 19_fifteen.minute interviews per
weekend for the three weeks above mentioned. In total
you will be doing about thirty interviews if plans pro-
ceed as they are now set. The format for each interview
remains the same in content and varies in questioning
style.

'Thank.you. I realize that the remuneration does not equal your profes-
sional worth, but, such are the limits of graduate student research.
‘When I call this weekend I will want to know: 1) if you are still
interested in being a Research Associate, and 2) when next week you can
come for a screening interview.

I am willing to share the procedures and outcomes of this research with

'you as we go along. This, in itself, might be a worthwhile learning
experience.

Gratefully,

Dolore Rockers
Doctoral Candidate, MSU

APPENDIX B

TRAINING PROGRAM FOR RESEARCH ASSOCIATES

 

APPENDIX B

TRAINING PROGRAM FOR RESEARCH ASSOCIATES

I. The following format will be used for each of the three training

sessions:

.A. Discussion of the Concepts (reviewed each time)

(fl-RMNH
O O O O

Inquiry'Modes

Initial Intake Interview
Information-Gathering Categories
. Occupational Role Distinctions
Standardized variables

B. Recognition of the Treatment MOdes
1. Using Typed Transcripts (from the baseline interviews)
2. Using Audio-Taped Examples (from baseline interviews)

C. Practice Interviews to Reach Criterion
l. Playback One's own for Analysis
2. Playback or Review by Researcher to Assure Criterion

III. For this research the above mentioned concepts are defined as

follows:

A. Inquiry Modes:

Qpen Inqgiry Mode--A twenty minute information
gathering interview in which at least 80%

of the inquiries are phrased in a.manner
which solicits the interviewee's thoughts,
opinions, views, feelings, facts, et .--
anything the person would like to say.

 

 

Closed Inquiry Mode--A.twenty minute infonma-
tion gathering interview in which at least
§9§_of the inquiries are phrased so as to
elicit a "yes," "no" or short factual answer
(under five words).

 

Mixed Inquig Mode--A twenty minute informa-
tion gathering interview in which at least
40% of the inquiries are open and at least
40% of the inquiries are closed.

 

 

 

90

 

91

B. Initial Intake Interview: This interview is to be conducted
as if it is the first contact between the
professional and the interviewee. The client
understands that he or she is coming to a
general clinic for some general tests. This
interview is to begin the process of history-
taking which both counselors and physicians

use.

C. Information-Gathering Categories: The following are the con-
tent areas about which you will seek.infor-
mation: ..
Parents/Siblings

Family'values/Religion
Marital History
Personal/Social History
Friends/Significant Others
Education/Military Career
Occupation/werk History
Hobbies/Interests

General Medical History
Use of Alcohol/Drugs/etc.
Average Day/weekend
Support Systems in Crisis
Other

 

Wise-

Each of these categories should follow in
order but the number of inquiries used in
each is at your own pacing. All should be
covered generally within twenty minutes.

The OTHER category is a time filler to be
used only when necessary.

D. Occupational Role Distinctions: YOu will be simulating two
professionals, counselor and physician, each
weekend. Each role will be made distinct by
variations in title, occupational role, place
of work, attire, name tag on your office door,
and directions that are given to the client
before he or she sees you.

 

 

 

 

For example: On Saturday you will introduce
yourself as Ms. Judy B , a Counselor
with the Mason Mental Health Center. You will
be attired in professional dress. The name
tag on your office door will call you Ms.

 

JUdy B ,‘MaA., Counselor. The client
‘will be told that a female counselor, Ms.
Judy B , will be doing the initial

 

interview.

92

On Sunday you will introduce yourself as
Dr. Judy C , a Resident Physi-
cian with the Michigan State Medical School.
You will wear a white lab coat over your
professional garb. The name-tag on the door

 

will call you Dr. Judy C , M.D.,
Physician. The client will 55 told that a
female physician, Dr. Judy C , will

be doing the initial interview.

E. Standardized Variables: In all of the interviews the follow-

ing procedures should be as similar as possi-
ble:

Keep head nods, umhmms, etc. out of your re-
sponses.

Space your questions so that there are not
periods of silence (more than 10 seconds)
between the client's answer and the next
question.

 

Position your body in a forward lean toward
the client.

The interview chairs should be placed so that
the client's back is to the window and so
that only the corner of the desk is between
interviewer and client.

Maintain consistent eye contact with the in-
terviewee.

APPENDIX C
SAMPLE OF OPEN AND CLOSED INQUIRIES

APPENDIX C
SAMPLE OF OPEN AND CLOSED INQUIRIES
Open Irguiry

An inquiry phrased in a manner which solicits the inter-
viewee's opinions, views, thoughts, feelings, facts, etc.
. ..anything the person would like to say.

Definition:

Tell me something about what went into that decision to transfer.
What, in your mind, are the qualities that make an ideal nurse?

What kinds of thingg influenced you in the first place? (Using the
plural makes this an open inquiry.)

HOW would you describe your eating habits?

What was it like having an attorney for a father?

You mentioned an interest in sports when you were growing up; what other
things interested you?

What happened exactly?

Think back to when you were a child and tell me the things that stand
out in your memory.

Tell me more about your brothers.

What can you tell me about your parents? (Tends toward a closed inquiry
but was classified as open.)

HOW about your religious background? (Takes on the inquiry mode of the
lead before it--when changing content areas so that there is no
preceding lead of the same content, this is classified as OPEN.)

HOW do you feel about that? (Classified as open even though it could be
answered with a short answer such as "fine.")

93

 

94

Closed Inquiry

An inquiry phrased so as to solicit a "yes", "no", or

Definition:
short factual answer (under five words).

Are both your parents living?

Are you working on those problems now?

Did that affect you adversely?

Do you find it really difficult to contact him?

Is school fairly easy for you?

When did they die?

Were you the only two in the family then?

Have you lived in Lansing all of your life?

HOW long has it been?

What did your father do when you were growing up?

HOW many of the regular childhood diseases have you had?
You said that you had. . .? (A clarification type of lead.)

But it is a surprise to you that all of a sudden it stopped. (reflective)

So then you're going to school more to enrich your own life than to get
a degree. (restatement)

was that uncomfortable for you?

Do You find that's a strain?

m

 

APPENDIX D
LETTER RECRUITING SUBJECTS

 

fl: '-’..‘-" 3-1.: -5: v _' .,

APPENDIX D

LETTER RECRUITING SUBJECTS

January 10, 1976

TO: The students in Introduction to Psychology, LCC

FRCM: Dolore Rockers, Doctoral Candidate in Counseling, MSU

RE: Participation in an Experiment on Interviewing Skills

Hello! I am a graduate student at Michigan State and I am currently

doing dissertation research on the interviewing styles of various health

professionals. During the past ten years I have helped to train many

such professionals in the art of interviewing. I have found that there
are certain techniques that work well and other methods that do not. I
am interested in empirically testing the effectiveness of certain inter-

viewing approaches .

In the months of January and February I will be conducting this research
and I wish that you would consider being a part of it. I have described
below the experimental situation and the conditions which you would have

to meet as a participant.

1. Come to MSU for approximately 999 hour on 9n_e_ Saturday or
Sunday in February.

2. Participate in a short interview (about 15 minutes) with a
designated health professional.

a. The questions the interviewer will ask will cover tOpic

b.
c. After the interview you will be given a short form to

(1.

areas such as family, education, occupation, hobbies,
habits, etc. These will be general questions to which
you may answer as nuch or as little as you wish.

The interview will be audio-taped.

complete. It asks your reactions to the interview.
The information which you have given will be coded in
such a manner as to assure the confidentiality of who
you are. After the tapes have been analyzed they will
be erased.

95

 

1..
‘q-I .' Wm ' u

96

3. After the study has been completed (late March) you will be
given detailed information as to the outcome of the experi-
ment, if you wish.

4. There are some personal gains for participating in this study.

a. In some cases, your professor of psychology has agreed
to count this experience as part of your course credit
for this tenn.

b. This may be an interesting experience for you as a
student of psychology.

c. You may experience some self-reinforcement for being
such a generous person.

iPlease fill out the attached questionnaire and return it to your instruc-
tor at the end of this class period.

 

I am interested in being a part of this research.

 

I need to think more about this before I make a decision.
I am.not interested in participating in this research.

Name Address

 

 

Ffixnua

 

'The best time of day to call is

 

 

 

I prefer to participate on Saturday FEBRUARY
(indicate as many choices
as you can) morning 7
afternoon 14
evening 21
anytime 28
Sunday FEBRUARY
morning 8
afternoon 15
evening 22
anytime 29
I could come on a weekday evening YES NO
day of the week time of evening
I would like feedback about the experimental outcomes YES * NO

 

Those of you who volunteer will be contacted personally within the next
two weeks. Thank you. I am grateful. dolore

 

APPENDIX E
DENDGRAPHIC QUESTIONNAIRE
SUD/MARY TABLES OF DEM)GRAPHIC CHARACTERISTICS

APPENDIX E

DEWERAPHIC QUESTIONNAIRE

 

The following questions ask for basic information about you. The
format parallels that used by the U. S. Census Bureau. As with all pre-
vious information you have provided, this data will be held in confi-
dence. You do not need to indentify yourself by name.

 

 

Please check or fill in all of the appropriate spaces. _g
1. Sex: Female_____ Male
2. Date of birth: Month_ ’ Year__ Present age__
3. Color or race: White____ Black/Negro___
J apanese___ Chinese
Mexican_______ Korean
Filipino___ Hawaiian

American Indian (print tribe)

 

Other (identify)

 

4. Marital status: Now Married Widowed
Divorced Separated
Never Married Other

5. Present home: Lansing East Lansing
Other I

 

6. Education: (Circle the level completed)
Highschool 9 10 11 12

Colle e 1 2 3 4 5 6+
(acafiemic year)

97

 

98

Vocational School (or similar training)
(number ofiyears)

 

 

 

 

 

l 2 3 4 or more

7. Occupation: Job Title

Place of Work

Paid full-time_____ Paid part-time_____

Unpaid full-time______ Unpaid part-time_____ r?
8. Income level (yours or your source of support): 1-

_____1ess than $2,000 _____§2,000 - 2,999

_____$3,000 - 4,999 _____§S,000 - 6,999

__$7,000 - 9,999 ___$10,000 - 14,999 L.»

_____§15,000 - 24,999 _____§25,000 or more

9. Within the last three years I have been to see a physician

____not at all ____once ____2-5 times ____more than 5 times
10. I liked the physician (circle one)

VERY MUCH SOMEWHAT AMBIVALENT NOTZMUOH PKHTAH'ALL

11. Within the last three years I have been to see a counselor

____not at all ____pnce ____2-5 times ____more than 5 times
12. I liked the counselor (circle one)

VERY MUCH EKIUWWMH‘ AMBIVALENT NOT MUCH NOT AT ALL

Please list below any additional comments that you would like to make
about your experience as an interviewee in this research.

 

 

 

 

 

THANK YOU!

SUMVIARY TABLES OF DENDGRAPHIC CHARACTERISTICS

Table E.l

Number of Subjects by Years of Age

 

 

 

 

 

 

 

 

 

 

 

 

YEARS OF AGE
16-20 21-25 26-30 30-39 40-49 50+
IWALE
SUBJECTS 16 21 4 2 l
(n=72)
FEMALE
SUBJECTS —. 12 26 8 5 2
(n=72)
Table E.2
NUmber of Subjects by Years of Education Completed
YEARS OF EDUCATION
Grade College vocational
12 1 2 3 4 5 6 l 2
IWALE
SUBJECTS 7 21 24 5 6 l l 3 3
(n=72)
FEMALE
SUBJECTS 16 22 18 6 2 l 4 l l
(ns72)

 

 

 

 

99

100

Table E.3

Marital Status of Subjects

 

 

Number of Subjects

 

 

IMarried 39
Divorced 10
Separated 4
Never Married 91
N=l44

Table E.4

Income Level of Subjects or Their Source of Support

 

 

Number of Subjects

 

Less than $2,000 28
$2,000 - 2,999 7
$3,000 - 4,999 19
$5,000 - 6,999 6
$7,000 - 9,999 15
$10,000 -14,999 25
$15,000 -24,999 20
More than $25,000 24

N=l44

 

 

101

Table E.5

Home Towns of Subjects

 

 

NUmber of Subjects

 

 

Lansing 63
East Lansing 42
Small Towns around
Lansing 39
N=l_4—4—
Table E.6

Race of Subjects

 

 

Number of Subjects

 

White 133
Black 7
hkmican 3
American Indian 1

N=l44

 

 

102

Table E.7

Number of Subjects by Occupation (N=l44)

 

 

 

 

Occupational Paid Paid Not
Category Full-Time Part-Time Paid

Student - - 55

Unskilled

Laborer 17 23 -

Skilled

Laborer 15 12 1

Business 13 l '

Professional 6 l

 

103

Table E.8

Number of Subjects Who saw a Physician over the Last Three Years
and Their Attitude toward the Physicianfi(N=l44)

 

 

 

 

 

 

I liked I have seen the physician

the PhYSiCia“ Nor AT ALL ONCE 2-5 TIMES MOREHTEQN 5
............ 17 -- -- --

NOT AT ALL -- -- 2 1

NOT MUCH -- 2 5 3
AMBIVALENT -- 3 7 8
SOMEWHAT -- 7 32 8
VERY MUCH -- 4 23 21

Table E.9

NUmber of Subjects Who saw a Counselor over the Last Three Years
and Their Attitude toward the Counselor (N=l44)

 

 

 

 

 

I liked I have seen the counselor
the counselor
IMORE THAN 5
bKfl‘AJ‘ALL ONCE 2-5 TIMES TIMES

............ 76 -- -- --

NOT AT ALL -- -- 2 l
NOU'NLKTI -- 2 5 3
AMBIVALENT -- 3 7 8
SOMEWHAT -- 7 32 8
VERY MICH -- 4 23 22

 

 

 

APPENDIX F
INTERVIEWEE PRODUCTIVITY MEASURE
TRAINING PROGRAM FOR TAPE-REVIEWERS
RELIABILITY CALCULATIONS

APPENDIX F

INTERVIEWEE PRODUCTIVITY MEASURE

Tape Review Form

 

TAPE CODE TAPE REVIEWER

 

 

DATE

 

INTERVIEW STRUCTURE
(Items should be transcribed verbatim.)

 

Name of Interviewer with Title:

 

Role Of Interviewer:

 

Place of Wbrk:

 

Purpose Of Interview:

Content of Interview:

 

Time Limits:

 

Confidentiality:

 

Interviewee Responsibility to Answer Questions:

 

Interviewee Opportunity to.Ask Questions:

 

Other:

 

REVIEWER COMMENTS:
104

 

‘FI-

105

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a
_

 

 

 

 

ESEU aae

 

 

 

 

washes.

3063 6:8

 

flats 5 meooosm ”toga

 

_L .---T--Lr]-ull

 

ecoxooz\swo ommuo><

 

.ou0\mw:ho\ao:ooa<.mo om:

 

beta: H8362

 

mammuou:H\mownoo:

 

snoumfir xu93\eowumasuoo

 

.828 .Cnfiiéaofiooaom

 

naofio ofioaoadameoaofia

 

spoumw: Hewuow\am:0muom

 

tonne: Henna:

 

:ofimwaom\mosam>.>aflsmm

 

omfi BBEEES

 

 

 

>HH>HHUDDomm mmzmm>mmth

 

 

 

Hoe :omqupomeHI
mmmzommmm Qz<_mo<mu mmzmH>umHzH
open

nozow>om came
geom.3mH>mm mm<H

 

meow made

TRAINING PROGRAM FOR TAPE-REVIEWERS

I. The following format will be used for each of the training sessions:

A. Discussion of the Concepts (reviewed each time)
1. Information Bits
2. Information-Gathering Categories
3. Inquiry Mbdes
4. Interview Structuring

 

B. Recognition of the variables
1. Using Typed Transcripts (from baseline interviews)
2. Using Audio-Taped Examples (from.baseline interviews)

C. Practice with the Interviewee Productivity Measure until
an inter-reviewer reliability Of at least .80 is reached

11. For this research the above mentioned concepts are defined as
follows:

.A. Information Bits: The factual and attitudinal data that
the interviewee volunteers in response
to the interviewer inquiry

Discriminations should be made acCording to the following
guidelines:

1. One tally is made for each.noun phrase even though it
may not be a complete sentence.

"I work at Ford, but I go to school at night." This is
. 1_information bits.

2. One word answers such as "yes" or "no" are tallied as
1 information bit.

3. Utterances such as "you know," "OK," "ummm," etc. are
considered punctuations and not counted.

4. Repeated information is not tallied.

5. When the conjunction "and" connects two noungphrases
each of the phrases are tallied separately;

When "an " connects two nouns in the samegphrase both

 

106

107

nouns are counted as one information bit.

. Prepositional phrases and adverbial phrases count as

spearate information bits.

. If there are other questions about what counts and what

does not, the mutual consensus of the tape-reviewers
will be the deciding factor. This consensus then becomes
a guideline for use in judging the experimental tapes.
It should be added to this list of guidelines.

B. Information -Gathering Categories: The second page of the

C.

Interviewee Productivity Measure lists the
categories of information in which the
interviewee's will be disclosing. Tally the
information bits beside each and,where there
is uncertainty about the category, put the
tally under other.

Inquiry Modes: Open Inquiry--an interviewer lead phrased in

 

a manner Which solicits the interviewee's
thoughts, opinions, views, feelings, facts,
etc.--anything the person would like to say.

Closed Inguiry--an interviewer lead phrased
so as to elicit a "yes," "no" or short
factual answer (under five words).

 

Informational Lead--any information-giving
or question-answering done by the interviewer.

 

D. Interview Structuring: The several statements made by the

interviewer to structure the interview situ-
ation immediately before beginning the infor-
mation-gathering (see Interviewee Productiv-
ity Measure--first page).

 

INTERiENIBMfilRELDUHlJTT*
&%flmE(JUEUUUION

 

 

Reviewer 1 Reviewer 2 Reviewer 3 Sum Sum2
Tape 1 440 480 400 1320 1742400
Tape 2 240 240 270 750 562500
Tape 3 350 300 360 1010 1020100
Tape 4 240 290 240 770 592900
SUM 1270 1310 1270 3850 3917900

SUM2 1,612,900 1,716,100 1,612,900 4,941,900

Sum of Squared Ratings 1,313,500

3850

Product of Sum and Mean 3850 x _17— a 1,235,195.50

SUM OF SQUARES

 

 

 

 

 

For Reviewers 4194:1900 - 1,235,195.50 = 279.50
For Tapes 3.9131900 - 1,235,195.50 = 70,771.17
For Total 1,313,500 - 1,235,195.50 = 78,304.50
For Error 78,304.50 - 70.771.17 = 7,533.33
MEAN SQUARE
70 771.17
F°r Tapes L3 - 23,590.39
7 533.33
F°r Err°r ‘L“3““ = 2,511.11
23,590.39 - 2,511.11 =
RELIABILITY OF REVIEWS 23,590.39 + (3_1) 2511.11 7367
RELIABILITY OF AVERAGE REVIEWS 23'590'39 ' 2511'11 = 8936

 

23,590.39

108

 

APPENDIX G
APPOINTMENT REMINDER FOR SUBJECTS

 

APPENDIX G
APPOINTMENT REMINDER FOR SUBJECTS

Dolore Rockers

125 Kenberry Drive, #9
East Lansing , Michigan
February 15, 1976

 

Dear

Thank you for being so willing to be a participant in my
research project. The time for you interview at Michigan State is

 

Attached is a map of the campus with Erickson Hall circled in
red. This will be the building where the interview will take place.
There are parking facilities directly in front of the Hall. Since this
building is locked on the weekend, I will have a receptionist at the
door to admit you. She will have a list of names and will ask you to
identify yourself.

You will be directed to the Counseling Center on second floor--
Room 250. The actual time of your involvement should be no longer than
one hour.

My phone number .is 351-0273. The phone number at the Counseling
Center is 355-1755.

Gratefully,

Dolore Rockers
Michigan State University

109

 

APPENDIX E
SUBJECT'S INTRODUCTION TO INTERVIEW SITUATION
CONSENT TO BE TAPED FORM

APPENDIX H
SUBJECT'S INTRODUCTION TO INTERVIEW SITUATION

Hello!

 

The procedures for today's activities are listed below:
1. Please read the attached Consent to be Taped Form, Sign it
(ask anyone near you to witness your signiture), and return
the form to Dolore or the receptionist before your interview.

 

 

 

2. You will be interviewed by ,

 

a Physician Counselor 0, in Room at

 

The receptionist will take you to the office when the inter-
viewer is ready.

**3. RESPOND TO THE INTERVIEW SITUATION AS IS YOU HAVE CGVIE TO
THIS CLINIC FOR 8(1va GENERAL TESTS. You will be asked person-
al information which will cover topics such as family, educa-
tion, occupation, hobbies, habits, etc. This history-taking
procedure is a practice in many clinics and is usually taken
before any specific tests are scheduled. If there are any
questions that you prefer not to answer, that is your right.

4. After the fiftenn.minute interview, please return to this
‘ room to complete the Interview Evaluation Inventories which

you will receive from the interviewer. Your job is finished
when you have returned this questionnaire to the receptionist.

 

 

S. The audio-tapes and the Interview Evaluation Inventory will
be coded (as on the tab at the top of this page) to protect
your identity. The information will be used for research pur-
poses only.

HELP YOURSELF TO THE BEVERAGES ON THE TABLE. They are a small token of

thanks for your cooperation. Dolore

110

CONSENT TO BE TAPED FORM

1, , hereby agree to permit an

 

audio-recording to be made of my interview with a designated health
professional in cooperation with the interview research project of Ms.
Dolore Rockers, a Michigan State University Doctoral Candidate. I author-
ize Ms. Rockers to use this tape and the data collected from the Inter-
view Evaluation Inventory for research purposes only. I, also, consent
to the publication of the results of this research as long as the infor-

mation discussed remains anonymous.

I hereby expressly waive any possible claim on my part for remuneration

or damages in any form in connection with this research.

Signed Date

 

 

Witness Date

 

 

111

APPENDIX I
INTERVIEWER'S PROMPT CARD

 

APPENDIX I
INTERVIEWER'S PROMPT CARD

. TUrn on the tape-recorded when the client knocks on the door.

. Introduce yourself. Your client's name is

 

. Tell the client the purpose of this interview (according to the
trained procedure.

The client has been told that this is a preliminary procedure before
other tests are conducted at this clinic.

. Using the prescribed treatment mode, inquire into the following areas
of the client's life:

Parents/Siblings Occupation/work History

Family values/Religion Hobbies/Interests

Marital History Medical History

Personal/Social History Use of.A1cohol/Drugs/etc.

Friends/Significant Others Average Day/weekend

Education/Military Career Support Systems in Crisis
Other

. When the tape runs out terminate the interview and ask the client to
return to the reception area.

. Make certain that the tape number corresponds to the number on the
Interview Evaluation Form that you hand to the interviewee.

112

APPENDIX J

ADDITIONAL UNIVARIATE TABLES

 

113

Table J.1

Univariate Analysis of Variance
of the Dependent variable for INQUIRY MODE Main Effect

 

 

 

 

 

IDiependent Mean df Univariate p
easures Square F
Barrett-Lennard 607.2986 2, 96 .3828 .6830
Counseling Evaluation 17.6944 2, 96 .2570 .7739
Interviewee Productivity 7638.6319 2, 96 .7206 .1845
Subscales of the CEI
Client Satsfaction 2.3819 2, 96 .2647 .7681
Counseling Climate 1.5625 2, 96 .1597 .8527
Counselor Comfort 4.6458 2, 96 .3525 .7039
Subscales of the BLRI
Unconditional Regard 101.1944 2, 96 .6787 .5098
Level of Regard 40.6875 2, 96 .3446 .7094
Empathic Understanding 66.0278 2, 96 .5976 .5522
Congruence 19.0903 2, 96 .1322 .8763

 

114

Table J.2

Univariate Analysis of Variance
of the Dependent Measures for OCCUPATIONAL STATUS Effect

 

 

 

 

 

Dependent Mean df Univar iate

Measures Square_ F p
Barrett- Lennard 2584.0278 1, 96 1.6290 .2050
Counseling Evaluation 46.6944 1, 96 .6783 .4123
Interviewee Productivity 4658.0625 1, 96 1.0493 .3083
Subscales of the CEI

Client Satisfaction .1736 1, 96 .0193 .8899

Counseling Climate 25.8403 1, 96 2.6409 .1075

Counselor Comfort 1.7778 1, 96 .1349 .7143
Subscales of the BLRI

Unconditional Regard 798.0625 1, 96 5.3521 .0229

Level of Regard 3.3611 1, 96 .0285 .8664

Empathic Understanding 222.5069 1, 96 2.0139 .1592

Congruence 115.5625 1, 96 .8005 .3732

 

115

Table J.3

Univariate Analysis of Variance

of the Dependent Measures for the'within.Mh1e and within Female Effect

 

 

 

 

 

IBlependent Mean df Univar iate p
easures Square F
Barrett-Lennard 1820.4444 1, 96 1.1476 .2868
Counseling Evaluation 32.1111 1, 96 .4665 .4963
Interviewee Productivity 73.6736 1, 96 .0166 .8978
Subscales of the CEI
Client Satisfaction 5.0625 1, 96 .5625 .4417
Counseling Climate 5.8403 1, 96 .5696 .4417
Counselor Comfort 1.0000 1, 96 .0759 .7836
Subscales of the BLRI
Uncondtitional Regard 458.6736 1, 96 3.0761 .0827
Level of Regard 4.6944 1, 96 .0398 .8424
Empathic Understanding 444.5069 1, 96 4.0232 .0477
Congruence 193.6736 1» 96 1.3417 .2497

 

Univariate Analysis of Variance

Table J.4

116

of the Dependent variables for the SUBJECT SEX Main Effect

 

 

 

 

 

aependent Mban df Univariate p
easures Square F
Barrett-Lennard 4160.2500 1, 96 .6226 .1087
Counseling Evaluation 100.0000 1, 96 .4526 .2311
Interviewee Productivity 2871.1736 1, 96 .6467 .4233
Subscales of the CEI
Client Satisfaction 3.0625 1, 96 .3403 .5611
Counseling Climate 39.0625' 1, 96 .9922 .0486
Counselor Comfort 4.0000 1, 96 .3035 .5830
Subscales of the BLRI
Unconditional Regard 351.5625 1, 96 .3577 .1280
Level of Regard 160.4444 1, 96 .3588 .2467 -
Empathic Understanding 364.1736 1, 96 .2961 .0726
Congruence 620.8403 1, 96 4.3008 .0408

 

"‘011111111111